Too much and too little consumption of phosphorus in the diet are deemed risky in relation to the likelihood of developing diabetes, with a study showing a U-shaped association between the phosphorous intake and new-onset diabetes.
The study included 16,272 participants who were free of diabetes at baseline from the China Health and Nutrition Survey. All participants completed three consecutive 24-hour dietary recalls, along with a household food inventory, that detailed dietary intake.
Over a median follow-up of 9.0 years, 1,101 incident cases of new-onset diabetes were recorded. New-onset diabetes was defined as self-reported physician-diagnosed diabetes, fasting glucose of ≥7.0 mmol/L, or glycated haemoglobin of ≥6.5 percent.
Multivariable Cox analysis showed that the association between dietary phosphorus intake and the risk of new-onset diabetes followed a U-shaped pattern (p<0.001 for nonlinearity). The risk significantly decreased per standard-deviation [SD] increment of dietary phosphorus intake among participants with phosphorus intake of <921.6 mg/day (hazard ratio [HR], 0.64, 95 percent CI, 0.48–0.84). On the other hand, the risk significantly increased per SD increment of dietary phosphorus intake among participants with phosphorus intake of ≥921.6 mg/day (HR, 1.33, 95 percent CI, 1.16–1.53).
When dietary phosphorus intake was assessed as quintiles, the risk of new-onset diabetes was significantly higher among participants in the highest quintiles (fourth and fifth [≥975.4 mg/day]: HR, 1.46, 95 percent CI, 1.19–1.78) and among those in the lowest quintiles (first and second [<905.0 mg/day]: HR, 1.59, 95 percent CI, 1.30–1.94) as compared with participants in the third quintile (905.0 to <975.4 mg/day).
Foods such as dairy, red meat, poultry, seafood, legumes, and nuts are the richest sources of phosphorous.