Objective Phosphorus-based food additives increase total phosphorus content of processed foods. However, the extent to which these additives augment total phosphorus intake per day is unclear. Design, setting, and measurements In order to examine the contribution of phosphorus-based food additives to the total phosphorus content of processed foods, separate four-day menus for a low-additive and additive-enhanced diet were developed using Nutrition Data System for Research (NDSR) software. The low-additive diet was designed to conform to United States Department of Agriculture guidelines for energy and phosphorus intake (~2,000 kcal per day and 900 mg of phosphorus per day) and contained minimally-processed foods. The additive-enhanced diet contained the same food items as the low-additive diet except that highly-processed foods were substituted for minimally-processed foods. Food items from both diets were collected, blended, and sent for measurement of energy and nutrient intake. Results Both the low-additive and additive-enhanced diet provided ~2,200 kcal, 700 mg of calcium and 3,000 mg of potassium per day on average. Measured sodium and phosphorus content standardized per 100 mg of food was higher each day of the additive-enhanced diet as compared to the low-additive. When averaged over the four menu days, measured phosphorus and sodium contents of the additive-enhanced diet were 606 ± 125 and 1,329 ± 642 mg higher than the low-additive diet, respectively, representing a 60% increase in total phosphorus and sodium content on average. When comparing the measured values of the additive-enhanced diet to NDSR-estimated values, there were no statistically significant differences in measured vs. estimated phosphorus contents. Conclusion Phosphorus and sodium additives in processed foods can substantially augment phosphorus and sodium intake, even in relatively healthy diets. Current dietary software may provide reasonable estimates of phosphorus content in processed foods.

Objective: Determine normative data by forced oscillation technique (FOT) in non-sedated normal term neonates and test the hypothesis that infants with transient tachypnea of the newborn (TTN) have higher resistance (R) and lower reactance (X) on day 1. Methods: Healthy term infants (n=138) and infants with TTN (n = 17) were evaluated on postnatal days 1 through 3 (NCT03346343). FOT was measured with a mask using a TremoFlo C-100 Airwave System™. R, X, and area under the reactance curve (AX) were measured at prime frequencies 7 to 41 Hz for 8s. Results: 86% of control infants had adequate measurements (coherence >0.8, CV < 0.25) on day 1. Infants with TTN had higher resistance at 13 Hz (TTN 32.5 cmH 2 O·s/L [95% CI 25.5–39.4]; controls 23.8 cmH 2 O·s/L [95% CI 22.2–25.3], P = 0.007) and lower reactance from 17 – 37 Hz (TTN −35.1 to −10.5; controls −26.3 to −6.1, P<0.05). In healthy controls, lung mechanics were unchanged from days 1–3. In TTN, lung mechanics normalized on days 2 and 3. Conclusions: FOT is feasible in neonates and distinguishes normal control infants from those with TTN on postnatal day 1. Oscillometry offers a non-invasive, longitudinal technique to assess lung mechanics in newborns. Trial Registration: Clinicaltrials.gov Identifier

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