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Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status?
J Ren Nutr. 2016 05; 26(3):136-40.JR

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.

Authors+Show Affiliations

Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, NY. Electronic address: davidstjules@gmail.com.Department of Nutrition, Food Studies, and Public Health, New York University Steinhardt, New York, NY.Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, NY.Division of Nephrology and Hypertension, Department of Medicine, University of California, Irvine, Irvine, CA.Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, NY.

Pub Type(s)

Journal Article
Review
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26873260

Citation

St-Jules, David E., et al. "Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status?" Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 26, no. 3, 2016, pp. 136-40.
St-Jules DE, Woolf K, Pompeii ML, et al. Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status? J Ren Nutr. 2016;26(3):136-40.
St-Jules, D. E., Woolf, K., Pompeii, M. L., Kalantar-Zadeh, K., & Sevick, M. A. (2016). Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status? Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 26(3), 136-40. https://doi.org/10.1053/j.jrn.2015.12.004
St-Jules DE, et al. Reexamining the Phosphorus-Protein Dilemma: Does Phosphorus Restriction Compromise Protein Status. J Ren Nutr. 2016;26(3):136-40. PubMed PMID: 26873260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reexamining the Phosphorus-Protein Dilemma: 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, Y1 - 2016/02/09/ PY - 2015/07/03/received PY - 2015/11/23/revised PY - 2015/12/16/accepted PY - 2016/2/14/entrez PY - 2016/2/14/pubmed PY - 2018/1/24/medline SP - 136 EP - 40 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 26 IS - 3 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. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/26873260/Reexamining_the_Phosphorus_Protein_Dilemma:_Does_Phosphorus_Restriction_Compromise_Protein_Status L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(15)00222-8 DB - PRIME DP - Unbound Medicine ER -