TY - JOUR
T1 - The percentage of dietary phosphorus excreted in the urine varies by dietary pattern in a randomized feeding study in adults
AU - McClure, Scott T.
AU - Rebholz, Casey M.
AU - Phillips, Katherine M.
AU - Champagne, Catherine M.
AU - Selvin, Elizabeth
AU - Appel, Lawrence J.
N1 - Funding Information:
STM was supported by the NIH/National Heart, Lung & Blood Institute grant T32 HL007024 and a grant from the Johns Hopkins School of Public Health Department of Epidemiology Doctoral Research Fund. CMR was supported by a Mentored Research Scientist Development Award from the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK107782). ES was supported by NIH/NIDDK grant K24DK106414. Author disclosures: STM, CMR, KMP, CMC, ES, and LJA, no conflicts of interest. Supplemental Figures 1 and 2 and Supplemental Tables 1–4 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. Address correspondence to LJA (E-mail: lappel@jhmi.edu). Abbreviations used: DASH, Dietary Approaches to Stop Hypertension; FV, fruits and vegetables; MENu, Moore’s Extended Nutrient database.
Publisher Copyright:
Copyright © American Society for Nutrition 2019. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: Urinary phosphorus excretion has been proposed as a recovery biomarker of dietary phosphorus intake. However, it is unclear whether phosphorus excretion is constant across a range of dietary and nondietary factors. Objective: We assessed whether percentage urinary phosphorus excretion is constant across 3 dietary patterns in the Dietary Approaches to Stop Hypertension (DASH) trial. Methods: DASH is a completed feeding study of 459 prehypertensive and stage 1 hypertensive adults (52% male, 56% black). After a 3-wk run-in on a typical American (control) diet, participants were randomly assigned to the control diet, a diet rich in fruits and vegetables (FV diet), or a diet rich in fruits, vegetables, and low-fat dairy with reduced saturated fat and cholesterol (DASH diet) for 8 wk. We estimated the percentage phosphorus excretion as urinary phosphorus excretion (from 24 h urine) divided by phosphorus intake (from analyzed food composites). Differences between group means for all 3 diets were compared by ANOVA followed by pairwise comparisons with Tukey’s honest significant difference test. Results: At the end of the intervention, the mean phosphorus intake was 1176 mg/d (95% CI: 1119, 1233 mg/d), 1408 mg/d (1352, 1464 mg/d), and 2051 mg/d (1994, 2107 mg/d) in the control, FV, and DASH diet, respectively (P < 0.001, all comparisons). The mean phosphorus excretion was 734 mg/d (682, 787 mg/d), 705 mg/d (654, 756 mg/d), and 872 mg/d (820, 923 mg/d) in the control, FV, and DASH diet, respectively (P = 0.74 control vs. FV, P < 0.001 all other comparisons). The mean percentage phosphorus excretion was 63% (60%, 67%), 51% (48%, 54%), and 43% (39%, 46%) in the control, FV, and DASH diet, respectively (P < 0.001, all comparisons). Conclusions: These findings in prehypertensive and stage 1 hypertensive adults strongly suggest that urinary phosphorus excretion should not be used as a recovery biomarker for dietary phosphorus intake, given the wide range of urinary phosphorus excretion across dietary patterns. This trial is registered at clinicaltrials.gov as NCT0000054.
AB - Background: Urinary phosphorus excretion has been proposed as a recovery biomarker of dietary phosphorus intake. However, it is unclear whether phosphorus excretion is constant across a range of dietary and nondietary factors. Objective: We assessed whether percentage urinary phosphorus excretion is constant across 3 dietary patterns in the Dietary Approaches to Stop Hypertension (DASH) trial. Methods: DASH is a completed feeding study of 459 prehypertensive and stage 1 hypertensive adults (52% male, 56% black). After a 3-wk run-in on a typical American (control) diet, participants were randomly assigned to the control diet, a diet rich in fruits and vegetables (FV diet), or a diet rich in fruits, vegetables, and low-fat dairy with reduced saturated fat and cholesterol (DASH diet) for 8 wk. We estimated the percentage phosphorus excretion as urinary phosphorus excretion (from 24 h urine) divided by phosphorus intake (from analyzed food composites). Differences between group means for all 3 diets were compared by ANOVA followed by pairwise comparisons with Tukey’s honest significant difference test. Results: At the end of the intervention, the mean phosphorus intake was 1176 mg/d (95% CI: 1119, 1233 mg/d), 1408 mg/d (1352, 1464 mg/d), and 2051 mg/d (1994, 2107 mg/d) in the control, FV, and DASH diet, respectively (P < 0.001, all comparisons). The mean phosphorus excretion was 734 mg/d (682, 787 mg/d), 705 mg/d (654, 756 mg/d), and 872 mg/d (820, 923 mg/d) in the control, FV, and DASH diet, respectively (P = 0.74 control vs. FV, P < 0.001 all other comparisons). The mean percentage phosphorus excretion was 63% (60%, 67%), 51% (48%, 54%), and 43% (39%, 46%) in the control, FV, and DASH diet, respectively (P < 0.001, all comparisons). Conclusions: These findings in prehypertensive and stage 1 hypertensive adults strongly suggest that urinary phosphorus excretion should not be used as a recovery biomarker for dietary phosphorus intake, given the wide range of urinary phosphorus excretion across dietary patterns. This trial is registered at clinicaltrials.gov as NCT0000054.
KW - Diet
KW - Feeding study
KW - Phosphorus
KW - Randomized trial
KW - Recovery biomarkers
KW - Urinary excretion
UR - http://www.scopus.com/inward/record.url?scp=85065555816&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065555816&partnerID=8YFLogxK
U2 - 10.1093/jn/nxy318
DO - 10.1093/jn/nxy318
M3 - Article
C2 - 31034014
AN - SCOPUS:85065555816
SN - 0022-3166
VL - 149
SP - 816
EP - 823
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 5
ER -