Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T08:30:01.114Z Has data issue: false hasContentIssue false
  • English
  • Français

High phosphorus intakes acutely and negatively affect Ca and bone metabolism in a dose-dependent manner in healthy young females

Published online by Cambridge University Press:  17 April 2007

Virpi E. Kemi ,
Merja U. M. Kärkkäinen  and
Christel J. E. Lamberg-Allardt
Virpi E. Kemi
Affiliation:
Calcium Research Unit, Department of Applied Chemistry and Microbiology, P.O. Box 66, University of Helsinki, FIN-00014 Helsinki, Finland
Merja U. M. Kärkkäinen
Affiliation:
Calcium Research Unit, Department of Applied Chemistry and Microbiology, P.O. Box 66, University of Helsinki, FIN-00014 Helsinki, Finland
Christel J. E. Lamberg-Allardt*
Affiliation:
Calcium Research Unit, Department of Applied Chemistry and Microbiology, P.O. Box 66, University of Helsinki, FIN-00014 Helsinki, Finland
*
*Corresponding author: Dr Christel Lamberg-Allardt, fax +358 9 19158269, email christel.lamberg-allardt@helsinki.fi
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Ca and P are both essential nutrients for bone and are known to affect one of the most important regulators of bone metabolism, parathyroid hormone (PTH). Too ample a P intake, typical of Western diets, could be deleterious to bone through the increased PTH secretion. Few controlled dose–response studies are available on the effects of high P intake in man. We studied the short-term effects of four P doses on Ca and bone metabolism in fourteen healthy women, 20–28 years of age, who were randomized to four controlled study days; thus each study subject served as her own control. P supplement doses of 0 (placebo), 250, 750 or 1500mg were taken, divided into three doses during the study day. The meals served were exactly the same during each study day and provided 495mg P and 250mg Ca. The P doses affected the serum PTH (S-PTH) in a dose-dependent manner (P=0·0005). There was a decrease in serum ionized Ca concentration only in the highest P dose (P=0·004). The marker of bone formation, bone-specific alkaline phosphatase, decreased (P=0·05) and the bone resorption marker, N-terminal telopeptide of collagen type I, increased in response to the P doses (P=0·05). This controlled dose–response study showed that P has a dose-dependent effect on S-PTH and increases PTH secretion significantly when Ca intake is low. Acutely high P intake adversely affects bone metabolism by decreasing bone formation and increasing bone resorption, as indicated by the bone metabolism markers.

Keywords

Parathyroid hormoneBone metabolismPhosphorus intakeDose–response study
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 3 , September 2006 , pp. 545 - 552
Copyright
Copyright © The Nutrition Society 2006

References

Almaden, Y, Hernandez, A, Torregrosa, V, Canalejo, A, Sabate, L, Fernandez, Cruz L, Campistol, JM, Torres, A & Rodriguez, M (1998) High phosphate level directly stimulates parathyroid hormone secretion and synthesis by human parathyroid tissue in vitro. J Am Soc Nephrol 9, 1845–1852.CrossRefGoogle ScholarPubMed
Boden, SD & Kaplan, FS (1990) Calcium homeostasis. Orthop Clin North Am 21, 31–42.CrossRefGoogle ScholarPubMed
Brixen, K, Nielsen, HK, Charles, P & Mosekilde, L (1992) Effects of a short course of oral phosphate treatment on serum parathyroid hormone (1–84) and biochemical markers of bone turnover: a dose – response study. Calcif Tissue Int 51, 276–281.CrossRefGoogle Scholar
Brot, C, Jorgensen, N, Madsen, OR, Jensen, LB & Sorensen, OH (1999) Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women. J Intern Med 245, 509–516.CrossRefGoogle ScholarPubMed
Calvo, MS (1993) Dietary phosphorus, calcium metabolism and bone. J Nutr 123, 1627–1633.CrossRefGoogle ScholarPubMed
Calvo, MS (1994) The effects of high phosphorus intake on calcium homeostasis. Adv Nutr Res 9, 183–207.Google ScholarPubMed
Calvo, MS, Kumar, R & Heath, H 3rd (1988) Elevated secretion and action of serum parathyroid hormone in young adults consuming high phosphorus, low calcium diets assembled from common foods. J Clin Endocrinol Metab 66, 823–829.CrossRefGoogle ScholarPubMed
Calvo, MS, Kumar, R & Heath, H (1990) Persistently elevated parathyroid hormone secretion and action in young women after four weeks of ingesting high phosphorus, low calcium diets. J Clin Endocrinol Metab 70, 1334–1340.CrossRefGoogle ScholarPubMed
Calvo, MS & Park, YK (1996) Changing phosphorus content of the U.S. diet: potential for adverse effects on bone. J Nutr 126, 1168S–1180S.CrossRefGoogle ScholarPubMed
Chwojnowska, Z, Charzewska, J, Chabros, E, Wajszczyk, B, Rogalska-Niedswieds, M & Jarosz, B (2002) Contents of calcium and phosphorus in the diet of youth from Warsaw elementary schools. Rocz Panstw Zakl Hig 53, 157–165.Google ScholarPubMed
Comité de Nutrición de la Asociación Española de Pediatría (2003) Consumption of fruit juices and beverages by Spanish children and teenagers: health implications of their poor use and abuse. An Pediatr (Barc) 58, 584–593.Google Scholar
Dawson-Hughes, B, Harris, S, Kramich, C, Dallal, G & Rasmussen, HM (1993) Calcium retention and hormone levels in black and white women on high-and low-calcium diets. J Bone Miner Res 8, 779–787.CrossRefGoogle ScholarPubMed
Estepa, JC, Aguilera-Tejero, E, Lopez, I, Almaden, Y, Rodriguez, M & Felsenfeld, AJ (1999) Effect of phosphate on parathyroid hormone secretion in vivo. J Bone Miner Res 14, 1848–1854.CrossRefGoogle ScholarPubMed
Fernando, GR, Martha, RM & Evangelina, R (1999) Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in postmenopausal women. J Clin Epidemiol 52, 1007–1010.CrossRefGoogle ScholarPubMed
Garnero, P, Shih, WJ, Gineyts, E, Karpf, DB & Delmas, PD (1994) Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment. J Clin Endocrinol Metab 79, 1693–1700.Google ScholarPubMed
Giachelli, CM (2004) Vascular calcification mechanisms. J Am Soc Nephrol 15, 2959–2964.CrossRefGoogle ScholarPubMed
Gillet, P & Reginster, JY (1999) Increased number of hip fractures. Lancet 353, 2160–2161.CrossRefGoogle ScholarPubMed
Gregory, J, Foster, K, Tyler, H & Wiseman, M (1990) The Dietary and Nutritional Study of British Adults. London: HMSO.Google Scholar
Grimm, M, Muller, A, Hein, G, Funfstuck, R & Jahreis, G (2001) High phosphorus intake only slightly affects serum minerals, urinary pyridinium crosslinks and renal function in young women. Eur J Clin Nutr 55, 153–161.CrossRefGoogle ScholarPubMed
Gronowska-Senger, A & Kotanska, P (2004) Phosphorus intake in Poland in 1994–2000 (abstract). Rocz Panstw Zakl Hig 55, 39.Google Scholar
Harnack, L, Stang, J & Story, M (1999) Soft drink consumption among US children and adolescents: nutritional consequences. J Am Diet Assoc 99, 436–441.CrossRefGoogle ScholarPubMed
Heaney, RP (2004) Phosphorus nutrition and the treatment of osteoporosis. Mayo Clin Proc 79, 91–97.CrossRefGoogle ScholarPubMed
Heaney, RP & Nordin, BEC (2002) Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 21, 239–244.CrossRefGoogle ScholarPubMed
Hodsman, AB, Fraher, LJ, Ostbye, T, Adachi, JD & Steer, BM (1993) An evaluation of several biochemical markers on bone formation and resorption in a protocol utilizing cyclical parathyroid hormone and calcitonin therapy for osteoporosis. J Clin Invest 91, 1138–1148.CrossRefGoogle Scholar
Huttunen, M, Pietilä, P, Viljakainen, H & Lamberg-Allardt, C (2005) Prolonged increase in dietary phosphate intake retards bone mineralization in adult male rats. J Nutr Biochem, (Epublication ahead of print version)Google Scholar
Joffe, P, Ladefoged, SD, Cintin, C, Jensen, LT & Hyldstrup, L (1994) Acute effect of oral, intraperitoneal, intravenous 1α-hydroxycholecalsiferol on markers of bone metabolism. Nephrol Dial Transplant 9, 524–531.CrossRefGoogle ScholarPubMed
Jono, S, McKee, MD, Murry, CE, Shioi, A, Nishizawa, Y, Mori, K, Morii, H & Giachelli, CM (2000) Phosphate regulation of vascular smooth muscle cell calcification. Circ Res 87, E10–E17.CrossRefGoogle ScholarPubMed
Kannus, P, Niemi, S, Parkkari, J, Palvanen, M, Vuori, I & Järvinen, M (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353, 802–805.CrossRefGoogle ScholarPubMed
Kärkkäinen, M & Lamberg-Allardt, C (1996) An acute intake of phosphate increases parathyroid hormone secretion and inhibits bone formation in young women. J Bone Miner Res 11, 1905–1912.CrossRefGoogle ScholarPubMed
Kärkkäinen, MUM, Lamberg-Allardt, CJE, Ahonen, S & Välimäki, M (2001) Does it make a difference how and when you take your calcium? The acute effects of calcium on calcium and bone metabolism. Am J Clin Nutr 74, 335–342.CrossRefGoogle ScholarPubMed
Katsumata, S, Masuyama, R, Uehara, M & Kazuharu, S (2005) High phosphorus diet stimulates receptor activator of nuclear factor κB ligand mRNA expression by increasing parathyroid hormone secretion in rats. Br J Nutr 94, 666–674.CrossRefGoogle ScholarPubMed
Kramer, H (2005) Screening for kidney disease in adults with diabetes and prediabetes. Curr Opin Nephrol Hypertens 14, 249–252.CrossRefGoogle ScholarPubMed
Laakso, M (2005) Prevention of type 2 diabetes. Curr Mol Med 5, 365–374.CrossRefGoogle ScholarPubMed
Männistö, S, Ovaskainen, M-L & Valsta, L (2003) The National FIN-DIET 2002 Study. Kansanterveyslaitoksen julkaisuja B3/2003. Helsinki: National Public Health Institute.Google Scholar
Martin-Malo, A, Rodriguez, M, Martinez, ME, Torres, A & Felsenfeld, AJ (1996) The interaction of PTH and dietary phosphorus and calcium on serum calcitriol levels in the rat with experimental renal failure. Nephrol Dial Transplant 11, 1553–1558.CrossRefGoogle ScholarPubMed
Metz, JA, Anderson, JJ & Gallagher, PN Jr (1993) Intakes of calcium, phosphorus, and protein, and physical-activity level are related to radial bone mass in young adult women. Am J Clin Nutr 58, 537–542.CrossRefGoogle ScholarPubMed
Miyamoto, K, Tatsumi, S, Segawa, H, Morita, K, Nii, T, Fujioka, A, Kitano, M, Inoue, Y & Takeda, E (1999) Regulation of PiT-1, a sodium-dependent phosphate co-transporter in rat parathyroid glands. Nephrol Dial Transplant 14, Suppl. 1, S73–S75.CrossRefGoogle ScholarPubMed
Murer, H, Hernando, N, Forster, I & Biber, J (2000) Proximal tubular phosphate reabsorption: molecular mechanisms. Physiol Rev 80, 1373–1409.CrossRefGoogle ScholarPubMed
Nielsen, SJ & Popkin, BM (2004) Changes in beverage intake between 1977 and 2001. Am J Prev Med 27, 205–210.CrossRefGoogle ScholarPubMed
Portale, AA, Halloran, BP & Morris, RC Jr (1989) Physiologic regulation of the serum concentration of 1,25-dihydroxyvitamin D by phosphorus in normal men. J Clin Invest 83, 1494–1499.CrossRefGoogle Scholar
Portale, AA, Halloran, BP, Murphy, MM & Morris, RC (1986) Oral intake of phosphorus can determine the serum concentration of 1,25-dihydroxyvitamin D by determining its production rate in humans. J Clin Invest 77, 7–12.CrossRefGoogle Scholar
Rubinacci, A, Melzi, R, Zampino, M, Soldarini, A & Villa, I (1999) Total and free deoxypyridinoline after acute osteoclast activity inhibition. Clin Chem 45, 1510–1516.CrossRefGoogle ScholarPubMed
Sax, L (2001) The Institute of Medicine's ‘Dietary reference intake’ for phosphorus: a critical perspective. J Am Coll Nutr 20, 271–278.CrossRefGoogle ScholarPubMed
Silverberg, SJ, Shane, E, Clemens, TL, Dempster, DW, Segre, GV, Lindsay, R & Bilezikian, JP (1986) The effect of oral phosphate administration on major indices of skeletal metabolism in normal subjects. J Bone Miner Res 1, 383–388.CrossRefGoogle ScholarPubMed
Slatopolsky, E, Finch, J, Denda, M, Ritter, C, Zhong, M, Dusso, A, MacDonald, PN & Brown, AJ (1996) Phosphorus restriction prevents parathyroid gland growth. High phosphorus directly stimulates PTH secretion in vitro. J Clin Invest 97, 2534–2540.CrossRefGoogle ScholarPubMed
Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine, National Research Council (1997) Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press.Google Scholar
Takeda, E, Sakamoto, K, Yokota, K, Shinohara, M, Taketani, Y, Morita, K, Yamamoto, H, Miyamoto, K & Shibayama, M (2002) Phosphorus supply per capita from food in Japan between 1960 and 1995 (abstract). J Nutr Sci Vitaminol 48, 102.CrossRefGoogle Scholar
Takeda, E, Taketani, Y, Morita, K & Miyamoto, K (1999) Sodium-dependent phosphate co-transporters. Int J Biochem Cell Biol 31, 377–381.CrossRefGoogle ScholarPubMed
Urho, U-M & Hasunen, K (1999) Yläasteen kouluruokailu 1998. Sosiaali-ja terveysministeriön selvityksiä 1995:5. Helsinki: Edita.Google Scholar
Uribarri, J & Calvo, MS (2003) Hidden sources of phosphorus in the typical American diet: does it matter in nephrology? Semin Dial 16, 186–188.CrossRefGoogle ScholarPubMed
Weaver, CM & Heaney, RP (1999) Calcium. In Modern Nutrition in Health and Disease, 9th ed., pp. 141–155 [Shils, ME, Olson, JA, Shike, M and Ross, CA, editors]. Baltimore, MD: Williams & Wilkins.Google Scholar
Whybro, A, Jagger, H, Barker, M & Eastell, R (1998) Phosphate supplementation in young men: lack of effect on calcium homeostasis and bone turnover. Eur J Clin Nutr 52, 29–33.CrossRefGoogle ScholarPubMed
Wyshak, G (2000) Teenaged girls, carbonated beverage consumption, and bone fractures. Arch Pediatr Adolesc 154, 610–613.CrossRefGoogle ScholarPubMed
Yates, AJ, Oreffo, RO, Mayor, K & Mundy, GR (1991) Inhibition of bone resorption by inorganic phosphate is mediated by both reduced osteoclast formation and decreased activity of mature osteoclasts. J Bone Miner Res 6, 473–478.CrossRefGoogle ScholarPubMed