Department of Nutrition and Dietetics, Indiana University-Purdue University Indianapolis, Indianapolis; Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis; Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis; Department of Food Science and Nutrition, University of Minnesota, St. Paul.
J Ren Nutr. 2023 Nov;33(6S):S13-S20. doi: 10.1053/j.jrn.2023.05.004. Epub 2023 Jun 19.
Phosphorus is a vital nutrient, but disturbances in phosphorus homeostasis are central to chronic kidney disease-mineral and bone disorder. To minimize disturbances, traditional dietary guidance focused on a numerical phosphorus target leading to the exclusion of many healthy foods and implementation challenges. Contemporary phosphorus guidance focuses on dietary source, avoiding additives, and emphasizing low-phosphorus bioaccessibility foods, leading to a more liberal approach. Additional work is needed to demonstrate the efficacy of these contemporary approaches and understand the influence of specific foods, processing, and cooking methods. Unfortunately, patient education using traditional and contemporary strategies may give mixed messages, particularly related to plant-based foods. Thus, greater clarity on the effects of specific foods and dietary patterns may improve phosphorus education. This review aims to discuss the evolution of dietary phosphorus management while highlighting areas for future research that can help move the field toward stronger evidence-based guidance to prevent and treat hyperphosphatemia.
磷是一种重要的营养物质，但磷稳态紊乱是慢性肾脏病-矿物质和骨异常的核心。为了将紊乱最小化，传统的饮食指导侧重于磷的数值目标，这导致许多健康食品被排除在外，并带来了实施方面的挑战。当代的磷指导则侧重于饮食来源，避免添加剂，并强调低磷生物可利用性食物，从而采取了更为宽松的方法。需要进一步的研究来证明这些当代方法的疗效，并了解特定食物、加工和烹饪方法的影响。不幸的是，使用传统和当代策略进行患者教育可能会传递相互矛盾的信息，特别是与植物性食物相关的信息。因此，对特定食物和饮食模式的影响有更清晰的认识可能会改善磷的教育。本综述旨在讨论饮食磷管理的演变，同时强调未来研究的领域，这有助于推动该领域朝着更强有力的循证指导方向发展，以预防和治疗高磷血症。
