Erem Sarah, Razzaque Mohammed S
Department of Pathology, Saba University School of Medicine, Saba, Dutch Caribbean, The Netherlands.
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
Histochem Cell Biol. 2018 Dec;150(6):711-719. doi: 10.1007/s00418-018-1711-8. Epub 2018 Aug 25.
Phosphate is a common ingredient in many healthy foods but, it is also present in foods containing additives and preservatives. When found in foods, phosphate is absorbed in the intestines and filtered from the blood by the kidneys. Generally, any excess is excreted in the urine. In renal pathologies, however, such as chronic kidney disease, a reduced renal ability to excrete phosphate can result in excess accumulation in the body. This accumulation can be a catalyst for widespread damage to the cellular components, bones, and cardiovascular structures. This in turn can reduce mortality. Because of an incomplete understanding of the mechanism for phosphate homeostasis, and the multiple organ systems that can modulate it, treatment strategies designed to minimize phosphate burden are limited. The Recommended Dietary Allowance (RDA) for phosphorous is around 700 mg/day for adults, but the majority of healthy adult individuals consume far more phosphate (almost double) than the RDA. Studies suggest that low-income populations are particularly at risk for dietary phosphate overload because of the higher amounts of phosphate found in inexpensive, processed foods. Education in nutrition, as well as access to inexpensive healthy food options may reduce risks for excess consumption as well as a wide-range of disorders, ranging from cardiovascular diseases to kidney diseases to tumor formation. Pre-clinical and clinical studies suggest that dietary phosphate overload has toxic and prolonged adverse health effects. Improved regulations for reporting of phosphate concentrations on food labels are necessary so that people can make more informed choices about their diets and phosphate consumption. This is especially the case given the lack of treatments available to mitigate the short and long-term effects of dietary phosphate overload-related toxicity. Phosphate toxicity is quickly becoming a global health concern. Without measures in place to reduce dietary phosphate intake, the conditions associated with phosphate toxicity will likely to cause untold damage to the wellbeing of individuals around the world.
磷酸盐是许多健康食品中的常见成分，但它也存在于含有添加剂和防腐剂的食品中。在食物中发现的磷酸盐会在肠道中被吸收，并由肾脏从血液中过滤出去。一般来说，任何多余的磷酸盐都会通过尿液排出体外。然而，在肾脏疾病中，如慢性肾脏病，肾脏排泄磷酸盐的能力下降会导致体内磷酸盐过度积累。这种积累可能会促使对细胞成分、骨骼和心血管结构造成广泛损害。这进而可能会降低死亡率。由于对磷酸盐稳态机制以及能够调节它的多个器官系统的理解不完整，旨在尽量减少磷酸盐负担的治疗策略有限。成年人磷的推荐膳食摄入量（RDA）约为每天700毫克，但大多数健康成年人摄入的磷酸盐（几乎是RDA的两倍）远远超过这个量。研究表明，低收入人群尤其面临膳食磷酸盐摄入过量的风险，因为在廉价的加工食品中发现了更高含量的磷酸盐。营养教育以及获得廉价健康食品的选择可能会降低过量消费的风险以及一系列疾病的风险，这些疾病包括心血管疾病、肾脏疾病和肿瘤形成。临床前和临床研究表明，膳食磷酸盐摄入过量具有毒性且会产生长期不良健康影响。有必要改进食品标签上磷酸盐浓度报告的规定，以便人们能够对自己的饮食和磷酸盐消费做出更明智的选择。鉴于缺乏减轻膳食磷酸盐摄入过量相关毒性的短期和长期影响的治疗方法，情况尤其如此。磷酸盐毒性正迅速成为一个全球健康问题。如果没有采取措施减少膳食磷酸盐摄入量，与磷酸盐毒性相关的疾病可能会给世界各地个人的健康造成难以估量的损害。
