Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status?

David E. St-Jules, Kathleen Woolf, Mary Lou Pompeii, Kamyar Kalantar-Zadeh, Mary Ann Sevick

Research output: Contribution to journalArticle

Abstract

Dietary phosphorus restriction is recommended to help control hyperphosphatemia in hemodialysis patients, but many high-phosphorus foods are important sources of protein. In this review, we examine whether restricting dietary phosphorus compromises protein status in hemodialysis patients. Although dietary phosphorus and protein are highly correlated, phosphorus intakes can range up to 600 mg/day for a given energy and protein intake level. Furthermore, the collinearity of phosphorus and protein may be biased because the phosphorus burden of food depends on: (1) the presence of phosphate additives, (2) food preparation method, and (3) bioavailability of phosphorus, which are often unaccounted for in nutrition assessments. Ultimately, we argue that clinically relevant reductions in phosphorus intake can be made without limiting protein intake by avoiding phosphate additives in processed foods, using wet cooking methods such as boiling, and if needed, substituting high-phosphorus foods for nutritionally equivalent foods that are lower in bioavailable phosphorus.

Original languageEnglish (US)
Pages (from-to)136-140
Number of pages5
JournalJournal of Renal Nutrition
Volume26
Issue number3
DOIs
StatePublished - May 1 2016

Fingerprint

Phosphorus
Dietary Phosphorus
Proteins
Food
Renal Dialysis
Phosphates
Hyperphosphatemia
Food Additives
Nutrition Assessment
Dietary Proteins
Cooking
Energy Intake
Biological Availability

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

Reexamining the Phosphorus-Protein Dilemma : Does Phosphorus Restriction Compromise Protein Status? / St-Jules, David E.; Woolf, Kathleen; Pompeii, Mary Lou; Kalantar-Zadeh, Kamyar; Sevick, Mary Ann.

In: Journal of Renal Nutrition, Vol. 26, No. 3, 01.05.2016, p. 136-140.

Research output: Contribution to journalArticle

St-Jules, David E. ; Woolf, Kathleen ; Pompeii, Mary Lou ; Kalantar-Zadeh, Kamyar ; Sevick, Mary Ann. / Reexamining the Phosphorus-Protein Dilemma : Does Phosphorus Restriction Compromise Protein Status?. In: Journal of Renal Nutrition. 2016 ; Vol. 26, No. 3. pp. 136-140.
@article{ecdde768bbfc475a8a977160dc1f1943,
title = "Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status?",
abstract = "Dietary phosphorus restriction is recommended to help control hyperphosphatemia in hemodialysis patients, but many high-phosphorus foods are important sources of protein. In this review, we examine whether restricting dietary phosphorus compromises protein status in hemodialysis patients. Although dietary phosphorus and protein are highly correlated, phosphorus intakes can range up to 600 mg/day for a given energy and protein intake level. Furthermore, the collinearity of phosphorus and protein may be biased because the phosphorus burden of food depends on: (1) the presence of phosphate additives, (2) food preparation method, and (3) bioavailability of phosphorus, which are often unaccounted for in nutrition assessments. Ultimately, we argue that clinically relevant reductions in phosphorus intake can be made without limiting protein intake by avoiding phosphate additives in processed foods, using wet cooking methods such as boiling, and if needed, substituting high-phosphorus foods for nutritionally equivalent foods that are lower in bioavailable phosphorus.",
author = "St-Jules, {David E.} and Kathleen Woolf and Pompeii, {Mary Lou} and Kamyar Kalantar-Zadeh and Sevick, {Mary Ann}",
year = "2016",
month = "5",
day = "1",
doi = "10.1053/j.jrn.2015.12.004",
language = "English (US)",
volume = "26",
pages = "136--140",
journal = "Journal of Renal Nutrition",
issn = "1051-2276",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Reexamining the Phosphorus-Protein Dilemma

T2 - Does Phosphorus Restriction Compromise Protein Status?

AU - St-Jules, David E.

AU - Woolf, Kathleen

AU - Pompeii, Mary Lou

AU - Kalantar-Zadeh, Kamyar

AU - Sevick, Mary Ann

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Dietary phosphorus restriction is recommended to help control hyperphosphatemia in hemodialysis patients, but many high-phosphorus foods are important sources of protein. In this review, we examine whether restricting dietary phosphorus compromises protein status in hemodialysis patients. Although dietary phosphorus and protein are highly correlated, phosphorus intakes can range up to 600 mg/day for a given energy and protein intake level. Furthermore, the collinearity of phosphorus and protein may be biased because the phosphorus burden of food depends on: (1) the presence of phosphate additives, (2) food preparation method, and (3) bioavailability of phosphorus, which are often unaccounted for in nutrition assessments. Ultimately, we argue that clinically relevant reductions in phosphorus intake can be made without limiting protein intake by avoiding phosphate additives in processed foods, using wet cooking methods such as boiling, and if needed, substituting high-phosphorus foods for nutritionally equivalent foods that are lower in bioavailable phosphorus.

AB - Dietary phosphorus restriction is recommended to help control hyperphosphatemia in hemodialysis patients, but many high-phosphorus foods are important sources of protein. In this review, we examine whether restricting dietary phosphorus compromises protein status in hemodialysis patients. Although dietary phosphorus and protein are highly correlated, phosphorus intakes can range up to 600 mg/day for a given energy and protein intake level. Furthermore, the collinearity of phosphorus and protein may be biased because the phosphorus burden of food depends on: (1) the presence of phosphate additives, (2) food preparation method, and (3) bioavailability of phosphorus, which are often unaccounted for in nutrition assessments. Ultimately, we argue that clinically relevant reductions in phosphorus intake can be made without limiting protein intake by avoiding phosphate additives in processed foods, using wet cooking methods such as boiling, and if needed, substituting high-phosphorus foods for nutritionally equivalent foods that are lower in bioavailable phosphorus.

UR - http://www.scopus.com/inward/record.url?scp=84957921687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957921687&partnerID=8YFLogxK

U2 - 10.1053/j.jrn.2015.12.004

DO - 10.1053/j.jrn.2015.12.004

M3 - Article

VL - 26

SP - 136

EP - 140

JO - Journal of Renal Nutrition

JF - Journal of Renal Nutrition

SN - 1051-2276

IS - 3

ER -