Dietary phosphate: what do we know about its toxicity

Inorganic phosphate (Pi) is an essential mineral required for diverse cellular processes. Recent genetic and dietary experiments in animal models indicate that Pi may be toxic to a variety of biological processes. High dietary Pi load in such animal models resulted in an increase in oxidative stress, DNA damage that resulted in phenotypic expression of premature aging, and short life span. Further, high Pi load was reported to induce carcinogenesis in lung and skin cancer animal models. So far, translational research is limited to observational studies that show an independent association of Pi intake with morbidity and mortality across all strata of kidney function. Fast-food and processed-food consumption in an average American diet leads to large increases in daily phosphate intake. Whether such dietary patterns explain the epidemiology of disease processes in humans remains to be further investigated.

Phosphotoxicity is a novel concept with a potential for a large public health impact in future, but urgent studies are needed to prove reducing Pi intake to a certain target generates better clinical outcomes.