Association between phosphorus intake and bone health in the NHANES population

The objective of this study was to estimate the independent associations between intake of phosphorus (P) and bone health parameters such as bone mineral content (BMC) and bone mineral density (BMD). It provides odds ratio (OR) of osteoporosis with quartiles of P intake adjusted for covariates (i.e., age, gender, BMI, and consumption of calcium (Ca), protein, total dairy foods, and vitamin D as well as intakes of supplemental Ca, vitamin D, and multivitamins/minerals). Data came from males and females aged 13–99 years who participated in the 2005–2010 National Health and Nutrition Examination Survey (NHANES). Analyses showed that higher P intake was associated with higher Ca intake, and that dietary Ca:P ratios (0.51-0.62, with a mean of 0.60 for adults) were adequate in all age/gender groups. High intake of P was positively associated with BMC in female teenagers (Q4 vs. Q1: BMC, 30.9 ± 1.1 vs. 29.0 ± 0.5 g, P = 0.001). It was also positively associated with BMC and BMD as well as reduced risk of osteoporosis in adults >20 years of age (Q4 vs. Q1: OR of osteoporosis, 0.55; 95% confidence interval [CI], 0.39- 0.79; P = 0.001; BMC, 37.5 ± 0.4 vs. 36.70 ± 0.3 g, P < 0.01; BMD, 0.986 ± 0.004 vs. 0.966 ± 0.005 g/cm2, P < 0.05). The data suggest that high intake of P has no adverse effect on bone metabolism in populations with adequate Ca intake, and that it is also associated with positive bone parameters in some age/gender groups.