009: Balancing Calcium and Phosphorus in the Diet, and the Importance of Measuring Parathyroid Hormone (PTH)

Mastering Nutrition Episode 9

Introduction

In this episode, I answer a listener’s question about whether I am worried about my phosphorus intake and whether a high phosphorus intake is ok as long as it is balanced by calcium. I describe the biochemistry and physiology of the system that regulates calcium and phosphorus, their distribution in foods, how to determine the right balance in the diet, and how to use parathyroid hormone (PTH) as a blood measurement to assess whether the dietary balance is working for an individual.

Show Notes

If you want to skip around within the episode, this will help you navigate:

• 00:32 Introduction

• 02:16 The listener’s question on Ca/P

• 02:53 Outline of the episode

• 05:26 Roles of calcium and phosphorus and distribution among foods

• 13:56 Physiological principle of need to balance calcium and phosphorus

• 21:18 Role of endocrine hormones in regulating calcium and phosphorus

• 43:24 How different foods rich in calcium and/or phosphorus affect PTH levels (different effects of phosphorus-based additives, whole grains, meats, and cheese)

• 52:20 My own calcium and phosphorus intakes

• 55:22 Weston Price’s data for calcium and phosphorus intakes in pre-industrial societies

• 1:02:20 Potential genetic differences in the requirement for calcium and vitamin D

Relevant Links for Episode 9

These are useful resources for better understanding the regulation of the calcium-phosphorus economy:

• The Linus Pauling Institute: Phosphorus (free)

• The calcium and phosphorus chapters in Modern Nutrition in Health and Disease.
  This is one of the few textbooks I was required to purchase in school and found so useful I kept as a cherished reference. When the most recent edition came out, I bought the Kindle version, which is incredibly easy to navigate and take notes from compared to the hardcover version I have in my office.

• Robert Heaney’s chapter in the Feldman Vitamin D textbook, Vitamin D: Role in the Calcium and Phosphorus Economies (behind a paywall but should be accessible through a library)

• Raposo et al., A mathematical model of calcium and phosphorus metabolism in two forms of hyperparathyroidism. The full text is available on researchgate.net.

These are the studies I talked about towards the end:

• Acute effects of different phosphorus sources on calcium and bone metabolism in young women: a whole-foods approach. The full text is available free on researchgate.net.

• Habitual high phosphorus intakes and foods with phosphate additives negatively affect serum parathyroid hormone concentration: a cross-sectional study on healthy premenopausal women. The full text is available free on researchgate.net.

• One of Jane Kerstetter’s studies showing meat enhances calcium bioavailability. (free full text)

If you know of better or contradictory studies please post them in the comments. Have any personal experiences with balancing calcium and phosphorus or using PTH to help interpret your health and dietary balance? Please share!

Read the Transcript or Leave a Comment

Masterpass members have access to the transcript below.

Masterpass members can also read and leave comments below. Non-members can read and leave comments on the general podcast page.

Learn more about the Masterpass here.