Nutrition Impact, LLC, Battle Creek, MI 49014, USA.
Think Healthy Group, LLC, Washington, DC 20001, USA.
Nutrients. 2022 Apr 22;14(9):1738. doi: 10.3390/nu14091738.
The Western diet is high in dietary phosphorus, partially due to added phosphorus, (i.e., phosphates) predominantly present in processed food products. Elevated serum phosphate levels, otherwise known as hyperphosphatemia, have been associated with changes in health status, of note detrimental effects on cardiovascular and renal health. However, the extent to which highly absorbed added phosphorus contributes to these changes is relatively unknown, due to its poor characterization among food composition databases. Industry-provided data on phosphorus source ingredients and ranges of added phosphorus present in food categories to enable a more accurate estimation of the total, added, and natural phosphorus intakes in the U.S. population. Using regression analyses, we then assessed relationships between estimated total, added, and natural phosphorus intakes on biomarkers of health status and mortality in individuals enrolled in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2001-2016 datasets. Total, added, and natural phosphorus intakes were associated with several biomarkers of health status. Added phosphorus intake was consistently inversely associated with HDL cholesterol in both men and women, whereas naturally occurring phosphorus intake was inversely correlated with the risk of elevated blood pressure. However, in most cases, the predicted impact of increases in phosphorus intake would result in small percentage changes in biomarkers. No meaningful associations between phosphorus and mortality were found, but indications of a correlation between mortality with quintiles of naturally occurring phosphorus were present, depending on covariate sets used. The disparate results for natural and added phosphorus intakes within the current study provide increased support for updating current food composition databases to more accurately account for dietary phosphorus intake as total, naturally occurring, and added phosphorus.
西方饮食中磷的含量很高，部分原因是加工食品中添加了磷（即磷酸盐）。血清磷酸盐水平升高，即高磷血症，与健康状况的变化有关，尤其是对心血管和肾脏健康的不利影响。然而，由于其在食物成分数据库中的特征描述较差，因此，高度可吸收的添加磷对这些变化的影响程度相对未知。行业提供的关于磷源成分和食品类别中添加磷的范围的数据，以便更准确地估计美国人口的总磷、添加磷和天然磷摄入量。然后，我们使用回归分析评估了估计的总磷、添加磷和天然磷摄入量与参加国家健康和营养检查调查（NHANES）1988-1994 年和 2001-2016 年数据集的个体健康状况和死亡率生物标志物之间的关系。总磷、添加磷和天然磷摄入量与健康状况的几个生物标志物有关。在男性和女性中，添加磷的摄入量与高密度脂蛋白胆固醇呈负相关，而天然存在的磷的摄入量与高血压风险呈负相关。然而，在大多数情况下，磷摄入量增加的预测影响将导致生物标志物的百分比变化很小。未发现磷与死亡率之间存在有意义的关联，但根据使用的协变量集，存在死亡率与天然存在的磷的五分位数之间存在相关性的迹象。在当前研究中，天然磷和添加磷摄入量的差异结果为更新当前食物成分数据库提供了更多支持，以更准确地考虑总磷、天然存在的磷和添加磷的饮食摄入量。
