Skip to main content
×
Home
    • Aa
    • Aa

Increased calcium intake does not completely counteract the effects of increased phosphorus intake on bone: an acute dose–response study in healthy females

  • Virpi E. Kemi (a1), Merja U. M. Kärkkäinen (a1), Heini J. Karp (a1), Kalevi A. E. Laitinen (a2) and Christel J. E. Lamberg-Allardt (a1)...
Abstract

A high dietary P intake is suggested to have negative effects on bone through increased parathyroid hormone secretion, as high serum parathyroid hormone (S-PTH) concentration increases bone resorption. In many countries the P intake is 2- to 3-fold above dietary guidelines, whereas Ca intake is too low. This combination may not be optimal for bone health. In a previous controlled study, we found that dietary P dose-dependently increased S-PTH and bone resorption and decreased bone formation. The aim of the present study was to investigate the dose–response effects of Ca intake on Ca and bone metabolism with a dietary P intake higher than recommended. Each of the twelve healthy female subjects aged 21–40 years attended three 24-h study sessions, which were randomized with regard to a Ca dose of 0 (control day), 600 or 1200 mg, and each subject served as her own control. The meals on each study day provided 1850 mg P and 480 mg Ca. S-PTH concentration decreased (P < 0·001) and serum ionized Ca concentration increased (P < 0·001) with increasing Ca doses. The bone formation marker, serum bone-specific alkaline phosphatase, did not differ significantly (P = 0·4). By contrast, the bone resorption marker, urinary N-terminal telopeptide of collagen type I, decreased significantly with both Ca doses (P = 0·008). When P intake was above current recommendations, increased Ca intake was beneficial for bone, as indicated by decreased S-PTH concentration and bone resorption. However, not even a high Ca intake could affect bone formation when P intake was excessive.

Copyright
Corresponding author
*Corresponding author: Dr Christel Lamberg-Allardt, fax +358 9 19158269, email christel.lamberg-allardt@helsinki.fi
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1O Johnell (1997) The socioeconomic burden of fractures: today and in the 21st century. Am J Med 103, 2025S.

2P Kannus , S Niemi , J Parkkari , M Palvanen , I Vuori & M Järvinen (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353, 802805.

4M Kärkkäinen & C Lamberg-Allardt (1996) An acute intake of phosphate increases parathyroid hormone secretion and inhibits bone formation in young women. J Bone Miner Res 11, 19051912.

5MS Calvo , R Kumar & H Heath III (1988) Elevated secretion and action of serum parathyroid hormone in young adults consuming high phosphorus, low calcium diets assembled from common foods. J Clin Endocrinol Metab 66, 823829.

6MS Calvo , R Kumar & H Heath III (1990) Persistently elevated parathyroid hormone secretion and action in young women after four weeks of ingesting high phosphorus, low calcium diets. J Clin Endocrinol Metab 70, 13341340.

11E Takeda , K Sakamoto , K Yokota , M Shinohara , Y Taketani , K Morita , H Yamamoto , K Miyamoto & M Shibayama (2002) Phosphorus supply per capita from food in Japan between 1960 and 1995. J Nutr Sci Vitaminol 48, 102(abstract).

16J Uribarri & MS Calvo (2003) Hidden sources of phosphorus in the typical American diet: does it matter in nephrology? Semin Dial 16, 186–188.

17RP Heaney (1993) Nutritional factors in osteoporosis. Ann Rev Nutr 13, 287316.

19B Shea , G Wells , A Cranney , N Zytaruk , V Robinson , L Griffith , Z Ortiz , J Peterson , J Adachi , P Tugwell & G Guyatt (2002) Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev 23, 552–559.

20SJ Whiting & RJ Wood (1997) Adverse effects of high-calcium diets in humans. Nutr Rev 55, 1–9.

21RP Heaney , K Rafferty , MS Dowell & J Bierman (2005) Calcium fortification system differ in bioavailability. J Am Diet Assoc 105, 807809.

22SH Kim , JH Han , QY Zhu & CL Keen (2003) Use of vitamins, minerals, and other dietary supplements by 17- and 18-year-old students in Korea. J Med Food 6, 27–42 (abstract).

23K Radimer , B Bindewald , J Hughes , B Ervin , C Swanson & MF Picciano (2004) Dietary supplements use by US adults: Data from the National Health and Nutrition Examination Survey, 1999-2000. Am J Epidemiol 160, 339349.

24P Henrix , R Van Cauwenbergh , HJ Robberrecht & HA Deelstra (1995) Measurement of the daily dietary calcium and magnesium intake in Belgium, using duplicate portion sampling. Z Lebensm Unters Forsch 201, 213–217 (abstract).

25RJ Bryant , J Cadogan & CM Weaver (1999) The new dietary reference intakes for calcium: implications for osteoporosis. J Am Coll Nutr 18, 406S412S.

26L Guéguen & A Pointillart (2000) The bioavailability of dietary calcium. J Am Coll Nutr 19, 119S–136S.

28MM Salamoun , AS Kizirian , RI Tannous , MM Nabulsi , MK Choucair , ME Deeb & GA El-Hajj Fuleihan (2005) Low calcium and vitamin D intake in healthy children and adolescents and their correlates. Eur J Clin Nutr 59, 177–184.

29M Koshihara , S-I Katsumata , M Uehara & K Suzuki (2005) Effects of dietary phosphorus intake on bone mineralization and calcium absorption in adult female rats. Biosci Biotechnol Biochem 69, 10251028.

33K Laitinen , C Lamberg-Allardt , R Tunninen , SL Karonen , R Tähtelä , R Ylikarhi & M Välimäki (1991) Transient hypoparathyroidism during acute alcohol intoxication. N Engl J Med 324, 721–727.

35CS Tam , JNM Heersche , TM Murray & JA Parson (1982) Parathyroid hormone stimulates the bone apposition rate independently of its resorptive action: differential effects of intermittent and continuous administration. Endocrinology 110, 506512.

36PC Schiller , G Dippolito , BA Roos & GA Howard (1999) Anabolic or catabolic responses of MC3T3-E1 osteoblastic cells to parathyroid hormone depend on time and duration of treatment. J Bone Miner Res 14, 15041512.

37K Herfarth , H Schmidt-Gayk , S Graf & A Maier (1992) Circadian rhythm and pulsatily of parathyroid hormone secretion in man. Clin Endocrinol 37, 511–519.

38E Slatopolsky , J Finch , M Denda , C Ritter , M Zhong , A Dusso , PN MacDonald & AJ Brown (1996) Phosphorus restriction prevents parathyroid gland growth. High phosphorus directly stimulates PTH secretion in vitro. J Clin Invest 97, 25342540.

39K Miyamoto , S Tatsumi , H Segawa , K Morita , T Nii , A Fujioka , M Kitano , Y Inoue & E Takeda (1999) Regulation of PiT-1, a sodium-dependent phosphate co-transporter in rat parathyroid glands. Nephrol Dial Transplant 14, Suppl. 1, S73–S75.

41H Sadideen & R Swaminathan (2004) Effect of acute oral calcium load on serum PTH and bone resorption in young healthy subjects: an overnight study. Eur J Clin Nutr 58, 16611665.

42J Woo , R Swaminathan , E Lau , D MacDonald , CP Pang & BEC Nordin (1991) Biochemical effects of a single oral dose of calcium on bone metabolism in elderly Chinese women. Calcif Tissue Int 48, 157–160.

43E Reiss , JM Canterbury , MA Bercovitz & EL Kaplan (1970) The role of phosphate in the secretion of parathyroid hormone in man. J Clin Invest 49, 21462149.

44SJ Silverberg , E Shane , TL Clemens , DW Dempster , GV Segre , R Lindsay & JP Bilezikian (1986) The effects of oral phosphate administration on major incidens of skeletal metabolism in normal subjets. J Bone Miner Res 1, 383–388.

45K Brixen , HK Nielsen , P Charles & L Mosekilde (1992) Effects of a short course of oral phosphate treatment on serum parathyroid hormone (1–84) and biochemical markers of bone turnover: a dose-response study. Calcif Tissue Int 51, 276–281.

46J Guillemant , C Accarie , G Peres & S Guillemant (2004) Acute effects of an oral calcium load on markers of bone metabolism during endurance cycling exercise in male athletes. Calcif Tissue Int 74, 407414.

47M Grimm , A Muller , G Hein , R Funfstuck & G Jahreis (2001) High phosphorus intake only slightly affects serum minerals, urinary pyrinidium crosslinks and renal function in young women. Eur J Clin Nutr 55, 153–161.

48L Sax (2001) The Institute of Medicine's ‘Dietary reference intake’ for phosphorus: A critical perspective. J Am Coll Nutr 20, 271278.

51AB Hodsman , LJ Fraher , T Ostbye , JD Adachi & BM Steer (1993) An evaluation of several biochemical markers on bone formation and resorption in a protocol utilizing cyclical parathyroid hormone and calcitonin therapy for osteoporosis. J Clin Invest 91, 11381148.

52AA Portale , BP Halloran & RC Morris Jr (1987) Dietary intake of phosphorus modulates the circadian rhythm in serum concentration of phosphorus. J Clin Invest 80, 11471154.

53A Whybro , H Jagger , M Barker & R Eastell (1998) Phosphate supplementation in young men:lack of effect on calcium homeostasis and bone turnover. Eur J Clin Nutr 52, 29–33.

58RP Heaney & BEC Nordin (2002) Calcium effects on phosphorus absorption: Implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 21, 239–244.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: