Dietary phosphorus enhances inflammatory response: A study of human gingivitis

Phosphates are associated with numerous disorders, ranging from vascular calcification to premature aging, possibly because of an increased inflammatory response. We therefore investigated the association of dietary phosphorus with gingivitis. We analyzed consumption of both phosphorus and sugar and related it to the concentrations of inflammatory biomarkers in saliva samples collected from 8314 children (mean age, 9.99 ± 0.68 years). About 64% of the children consumed more than 1250 mg phosphorus daily, and 34% consumed more than 82 g of sugar daily. Gingivitis was prevalent, with an average of 74% of possible gingival sites considered red. Quantile regression analysis revealed a statistically significant correlation between the occurrence of gingivitis and calorie-adjusted phosphorus intake and between gingivitis and calorie-adjusted sugar intake (both significant either as a linear trend or a categorical variable). In a subset (n = 744) investigation of nutrient consumption related to salivary biomarkers, we found that elevated calorie-adjusted phosphorus intake was directly associated with salivary IL-1β concentration (OR1.40, 95% CI 1.04-1.89), and inversely associated with salivary IL-4 concentration (OR0.62, 95% CI 0.46-0.84). Sugar intake was not significantly associated with either biomarker. Thus, elevated dietary phosphorus consumption may influence inflammatory disease by altering cytokine levels.