High phosphorus intake and gut-related parameters - results of a randomized placebo-controlled human intervention study

Nutr J. 2018 Feb 16;17(1):23. doi: 10.1186/s12937-018-0331-4.

Abstract

Background: In recent years, high phosphate intakes were discussed critically. In the small intestine, a part of the ingested phosphate and calcium precipitates to amorphous calcium phosphate (ACP), which in turn can precipitate other intestinal substances, thus leading to a beneficial modulation of the intestinal environment. Therefore, we analysed faecal samples obtained from a human intervention study regarding gut-related parameters.

Methods: Sixty-two healthy subjects (men, n = 30; women, n = 32) completed the double-blind, placebo-controlled and parallel designed study (mean age: 29 ± 7 years; mean BMI: 24 ± 3 kg/m2). Supplements were monosodium phosphate and calcium carbonate. During the first 2 weeks, all groups consumed a placebo sherbet powder, and afterwards a sherbet powder for 8 weeks according to the intervention group: P1000/Ca0 (1000 mg/d phosphorus), P1000/Ca500 (1000 mg/d phosphorus and 500 mg/d calcium) and P1000/Ca1000 (1000 mg/d phosphorus and 1000 mg/d calcium). After the placebo period and after 8 weeks of intervention faecal collections took place. We determined in faeces: short-chain fatty acids (SCFA) and fat as well as the composition of the microbiome (subgroup) and cyto- and genotoxicity of faecal water (FW). By questionnaire evaluation we examined tolerability of the used phosphorus supplement.

Results: Faecal fat concentrations did not change significantly due to the interventions. Concentrations of faecal total SCFA and acetate were significantly higher after 8 weeks of P1000/Ca500 supplementation compared to the P1000/Ca0 supplementation. In men, faecal total SCFA and acetate concentrations were significantly higher after 8 weeks in the P1000/Ca1000 group compared to the P1000/Ca0 one. None of the interventions markedly affected cyto- and genotoxic activity of FW. Men of the P1000/Ca1000 intervention had a significantly different gut microbial community compared to the men of the P1000/Ca0 and P1000/Ca500 ones. The genus Clostridium XVIII was significantly more abundant in men of the P1000/Ca1000 intervention group compared to the other groups. Supplementations did not cause increased intestinal distress.

Conclusions: The used high phosphorus diet did not influence cyto- and genotoxicity of FW and the concentrations of faecal fat independent of calcium intake. Our study provides first hints for a potential phosphorus-induced modulation of the gut community and the faecal total SCFA content.

Trial registration: The trial is registered at ClinicalTrials.gov as NCT02095392 .

Keywords: Calcium intake; Cytotoxicity; Faecal water; Genotoxicity; Human study; Phosphate intake; Phosphorus intake; Short-chain fatty acids.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / metabolism
  • Adult
  • Calcium Carbonate / administration & dosage*
  • Calcium Carbonate / metabolism
  • Dietary Supplements*
  • Double-Blind Method
  • Fatty Acids / metabolism
  • Feces / microbiology*
  • Female
  • Gastrointestinal Microbiome / drug effects*
  • Humans
  • Intestines / drug effects*
  • Intestines / microbiology
  • Male
  • Phosphorus, Dietary / administration & dosage*
  • Phosphorus, Dietary / metabolism

Substances

  • Acetates
  • Fatty Acids
  • Phosphorus, Dietary
  • Calcium Carbonate

Associated data

  • ClinicalTrials.gov/NCT02095392