Consequences of Phosphate Additives on Cardiovascular Health:
There is a booming medical concern about the safety of phosphate additives, which is quite justified. Regarding cardiovascular health, the emphasis has traditionally been on cholesterol as a major cause. However, recent discussions and research within the medical community have revealed the potential health risks associated with phosphate additives and predicted that phosphate additives will be the next taboo thing.
It is unnecessary to reduce the content of natural phosphate, such as organic esters, in food because this form of phosphate is not fully absorbed, and restricting its intake may even lead to protein malnutrition. Conversely, inorganic phosphate found in food additives is efficiently absorbed and can significantly elevate serum phosphate levels, especially in advanced chronic kidney disease (CKD) patients.
A study conducted by the National Center for Biotechnology Information indicates that your body absorbs approximately 90% of phosphate additives, while only 40 to 60% of naturally occurring phosphorus in foods gets absorbed. This shows the importance of actively monitoring and controlling the intake of inorganic phosphorus from additives.
Phosphorus is a vital mineral present in every cell of your body. It is predominantly present in the bones, teeth, and genetic material. Its essential role involves facilitating energy production and supporting various processes within the body such as cellular repair, bone health, muscle contraction, and nerve function.
Your daily phosphorus need depends on your age and health condition. Ideally, adults and the elderly need 700 mg of phosphorus per day. People with lower socioeconomic status often consume more processed and fast food so they’re prone to ingesting foods with added phosphate. The primary pathophysiological consequence of phosphate is vascular damage, including endothelial dysfunction and vascular calcification. Alongside the attention given to the quality of phosphate in the diet, it is recommended that normal people and patients with advanced renal failure limit their phosphate intake to no more than 1000 mg per day, as stipulated by guidelines.
Cholesterol Vs. Phosphate:
Cholesterol is a fatty substance crucial for the body's normal functioning. It plays a vital role in building cell membranes, producing hormones, and aiding in the digestion of fats. However, abnormally high levels of cholesterol in the blood, particularly low-density lipoprotein (LDL) cholesterol cause cardiovascular diseases such as heart attacks and strokes. Dietary choices, genetic factors, and lifestyle habits can contribute to high cholesterol levels. While cholesterol remains a prominent concern, the role of phosphate additives in cardiovascular health is often underestimated. The excessive intake of inorganic phosphorus, often in the form of additives in processed foods and other dairy products, may pose serious health risks. People are often unaware of the significant amounts of inorganic phosphorus present in everyday items. Toothpaste, canned tuna, coffee creamers, sausages, processed meat, baked goods, cola drinks, soft drinks, and certain supplements increase your daily phosphorus intake.
Unlike organic phosphorus found in whole foods, inorganic phosphorus is rapidly absorbed by the body, potentially disrupting the delicate balance of minerals and electrolytes. Some types of phosphate additives are dicalcium phosphate, disodium phosphate, monosodium phosphate, phosphoric acid, trisodium phosphate, sodium hexametaphosphate, sodium tripolyphosphate, and tetrasodium pyrophosphate.
Trisodium phosphate and other sodium phosphate additives are the most commonly used among all. These additives help to reduce acidity and increase the texture of various foods, including baked goods and meats. In baking, they help to improve the structural integrity of the dough.
For instance, trisodium phosphate is a widely used ingredient in store-bought bread, cakes, muffins, and cake mixes to add fluffiness and height to these products. Furthermore, sodium phosphate additives balance pH levels in foods to prevent excessive acidity or alkalinity that could accelerate spoilage.
A study found that sodium phosphate additives can impact health differently than naturally occurring phosphate. This is because it’s absorbed differently by your body. According to the abstract, high levels of phosphate may increase mortality rates for the general public, as well as for those with chronic kidney disease and cardiovascular disease. Researchers linked high phosphate levels to premature aging and vascular damage. The researchers recommended eating foods with naturally occurring phosphates instead of food with added sodium phosphate.
Some athletes take sodium phosphate as a supplement to boost their strength and performance. However, a study, reported in the International Journal of Sport Nutrition and Exercise Metabolism, revealed that supplementation with sodium phosphate does not improve aerobic ability in athletes. Nausea, dizziness, seizures, headache, bloating, reduced urine, and abdominal pain are common side effects of sodium phosphate additives.
Cardiovascular Risks Associated with Phosphate Additives:
Research suggests that high levels of inorganic phosphorus may contribute to vascular calcification. Vascular calcification is a process where calcium deposits accumulate in the arteries, leading to arterial stiffness, atherosclerosis, blood clots, and increased cardiovascular collapse risk. Additionally, excessive phosphorus intake may disrupt the balance of other minerals, such as calcium and magnesium which are important for heart health. Studies have linked high levels of phosphate with health conditions such as heart disease, decreased bone density, premature aging, kidney issues, and even early death. Though everyone should avoid foods having phosphate additives, people with certain medical conditions are at higher risk such as people with kidney disease or renal failure, those with osteoporosis, osteopenia, heart conditions, and inflammatory bowel disease.
Managing Phosphate Intake:
Maintaining cardiovascular health involves a comprehensive approach that includes managing both cholesterol and phosphate intake. While it's crucial to be mindful of cholesterol-rich foods and adopt heart-healthy dietary habits, you should also pay attention to the phosphorus content in processed products and supplements. Reading food labels, choosing whole foods over processed alternatives, and discussing concerns with healthcare professionals can help create a balanced approach to cardiovascular well-being.
Conclusion:
In conclusion, phosphate accumulation produces detrimental effects on your cardiovascular system resulting in poor health outcomes. These effects are not limited to people with specific health conditions, instead, everyone can become the victim. The worst part is that the accumulation of phosphate occurs long before the rise in serum phosphate above the normal range. A high phosphate diet can increase serum phosphate and FGF-23. FGF-23 or Fibroblast growth factor 23 is a protein and member of the fibroblast growth factor family that participates in the regulation of phosphate in blood plasma and vitamin D metabolism. FGF-23 has a direct effect on cardiac myocytes and leads to myocardial hypertrophy. Increased extracellular phosphate is toxic to endothelial cells, and promotes the formation of CPPs which is chronic prostatitis. It also induces VSMC (cellular components of blood vessels) transformation to osteogenic phenotype. So avoiding phosphate additive-containing foods is a must for every person of any age or health condition.’
References:
Foley RN, et al. Serum phosphorus levels associated with coronary atherosclerosis in young adults. JASN. 2009;20:397–404. [PMC free article] [PubMed] [Google Scholar]
Dhingra R, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007;167:879–885. [PubMed] [Google Scholar]
Tonelli M, et al. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005;112:2627–2633. [PubMed] [Google Scholar]
Gutierrez OM, et al. Low socioeconomic status is associated with higher serum phosphate irrespective of race. JASN. 2010;21:1953–1960. [PMC free article] [PubMed] [Google Scholar]
Berndt T, Kumar R. Novel mechanisms in the regulation of phosphorus homeostasis. Physiology (Bethesda) 2009;24:17–25. [PMC free article] [PubMed] [Google Scholar]
Liu S, Quarles LD. How fibroblast growth factor 23 works. JASN. 2007;18:1637–1647. [PubMed] [Google Scholar]