Table 1.
Effects of high phosphorus dietary interventions on bone metabolism in human subjects
| Study Characteristics | Effects of higher dietary P | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Ref | Subject Descript ion |
Phosphorus Form |
P intake level(s), mg/d |
Ca intak e level( s), mg/d |
Ca:P mass ratio( s) |
Interven tion Length |
Resorptio n Markers |
Formatio n Markers* |
Serum P & Ca |
PTH |
| Reiss et al. (1970) (45) | 5 men and women, 23–46 y | Sodium phosphate | + 1000(to baseline) | unknown | unknown | 2 hours | ↔ P ↓ Ca, iCa |
↑ | ||
| Bell et al. (1977) (66) | 8 men and women, 24–36 y | Additive substitutions from food | 979 2124 |
~ 700 ~ 700 |
0.7 0.33 |
4 weeks | ↑ hydroxyproline | ↑ P ↓ Ca |
N/A | |
| Zemel & Linkswiler (1981) (67) | 8 men, 18–24 y | Monobasic potassium phosphate (MP), polyphosphate (PP), sodium hexametaphosphate (SH), or orthophosphate (O) | Baseline: 835 +1000 (to baseline as O) +1000 as SH +1000 as MP) |
399 399 399 +800 |
0.48 0.22 0.22 0.65 |
15 days | ↔ hydroxyproline | |||
| Kuntz et al. (1986) (68) | 19 postmenopausal women with vertebral osteopenia | Glycerol phosphate/magnesium phosphate monobasic | + 0(to baseline) + 1500 |
6 months | ↔ hydroxyproline Histomorphometry ↔ osteoclastic resorption surface |
Histomorpho metry ↑ osteoblastic surface ↔ trabecular bone volume |
↔ P ↔ Ca |
↔ | ||
| Silverberg et al. (1986) (43) | 13 men and women, 19–36 y | Unknown supplement | + 2000(to baseline) | unknown | unknown | 5 days | ↔ hydroxyproline | ↑ osteocalcin | ↑ P ↓ Ca |
↑ |
| Calvo et al. (1988) (37) | 9 men and women, 18–25 y | Substitutions from food | ~ 1600 ~ 800 |
~ 400 ~ 800 |
0.25 1.0 |
24 hours | ↑ hydroxyproline | ↑ P ↔ Ca, iCa (men) ↓ Ca, iCa (women) |
↑ | |
| Calvo et al (1988) (46) | 16 men and women, 18–25 y | Sodium-potassium phosphate | + 1000(to baseline) + 1500 |
unknown | unknown | 5 hours | ↑ P (both) ↔ iCa (both) |
↔ (w/1g P) ↑ (w/1.5g P) |
||
| Calvo et al. (1990) (38) | 15 women, 18–25 y | Additive substitutions from food | ~ 900 ~ 1700 |
~ 800 ~ 400 |
0.9 0.24 |
4 weeks | ↔ hydroxyproline | ↔ ALP ↔ osteocalcin |
↔ P ↓ iCa |
↑ |
| Brixen et al. (1992) (35) | 79 women, 50–75 y, history of fracture | Ammonium phosphate/potassium phosphate/glycerol phosphate | + 0(to baseline) + 750 + 1500 + 2550 |
unknown | unknown | 7 days (follow-up until 4 months) | ↔ hydroxyproline | ↔ osteocalcin ↔ BALP |
↔ P ↔ Ca |
↑ |
| Kärkkäinen and Lamberg-Allardt (1996) (40) | 20 women, 21–34 y | Sodium phosphate | 878 2378 |
375 375 |
0.43 0.16 |
24 hours | ↔ ICTP ↔ DPD |
↓ PICP (single dose) ↔ PICP (3 doses spread out) ↔ osteocalcin ↓ BALP |
↑ P ↓ Ca (single dose) |
↑ |
| Whybro et al. (1998) (44) | 22 men, 19–38 y | Sodium acid phosphate/sodium bicarbonate/pot assium bicarbonate | Exp1: ~800, 1800 Exp2: ~1000, 2000, 2500, 3000 |
Exp1: ~800 Exp2: ~1000 |
Exp 1: 1.0, 0.44 Exp 2: 1.0, 0.5, 0.4, 0.33 |
1 week | ↔ DPD (Exp 2) ↔ NTX (Exp 1) |
↔ osteocalcin (Exp 1) | ↔ P ↔ Ca |
↑ (Exp 1) ↔ (Exp 2, highest vs lowest P) |
| Grimm et al. (2001) (39) | 10 women, 23–29 y | Sodium polyphosphates | 1700 3008 |
1500 1995 |
0.88 0.66 |
4 weeks | ↔ DPD ↔ PYD |
↔ osteocalcin | ↔ P ↔ Ca |
↑ |
| Ferrari et al. (2005) (47) | 29 men, 20.7–38.6 y | Potassium-phosphorus syrup | 540 2860 |
590 1660 |
1.09 0.58 |
5 days | ↔ P ↔ Ca, iCa |
↔ (also higher Ca) | ||
| Burnett et al. (2006) (36) | 66 men and women, 28±8 and 26±7 y | Sodium and potassium phosphate | 500 (+ P binders) 2500 | 1000 1000 |
2.0 0.4 |
4 days | ↔ P ↔ Ca |
↑ | ||
| Antoniucci et al. (2006) (34) | 13 men, 28–43 y | Sodium and potassium phosphate | 625 2300 |
850 850 |
1.36 0.40 |
9 days | ↔ P ↔ Ca |
↑ | ||
| Kemi et al. (2006) (42) | 14 women, 20–28 y | Disodium and trisodium phosphate | 495 745 1245 1995 |
990 990 990 990 |
0.51 0.34 0.20 0.13 |
4 weeks | ↑ NTX | ↓ BALP | ↑ P ↓ iCa (highest dose) |
↑ |
| Karp et al. (2007) (41) | 16 women, 20–30 y | Meat, cheese, whole grains | 484 (control) 1435 (meat) 1509 (whole grains) 1624 (cheese) 1458 (supplement) |
235 274 352 2044 246 |
0.49 0.19 0.23 1.26 0.17 |
24 hours | ↑ NTX (meat, whole grain), ↓ (cheese) | ↔ BALP | ↑ P (all vs control) ↑ iCa (cheese), ↓ supplement |
↓ (w/cheese) ↑ (w/supplement) |
| Kemi et al. (2008) (69) | 12 women, 21–40 y | Calcium carbonate | 1850 1850 1850 |
480 1080 1680 |
0.26 0.58 0.91 |
24 hours | ↑ NTX (with lower Ca:P) | ↔ BALP | ↔ P ↓ iCa (with lower Ca:P) ↔ Ca |
↑ (with lower Ca:P) |
| Vervloet et al. (2011) (48) | 10 men and women, 23.5±1.6 y | Substitutions from food | 850 2880 |
280 1700 |
0.33 0.59 |
36 hours | ↑ P | ↓ (also high Ca) | ||
| Sigrist et al. (2013) (70) | 30 men and women Healthy: 31–48 y CKD: 57–77 y |
Substitutions from food | 750 (+ P binder) 750 2000 |
unknown | unknown | 7 days | ↑ P ↔ Ca |
↔ | ||
| Gutiérrez et al. (2015) (65) | 10 men and women, 31±9 y | Additive substitutions from food | ~ 1000 ~ 1600 |
~ 700 ~ 700 |
0.7 0.44 |
1 week | ↔ CTX Also: ↑ osteopontin |
↓ P1NP (p = 0.06) ↑ osteocalcin Also: ↓ sclerostin |
↔ P ↔ Ca |
↔ |
*
osteocalcin is included in the formation marker column, but is generally considered a marker of overall bone turnover, rather than specific to formation.