Impact of Phosphorus-Based Food Additives on Bone and Mineral Metabolism
Orlando M Gutiérrez1, Alexandra Luzuriaga-McPherson1, Yiming Lin1
1Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
Context:
Phosphorus-based food additives can substantially increase total phosphorus intake per day, but the effect of these additives on endocrine factors regulating bone and mineral metabolism is unclear.
Objective:
This study aimed to examine the effect of phosphorus additives on markers of bone and mineral metabolism. Design and Setting, and Participants: This was a feeding study of 10 healthy individuals fed a diet providing ∼1000 mg of phosphorus/d using foods known to be free of phosphorus additives for 1 week (low-additive diet), immediately followed by a diet containing identical food items; however, the foods contained phosphorus additives (additive-enhanced diet). Parallel studies were conducted in animals fed low- (0.2%) and high- (1.8%) phosphorus diets for 5 or 15 weeks.
Main Outcome Measures:
The changes in markers of mineral metabolism after each diet period were measured.
Results:
Participants were 32 ± 8 years old, 30% male, and 70% black. The measured phosphorus content of the additive-enhanced diet was 606 ± 125 mg higher than the low-additive diet (P < .001). After 1 week of the low-additive diet, consuming the additive-enhanced diet for 1 week significantly increased circulating fibroblast growth factor 23 (FGF23), osteopontin, and osteocalcin concentrations by 23, 10, and 11%, respectively, and decreased mean sclerostin concentrations (P < .05 for all). Similarly, high-phosphorus diets in mice significantly increased blood FGF23, osteopontin and osteocalcin, lowered sclerostin, and decreased bone mineral density (P < .05 for all).
Conclusions:
The enhanced phosphorus content of processed foods can disturb bone and mineral metabolism in humans. The results of the animal studies suggest that this may compromise bone health.
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