Dietary phosphorus intake is negatively associated with bone formation among women and positively associated with some bone traits among men—a cross-sectional study in middle-aged Caucasians

• Published in: Nutrition research (New York, N.Y.) N.Y.), 2017-01, Vol.37, p.58-66
• Main Authors: Itkonen, Suvi T, Rita, Hannu J, Saarnio, Elisa M, Kemi, Virpi E, Karp, Heini J, Kärkkäinen, Merja U.M, Pekkinen, Minna H, Laitinen, E. Kalevi, Risteli, Juha, Koivula, Marja-Kaisa, Sievänen, Harri, Lamberg-Allardt, Christel J.E
• Format: Article
• Language: English
• Subjects: Adult; Bone and Bones - drug effects; Bone and Bones - metabolism; Bone Density; Bone mineral density; Bone Remodeling - drug effects; Bone turnover markers; Calcium; Calcium, Dietary - administration & dosage; Calcium, Dietary - pharmacology; Collagen Type I - blood; Cross-Sectional Studies; Cross-sectional study; Energy Intake; European Continental Ancestry Group; Feeding Behavior; Female; Finland; Gastroenterology and Hepatology; Humans; Male; Middle Aged; Models, Biological; Osteogenesis - drug effects; Osteoporosis; Peripheral quantitative computed tomography; Phosphorus; Phosphorus, Dietary - adverse effects; Phosphorus, Dietary - pharmacology; Premenopause; Radius - drug effects; Radius - metabolism; Sex Factors; Tibia - drug effects; Tibia - metabolism; Vitamin D - analogs & derivatives; Vitamin D - blood
• ISSN: 0271-5317; 1879-0739
• DOI: 10.1016/j.nutres.2016.12.009

Abstract High dietary phosphorus (P) intake has acute negative effects on calcium (Ca) and bone metabolism, but long-term clinical data are contradictory. We hypothesized that high P intake is associated with impaired bone health as suggested by earlier short-term studies on bone metabolism. In this cross-sectional study, we investigated associations between dietary P intake, bone traits in the radius and tibia, and bone turnover in a population-based sample of 37- to 47-year-old Caucasian premenopausal women (n = 333) and men (n = 179) living in Southern Finland (60°N). We used various regression models in an “elaboration approach” to elucidate the role of P intake in bone traits and turnover. The addition of relevant covariates to the models mainly removed the significance of P intake as a determinant of bone traits. In the final regression model (P intake, weight, height, age, Ca intake, serum 25-hydroxyvitamin D, physical activity, smoking, contraceptive use in women), P intake was slightly positively associated only with bone mineral content and cross-sectional cortical bone area in the tibia of men. Among women, inclusion of Ca removed all existing significance in the crude models for any bone trait. In women P intake was negatively associated with the bone formation marker serum intact pro–collagen type I amino-terminal propeptide, whereas no association was present between P intake and bone turnover in men. In conclusion, these findings disagree with the hypothesis; P intake was not deleteriously associated with bone traits; however, P intake may negatively contribute to bone formation among women.