WHEN PHYSIOLOGY MEETS THE BUILT ENVIRONMENT: THE PHOSPHORUS STORY

Phosphorus metabolism disorders are independent risk factors for cardiovascular disease, kidney disease, and mortality. Given that excessive dietary phosphorus intake is prevalent in the general population and significantly contributes to disruptions in phosphorus balance, there is growing interest in limiting phosphorus intake as a potential strategy to enhance cardiovascular and kidney health. Socioeconomic status is a major determinant of phosphorus intake, as extensive epidemiological research indicates a direct correlation between income, education, and diet quality. Beyond individual socioeconomic indicators like income and education, built environment factors such as the availability of and access to healthy food outlets, as well as the density of fast-food restaurants in certain areas, greatly affect individuals' ability to moderate phosphorus consumption. Given the strong link between the built environment and diet quality, any effective strategy to reduce excess phosphorus intake and improve health outcomes must address built environmental challenges in accessing healthy foods.