Phosphorus as phosphate is a major buffer of acid in urine by virtue of its monovalent, divalent and trivalent forms. Information and translations of Phosphorus in the most comprehensive dictionary definitions resource on the web. Dietary phosphorus is associated with greater left ventricular mass. Phosphorus additives and albuminuria in early stages of CKD: a randomized controlled trial. Phosphorus is an essential macromineral, meaning to be healthy you must include this nutrient in your diet. Many different types of foods contain phosphorus, including dairy products, meats and poultry, fish, eggs, nuts, legumes, vegetables, and grains [13,14]. Asia Pac J Clin Nutr 2011;20:411-7. Clinical Aspects of Natural and Added Phosphorus in Foods. The implications of this analysis for the potential adverse effects of high phosphorus intakes are unclear. High phosphorus intakes rarely produce adverse effects in healthy people. Information and translations of phosphorus, dietary in the most comprehensive dictionary definitions resource on the web. Calcium from foods and supplements can bind to some of the phosphorus in foods and prevent its absorption [1,17]. In most cases, hypophosphatemia is caused by medical conditions, such as hyperparathyroidism, kidney tubule defects, and diabetic ketoacidosis [35]. Boca Raton, Florida: CRC Press; 2018:221-33. To avoid phosphorus-containing additives, check the ingredients lists of packaged foods for anything with “phosph-” or “phosphate” in the name—such as phosphoric acid, pyrophosphate, dipotassium phosphate, hexametaphosphate or diammonium phosphate. It mainly cycles through the soil, water, and sediments. Phosphorus is the second most abundant mineral nutrient in the body, after calcium. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. Am J Clin Nutr 2008;88:1511-8. Washington, DC: Wiley-Blackwell; 2012:447-58. U.S. Department of Agriculture, Agricultural Research Service. Examples of phosphorus added to food include: More About this Book. High phosphorus intakes might be signs of diets that are unhealthy in other ways, for example [65]. What does Phosphorus mean? For example, an analysis of NHANES III (1988-1994) data on 1,105 adults (mean age 67–71 years, depending on their phosphate intake tertile) with moderate CKD found that serum phosphate levels were very similar, regardless of phosphate intake—3.6 mg/dL in the lowest tertile of phosphorus intake (532 mg/day) and 3.5 mg/dL in the highest intake tertile (1,478 mg/day)—and that high phosphorus intakes were not associated with increased mortality rates over 6–12 years, possibly because these patients did not have severe CKD [53]. In adults, normal phosphate concentration in serum or plasma is 2.5 to 4.5 mg/dL (0.81 to 1.45 mmol/L) [10]. In addition, phosphorus and calcium make up hydroxyapatite, the main structural component in bones and tooth enamel [3]. [, Tonelli M, Sacks F, Pfeffer M, et al. Most of the phosphorus is wasted on its journey from mining to being eaten by humans, and the wasted phosphorus ends up in waterways where it can cause algal blooms. Updated: June 4, 2020 History of changes to this fact sheet, U.S. Department of Health & Human Services, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, How To Evaluate Health Information on the Internet, NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Analytical Methods and Reference Materials (AMRM), Dietary Supplement Ingredient Database (DSID), Computer Access to Research on Dietary Supplements (CARDS) Database. Special nutritional needs of chronic kidney disease and end-stage renal disease patients: rationale for the use of plant-based diets. Cardiovascular disease Because of this, foods with phosphorus additives should be avoided if you are trying to limit phosphorus. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. Phosphorus deficiency in preterm infants is one of the main causes, along with calcium deficiency, of osteopenia of prematurity (impaired bone mineralization) [36]. Meat, dairy, seafood and eggs are full of the mineral, but you'll also get phosphorus from plant-based foods, like legumes and nuts. The kidneys, bones, and intestines regulate phosphorus homeostasis, which requires maintenance of urinary losses at equivalent levels to net phosphorus absorption and ensuring that equal amounts of phosphorus are deposited and resorbed from bone [1,7,8]. Kidney Int 2013;83:707-14. Most Americans consume more than the recommended amounts of phosphorus. Several observational studies support a link between high phosphate levels and CVD risk in people with and without a history of CVD [58,59]. People with severe protein or calorie malnutrition can develop refeeding syndrome, also known as refeeding hypophosphatemia, within 2 to 5 days of starting enteral or parenteral nutrition because of the shift in metabolism from a catabolic to an anabolic state [42,43]. In the form of phospholipids, phosphorus is also a component of cell membrane structure and of the body’s key energy source, ATP. [, Calvo MS, Sherman RA, Uribarri J. Dietary phosphate and the forgotten kidney patient: a critical need for FDA regulatory action. For example, an analysis of 14,675 participants (55% women) without atrial fibrillation found, based on almost 20 years of follow-up, that each 1 mg/dL increase in serum phosphate was associated with a 13% higher risk of atrial fibrillation [60]. Hypophosphatemic rickets: etiology, clinical features and treatment. Phosphorus is a component of bones, teeth, DNA, and RNA [1]. [, Slinin Y, Blackwell T, Ishani A, Cummings SR, Ensrud KE. Serum phosphorus and progression of CKD and mortality: a meta-analysis of cohort studies. Causes of malnutrition that can lead to refeeding syndrome include chronic diseases (e.g., cancer, chronic obstructive pulmonary disease, or cirrhosis), very low birthweight, cachexia, low body weight, anorexia nervosa, excessive alcohol intake, and chewing or swallowing problems. [, Bai W, Li J, Liu J. Serum phosphorus, cardiovascular and all-cause mortality in the general population: A meta-analysis. A diet that includes the right amounts of calcium and protein will also provide enough phosphorus. [, Ruospo M, Palmer SC, Natale P, et al. These additives are used for such purposes as preserving moisture or color and enhancing and stabilizing frozen foods [18]. Of this amount, 85% is in bones and teeth, and the other 15% is distributed throughout the blood and soft tissues [1]. Phosphate helps to protect blood systemic acid/base balance… JJ Am Soc Nephrol 2014;25:2730-9. Phosphorus is a chemical element with the symbol P and atomic number 15. To prevent the complications of high phosphate levels in patients with CKD, clinicians sometimes encourage patients to limit their phosphorus intakes (e.g., by replacing most animal proteins in their diets with plant-based protein sources, whose phosphorus is less bioavailable) and eat more calcium-rich foods [9,54]. Several food sources of phosphorus are listed in Table 2. Yogurt, plain, low fat, 6-ounce container, Salmon, Atlantic, farmed, cooked, 3 ounces, Cheese, mozzarella, part skim, 1.5 ounces, Beef patty, ground, 90% lean meat, broiled, 3 ounces, Potatoes, Russet, flesh and skin, baked, 1 medium. Functions in bones and teeth and in cell energy production. Some laxatives, such as Fleet Prep Kit #1, contain sodium phosphate, and ingesting these products can increase serum phosphate levels [73]. A meta-analysis of data from four prospective cohort studies with 13,515 participants (with percentages of male participants ranging, depending on the study, from 44 to 100% and mean ages from 43 to 74 years) followed for 6–29 years showed a 36% higher risk of cardiovascular mortality in those with the highest phosphate concentration (2.79–4.0 mg/dL) compared with participants with a phosphate concentration of 0.61–3.28 mg/dL [61]. Definition of phosphorus, dietary in the Definitions.net dictionary. Bioavailability of phosphorus. Serum calcium, phosphorus and cardiovascular events in post-menopausal women. Land-based cycle transfers phosphorus from soil to plants, to animals. Nuts, seeds, and many vegetables are rich in phosphorus as well. It can be found in many foods, but is especially high in … Phosphorus in supplements is usually in the form of phosphate salts (e.g., dipotassium phosphate or disodium phosphate) or phospholipids (e.g., phosphatidylcholine or phosphatidylserine). The main effects of hyperphosphatemia include changes in the hormones that regulate calcium metabolism and calcification of nonskeletal tissues, especially in the kidney [2]. Treatment typically consists of vitamin D and phosphorus supplementation from diagnosis until growth is complete [41]. [, Calvo MS, Uribarri J. Am J Kidney Dis 2017;69:200-9. Kidney Int 2016;89:176-84. Products typically provide 10% or less of the DV for phosphorus, but a small proportion deliver more than 100% [30]. The relationship between habitual dietary phosphorus and calcium intake, and bone mineral density in young Japanese women: a cross-sectional study. Not all observational data, however, support a link between serum phosphate concentrations and CVD risk. Kidney Int 2006;69:1945-53. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. 10th ed. [, Pavone V, Testa G, Gioitta Iachino S, et al. Trautvetter U, Jahreis G, Kiehntopf M, Glei M. Consequences of a high phosphorus intake on mineral metabolism and bone remodeling in dependence of calcium intake in healthy subjects - a randomized placebo-controlled human intervention study. That means there is a land-based phosphorus cycle and water-based phosphorus cycle. Moorthi RN, Moe SM. Semin Dial 2013;26:54-61. [, McClure ST, Chang AR, Selvin E, et al. Phosphorus is a chemical element that is considered a mineral when discussing nutrition. (See Appendix 6.) Am J Clin Nutr 2013;98:6-15. Ask ODS Phosphorus is the second most abundant mineral nutrient in the body, after calcium. These intakes are twice the RDA for adults—less than daily intakes in many men (especially those who are white or Hispanic) and well below the UL. In its clinical practice guideline for CKD mineral and bone disorder, the "Kidney Disease: Improving Global Outcomes" guidelines development group recommends that patients with stage 3–5 (more severe) CKD limit dietary phosphorus intake either alone or in combination with other treatments to reduce phosphate levels [57]. A subsequent study not included in this meta-analysis in 13,165 nonpregnant adult participants (mean age 43–45 years, 52% female) in NHANES III (1988–1994) followed for a median of 14.3 years found that for every 1 mg/dL increase in phosphate above 3.5 mg/dL, the risk of death rose by 35% and the risk of cardiovascular death increased by 45% [62]. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Admission serum phosphate levels predict hospital mortality. Nutrients 2018;10. Calcif Tissue Int 1990;47:291-5. High dietary phosphorus intake is associated with all-cause mortality: results from NHANES III. According to one analysis of data on healthy U.S. adults using NHANES III data collected in 1988–1994, high phosphorus intakes (1,000 mg/day or more) were associated with increased rates of all-cause and cardiovascular mortality in adults through 2006 [65]. Intake recommendations for phosphorus and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine [12]. The following groups are most likely to have inadequate phosphorus status. Get the latest public health information from CDC: https://www.coronavirus.gov [, Gattineni J, Baum M. Genetic disorders of phosphate regulation. The DV for phosphorus on the new Nutrition Facts and Supplement Facts labels and used for the values in Table 2 is 1,250 mg for adults and children age 4 years and older [26]. Karpen HE. Foods High in Phosphorus . [, Scanni R, vonRotz M, Jehle S, et al. Phosphorus occurs naturally at low levels in water, plants, and animals. J Endocr Soc 2017;1:407-14. Advances in Chronic Kidney Disease 2007;14:3-12. As a result, PTH and fibroblast growth factor 23 lose their ability to suppress phosphorus resorption by the kidneys [45]. The symbol for phosphorus is P. Trautvetter U, Ditscheid B, Jahreis G, Glei M. Habitual intakes, food sources and excretions of phosphorus and calcium in three German study collectives. [. Phosphorus is an essential element in the diet; in the form of phosphates it is a major component of the mineral phase of bone and is involved in almost all metabolic processes. Includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. Clin Chim Acta 2017;474:108-13. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.". In utero physiology: role in nutrient delivery and fetal development for calcium, phosphorus, and vitamin D. Am J Clin Nutr 2007;85:604S-7S. Helps synthesize protein and is part of phospholipids (fat molecules), such as lecithin, which cells use to make membranes. People with chronic kidney disease (CKD) typically have to restrict and monitor their intake of phosphorus. [, Parli SE, Ruf KM, Magnuson B. Pathophysiology, treatment, and prevention of fluid and electrolyte abnormalities during refeeding syndrome. 1. Present Knowledge in Nutrition. Phosphate additives (e.g., phosphoric acid, sodium phosphate, and sodium polyphosphate) are present in many foods, especially processed food products. A meta-analysis of 9 cohort studies in 199,289 patients aged 50–73 years with end-stage renal disease showed, for example, that patients on dialysis with the highest phosphate levels (greater than 5.2–7.5 mg/dL, depending on the study) had a 39% greater risk of all-cause mortality during 12 to 97.6 months of follow-up than those with normal phosphate levels (defined in the analysis as 3.0–5.5 mg/dL, depending on the study) [51]. Additional research is needed to address this issue. Phosphorus and calcium are interrelated because hormones, such as vitamin D and parathyroid hormone (PTH), regulate the metabolism of both minerals. phosphorus (P) [fos´for-us] a chemical element, atomic number 15, atomic weight 30.974. Adults need about 800 mg daily. [, Abrams SA. Nutr J 2016;15:7. Antacids [, Lopez FL, Agarwal SK, Grams ME, et al. Assessing the health impact of phosphorus in the food supply: issues and considerations. Its Greek name means light-bearer since it emits a faint glow when exposed to oxygen. Dietary Phosphorus: Health, Nutrition, and Regulatory Aspects. Concerns have arisen about phosphorus use, however. Gutierrez OM, Luzuriaga-McPherson A, Lin Y, et al. Many proteins and sugars in the body are phosphorylated. EFSA Panel on Dietetic Products N, Allergies. The benefits of providing extra phosphorus and calcium for bone health in preterm babies is not clear. Whole-grain breads and cereals contain more phosphorus than cereals and breads made from refined flour. Am J Kidney Dis 2019;73:542-51. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet. In their natural form phosphates are chemical compounds made of oxygen and phosphorus. Food Labeling: Revision of the Nutrition and Supplement Facts Labels and Serving Sizes of Foods That Can Reasonably Be Consumed at One Eating Occasion; Dual-Column Labeling; Updating, Modifying, and Establishing Certain Reference Amounts Customarily Consumed; Serving Size for Breath Mints; and Technical Amendments; Proposed Extension of Compliance Dates. Adv Nutr 2015;6:860-2. Adv Nutr 2014;5:104-13. When trying to limit phosphorus, avoid foods that list terms with "phos" among the ingredients. World J Gastroenterol 2009;15:5960-5. In: Uribarri J, Calvo MS, eds. Phosphorus is a chemical element that glows in the dark and in moist air. Deficiency of phosphorus causes older leaves to turn dark green. The use of phosphate additives is rising, as are the amounts of these additives in foods [22,23]. Pediatr Nephrol 2012;27:1477-87. Walter K. Dodds, Matt R. Whiles, in Freshwater Ecology (Third Edition), 2020. phosphorus Origin: L, the morning star, Gr, lit, light bringer; light – to bring. In humans, phosphorus makes up about 1 to 1.4% of fat-free mass. Known as "P" on the periodic chart, and in the N-P-K ratio found on fertilizer, ~ is a naturally occurring and essential element, commonly found in inorganic phosphate rocks. Int J Cardiol 2011;149:335-40. The morning star; phosphor. Elemental phosphorus exists in two major forms, white phosphorus and red phosphorus, but because it is highly reactive, phosphorus is never found as a free element on Earth. Phosphorus definition, a solid, nonmetallic element existing in at least three allotropic forms, one that is yellow, poisonous, flammable, and luminous in the dark, one that is red, less poisonous, and less flammable, and another that is black, insoluble in most solvents, and the least flammable. Furthermore, a Cochrane review of nine studies in 634 participants with CKD followed for 1–18 months found only limited, low-quality evidence indicating that dietary interventions might have a positive impact on CKD mineral and bone disorder [45]. So, phosphorus can mainly be found as tiny dust particles in the atmosphere. Clinical Aspects of Natural and Added Phosphorus in Foods. This systemic condition is characterized by abnormal metabolism of phosphorus, calcium, PTH, and/or vitamin D; abnormal bone turnover, mineralization, volume, growth, or strength; and vascular or other soft-tissue calcification [46]. Heaney RP. [, Chang AR, Grams ME. Arch Intern Med 2007;167:879-85. phosphorus meaning: 1. a poisonous chemical element that is usually yellowish-white or sometimes red or black in…. Phosphorus occurs unnaturally in fertilizers (used in agriculture), cleaners (used in industry) and wastewater (from household sewage). Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. [, Group KDIGOC-MUW. Cochrane Database Syst Rev 2018;8:CD006023. For infants from birth to 12 months, the FNB established an AI for phosphorus that is equivalent to the mean intake of phosphorus in healthy, breastfed infants. Phosphorus is the second most abundant inorganic element in the body and is a part of many important compounds, including deoxyribonucleic acid (DNA), ribonucleic acid (RNA), (S)-2-amino-3-[5-tert-butyl-3-(phosphonomethoxy)-4-isoxazolyl]propionic acid (ATPO), adenosine diphosphate (ADP), phospholipids and sugar phosphates. The effects of hypophosphatemia can include anorexia, anemia, proximal muscle weakness, skeletal effects (bone pain, rickets, and osteomalacia), increased infection risk, paresthesias, ataxia, and confusion [1]. Phosphorus can interact with certain medications, and some medications can have an adverse effect on phosphate levels. Vegetables and chicken contribute 5% each. Am J Cardiol 2013;111:857-62. Dental Health Services Victoria: "Calcium, vitamin D and phosphorus." People should avoid eating meats which typically contain more easily absorbed phosphorus than found in plants. Hospital Practice 2018;46:121-7. The main food sources of phosphorus are meat, milk, and whole grains, nuts and seeds (though the phosphorus is in a bound form in these foods and is about 50 percent less bio-available than phosphorus from other meat and milk sources). Here is a list of foods high in phosphorus to help as you navigate grocery shopping, cooking, and eating out. Patients with severe malnutrition The absorption rate for the phosphorus naturally contained in food is 40%–70%; phosphorus from animal sources has a higher absorption rate than that from plants [15,16]. [. Phosphorus deficiency (hypophosphatemia) is rare in the United States and is almost never the result of low dietary intakes [1]. Heaney RP, Nordin BE. [. As kidney function declines, phosphate excretion becomes less efficient and serum phosphate concentration rises. Phosphorus is a required mineral. Several large epidemiologic studies have also found associations between higher serum phosphate concentrations and risk of cardiovascular mortality in healthy adults. Conversely consuming too much phosphorus causes the body to send calcium from the bones to the blood in an attempt to restore balance. However, phosphorus in seeds and unleavened breads is in the form of phytic acid, the storage form of phosphorus [2]. Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm. In 7,895 adults (mean age 47 years, 52% Caucasian), participants with moderately reduced kidney function had significantly higher serum phosphate levels (4.12 ml/dL) than those with normal kidney function (3.74 mg/dL) [47]. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. Phosphorus forms. Phosphate additives are estimated to contribute 300 to 1,000 mg to total daily phosphorus intakes [11,20], or about 10%–50% of phosphorus intakes in Western countries [21]. Phosphorus is essential for life, so you'll get it from just about every type of food. Clin Perinatol 2018;45:129-41. FDA Drug Safety Communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphate products to treat constipation. Eur J Orthop Surg Traumatol 2015;25:221-6. [, Moore LW, Nolte JV, Gaber AO, Suki WN. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Definition of Phosphorus in the Definitions.net dictionary. J Ren Nutr 2017;27:97-105. Foods containing these additives have an average of 67 mg more phosphorus per serving than similar foods not containing the additives, and these additives contribute to overall phosphorus intakes in the United States [18,19]. Association of dietary phosphate and serum phosphorus concentration by levels of kidney function. Hyperphosphatemia after sodium phosphate laxatives in low risk patients: prospective study. Two examples are provided below. Boca Raton, Florida: CRC Press; 2018:235-46. de Fornasari ML, Dos Santos Sens YA. [, Murtaugh MA, Filipowicz R, Baird BC, Wei G, Greene T, Beddhu S. Dietary phosphorus intake and mortality in moderate chronic kidney disease: NHANES III. Replacing phosphorus-containing food additives with foods without additives reduces phosphatemia in end-stage renal disease patients: a randomized clinical trial. [, Cheungpasitporn W, Thongprayoon C, Mao MA, et al. [, Menon MC, Ix JH. However, high phosphate levels do not seem to have the same associations in people with milder CKD [52,53]. In: Gutierrez OM, Kalantar-Zadeh K, Mehrotra R, eds. [. Mineral homeostasis and effects on bone mineralization in the preterm neonate. The human response to acute enteral and parenteral phosphate loads. Cochrane Database Syst Rev 2015:Cd010350. This is a fact sheet intended for health professionals. Hypophosphatemia is defined as serum phosphate concentrations lower than the low end of the normal range, whereas a concentration higher than the high end of the range indicates hyperphosphatemia. It’s then cycled back to soil again. Phosphorus is found in water, solids (detritus), and in the bodies of biological organisms. Dietary Phosphorus: Health, Nutrition, and Regulatory Aspects. about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. The phosphorus cycle is the process by which phosphorus moves through the lithosphere, hydrosphere, and biosphere. [, Chang AR, Miller ER, Anderson CA, et al. In: Uribarri J, Calvo MS, eds. A post hoc analysis of data from 7,269 postmenopausal women, mean age 66 years, with osteoporosis found no association between higher serum phosphate levels and risk of cardiovascular outcomes during 4 years of follow-up [63]. [, Leon JB, Sullivan CM, Sehgal AR. Phosphorus is essential for plant and animal growth, as well as the health of microbes inhabiting the soil, but is gradually depleted from the soil over time. [. Appendix F: Calculate the Percent Daily Value for the Appropriate Nutrients). These values, which vary by age and sex, include: Table 1 lists the current RDAs for phosphorus [2]. Phosphorus Intake of Americans: What We Eat in American, NHANES 2011-2012. Lack of influence of calcium/phosphorus ratio on hip and lumbar bone mineral density in older Americans: NHANES 2005-2006 cross-sectional data. [, Calvo MS, Lamberg-Allardt CJ. Institute of Medicine, Food and Nutrition Board. Phosphorus is found in almost every food, and as such, deficiency is rare. Rare genetic disorders of phosphorus metabolism include X-linked hypophosphatemic rickets [39]. Phosphorus-Containing Foods. Whole-grain breads and cereals contain more phosphorus than cereals and breads made from refined flour. Food manufacturers do not have to list the amount of phosphorus on labels. [, Hou Y, Li X, Sun L, Qu Z, Jiang L, Du Y. Phosphorus and mortality risk in end-stage renal disease: A meta-analysis. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Because human intestines lack the phytase enzyme, much phosphorus in this form is unavailable for absorption [1]. Since meats are restricted in a CKD diet, egg whites can be a good low-phosphorus source … Phosphorus is a mineral that is part of every cell in your … 2. [, Selamet U, Tighiouart H, Sarnak MJ, Beck G, Levey AS, Block G, et al. Learn more. This section focuses on two diseases in which phosphorus might play a role: chronic kidney disease (CKD) and cardiovascular disease (CVD). The ULs do not apply to individuals who are receiving supplemental phosphorus under medical supervision. The Regulatory Aspects of Phosphorus Intake: Dietary Guidelines and Labeling. Cochrane Database Syst Rev 2017;2:Cd003310. About 95 percent of the phosphate rock mined in the United States is used to make fertilizer or food supplements for animals. The bioavailability of other forms of phosphorus in supplements has not been determined in humans. Am J Kidney Dis 2015;66:258-65. Arq Bras Endocrinol Metabol 2006;50:802-13. [, Malberti F. Hyperphosphataemia: treatment options. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? [, Ito S, Ishida H, Uenishi K, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. J Am Coll Nutr 2002;21:239-44. In minerals, phosphorus generally occurs as phosphate. [, de Menezes Filho H, de Castro LC, Damiani D. Hypophosphatemic rickets and osteomalacia. The absorption rate for the phosphorus in phosphate additives is approximately 70% [24]. *Adequate Intake (AI) Sources of Phosphorus. After 13 reports of deaths associated with taking one dose that was higher than recommended on the label of a laxative containing sodium phosphate, the FDA issued a warning that these products are potentially dangerous if more than recommended doses are taken, especially in people with kidney disease, heart disease, or dehydration [74]. * Breast milk, formula, and food should be the only sources of phosphorus for infants. J Clin Endocrinol Metab 2015;100:4264-71. According to an analysis of 2013–2014 NHANES data, the average daily phosphorus intake from both foods and supplements is 1,301 mg for women and 1,744 mg for men [32]. Read the ingredients and look out for any beginning with “PHOS.” Other rare genetic disorders of phosphorus regulation associated with rickets include autosomal-dominant and autosomal-recessive hypophosphatemic rickets and hereditary hypophosphatemic rickets with hypercalciuria [40]. Sodas and other drinks containing phosphoric acid may cause excessive amounts of phosphorus intake, which can interfere with proper calcium metabolism. It also plays an important role in cell metabolism. Although phosphorus status is not typically assessed, phosphate can be measured in both serum and plasma [10]. Some experts question whether the dietary data collection instruments used by NHANES and other large population-based studies capture true dietary phosphorus intakes because these surveys do not account for the additional contributions of phosphate additives in foods [33,34]. FDA required manufacturers to use these new labels starting in January 2020, but companies with annual sales of less than $10 million may continue to use the old labels that list a phosphorus DV of 1,000 mg until January 2021 [27,28]. Dietary Sources of Phosphorus among Adults in the United States: Results from NHANES 2001-2014. Circulation 2005;112:2627-33. Some evidence shows that replacing foods containing phosphorus additives with foods that lack these additives can reduce serum phosphate levels [55]. Your main energy-storage molecule, adenosine triphosphate (ATP) contains phosphorus. phosphorus definition: 1. a poisonous chemical element that is usually yellowish-white or sometimes red or black in…. The connection between dietary phosphorus, cardiovascular disease, and mortality: where we stand and what we need to know. Scientific Opinion on Dietary Reference Values for phosphorus. The U.S. Department of Agriculture’s (USDA’s) FoodData Central [29] lists the nutrient content of many foods and provides a comprehensive list of foods containing phosphorus arranged by nutrient content. About 85% of phosphorus is found in the skeleton and teeth as calcium phosphate crystals, 14% in soft tissues, and the remaining 1% in body fluids. Nutrition 2018;47:13-20. Drugs 2013;73:673-88. [, Calvo MS, Park YK. And yes, there is a difference. [, Anderson JJB, Adatorwovor R, Roggenkamp K, Suchindran CM. Phosphorus is an essential nutrient required for bone health and many other bodily functions. [, Calvo MS, Uribarri J. People with genetic phosphate regulation disorders Institute of Medicine, Food and Nutrition Board. Phosphorus found in animal foods is absorbed more easily than phosphorus found in plant foods. Calvo MS, Uribarri J. Phosphorus: Essential Nutrition for All Body Cells, Boron: A Trace Mineral Necessary for Good Health, Calcium: Essential Nutrition for Teeth and Bones, Glycine for Helping Wounds Heal and Detoxifying. Am J Clin Nutr 2014;99:320-7. (Science: chemistry) A poisonous nonmetallic element of the nitrogen group, obtained as a white, or yellowish, translucent waxy substance, having a characteristic disagreeable smell. Phosphorus is an essential macromineral, meaning to be healthy you must include this nutrient in your diet. Phosphorus, an essential mineral, is naturally present in many foods and available as a dietary supplement. Dietary supplements Learn more. Dietary sources include almost all foods. The main food sources are the protein food groups of meat and milk. J Infus Nurs 2014;37:197-202. *DV = Daily Value. [, Friedli N, Stanga Z, Culkin A, et al. Additives that contain phosphorus include monopotassium phosphate, phosphoric acid, pyrophosphate polyphosphate, disodium phosphate and calcium phosphate. Check food labels to see whether any ingredients contain "phos" in the term. Individuals taking these and other medications on a regular basis should discuss their phosphorus status with their healthcare providers. ... Phosphorus used in foods or obtained from food. Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population. Phosphorus is available in dietary supplements containing only phosphorus, supplements containing phosphorus in combination with other ingredients, and a few multivitamin/multimineral products [30]. According to one analysis, a very high calcium intake of 2,500 mg/day binds 0.61–1.05 g phosphorus [17]. What does phosphorus, dietary mean? Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Nutrients 2017;9. Dietitians of Canada: "Food Sources of Phosphorus." Antacids containing calcium carbonate (Rolaids, Tums, Maalox) also decrease instestinal absorption of dietary phosphorus [72]. Am J Clin Nutr 2015;102:444-53. Gutierrez OM. Meaning of phosphorus, dietary. J Ren Nutr 2013;23:265-70.e2. [, Moe S, Drueke T, Cunningham J, et al. Increased phosphorus retention often leads to CKD mineral and bone disorder. Phosphorus is also an important element in energy production. [, Beloosesky Y, Grinblat J, Weiss A, et al. In infants, phosphorus bioavailability ranges from 85%–90% for human milk to approximately 59% for soy-based formulas [2]. Phosphorus additives in food are absorbed nearly 100% into your blood, whereas the phosphorus in more natural foods like meats, beans, and nuts are only absorbed 20-50%. If you’ve taken biology or chemistry classes, you might remember phosphorus from the Periodic Table of Elements.. Phosphates are minerals our bodies need to maintain healthy teeth, bones, heart function, muscles and blood vessels. [, Chines A, Pacifici R. Antacid and sucralfate-induced hypophosphatemic osteomalacia: a case report and review of the literature. In: Gutierrez OM, Kalantar-Zadeh K, Mehrotra R, eds. New York, New York: Springer-Verlag; 2017:47-76. The combination of high phosphorus intakes with low calcium intakes increases serum PTH levels, but evidence is mixed on whether the increased hormone levels decrease bone mineral density [2,4-6]. Phosphorus is also commonly added to processed food as a thickening agent or taste enhancer, or to stop unwanted alterations in food color. However, plasma and serum phosphate levels do not necessarily reflect whole-body phosphorus content [1,11]. Preterm newborns Phosphorus is an essential element in the diet; in the form of phosphates it is a major component of the mineral phase of bone and is involved in almost all metabolic processes. J Nutr 1996;126:1168S-80S. Phosphorus that has been added to food in the form of an additive or preservative (inorganic phosphorus) is found in foods such as fast foods, ready to eat foods, canned and bottled drinks, enhanced meats, and most processed foods. The optimum calcium to phosphorus ratio is approximately 1:1, but in the average American diet, that ratio commonly varies between 1:2 and 1:4. Changing phosphorus content of the U.S. diet: potential for adverse effects on bone. [, Calvo MS, Moshfegh AJ, Tucker KL. Electrolyte disorders following oral sodium phosphate administration for bowel cleansing in elderly patients. JAMA Internal Medicine 2003;163:803-8. New York, New York: Springer-Verlag; 2017:11-28. Phosphorus. [, Harding JE, Wilson J, Brown J. Calcium and phosphorus supplementation of human milk for preterm infants. Chronic kidney disease In addition, phosphorus plays key roles in regulation of gene transcription, activation of enzymes, maintenance of normal pH in extracellular fluid, and intracellular energy storage. [, Palmer SC, Hayen A, Macaskill P, et al. Lee KJ, Kim KS, Kim HN, et al. Phosphorus definition is - a phosphorescent substance or body; especially : one that shines or glows in the dark. For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's ChooseMyPlate. Get the latest research information from NIH: https://www.nih.gov/coronavirus, Have a question? High phosphorus foods. American Society for Bone and Mineral Research: "Bone Structure and Function." In: Erdman JW, Macdonald IA, Zeisel SH, eds. Kidney Int Suppl (2011) 2017;7:1-59. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD),. [, Casais MN, Rosa-Diez G, Perez S, et al. (See Appendix 6.) Nephrol Dial Transplant 2012;27:990-6. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. Additional studies are needed on the link between phosphate concentrations and both CKD risk and morbidity in patients with CKD as well as the impact of dietary phosphorus restriction in patients with this disease. J Physiol 2014;592:3985-95. [, Moe SM, Drüeke T, Lameire N, Eknoyan G. Chronic kidney disease--mineral-bone disorder: a new paradigm. Includes a variety of vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, and oils. Data from the 2015–2016 National Health and Nutrition Examination Survey (NHANES) show that among children and teens aged 2–19 years, the average daily phosphorus intake from foods is 1,237 mg [31]. Almost all foods contain phosphorus, but the amounts of phosphorus are greater in animal products and high-protein foods like meats, fowl, fish, eggs, and dairy. Several studies have shown an increased risk of mortality or disease progression in patients who have CKD and high phosphate levels [48-50]. [, Shinaberger CS, Greenland S, Kopple JD, et al. Am J Kidney Dis 2014;64:567-73. However, milk fortified with higher amounts of these minerals and other nutritional components is typically recommended to support overall growth and development [37,38]. In spite of the evidence supporting a link between increased phosphate levels and CVD risk, the literature offers no evidence on whether restricting phosphorus consumption can prevent CVD in healthy adults [64]. Many different types of foods contain phosphorus, mainly in the form of phosphates and phosphate esters [1]. Encyclopedia of Healing Foods. Dietary phosphorus, serum phosphorus, and cardiovascular disease. Dietary interventions for mineral and bone disorder in people with chronic kidney disease. It has a concentration in the Earth's crust of about one gram per kilogram (compare copper at about 0.06 grams). CKD, which affects 5%–10% of the population worldwide, can lead to CVD and early death [44]. Most refined oils, fruits, vegetables, and refined grains are low in phosphorus. In fact, 85 percent of the phosphorus found in the body resides in … Jama 2011;305:1119-27. Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis. Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD). Washington, DC: National Academies Press; 1997. These drugs can also aggravate existing phosphate deficiency. When kidney function declines, as in chronic kidney failure, the body cannot excrete phosphate efficiently, and serum levels rise [9]. Symbol P A highly reactive, poisonous, nonmetallic element occurring naturally in phosphates, especially apatite, and existing in three allotropic forms, white (or sometimes yellow), red, and black (or violet). However, restricting phosphorus intakes can also reduce protein intakes because many foods (e.g., fish, meats, and legumes) containing large amounts of phosphorus also contain large amounts of protein [56]. Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals. [. In: Uribarri J, Calvo MS, eds. Association between dietary calcium and phosphorus intakes, dietary calcium/phosphorus ratio and bone mass in the Korean population. [, Dhingra R, Sullivan LM, Fox CS, et al. ... Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. [. Prophylactic administration of phosphorus and thiamin in patients at risk of refeeding syndrome can prevent this condition [43]. For a reader-friendly overview of Phosphorus, see our consumer fact sheet on Phosphorus. Hruska K. Overview of phosphorus homeostasis. Phosphorus is a mineral that’s found in the bones and processed by the kidneys. The ULs for phosphorus from food and supplements for healthy individuals are therefore based on intakes associated with normal serum phosphate concentrations [2]. The prevalence of phosphorus-containing food additives in top-selling foods in grocery stores. Adv Nutr 2013;4:723-9. Food Many different types of foods contain phosphorus, including dairy products, meats and poultry, fish, eggs, nuts, legumes, vegetables, and grains [13,14].In the United States, dairy products contribute about 20% of total phosphorus intakes, and bakery products (e.g., breads, tortillas, and sweet bakery products) contribute 10% []. USDA National Nutrient Database for Standard Reference, Legacy Release. [. Antacids that contain aluminum hydroxide, such as Maalox HRF and Rulox, bind phosphorus in the intestines, and their chronic use for 3 months or longer can therefore lead to hypophosphatemia [1,71]. Food While phosphorus is not usually listed on the nutrition facts label, it may be listed as an ingredient. Food Sources of Phosphorus. Eating foods high in phosphorus is a very good way to boost bone and teeth health, while also improving key metabolic functions.. Phosphorus Foods. Itkonen ST, Karp HJ, Lamberg-Allardt CJ. Because two-thirds of fetal bone mineral content is acquired during the third trimester of pregnancy, preterm infants are born with low stores of calcium and phosphorus in their bones [37]. The federal government's 2015–2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. FDA does not require food labels to list phosphorus content unless phosphorus has been added to the food. However, the group notes that clinical trial data showing that treatments that lower serum phosphate levels improve patient-centered outcomes are lacking, and it acknowledges that this recommendation is weak. Nutr J 2014;13:114. rus (fŏs′fər-əs) n. 1. [, Yamamoto KT, Robinson-Cohen C, de Oliveira MC, et al. Dietary sources include almost all foods. In the United States, dairy products contribute about 20% of total phosphorus intakes, and bakery products (e.g., breads, tortillas, and sweet bakery products) contribute 10% [13]. The main food sources are the protein food groups of meat and milk, as well as processed foods that contain sodium phosphate. Ann N Y Acad Sci 2013;1301:21-6. Phosphorus. Serum phosphorus and mortality in the Third National Health and Nutrition Examination Survey (NHANES III): effect modification by fasting. The effects of refeeding syndrome can include impaired neuromuscular function, hypoventilation, respiratory failure, impaired blood clotting, confusion, coma, cardiac arrest, congestive heart failure, and death [43]. Washington, DC: National Academies Press; 2001. Phosphorus Cycle Definition. Several hormones, including estrogen and adrenaline, also affect phosphorus homeostasis. Phosphorus deficiency is rare due to its abundance in food but can cause low bone density, compromised growth and poor tooth development, weakness, irritability, weak or stiff joints and bone pain. Phosphorus undergoes passive absorption in the small intestine, although some is absorbed by active transport [2]. An analysis of 2003–2006 NHANES data illustrates the association between CKD and phosphate levels. In adults aged 20 and older, the average daily phosphorus intake from foods is 1,189 mg for women and 1,596 mg for men. In addition to rickets, patients with this disease develop osteomalacia, pseudofractures (formation of new bone and thickened connective tissue over injured bone), enthesopathy (mineralization of ligaments and tendons), and dental damage. Generally foods that are particularly rich in protein are also high in phosphorus. phosphorus (P) [fos´for-us] a chemical element, atomic number 15, atomic weight 30.974. Boca Raton, Florida: CRC Press; 2018:249-66. Manufacturers may add phosphorus when processing foods to thicken them, improve taste, prevent discoloration or preserve them. This mineral is part of all cells, especially cell membranes, and is essential to bone strength, because it’s the […] A diet that includes the right amounts of meal plan calcium and protein will also provide enough phosphorus. It also plays an important role in cell metabolism. Laxatives Join the ODS Email List. The name of the element comes from the Greek word phosphoros , meaning “light bearing.” Scientists use symbols to stand for the chemical elements. Serum Phosphate The Dietary Guidelines for Americans describes a healthy eating pattern as one that: This fact sheet by the Office of Dietary Supplements provides information that should not take the place of medical advice. [, Lederer E. Regulation of serum phosphate. Phosphorus Additives Many food products now contain phosphorus additives. Relationship of dietary phosphate intake with risk of end-stage renal disease and mortality in chronic kidney disease stages 3-5: The Modification of Diet in Renal Disease Study. [, Da J, Xie X, Wolf M, et al. [, Liu Z, Su G, Guo X, et al. Relation of serum phosphorus levels to the incidence of atrial fibrillation (from the Atherosclerosis Risk In Communities [ARIC] study). Phosphorus deficiency and toxicity are not very predominant; excesses of phosphorus may alter calcium balance, and phosphorus deficiency may lead to energy and metabolic problems. Very high phosphorus intakes over short periods (e.g., two 6,600 mg doses of sodium phosphate taken in one day) can cause hyperphosphatemia [69,70]. Contributions to total phosphorus intake: all sources considered. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.)