Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
Nutrients. 2023 Aug 9;15(16):3510. doi: 10.3390/nu15163510.
The consumption of ultra-processed food (UPF) keeps rising, and at the same time, an increasing number of epidemiological studies are linking high rates of consumption of UPF with serious health outcomes, such as cardiovascular disease, in the general population. Many potential mechanisms, either in isolation or in combination, can explain the negative effects of UPF. In this review, we have addressed the potential role of inorganic phosphate additives, commonly added to a wide variety of foods, as factors contributing to the negative effects of UPF on cardiorenal disease. Inorganic phosphates are rapidly and efficiently absorbed, and elevated serum phosphate can lead to negative cardiorenal effects, either directly through tissue/vessel calcification or indirectly through the release of mineral-regulating hormones, parathyroid hormone, and fibroblast growth factor-23. An association between serum phosphate and cardiovascular and bone disease among patients with chronic kidney disease is well-accepted by nephrologists. Epidemiological studies have demonstrated an association between serum phosphate and dietary phosphate intake and mortality, even in the general American population. The magnitude of the role of inorganic phosphate additives in these associations remains to be determined, and the initial step should be to determine precise estimates of population exposure to inorganic phosphate additives in the food supply.
超加工食品（UPF）的消费不断增加，与此同时，越来越多的流行病学研究将 UPF 的高消费率与普通人群中的严重健康后果（如心血管疾病）联系起来。许多潜在的机制，无论是单独作用还是联合作用，都可以解释 UPF 的负面影响。在这篇综述中，我们探讨了无机磷酸盐添加剂的潜在作用，这些添加剂通常添加到各种食品中，是导致 UPF 对心脏和肾脏疾病产生负面影响的因素之一。无机磷酸盐被迅速有效地吸收，血清磷酸盐水平升高可导致心脏和肾脏的负面作用，其机制既可以是组织/血管钙化，也可以是通过释放矿物质调节激素甲状旁腺激素和成纤维细胞生长因子 23 间接引起。肾病学家已经认可了血清磷酸盐与慢性肾脏病患者心血管和骨骼疾病之间的关联。流行病学研究表明，血清磷酸盐和饮食磷酸盐摄入与死亡率之间存在关联，即使在美国普通人群中也是如此。无机磷酸盐添加剂在这些关联中的作用程度仍有待确定，最初应该确定人群在食物供应中接触无机磷酸盐添加剂的确切估计值。
