Abstract

There are limited data on phosphorus balance and the effect of dietary calcium supplements on phosphorus balance in adolescents. The purpose of this study was to determine phosphorus balance and the effect of increasing dietary calcium intake with a supplement on net phosphorus absorption and balance in healthy adolescent girls. This study utilized stored urine, fecal, and diet samples from a previously conducted study that focused on calcium balance. Eleven healthy girls ages 11 to 14 years participated in a randomized crossover study, which consisted of two 3-week periods of a controlled diet with low (817 ± 19.5 mg/d) or high (1418 ± 11.1 mg/d) calcium, separated by a 1-week washout period. Phosphorus intake was controlled at the same level during both placebo and calcium supplementation (1435 ± 23.5 and 1453 ± 28.0 mg/d, respectively, p = 0.611). Mean phosphorus balance was positive by about 200 mg/d and was unaffected by the calcium supplement (p = 0.826). Urinary phosphorus excretion was lower with the calcium supplement (535 ± 42 versus 649 ± 41 mg/d, p = 0.013), but fecal phosphorus and net phosphorus absorption were not significantly different between placebo and calcium supplement (553 ± 60 versus 678 ± 63 versus mg/d, p = 0.143; 876 ± 62 versus 774 ± 64 mg/d, p = 0.231, respectively). Dietary phosphorus underestimates using a nutrient database compared with the content measured chemically from meal composites by ~40%. These results show that phosphorus balance is positive in girls during adolescent growth and that a calcium dietary supplement to near the current recommended level does not affect phosphorus balance when phosphorus intake is at 1400 mg/d, a typical US intake level.

Highlights

  • Because of rapid growth in adolescence, the phosphorus recommended dietary allowance (RDA) for girls and boys ages 9-13y is set at 1250 mg/day, nearly twice as high as the RDA of 700 mg/day for adults [1]

  • Limited information exists on phosphorus balance and the effect of a dietary calcium supplement on phosphorus retention during adolescent growth to inform the phosphorus Dietary Reference Intakes (DRI) [5,6,7]

  • Dietary phosphorus intake measured chemically did not differ between placebo and calcium (p = 0.611, Table 2), and calcium intake was significantly different by design between placebo and calcium phases

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Summary

Introduction

Because of rapid growth in adolescence, the phosphorus recommended dietary allowance (RDA) for girls and boys ages 9-13y is set at 1250 mg/day, nearly twice as high as the RDA of 700 mg/day for adults [1]. The interaction between phosphorus and calcium in the intestine in healthy adults demonstrated that the phosphorus binding capacity of calcium carbonate and calcium acetate at approximately 45 mg phosphorus per gram calcium salt [3]. Limited information exists on phosphorus balance and the effect of a dietary calcium supplement on phosphorus retention during adolescent growth to inform the phosphorus Dietary Reference Intakes (DRI) [5,6,7]. This deficit in knowledge is important because it is estimated from NHANES data that 24% of females aged 9-13 use supplemental calcium [8]

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