Abstract
Interest in the health effects of dietary phosphorus is burgeoning, yet sources and trends in phosphorus consumption have not been well characterized. We describe trends in and primary sources of dietary phosphorus in a nationally representative sample of 34,741 US adults, 20+ years old (NHANES 2001–2014). Dietary sources of phosphorus were estimated in nine food groups and 26 food categories. Phosphorus consumption was expressed in absolute intake, phosphorus density, and proportion contributed by dietary sources. Between 2001 and 2014, dietary phosphorus intake increased from 1345 to 1399 mg/day (p-trend = 0.02), while calorie intake slightly declined (p-trend = 0.1). Grains were the largest dietary phosphorus source, followed by meats, and milk products. Soft drinks accounted for just 3.3% of total dietary phosphorus. Phosphorus intake from grains increased 68 mg/day (p < 0.001), 25 mg/day from meats (p = 0.02), and decreased 75 mg/day (p < 0.001) from milk products. Dietary phosphorus intake and the phosphorus density of the diet are increasing. Grains are an important dietary phosphorus source that has increased in total consumption and phosphorus density. Further research is needed to determine if this is due to individuals’ selection of grains or the composition of those available.
Highlights
Phosphorus is an essential dietary nutrient, and a major component of many structures in the body
Extrapolating serum phosphorus outcomes to dietary phosphorus intake is challenging as serum phosphorus is tightly regulated by parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) [9]
Estimated mean dietary phosphorus consumption for the period between 2001 and 2014 was mg/day with a phosphorus density of 0.633 mg phosphorus per kcal energy intake
Summary
Phosphorus is an essential dietary nutrient, and a major component of many structures in the body. Healthy adults have a recommended dietary allowance of at least 700 mg of phosphorus per day, and deficiency is uncommon in the United States [1]. The adverse health effects of high serum phosphorus levels are well documented, and dietary phosphorus restriction is recommended by Kidney. Disease | Improving Global Outcomes (KDIGO) guidelines in the treatment of hyperphosphatemia among individuals with chronic kidney disease [2]. Many observational studies have demonstrated an association between serum phosphorus levels and cardiovascular disease, ESRD, and mortality, even within the high-normal range [3,4,5,6,7,8]. Studies have found associations between FGF23 and kidney disease progression, cardiovascular disease, and mortality [10,11,12].
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