Phosphates and Behavioral Abnormalities

Abstract

In their review article, Ritz et al. described the consequences of hyperphosphatemia caused by phosphate additives in food with regard to increased renal and cardiovascular morbidity and mortality (1). I want to add that phosphates for some time have been suspected of being associated with behavioral abnormalities. The doctor and children’s book author Heinrich Hoffmann described in his character of Fidgety Philip not only a child in whom nowadays attention deficit hyperactivity disorder (ADHD) would be diagnosed, but he also adds that “a normal human being has only 1.5/1000 phosphorus in their brain”, and wonders if it should be investigated whether “any fellow who was happy as a lark did not carry two or three times of that amount in his head” (2). The association of phosphorus and behavioral abnormalities has been the subject of a controversial discussion ever since, and in ADHD, a low-phosphate diet has been recommended. However, only recently, several clinical studies have suggested an association between (organo-)phosphates and ADHD (3, 4). Bearing in mind the rising incidence of ADHD and increasing numbers of prescriptions for methylphenidate, it would be interesting to study the association between dietary components such as in fast food and processed food with a high phosphate content and a causal association with the development of ADHD.