Dietary phosphorus is associated with greater left ventricular mass

Dietary phosphorus consumption has risen steadily in the United States. Oral phosphorus loading alters key regulatory hormones and impairs vascular endothelial function, which may lead to an increase in left ventricular mass (LVM). We investigated the association of dietary phosphorus with LVM in 4494 participants from the Multi-Ethnic Study of Atherosclerosis, a community-based study of individuals who were free of known cardiovascular disease. The intake of dietary phosphorus was estimated using a 120-item food frequency questionnaire and the LVM was measured using magnetic resonance imaging. Regression models were used to determine associations of estimated dietary phosphorus with LVM and left ventricular hypertrophy (LVH). Mean estimated dietary phosphorus intake was 1167mg/day in men and 1017mg/day in women. After adjustment for demographics, dietary sodium, total calories, lifestyle factors, comorbidities, and established LVH risk factors, each quintile increase in the estimated dietary phosphate intake was associated with an estimated 1.1 g greater LVM. The highest gender-specific dietary phosphorus quintile was associated with an estimated 6.1g greater LVM compared with the lowest quintile. Higher dietary phosphorus intake was associated with greater odds of LVH among women, but not men. These associations require confirmation in other studies. Kidney International (2013) 83, 707-714; doi:10.1038/ki.2012.303; published online 2 January 2013