Matthew Messer

Matthew Messer

Editor-in-chief

Phosphorus is an essential mineral substance that the body needs for healthy functioning. The problem is that unlike many mineral substances we consume not less but much more phosphorus than necessary. (1,2) This is due to modern diet, more precisely mass produced, processed foods most of which contain some sort of additive with phosphorus. (2,3) As a result, average phosphorus consumption far exceeds the necessary amount and apparently it might be dangerous in the long run.

How much more than necessary do we consume?

Health organizations specify the ideal daily intake between 550 and 700 mg which roughly equals the amount a healthy, natural food based diet is able to provide. (4,5)

In contrast, daily phosphorus intake is almost double that amount, but many consume five times more. (1,2,6) We usually need much less mineral substances and trace elements than vitamins because it’s more difficult for the body to get rid of the surplus.

Although less is known about the medical effects of phosphorus than of magnesium or iron, an adequate number of studies have found worrying results to make one think whether we harm our bodies with the enormous amount of unnecessary phosphorus we consume.

Why is it a problem that we eat too much phosphorus?

The body needs phosphorus especially for a good bone structure and energy production, but excess consumption has a negative effect on these processes as well.

Bones are mainly composed of a material made up of phosphorus and calcium but if their ratio becomes unbalanced the bones’ calcium content might decrease and they weaken in time. (7)

The same applies for energy production. In the case of mice too much phosphorus decreased oxygen uptake and oxidation of fatty acids, and their working capacity became proportionally lower. (8)

In addition, high phosphorus intake can cause calcification in the tissues just like calcium, especially if it’s accompanied by inadequate kidney function. (16) These deposits may lead to cardiovascular and other diseases over time.

It lowers the body’s energy level

In a study published in 2019 the effect of increased phosphorus intake was first observed on mice. Various problems occurred in the mice’s metabolism: they were unable to use fat as energy and both their oxygen uptake and physical activity decreased. (8)

This trend was noticeable in humans as well, those with a higher phosphorus level became much more inactive and spent less time working out. (8) On the basis of this study it’s possible that many don’t exercise enough because they are constantly tired due to their high phosphorus intake.

It has a negative effect on the bone system

Phosphorus resembles calcium in many regards, for example, vitamin D and parathormone also affect the metabolism of phosphorus. Too high phosphorus and low calcium intake can increase parathormone levels in the same way as vitamin D deficiency. As a result, the calcium content of bones decreases over time and bones become brittle.

In a study 147 healthy women were divided into groups according to their diets’ calcium-phosphorus ratio. The women whose low calcium intake was coupled with high phosphorus intake had a significantly higher parathormone level and their urine contained more calcium. This suggests that compared to the members of the other groups their bones degraded to a greater extent. (9)

In another study low calcium levels were much more common among post menopausal women who consumed a lot of soft drinks containing phosphorus. (10)

In a 2015 research additives containing phosphorus were tested with the participation of 10 people. First the participants followed an average phosphorus-content diet for a week then “supplemented” it with additives containing phosphorus. These disturbed their bone metabolism and several of their blood values changed. The same supplementation was tested on mice in parallel but for a longer period. In their case the difference between low and high phosphorus intake was much greater and their bone density also significantly decreased. (11)

Increases the risk of cardiovascular diseases

The negative effects mentioned can all contribute to the fact that several observational studies found a significantly increased risk of cardiovascular disease and death in the case of people with a high phosphorus level. (12,13,14)

The negative effects of too much phosphorus are even more apparent in cases of chronic kidney failure. Since excess phosphorus is secreted by the kidneys if there’s a problem, it accumulates much faster which considerably shortens the life of patients suffering from kidney disease. (15)

Phosphorus level is also regulated by various genes. In animal models where these genes were deleted phosphorus accumulated very fast and as a result, the aging of the animals accelerated remarkably. (16,17)

How to decrease phosphorus intake

Strive to eat less processed, natural foods because they tend not to contain added phosphate. Avoid mass produced food, read the list of ingredients and if the food contains a lot of phosphate, avoid eating it.

Among natural foods, dairy products and vegetables have the best calcium-phosphorus ratio while meat, pulses and grains contain a significant amount of phosphorus but very little calcium.

  1. Calvo MS, Park YK. Changing phosphorus content of the U.S. diet: potential for adverse effects on bone. J Nutr. 1996 Apr;126(4 Suppl):1168S-80S. doi: 10.1093/jn/126.suppl_4.1168S. PMID: 8642452.
  2. https://www.efsa.europa.eu/en/efsajournal/pub/5674
  3. León JB, Sullivan CM, Sehgal AR. The prevalence of phosphorus-containing food additives in top-selling foods in grocery stores. J Ren Nutr. 2013 Jul;23(4):265-270.e2. doi: 10.1053/j.jrn.2012.12.003. Epub 2013 Feb 8. PMID: 23402914; PMCID: PMC3674209.
  4. https://www.efsa.europa.eu/en/efsajournal/pub/4185
  5. https://ods.od.nih.gov/factsheets/Phosphorus-HealthProfessional/#en2
  6. Chang AR, Lazo M, Appel LJ, Gutiérrez OM, Grams ME. High dietary phosphorus intake is associated with all-cause mortality: results from NHANES III. Am J Clin Nutr. 2014 Feb;99(2):320-7. doi: 10.3945/ajcn.113.073148. Epub 2013 Nov 13. Erratum in: Am J Clin Nutr. 2017 Apr;105(4):1021. PMID: 24225358; PMCID: PMC3893724.
  7. Kemi VE, Kärkkäinen MU, Rita HJ, Laaksonen MM, Outila TA, Lamberg-Allardt CJ. Low calcium:phosphorus ratio in habitual diets affects serum parathyroid hormone concentration and calcium metabolism in healthy women with adequate calcium intake. Br J Nutr. 2010 Feb;103(4):561-8. doi: 10.1017/S0007114509992121. Epub 2009 Sep 28. PMID: 19781123.
  8. Peri-Okonny P, Baskin KK, Iwamoto G, Mitchell JH, Smith SA, Kim HK, Szweda LI, Bassel-Duby R, Fujikawa T, Castorena CM, Richardson J, Shelton JM, Ayers C, Berry JD, Malladi VS, Hu MC, Moe OW, Scherer PE, Vongpatanasin W. High-Phosphate Diet Induces Exercise Intolerance and Impairs Fatty Acid Metabolism in Mice. Circulation. 2019 Mar 12;139(11):1422-1434. doi: 10.1161/CIRCULATIONAHA.118.037550. PMID: 30612451; PMCID: PMC6411426.
  9. Kemi VE, Kärkkäinen MU, Rita HJ, Laaksonen MM, Outila TA, Lamberg-Allardt CJ. Low calcium:phosphorus ratio in habitual diets affects serum parathyroid hormone concentration and calcium metabolism in healthy women with adequate calcium intake. Br J Nutr. 2010 Feb;103(4):561-8. doi: 10.1017/S0007114509992121. Epub 2009 Sep 28. PMID: 19781123.
  10. Fernando GR, Martha RM, Evangelina R. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in postmenopausal women. J Clin Epidemiol. 1999 Oct;52(10):1007-10. doi: 10.1016/s0895-4356(99)00097-9. PMID: 10513764.
  11. Gutiérrez OM, Luzuriaga-McPherson A, Lin Y, Gilbert LC, Ha SW, Beck GR Jr. Impact of Phosphorus-Based Food Additives on Bone and Mineral Metabolism. J Clin Endocrinol Metab. 2015 Nov;100(11):4264-71. doi: 10.1210/jc.2015-2279. Epub 2015 Aug 31. PMID: 26323022; PMCID: PMC4702463.
  12. Chang AR, Lazo M, Appel LJ, Gutiérrez OM, Grams ME. High dietary phosphorus intake is associated with all-cause mortality: results from NHANES III. Am J Clin Nutr. 2014 Feb;99(2):320-7. doi: 10.3945/ajcn.113.073148. Epub 2013 Nov 13. Erratum in: Am J Clin Nutr. 2017 Apr;105(4):1021. PMID: 24225358; PMCID: PMC3893724.
  13. Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G; Cholesterol And Recurrent Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005 Oct 25;112(17):2627-33. doi: 10.1161/CIRCULATIONAHA.105.553198. Erratum in: Circulation. 2007 Dec 4;116(23):e556. PMID: 16246962.
  14. Dhingra R, Sullivan LM, Fox CS, Wang TJ, D'Agostino RB Sr, Gaziano JM, Vasan RS. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007 May 14;167(9):879-85. doi: 10.1001/archinte.167.9.879. PMID: 17502528.
  15. Da J, Xie X, Wolf M, Disthabanchong S, Wang J, Zha Y, Lv J, Zhang L, Wang H. Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies. Am J Kidney Dis. 2015 Aug;66(2):258-65. doi: 10.1053/j.ajkd.2015.01.009. Epub 2015 Mar 21. PMID: 25804679.
  16. Razzaque MS. Phosphate toxicity: new insights into an old problem. Clin Sci (Lond). 2011 Feb;120(3):91-7. doi: 10.1042/CS20100377. PMID: 20958267; PMCID: PMC3120105.
  17. Lanske B, Razzaque MS. Premature aging in klotho mutant mice: cause or consequence? Ageing Res Rev. 2007 May;6(1):73-9. doi: 10.1016/j.arr.2007.02.002. Epub 2007 Feb 20. PMID: 17353153; PMCID: PMC2896497.

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