Phosphorus in Food: Uncovering Hidden Health Risks in Your Diet

Phosphorus

Phosphorus is the 15th element on the periodic table and is crucial for the growth and bodily functions of animals, plants, and humans. There are two types of phosphorus – organic and inorganic – that each play a role in our daily diets. Approximately 85% of inorganic phosphorus (phosphate) is stored in the bones and teeth of the human body. Phosphorus in our diet aids in processing carbohydrates and fats, as well as in the production and regulation of ATP, the body’s primary energy source. Moreover, phosphate is essential for cellular functions such as DNA and RNA production, pH balance, and tissue maintenance and repair.

Sources of Phosphorus

Organic: Organic phosphorus in our diet can be defined as the type of phosphorus that occurs naturally and is found in animal and plant-based foods. Nutrient-rich organic sources include dairy, red meat, seafood, poultry, legumes, and nuts, which contain phytate (Peacock, 2021).

Inorganic: Inorganic phosphorus refers to phosphorus added to processed foods, often used as additives to enhance appearance, taste, color, and shelf life. Common examples include fast food, sodas, and processed meats. Typically, inorganic sources of phosphorus commonly consist of phosphate salts.

Phosphorus Overconsumption and its Causes

According to The Food and Drug Administration (FDA), adults should aim for a daily phosphorus intake of 700 mg/d, while developing children should target 1,250 mg/d (Anderson, 2013). However, the mean daily intake of phosphorus for all age groups in the United States typically exceeds 1,000 mg/day (Borgi, 2019). Excessive phosphorus intake can result from consuming inorganic phosphorus found in food additives (Figure 1) (Ritz et al., 2012). Another link with similar information on food with high phosphorus content can be found on Healthline: How Your Body Uses Phosphorus.

Figure 1. Common foods in grocery stores containing phosphorus additives (León et al., 2013).

Another factor contributing to phosphorus overconsumption is the absence of detailed phosphorus content on food labels (Borgi, 2019). Food manufacturers are mandated to list phosphorus in the ingredients list only if phosphorus additives are used in a product, without specifying the quantity added or the total phosphorus content (including naturally occurring phosphorus) in the food item (León et al., 2013).

Health Risk Associated with Phosphorus Overconsumption

Organic phosphorus sources are generally absorbed at rates of 40% to 60%, whereas inorganic sources have a higher absorption efficiency, ranging from 80% to 100%. In comparison, calcium is absorbed at approximately 20% to 30% (Calvo et al., 2014). These significant differences in nutrient absorption rates have the potential to disrupt cellular functions and hormonal balance. Phosphorus additives (e.g., phosphate salts) are often included in food without essential co-nutrients like calcium, leading to an imbalance. Ideally, the calcium-to-phosphorus molar intake ratio should be maintained between 1.5:1 and 1:1. The imbalance of insufficient calcium compared to phosphorus increase the risk of experiencing health issues including, Hyperphosphatemia, Chronic Kidney Disease, Cardiovascular Disease, Cognitive Impairments, Bone Loss, Hypertension, and Hyperparathyroidism (Moe and Zidehsarai, 2006; Calvo and Tucker, 2013)

How to Minimize the Risks of Phosphorus Overconsumption

Balance your Diet: Maintaining healthy, balanced diet rich in whole foods is essential. Whenever possible, avoid fast-food establishments and over-processed food (read food labels). If you have the opportunity, consider growing your own fruits and vegetables, and consume locally grown fruits and vegetables.

Advocate for Yourself: If you suspect that you are experiencing a health issues associated with phosphorus consumption (Anderson, 2013; Bird et al., 2021; Calvo et al., 2014; Calvo et al., 2013; Calvo & Uribarri, 2013; Komaba and Fukagawa, 2016; Pravst, 2011; Takeda et al., 2012; Vorland et al., 2017) and are interested in learning more, consult a trusted physician who can guide you toward tailored mitigation techniques aligned with your personalized dietary needs (Jin and Bierma, 2018).

Adopt Sustainable Principles: The Sustainable Phosphorus Alliance developed a Twelve-step program for a more phosphorus-efficient use. These principles extend beyond diet and include best practices of home maintenance and environmental stewardship (Metson et al., 2012).

Spread Awareness: Spread the knowledge you gained today with others and support further research to enhance our understanding of the sources and health effects of excessive phosphorus consumption.

Join advocacy groups: Participate in health advisory groups to foster individual and community awareness and to influence policies and regulations aimed at reducing the risks associated with excessive consumption and exposure to phosphorus.

Additional Resources

To learn more about your personal phosphorus consumption, consult a trusted physician. For further information on phosphorus consumption, see National Institute of Health, Phosphorus.

Glossary

DNA: “Deoxyribonucleic acid (abbreviated DNA) is the molecule that carries genetic information for the development and functioning of an organism” (Bates, 2024).

Food additive: “Food additives are substances primarily added to processed foods, or other foods produced on an industrial scale, for technical purposes, e.g. to improve safety, increase the amount of time a food can be stored, or modify sensory properties of food” (World Health Organization, 2023).

Molar intake ratio: The ratio of nutrients expressed in units of molarity. For example, an intake ratio of 1.5:1 indicates that the intake of “x” should be 1.5 times higher than the intake of “y”. In the article a case of “x=calcium” and “y=phosphate” is described for this 1.5:1 scenario (World Health Organization, 2003).

Molarity: A unit of concentration (mass in a given volume of solution) that measures the number of moles dissolved in one liter of solution.

For this calculation, one mole equals contains 6×10²³ entities of the molecule, which is dissolved (Pietrzyk and Frank, 1979).

Nutrient absorption: The process of taking nutrients from the digestive system into the blood so they can be used in the body (National Institutes of Health, 2024)

RNA: “Ribonucleic acid (abbreviated RNA) is a nucleic acid present in all living cells that has structural similarities to DNA” (Bates, 2024).

Phosphate: “Phosphate is an essential electrolyte in the human body as it constitutes about 1% of the total body weight” (Qadeer et al., 2023)

Phytate: The salt form of a compound known as “phytic acid”, a type of organic phosphorus produced by plants; found primarily in seeds, nuts, legumes, and cereals (Pires et al., 2023).

Acknowledgment

This work was supported by the Science and Technologies for Phosphorus Sustainability (STEPS) Center, a National Science Foundation Science and Technology Center (CBET-2019435). The authors would also like to acknowledge Clemson Downs for their support and for granting access to their facility during this work.

Sources:

1. Anderson J. J. (2013). Potential health concerns of dietary phosphorus: cancer, obesity, and hypertension. Annals of the New York Academy of Sciences, 1301, 1–8. https://doi.org/10.1111/nyas.12208
2. Bates, S. A. (2024). https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid (accessed on 10/3/2024)
3. Bird, R. P., & Eskin, N. A. M. (2021). The emerging role of phosphorus in human health. Advances in food and nutrition research, 96, 27–88. https://doi.org/10.1016/bs.afnr.2021.02.001
4. Borgi, L. (2019). Inclusion of phosphorus in the nutrition facts label. Clinical Journal of the American Society of Nephrology, 14(1), 139-140. 10.2215/CJN.07230618
5. Calvo, M. S., Moshfegh, A. J., & Tucker, K. L. (2014). Assessing the health impact of phosphorus in the food supply: issues and considerations. Advances in nutrition (Bethesda, Md.), 5(1), 104–113. https://doi.org/10.3945/an.113.004861
6. Calvo, M. S., & Tucker, K. L. (2013). Is phosphorus intake that exceeds dietary requirements a risk factor in bone health? Annals of the New York Academy of Sciences, 1301, 29–35. https://doi.org/10.1111/nyas.12300
7. Calvo, M. S., & Uribarri, J. (2013). Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population. The American journal of clinical nutrition, 98(1), 6–15. https://doi.org/10.3945/ajcn.112.053934
8. Jin, G., & Bierma, T. J. (2018). SPECIAL REPORT: Phosphorus Recovery From Surface Waters: Protecting Public Health and Closing the Nutrient Cycle. Journal of Environmental Health, 81(2), 16–23. https://www.jstor.org/stable/26505154
9. Komaba, H., & Fukagawa, M. (2016). Phosphate—a poison for humans? Kidney International, 90(4), 753–763. https://doi.org/10.1016/j.kint.2016.03.039
10. León, J.B., Sullivan, C.M., & Sehgal, A.R., (2013). The prevalence of phosphorus-containing food additives in top-selling foods in grocery stores. Journal of renal nutrition, 23(4), 265-270. https://doi.org/10.1053/j.jrn.2012.12.003
11. Metson, G.S., Bennett, E.M. and Elser, J.J., 2012. The role of diet in phosphorus demand. Environmental Research Letters, 7(4), p.044043. 10.1088/1748-9326/7/4/044043
12. Moe, S. M., & Zidehsarai, M. P. (2006). The role of phosphorus in the pathogenesis of renal osteodystrophy. Seminars in Nephrology, 26(1), 44-49.
13. National Institute of Health (2024). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/absorption. (Accessed on 10/3/2024).
14. Peacock, M. (2021). Phosphate metabolism in health and disease. Calcified Tissue International, 108, 3-15. https://doi.org/10.1007/s00223-020-00686-3
15. Pietrzyk, D. J., & Frank, C. W. (1979). Chapter Three – Stoichiometry. Analytical Chemistry, 20-47. https://doi.org/10.1016/B978-0-12-555160-1.50007-1.
16. Pires, S.M., Reis, R.S., Cardoso, S.M., Pezzani, R., Paredes-Osses, E., Seilkhan, A., Ydyrys, A., Martorell, M., Sönmez Gürer, E., Setzer, W.N. and Abdull Razis, A.F. (2023). Phytates as a natural source for health promotion: A critical evaluation of clinical trials. Frontiers in Chemistry, 11, p.1174109. doi: 10.3389/fchem.2023.1174109
17. Pravst, I. (2011). Risking public health by approving some health claims? – The case of phosphorus. Food Policy, 36(5), 726–728. https://doi.org/10.1016/j.foodpol.2011.05.005
18. Qadeer, H.A. & Bashir, K. (2020). Physiology, phosphate. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
19. https://www.ncbi.nlm.nih.gov/books/NBK560925/
20. Ritz, E., Hahn, K., Ketteler, M., Kuhlmann, M.K. & Mann, J., (2012). Phosphate additives in food—a health risk. Deutsches Ärzteblatt International, 109(4), p.49. https://doi.org/10.3238%2Farztebl.2012.0049
21. Takeda, E., Yamamoto, H., Yamanaka-Okumura, H., & Taketani, Y. (2012). Dietary phosphorus in bone health and quality of life. Nutrition reviews, 70(6), 311–321. https://doi.org/10.1111/j.1753-4887.2012.00473.x
22. Vorland, C. J., Stremke, E. R., Moorthi, R. N., & Hill Gallant, K. M. (2017). Effects of Excessive Dietary Phosphorus Intake on Bone Health. Current osteoporosis reports, 15(5), 473–482. https://doi.org/10.1007/s11914-017-0398-4
23. World Health Organization (2003) Diet, Nutrition, and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series 916. World Health Organization. (2023). https://www.who.int/news-room/fact-sheets/detail/food-additives (accessed on 10/3/2024)