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Phosphorus Intake and Potential Dietary Influences Examined via 24-Hour Urinary Biomarker Measurements in German
Luciana Peixoto Franco1, Seyedeh-Masomeh Derakhshandeh-Rishehri1, Yifan Hua1
1DONALD Study Center, Institute of Nutrition and Food Science, Department of Nutritional Epidemiology, University of Bonn, Dortmund, Germany.
Insights
Phosphorus intake remained stable in German children and adolescents over 30 years, despite increasing sodium excretion linked to processed foods. This study tracked 24-hour urinary phosphate excretion (PO4-Ex) in youth.
Area of Science:
- Nutritional Epidemiology
- Pediatric Nutrition
- Biomarker Research
Background:
- Phosphorus intake trends in adults are known, but data on children are limited.
- Biomarker-based evidence is needed to assess phosphorus status changes in pediatric populations.
Purpose of the Study:
- To examine 24-hour urinary phosphate excretion (PO4-Ex) in German children and adolescents from 1985 to 2015.
- To identify diet-related biomarkers influencing phosphorus status over three decades.
Main Methods:
- Longitudinal cohort study using noninvasive biomarkers from 24-hour urine samples.
- Analysis of 6,737 urine samples from 1,057 healthy participants aged 3-17 years over 30 years.
- Assessment of PO4-Ex, net acid, urea-nitrogen, sodium, and potassium excretions to evaluate phosphorus intake and influencing factors.
Main Results:
- No significant changes in 24-hour PO4-Ex were observed across age groups over the 30-year study period.
- Sodium excretion significantly increased over the decades (P = .001).
- PO4-Ex showed direct correlations with net acid, urea-nitrogen, and sodium excretion, and an inverse correlation with fruit and vegetable intake biomarkers.
Conclusions:
- Despite a positive association between PO4-Ex and sodium excretion (a marker for processed food intake), phosphorus intake remained stable in children and adolescents.
- Long-term biomarker data indicate stable phosphorus status in German youth despite dietary shifts.
- Further research into the impact of processed food components on pediatric nutrient status is warranted.
Background:
Increases in phosphorus intake have been observed over the past years in adult populations. However, biomarker-based data are lacking on whether or not phosphorus intake also increased in children.
Objective:
The aim of this study was to examine 24-hour urinary phosphate excretion (PO4-Ex) and diet-related biomarkers potentially influencing phosphorus status in German children and adolescents from 1985 to 2015.
Design:
This longitudinal noninvasive biomarker-based cohort study examined 24-hour urine samples from children and adolescents of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study, collected over 3 decades.
Participants/Setting:
Examined individuals (n = 1,057) were healthy participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study, situated in Dortmund, Germany, who had been asked to collect one yearly 24-hour urine sample. Six thousand seven hundred thirty-seven samples collected from participants aged 3 to 17 years between 1985 (baseline) and 2015, were included.
Main Outcome Measures:
phosphorus intake was examined biomarker-based by analyzed PO4-Ex in 24-hour urine samples. Whether acid-base status and intakes of protein, salt, and fruits and vegetables, may have relevantly contributed to PO4-Ex levels was assessed by determining 24-hour excretions of net acid, urea-nitrogen, and sodium as well as specific standardized excretions of potassium plus oxalate.
Statistical Analyses Performed:
Trend analysis over 30 years and potentially influencing diet factors were examined using linear mixed-effect regression models (PROC-MIXED). Adjustments for sex, age, and body surface area were performed.
Results:
No change was identifiable for PO4-Ex over the 3 decades; neither in 3 to 8, 9 to 13, nor in 14 to 17 year olds. However, sodium excretion increased (P = .001). PROC-MIXED analysis on intraindividual changes in PO4-Ex revealed direct relationships with net acid excretion, urea-nitrogen, and sodium excretion and an inverse relationship with a biomarker of fruit and vegetable intake.
Conclusions:
Despite a direct relationship between PO4-Ex and a biomarker of industrially processed food consumption; that is, sodium excretion, which showed an increasing time trend, phosphorus intake was found to remain stable over decades in children and adolescents.
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