Yoko Narasaki1, Michiyo Yamasaki2, Sayaka Matsuura2, Mayumi Morinishi2, Tomomi Nakagawa2, Mami Matsuno2, Misaki Katsumoto2, Sachi Nii2, Yuka Fushitani2, Kohei Sugihara2, Tsuneyuki Noda3, Takeshi Yoneda3, Masashi Masuda2, Hisami Yamanaka-Okumura2, Eiji Takeda2, Hiroshi Sakaue4, Hironori Yamamoto5, Yutaka Taketani6. 1. Department of Clinical Nutrition and Food Management, Tokushima University Graduate School of Nutrition and Biosciences, Tokushima, Japan; Japan Society for the Promotion of Science, Tokyo, Japan. 2. Department of Clinical Nutrition and Food Management, Tokushima University Graduate School of Nutrition and Biosciences, Tokushima, Japan. 3. Saga Nutraceuticals Research Institute, Otsuka Pharmaceutical Co., Ltd., Yoshinogari, Saga, Japan. 4. Department of Nutrition and Metabolism, Tokushima University Graduate School of Nutrition and Biosciences, Tokushima, Japan. 5. Jin-ai University, Echizen, Fukui, Japan. 6. Department of Clinical Nutrition and Food Management, Tokushima University Graduate School of Nutrition and Biosciences, Tokushima, Japan. Electronic address: taketani@tokushima-u.ac.jp.
Abstract
OBJECTIVE: Dietary phosphorus (P) restriction is crucial to treat hyperphosphatemia and reduce cardiovascular disease risk and mortality in patients with chronic kidney disease (CKD) and the wider population. Various methods for dietary P restriction exist, but the bioavailability of P in food should also be considered when making appropriate food choices to maintain patients' quality of life. Here, we propose the "Phosphatemic Index" (PI) as a novel tool for evaluating dietary P load based on P bioavailability; we also evaluated the effect of continuous intake of different PI foods in mixed meals on serum intact fibroblast growth factor 23 concentration. DESIGN AND METHODS: A 2-stage crossover study was conducted: Study 1: 20 healthy participants consumed 10 different foods containing 200 mg of P, and the PI was calculated from the area under the curve of a time versus serum P concentration curve; Study 2: 10 healthy participants consumed 4 different test meals (low, medium, or high PI meals or a control) over a 5-day period. RESULTS: Study 1 showed milk and dairy products had high PI values, pork and ham had medium PI values, and soy and tofu had low PI values. In Study 2, ingestion of high PI test meals showed higher fasting serum intact fibroblast growth factor 23 levels and lower serum 1,25-dihydroxyvitamin D levels compared with ingestion of low PI test meals. CONCLUSION: These findings suggest that the PI can usefully evaluate the dietary P load of various foods and may help to make appropriate food choices for dietary P restriction in CKD patients.
OBJECTIVE: Dietary phosphorus (P) restriction is crucial to treat hyperphosphatemia and reduce cardiovascular disease risk and mortality in patients with chronic kidney disease (CKD) and the wider population. Various methods for dietary P restriction exist, but the bioavailability of P in food should also be considered when making appropriate food choices to maintain patients' quality of life. Here, we propose the "Phosphatemic Index" (PI) as a novel tool for evaluating dietary P load based on P bioavailability; we also evaluated the effect of continuous intake of different PI foods in mixed meals on serum intact fibroblast growth factor 23 concentration. DESIGN AND METHODS: A 2-stage crossover study was conducted: Study 1: 20 healthy participants consumed 10 different foods containing 200 mg of P, and the PI was calculated from the area under the curve of a time versus serum P concentration curve; Study 2: 10 healthy participants consumed 4 different test meals (low, medium, or high PI meals or a control) over a 5-day period. RESULTS: Study 1 showed milk and dairy products had high PI values, pork and ham had medium PI values, and soy and tofu had low PI values. In Study 2, ingestion of high PI test meals showed higher fasting serum intact fibroblast growth factor 23 levels and lower serum 1,25-dihydroxyvitamin D levels compared with ingestion of low PI test meals. CONCLUSION: These findings suggest that the PI can usefully evaluate the dietary P load of various foods and may help to make appropriate food choices for dietary P restriction in CKDpatients.
Authors: Yoko Narasaki; Amy S You; Shaista Malik; Linda W Moore; Rachelle Bross; Mackenzie K Cervantes; Andrea Daza; Csaba P Kovesdy; Danh V Nguyen; Kamyar Kalantar-Zadeh; Connie M Rhee Journal: Am J Clin Nutr Date: 2022-10-06 Impact factor: 8.472
Authors: Valerie K Sullivan; Lawrence J Appel; Jesse C Seegmiller; Scott T McClure; Casey M Rebholz Journal: J Nutr Date: 2021-10-01 Impact factor: 4.687