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The Institute of Medicine’s "Dietary Reference Intake" for Phosphorus: A Critical Perspective

Poolesville, Maryland E-mail: leonardsax{at}prodigy.net

Address reprint requests to: Leonard Sax, M.D., Ph.D., P.O. Box 108, Poolesville, MD, 20837. E-mail: leonardsax{at}prodigy.net

ABSTRACT

Two questions relevant to the safety of phosphate additives have been raised in the literature: 1) Is the dietary ratio of calcium to phosphorus clinically significant in humans? Specifically, can a high-phosphorus, low-calcium diet cause hypocalcemia and/or secondary hyperparathyroidism in humans? 2) Does the growing use of phosphate-containing food additives increase the risk of low bone density and/or fracture in humans?

In 1999, the Institute of Medicine published a monograph which addressed these two questions. This article critically reviews the findings and conclusions of the Institute of Medicine in the light of recent research.

Key words: dietary phosphorus, dietary calcium, parathyroid hormone, bone density

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