Dietary intake of phosphorus is required for human health, and dietary reference intakes for phosphorus have been established. Food-grade phosphates are used as additives to provide a wide range of technical functions in food production. Phosphates are often the most efficient ingredients to provide the required functionality in many applications, and in some cases, there are not effective and approved alternatives. However, many investigators have expressed concern about the quantities of phosphorus and food-additive phosphate present in the diets of many populations. This paper presents the outcome of an extensive review of 110 primary research articles focused on identifying evidence that substantiates or refutes associations of total dietary phosphorus and food-additive phosphate intake with health and disease in humans. The lack of conclusive evidence prevented the drawing of firm conclusions about the safety and possible risks of food-additive phosphate in the general population, which is consonant with the overall assessments of authoritative institutions who have concluded that available data are insufficient to make the required determinations. Despite the inadequacy of the evidence currently available, many of the authors of the publications reviewed for this paper expressed concerns about the quantities of phosphorus and food-additive phosphate in the diets of the populations and subpopulations they studied. At the same time, most of these authors offered only qualified conclusions and expressed themselves tentatively. In addition, authors of primary research publications, authors of review articles, and authoritative institutions have called for the conduct of further research.Keywords: dietary phosphate, dietary phosphorus phosphate, phosphate additive, serum phosphorus
Executive SummaryPhosphorus is integral to many central metabolic processes and is an essential constituent of anatomical structure. Dietary intake of phosphorus (in the form of organic and inorganic phosphates) is required for human health, and dietary reference intakes for phosphorus have been published that include estimates of average requirements and recommended dietary allowances. Not all authoritative bodies have provided tolerable upper intake levels for dietary phosphorus, however, and many investigators have expressed concern about the quantities of phosphorus and foodadditive phosphate present in the diets of many populations, quantities they believe to be excessive and possibly injurious to health.Food-grade phosphates are used as additives in food production to function as buffers, sequestrants, acidulants, bases, flavors, cryoprotectants, gel accelerants, dispersants, nutrients, or precipitants, as well as to function as free-flow or ion-exchange agents. Food-grade phosphates are used to chemically leaven cakes, cookies, pancakes, waffles, and donuts; to maintain the structure and hydration of meat, poultry, and seafood products; to improve fluidity of evaporated milk; flavor or add minerals to beverages; and ...