Dynamics of bone mineralization in primiparous sows as a function of dietary phosphorus and calcium during lactation.

To maximize the efficiency of dietary P utilization in swine production, understanding the mechanisms of P utilization in lactating sows is relevant due to their high P requirement and the resulting high inorganic P intake. Gaining a better knowledge of the Ca and P quantities that can be mobilized from bones during lactation, and subsequently replenished during the following gestation, would enable the development of more accurate P requirements incorporating this process of bone dynamics. The objective was to measure the amount of body mineral reserves mobilized during lactation, depending on dietary digestible P and phytase addition and to measure the amount recovered during the following gestation. Body composition of 24 primiparous sows was measured by dual-energy x-ray absorptiometry 2, 14, 26, 70 and 110 days after farrowing. Four lactation diets were formulated to cover nutritional requirements, with the exception of Ca and digestible P: 100% (Lact100; 9.9 g Ca and 3.0 g digestible P/kg), 75% (Lact75), 50% without added phytase (Lact50) and 50% with added phytase (Lact50 + FTU). The gestation diet was formulated to cover the nutritional requirements of Ca and digestible P (8.2 g Ca and 2.6 g digestible P/kg). During the 26 days of lactation, each sow mobilized body mineral reserves. The mean amount of mobilized bone mineral content (BMC) was 664 g, representing 240 g Ca and 113 g P. At weaning, the BMC (g/kg of BW) of Lact50 sows tended to be lower than Lact100 sows (-12.8%, linear Ca and P effect × quadratic time effect) while the BMC of Lact50 + FTU sows remained similar to that of Lact100 sows. During the following gestation, BMC returned to similar values among treatments. Therefore, the sows fed Lact50 could recover from the higher bone mineral mobilization that occurred during lactation. The P excretion was reduced by 40 and 43% in sows fed Lact50 and Lact50 + FTU, respectively, relative to sows fed Lact100. In conclusion, the quantified changes in body composition during the lactation and following gestation of primiparous sows show that bone mineral reserves were mobilized and recovered and that its degree was dependent on the dietary P content and from phytase supplementation during lactation. In the future, considering this potential of the sows' bone mineralization dynamics within the factorial assessment of P requirement and considering the digestible P equivalency of microbial phytase could greatly limit the dietary use of inorganic phosphates and, thus, reduce P excretion.

The relationship between dietary phosphorus and peripheral neuropathy in the general population of the United States: A preliminary research.

BACKGROUND: Dietary phosphorus intake may serve as a potential predictor for peripheral neuropathy (PN). While past research has predominantly focused on the relationship between dietary phosphorus and bone health, relatively little is known about its role in the nervous system, particularly its association with PN. METHODS: A cross-sectional study was conducted using data from NHANES 1999-2004. Participants were categorized into different dietary phosphorus intake groups, and the relationship between dietary phosphorus and PN was explored using multifactorial logistic regression, restricted cubic splines (RCS) analysis, and threshold effect analysis based on dietary intake. RESULTS: The final study included 7726 participants, with 1378 diagnosed with PN and 6348 without. The study revealed a U-shaped non-linear relationship between dietary calcium and magnesium intake levels and PN, indicating that both excessive and insufficient dietary phosphorus intake may increase the risk of PN. Specifically, the incidence rates in the first quintile (1.433, 95% CI: 1.080-1.901), the fourth quintile (1.284, 95% CI: 1.000-1.648), and the fifth quintile (1.533, 95% CI: 1.155-2.035) significantly higher than the second quintile, with an overall trend showing a decrease followed by an increase in incidence rates. The results of RCS and threshold effect analysis indicate that when dietary phosphorus intake is below 939.44mg, the risk of PN decreases with increasing dietary phosphorus intake. On the contrary, when dietary phosphorus intake exceeds 939.44mg, the risk of PN increases with increasing dietary phosphorus intake. CONCLUSION: This study reveals a U-shaped correlation between dietary phosphorus intake and PN. Future research should further elucidate the molecular mechanisms underlying this association, providing guidance for more scientifically informed dietary adjustments to prevent the occurrence of PN.

Hyperparathyroidism, Serum Phosphorus and Dietary Intake in Hemodialysis Patients: Is There a Novel Relationship?

The management of hyperparathyroidism (intact parathyroid hormone (iPTH) serum levels > 585 pg/mL), frequently focuses on the appropriate control of mineral and bone markers, with the decrease in serum and dietary phosphorus as two of the targets. We aimed to investigate the association between iPTH, serum phosphorus levels and dietary intake. This was a cross-sectional, multicenter, observational study with 561 patients on hemodialysis treatment. Clinical parameters, body composition and dietary intake were assessed. For the analysis, patients were divided into three groups: (a) iPTH < 130, (b) iPTH between 130 and 585 and (c) iPTH > 585 pg/mL. The association between PTH, serum phosphorus and dietary intake was analyzed using linear regression models. In the whole sample, 23.2% of patients presented an iPTH > 585 pg/mL. Patients with higher iPTH levels were those with longer HD vintage and lower ages, higher serum phosphorus, serum calcium, Ca/P product, albumin and caffeine intake, and a lower dietary intake of phosphorus, fiber, riboflavin and folate. Higher serum phosphorus predicted higher iPTH levels, even in the adjusted model. However, lower dietary phosphorus and fiber intake were predictors of higher iPTH levels, including in the adjusted model. Our results bring new data to the relationship between dietary intake and iPTH values. Despite higher serum phosphorus being observed in patients with HPTH, an opposite association was noted regarding dietary phosphate and fiber.

Dietary calcium, phosphorus, and potassium intake associated with erectile dysfunction in the National Health and Nutrition Examination Survey (NHANES) 2001 to 2004.

BACKGROUND: Erectile dysfunction is now a common disorder of sexual function, and its relationship to dietary calcium, phosphorus, and potassium has not been well studied. We set out to determine if dietary intakes of calcium, phosphorus, and potassium are related to erectile dysfunction in U.S. men. METHODS: For this cross-sectional investigation, we used data from NHANES 2001-2004. To investigate the connection of dietary calcium, phosphorus, and potassium intake with erectile dysfunction, we employed multivariate logistic regression, smoothed curve fitting, and subgroup analysis. RESULTS: This cross-sectional study comprised 3,556 eligible male subjects in total, with a weighted mean age of 49.93±18.13 years. After controlling for race and age, the greatest tertile of calcium consumption was found to have a 34% lower risk of erectile dysfunction than the lowest tertile (OR = 0.66; 95% CI = 0.52-0.84; p = 0.0006). The risk of erectile dysfunction was found to be reduced by 33% (OR = 0.67; 95% CI = 0.52-0.87; p = 0.0024) for the highest tertile of phosphorus intake compared to the lowest tertile of phosphorus intake and by 35% (OR = 0.65; 95% CI = 0.50-0.83; p = 0.0006) for the highest tertile of potassium intake compared to the lowest tertile of potassium intake in the fully adjusted model. CONCLUSION: Erectile dysfunction and dietary consumption of calcium, phosphorus, and potassium are inversely associated with the U.S. population. To confirm the accuracy of our findings, additional prospective studies are necessary. Furthermore, it is imperative to do further fundamental research at the molecular level to gain a deeper understanding of the underlying mechanisms.

Dairy product consumption, eating habits, sedentary behaviour and physical activity association with bone mineral density among adolescent boys: a cross-sectional observational study.

BACKGROUND: During childhood and adolescence, skeletal microarchitecture and bone mineral density (BMD) undergo significant changes. Peak bone mass is built and its level significantly affects the condition of bones in later years of life. Understanding the modifiable factors that improve bone parameters at an early age is necessary to early prevent osteoporosis. To identify these modifiable factors we analysed the relationship between dairy product consumption, eating habits, sedentary behaviour, and level of physical activity with BMD in 115 young boys (14-17 years). METHODS: Bone parameters were measured by dual energy x-ray absorptiometry using paediatric specific software to compile the data. Dairy product consumption and eating habits were assessed by means of a dietary interview. Sedentary behaviour and physical activity was assessed in a face-to-face interview conducted using the International Physical Activity Questionnaire. Data collection on total physical activity level was performed by collecting information on the number of days and the duration of vigorous and moderate intensity (MVPA) and average daily time spent in sitting (SIT time). RESULTS: The strongest relationships with BMD in distal part of forearm were found for moderate plus vigorous activity, sit time, and intake of dairy products, intake of calcium, protein, vitamin D, phosphorus from diet. Relationships between BMD, bone mineral content (BMC) in the distal and proximal part of the forearm and PA, sit time and eating parameters were evaluated using the multiple forward stepwise regression. The presented model explained 48-67% (adjusted R2 = 0.48-0.67; p < 0.001) of the variance in bone parameters. The predictor of interactions of three variables: protein intake (g/person/day), vitamin D intake (µg/day) and phosphorus intake (mg/day) was significant for BMD dis (adjusted R2 = 0.59; p < 0.001). The predictor of interactions of two variables: SIT time (h/day) and dairy products (n/day) was significant for BMD prox (adjusted R2 = 0.48; p < 0.001). Furthermore, the predictor of interactions dairy products (n/day), protein intake (g/person/day) and phosphorus intake (mg/day) was significant for BMC prox and dis (adjusted R2 = 0.63-0.67; p < 0.001). CONCLUSIONS: High physical activity and optimal eating habits especially adequate intake of important dietary components for bone health such as calcium, protein, vitamin D and phosphorus affect the mineralization of forearm bones.

Phosphorus equivalency of exogenous phytase relative to phosphorus in monosodium phosphate in broiler chickens.

The objective of this study was to estimate phosphorus (P) equivalency of exogenous phytase relative to P from monosodium phosphate (MSP) in broiler chickens. To attain this objective, the impact of dietary MSP or exogenous phytase on growth performance, ileal digestibility of P, and bone characteristics in broiler chickens was assessed. Six experimental diets consisting of a P-deficient basal diet based on corn and soybean meal, basal diet plus 0.9 or 1.8 g/kg of inorganic P from MSP, and basal diet plus 500, 1,000, or 2,000 FYT/kg of exogenous phytase. Calcium to P ratio in all diets was maintained at 1.5:1. A total of 576 male broiler chickens (Cobb 500; initial BW = 190 ± 17 g) on d 8 post hatching were allotted to the 6 dietary treatments in a randomized complete block design using BW as a blocking factor. Each dietary treatment contained 8 replicate cages with 12 birds per cage. On d 11 post hatching, 7 birds from each cage were euthanized by CO2 asphyxiation and dissected for the collection of ileal digesta. On d 18, ileal digesta were also collected from the remaining 5 birds in each cage. The left femur and tibia were collected from the bird with the median BW on d 11 and 18 from each cage, and analyzed for bone breaking strength and bone ash. Weight gain and gain-to-feed ratio linearly or quadratically increased (P < 0.05) in every period as the inclusion rate of MSP or phytase increased. Ileal digestibility of P linearly increased (P < 0.05) on d 11 with increasing MSP, but there was no significant effect on d 18. Increasing phytase concentration linearly increased (P < 0.05) ileal digestibility of P on d 11 and 18. Increasing dietary MSP or phytase linearly increased ileal digestible P concentration in diets (P < 0.05). Bone breaking strength and bone ash linearly or quadratically increased (P < 0.05) with increasing inclusion rate of MSP or phytase on d 11 and 18. The equivalency of 1,000 FYT/kg of exogenous phytase based on dietary ileal digestible P concentration was 1.5 and 1.2 g/kg of inorganic P in diets on d 11 and 18, respectively. The current results showed that the supplementation of MSP or exogenous phytase can increase growth performance, ileal P digestibility, bone breaking strength, and bone ash in young broiler chickens.

Effect of 25-hydroxycholecalciferol supplementation with different dietary available phosphorus levels for broilers.

1. Based on the hypothesis that 25-hydroxycholecalciferol (25-OH-D3) inclusion would optimise dietary mineral digestibility and ameliorate growth performance and bone mineralisation in available phosphorus (AvP) deficient-fed broilers, a trial was conducted to evaluate its effect on diets with different levels of AvP.2. Broilers aged 1-21 d were randomly assigned one of the eight treatments, consisting of four dietary levels of AvP (0.45%, 0.42%, 0.39%, and 0.36%) and with or without supplementation with 25-OH-D3 at 69 µg/kg of feed. All diets contained 100 µg/kg of vitamin D3 (cholecalciferol).3. The addition of 25-OH-D3 resulted in higher feed intake and body weight gain, and lower FCR (P < 0.05) compared to non-supplemented diets, whereas AvP levels had a quadratic effect only on feed intake. There were no interactions between treatment factors.4. Increasing AvP levels linearly reduced the ileal digestibility of Ca and P (P < 0.01) and supplementing 25-OH-D3 increased both Ca and P ileal digestibility (P < 0.05), without any interactions observed for ileal digestibility.5. There was an interaction, whereby 25-OH-D3 inclusion increased serum metabolites in broilers fed 0.36% to 0.42% AvP compared to the non-supplemented diets (P < 0.001), whereas, at 0.45% AvP, diets with or without 25-OH-D3 had similar results.6. The P content in bone linearly increased in line with AvP levels (P < 0.05) and supplementation of 25-OH-D3 increased ash bone content (P < 0.001).7. Broilers can benefit from 25-OH-D3 supplementation combined with cholecalciferol with regard to Ca and P utilisation and vitamin D status, allowing for a reduction of dietary AvP levels down to 0.36% without impairing growth performance or bone status.

Dietary phosphorus requirement of silver CARP (Hypophthalmichthys molitrix) fingerlings.

The aim of this study was to determine the optimal dietary phosphorus (P) requirement and its effects on growth performance, body composition, mineralization and alkaline phosphate (ALP) activity in silver carp (Hypophthalmichthys molitrix). A total of 360 fish with an average initial weight of 7.0 ± 0.15 g were divided into 18 tanks (70 L capacity each) with a stocking density of 20 fish per tank in triplicate. The fish were fed diets containing six levels of P (3.3, 4.4, 5.5, 6.5, 7.5 and 8.6 g/kg) up to satiation for 90 days twice daily at 09:00 and 16:00. The results showed that fish fed diets containing 6.5 and 7.5 g/kg dietary P had significantly higher (p < 0.05) growth performance in terms of final weight gain, average weight gain (AWG), weight gain% (WG%), protein efficiency ratio (PER) and specific growth rate (SGR) than fish fed other diets. The best value of the feed conversion ratio (FCR) was observed in fish fed the 6.5 g/kg P diet, which was not significantly different from the 7.5 g/kg P diet. Increasing P supplementation above 6.5 g/kg significantly reduced (p < 0.05) the feed intake of silver carp. Whole-body composition analysis indicated that increasing P levels resulted in a decrease (p < 0.05) in crude fat (CF) and an increase (p < 0.05) in crude ash (CA) content, while crude protein (CP) and moisture content remained unaffected (p > 0.05). Fish fed diets containing ≥6.5 g/kg P had significantly higher (p < 0.05) Ca content in the whole body, bones and scales compared to those fed diets containing ≤5.5 g/kg P. A similar trend was observed for P and Mg contents in the whole body, bones and scales. The Zn content tended to decrease (p < 0.05) with increasing P supplementation in the whole body and bones, but fish fed diets containing ≥6.5 g/kg P had significantly higher (p < 0.05) Zn content compared to fish fed diets containing ≤5.5 g/kg P. The Ca/P ratio was significantly affected by P supplementation. Fish fed diets containing ≥6.5 g/kg P had significantly higher (p < 0.05) Ca and P contents in the serum than fish fed other diets. ALP activity increased (p < 0.05) with increasing P levels up to 6.5 g/kg P and decreased (p < 0.05) thereafter. In conclusion, supplementing P up to 6.35 g/kg is recommended for the optimal growth of silver carp.

Regression equation for predicting dietary phosphorus intake based on estimated dietary protein intake: A multicenter cross-sectional study in China.

BACKGROUND: Protein and phosphorus intake, which affect chronic kidney disease (CKD), is assessed using cumbersome food diaries. Therefore, more straightforward and accurate methods of assessing protein and phosphorus intake are needed. We decided to investigate the nutrition status and dietary protein and phosphorus intake of patients with stages 3, 4, 5, or 5D CKD. METHODS: This cross-sectional survey included outpatients with CKD at seven class A tertiary hospitals in Beijing, Shanghai, Sichuan, Shandong, Liaoning, and Guangdong in China. Protein and phosphorus intake levels were calculated using 3-day food records. Protein levels and calcium and phosphorus serum concentrations were measured; urinary urea nitrogen was determined using a 24-h urine test. Protein and phosphorus intakes were calculated using the Maroni and Boaz formulas, respectively. The calculated values were compared with the recorded dietary intakes. An equation that regressed phosphorus intake on protein intake was constructed. RESULTS: The average recorded energy and protein intake was 1637.5 ± 595.74 kcal/day and 56.97 ± 25.25 g/day, respectively. Overall, 68.8% of patients had a good nutrition status (grade A on the Subjective Global Assessment). The correlation coefficient between protein intake and calculated intake was 0.145 (P = 0.376) and that between phosphorus intake and calculated intake was 0.713 (P < 0.001). CONCLUSION: Protein and phosphorus intakes correlated linearly. Chinese patients with stage 3-5 CKD had low daily energy intake but high protein intake. Malnutrition was present in 31.2% of patients with CKD. The phosphorus intake could be estimated from the protein intake.

Comparison of different protein sources on the phosphorus digestibility of soybean meal for broiler chickens determined using the regression method.

A study was conducted to evaluate the P digestibility in soybean meal (SBM) using the regression method with different basal diet that varied in protein sources. The treatments were organized in a 4 × 3 factorial arrangement, where 4 semipurified diets were formulated with varying source of protein (no protein supplement, or added casein, potato protein isolate (PPI), or dried egg albumen (DEA) at 60 g/kg) and 3 dietary levels of SBM (290, 370, or 450 g/kg). The study was a randomized complete block design with 8 replicate cages of 6 birds per cage. The experimental diets were fed from d 19 to 22 posthatching, excreta samples were collected from d 20 to 22, and ileal digesta samples were collected on d 22. Data were analyzed as a 2-way ANOVA using the GLM procedure. The digestibility and total tract utilization of DM, P, Ca, and N were affected by protein source (P < 0.05). Diets with casein presented the highest (P < 0.05) digestibility of N. Increasing SBM level in all dietary protein sources reduced (P < 0.001) the digestibility and total tract utilization of DM. The regression-derived ileal digestibility of P in SBM was 57.8 (SE = 3.78), 63.2 (SE = 5.02), 58.8 (SE = 4.53), and 35.3% (SE = 5.27) for diets without protein supplement, with casein, PPI, or DEA, respectively; the corresponding P retention were 52.2 (SE = 11.09), 83.4 (SE = 14.89), 42.6 (SE = 15.88), and 51.9% (SE = 14.67). The protein source affected (P < 0.05) the slope and intercept of P digestibility in SBM. A comparison of the coefficients using confidence intervals demonstrated that the ileal digestibility of P in SBM determined in diets with DEA was lower (P < 0.05) than the other protein sources, which did not differ from one another. These results indicate that the selection of dietary protein supplements may affect P digestibility assays using the regression method.

Phosphorus absorption kinetics and exudation strategies of roots developed by three lupin species to tackle P deficiency.

MAIN CONCLUSION: Different lupin species exhibited varied biomass, P allocation, and physiological responses to P-deprivation. White and yellow lupins had higher carboxylate exudation rates, while blue lupin showed the highest phosphatase activity. White lupin (Lupinus albus) can produce specialized root structures, called cluster roots, which are adapted to low-phosphorus (P) soil. Blue lupin (L. angustifolius) and yellow lupin (L. luteus), which are two close relatives of white lupin, do not produce cluster roots. This study characterized plant responses to nutrient limitation by analyzing biomass accumulation and P distribution, absorption kinetics and root exudation in white, blue, and yellow lupins. Plants were grown in hydroponic culture with (64 µM NaH2PO4) or without P for 31 days. Under P limitation, more biomass was allocated to roots to improve P absorption. Furthermore, the relative growth rate of blue lupin showed the strongest inhibition. Under + P conditions, the plant total-P contents of blue lupin and yellow lupin were higher than that of white lupin. To elucidate the responses of lupins via the perspective of absorption kinetics and secretion analysis, blue and yellow lupins were confirmed to have stronger affinity and absorption capacity for orthophosphate after P-deprivation cultivation, whereas white lupin and yellow lupin had greater ability to secrete organic acids. The exudation of blue lupin had higher acid phosphatase activity. This study elucidated that blue lupin was more sensitive to P-scarcity stress and yellow had the greater tolerance of P-deficient condition than either of the other two lupin species. The three lupin species have evolved different adaptation strategies to cope with P deficiency.

The transporter PHO84/NtPT1 is a target of aluminum to affect phosphorus absorption in Saccharomyces cerevisiae and Nicotiana tabacum L.

The molecular mechanism of aluminum toxicity in biological systems is not completely understood. Saccharomyces cerevisiae is one of the most used model organisms in the study of environmental metal toxicity. Using an unbiased metallomic approach in yeast, we found that aluminum treatment caused phosphorus deprivation, and the lack of phosphorus increased as the pH of the environment decreased compared to the control strain. By screening the phosphate signaling and response pathway (PHO pathway) in yeast with the synthetic lethality of a new phosphorus-restricted aluminum-sensitive gene, we observed that pho84Δ mutation conferred severe growth defect to aluminum under low-phosphorus conditions, and the addition of phosphate alleviated this sensitivity. Subsequently, the data showed that PHO84 determined the intracellular aluminum-induced phosphorus deficiency, and the expression of PHO84 was positively correlated with aluminum stress, which was mediated by phosphorus through the coordinated regulation of PHO4/PHO2. Moreover, aluminum reduced phosphorus absorption and inhibited tobacco plant growth in acidic media. In addition, the high-affinity phosphate transporter NtPT1 in tobacco exhibited similar effects to PHO84, and overexpression of NtPT1 conferred aluminum resistance in yeast cells. Taken together, positive feedback regulation of the PHO pathway centered on the high-affinity phosphate transporters is a highly conservative mechanism in response to aluminum toxicity. The results may provide a basis for aluminum-resistant microorganisms or plant engineering and acidic soil treatment.

Dietary non-phytate phosphorus requirements for optimal productive and reproductive performance, and egg and tibial quality in egg-type duck breeders.

Optimal dietary non-phytate phosphorus (NPP) is essential in poultry to maximise productive and reproductive performance, along with indices of egg and bone quality. This study aimed to establish the NPP requirements of egg-type duck breeders aged from 54 to 80 weeks on the following traits: egg production, egg incubation, egg quality, tibial characteristics, reproductive organ, plasma indices, and the expression of genes related to phosphorus absorption. Longyan duck breeders aged 54 weeks (n = 300) were randomly allotted to five treatments, each containing six replicates of 10 individually caged birds. Birds were fed corn-soybean meal-based diets containing 0.18, 0.25, 0.32, 0.38, and 0.45% NPP/kg for 27 weeks. The tested dietary NPP levels did not affect egg production or egg quality indices. The hatchling weight of ducklings increased (quadratic, P < 0.01) as dietary NPP level increased, and the highest value occurred with 0.25% NPP. The number of large yellow follicles (LYF), and the relative weights of LYF and ovary showed linear and quadratic responses to dietary NPP levels; the lowest number and relative weight of LYF occurred with 0.38% NPP, and the lowest ovarian weight was obtained with 0.25% NPP. There were no differences in tibial length, breaking strength, and mineral density in response to dietary NPP levels. In contrast, tibial content of Ca increased (linear, P < 0.01) with dietary NPP levels increasing from 0.18 to 0.45%, and the tibial content of P increased at 0.32% NPP and the higher dietary NPP levels. Plasma concentration of P showed a quadratic (P < 0.05) response to the dietary NPP levels, where the highest value was seen at 0.38% NPP. In conclusion, dietary NPP levels from 0.18 to 0.45% had no effects on egg production, and egg and tibial quality of duck breeders. The duck breeders fed a diet with 0.25% NPP showed the highest hatchling weight of their offspring, while those fed 0.38% NPP had the lowest number and relative weight of LYF. These results indicated that the diet with 0.25% NPP can be used in egg-type duck breeders to improve the hatchling weight of their offspring, without adverse effects on their productivity. The regression model indicated that the maximal hatchling weight of ducklings was obtained from duck breeders fed the diet with 0.30% NPP.

The effect of bone and analytical methods on the assessment of bone mineralization response to dietary phosphorus, phytase, and vitamin D in nursery pigs.

A total of 360 pigs (DNA 600 × 241, DNA; initially 11.9 ±â€…0.56 kg) were used in a 28-d trial to evaluate the effects of different bones and analytical methods on the assessment of bone mineralization response to dietary P, vitamin D, and phytase in nursery pigs. Pens of pigs (six pigs per pen) were randomized to six dietary treatments in a randomized complete block design with 10 pens per treatment. Dietary treatments were designed to create differences in bone mineralization and included: (1) 0.19% standardized total tract digestibility (STTD) P (deficient), (2) 0.33% STTD P (NRC [2012] requirement) using monocalcium phosphate, (3) 0.33% STTD P including 0.14% release from phytase (Ronozyme HiPhos 2700, DSM Nutritional Products, Parsippany, NJ), (4) 0.44% STTD P using monocalcium phosphate, phytase, and no vitamin D, (5) diet 4 with vitamin D (1,653 IU/kg), and (6) diet 5 with an additional 50 µg/kg of 25(OH)D3 (HyD, DSM Nutritional Products, Parsippany, NJ) estimated to provide an additional 2,000 IU/kg of vitamin D3. After 28 d on feed, eight pigs per treatment were euthanized for bone (metacarpal, 2nd rib, 10th rib, and fibula), blood, and urine analysis. The response to treatment for bone density and ash was dependent upon the bone analyzed (treatment × bone interaction for bone density, P = 0.044; non-defatted bone ash, P = 0.060; defatted bone ash, P = 0.068). Thus, the response related to dietary treatment differed depending on which bone (metacarpal, fibula, 2nd rib, or 10th rib) was measured. Pigs fed 0.19% STTD P had decreased (P < 0.05) bone density and ash (non-defatted and defatted) for all bones compared to 0.44% STTD P, with 0.33% STTD P generally intermediate or similar to 0.44% STTD P. Pigs fed 0.44% STTD P with no vitamin D had greater (P < 0.05) non-defatted fibula ash compared to all treatments other than 0.44% STTD P with added 25(OH)D3. Pigs fed diets with 0.44% STTD P had greater (P < 0.05) defatted second rib ash compared to pigs fed 0.19% STTD P or 0.33% STTD P with no phytase. In summary, bone density and ash responses varied depending on bone analyzed. Differences in bone density and ash in response to P and vitamin D were most apparent with fibulas and second ribs. There were apparent differences in the bone ash percentage between defatted and non-defatted bone. However, differences between the treatments remain consistent regardless of the analytic procedure. For histopathology, 10th ribs were more sensitive than 2nd ribs or fibulas for the detection of lesions.

Lameness is defined as impaired movement or deviation from normal gait. There are many factors that can contribute to lameness, including but not limited to: infectious disease, genetic and conformational anomaly, and toxicity that affects the bone, muscle, and nervous systems. Metabolic bone disease is another cause of lameness in swine production and can be caused by inappropriate levels of essential vitamins or minerals. To understand and evaluate bone mineralization, it is important to understand the differences in diagnostic results between different bones and analytical techniques. Historically, percentage bone ash has been used as one of the procedures to assess metabolic bone disease as it measures the level of bone mineralization; however, procedures and results vary depending on the methodology and type of bone measured. Differences in bone density and ash in response to dietary P and vitamin D were most apparent in the fibulas and second ribs. There were apparent differences in the percentage of bone ash between defatted and non-defatted bone; however, the differences between the treatments remain consistent regardless of the analytic procedure. For histopathology, 10th ribs were more sensitive than 2nd ribs or fibulas for detection of lesions associated with metabolic bone disease.

High Dietary Phosphorus Is Associated with Increased Breast Cancer Risk in a U.S. Cohort of Middle-Aged Women.

Research has shown that high amounts of dietary phosphorus that are twice the amount of the U.S. dietary reference intake of 700 mg for adults are associated with all-cause mortality, phosphate toxicity, and tumorigenesis. The present nested case-control study measured the relative risk of self-reported breast cancer associated with dietary phosphate intake over 10 annual visits in a cohort of middle-aged U.S. women from the Study of Women's Health Across the Nation. Analyzing data from food frequency questionnaires, the highest level of daily dietary phosphorus intake, >1800 mg of phosphorus, was approximately equivalent to the dietary phosphorus levels in menus promoted by the United States Department of Agriculture. After adjusting for participants' energy intake, this level of dietary phosphorus was associated with a 2.3-fold increased risk of breast cancer incidence compared to the reference dietary phosphorus level of 800 to 1000 mg, which is based on recommendations from the U.S. National Kidney Foundation, (RR: 2.30, 95% CI: 0.94-5.61, p = 0.07). Despite the lack of statistical significance, likely due to the small sample size of the cohort, the present nested case-control study's clinically significant effect size, dose-response, temporality, specificity, biological plausibility, consistency, coherence, and analogy with other research findings meet the criteria for inferred causality in observational studies, warranting further investigations. Furthermore, these findings suggest that a low-phosphate diet should be tested on patients with breast cancer.

Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study.

BACKGROUND: This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD: This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS: Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION: The findings of this study can be used in various fields of healthcare in the hospital and community.

Evaluation of a novel phytase derived from Citrobacter braakii and expressed in Aspergillis oryzae on growth performance and bone mineralization indicators in nursery pigs.

A total of 297 pigs (DNA 241 × 600; initially 8.64 ±â€…0.181 kg) were used in a 21-d trial to determine the efficacy of a novel phytase derived from Citrobacter braakii and expressed in Aspergillis oryzae (HiPhorius; DSM Nutritional Products, Animal Nutrition & Health, Parsippany, NJ) on pig growth and bone mineralization indicators. Pens of pigs were assigned to 1 of 5 dietary treatments in a randomized complete block design with 5 pigs per pen and 12 pens per treatment. The trial was initiated 14-d after weaning. The first three treatments were formulated to contain 0.09% aP; without added phytase (control), or the control diet with 600 or 1,000 FYT/kg of added phytase (considering a release of 0.15% or 0.18% aP, respectively). The remaining two treatments were formulated to contain 0.27% aP, one without added phytase and the other with 1,000 FYT/kg. From days 0 to 21, pigs fed increasing phytase in diets containing 0.09% aP had increased (linear, P ≤ 0.002) ADG, ADFI, and G:F, but added phytase in the 0.27% aP diet did not impact growth performance. Increasing phytase in diets containing 0.09% aP increased percentage bone ash in metacarpals and 10th ribs (linear, P < 0.001; quadratic, P = 0.004, respectively), and increased grams of Ca and P in metacarpals, 10th ribs, and fibulas (linear, P ≤ 0.027). Adding 1,000 FYT/kg phytase in diets with 0.27% aP increased (P ≤ 0.05) percentage bone ash and grams of Ca and P in fibulas and 10th ribs compared with pigs fed 0.27% aP without added phytase. Increasing aP from 0.09% to 0.27% in diets without added phytase increased (P < 0.001) ADG, ADFI, and G:F. Increasing aP from 0.09% to 0.27% in diets without added phytase increased bone density (P ≤ 0.002) in fibulas and metacarpals, percentage bone ash in all bones (P ≤ 0.074), and increased (P < 0.05) grams of Ca and P in fibulas and 10th ribs. Pigs fed diets containing 0.09 or 0.27% aP, both with 1,000 FYT added phytase, had increased (P < 0.05) bone density in fibulas and metacarpals, percentage bone ash in all bones, and increased grams of Ca and P in fibulas and 10th ribs. For growth performance (average of ADG and G:F), aP release was calculated to be 0.170% for 600 FYT/kg and 0.206% for 1,000 FYT/kg. For the average of all bone measurements (average of 3 bones for both bone density and percentage bone ash), aP release was calculated to be 0.120% and 0.125% for 600 and 1,000 FYT/kg, respectively.

Approximately 60% to 80% of phosphorus (P) in feedstuffs of plant origin is stored in the form of phytic acid. Phytase is an enzyme used in swine diets to improve the digestibility of phytate-bound P. As phytase sources continue to advance, their efficacy must be evaluated. In this study, nursery pigs (9 kg) were used to determine the efficacy of a novel phytase derived from Citrobacter braakii and expressed in Aspergillis oryzae in releasing phytate-bound P. Increasing phytase added to diets deficient in aP improved growth performance and bone mineralization. Adding phytase to a diet already adequate in aP did not affect growth performance, but improved bone mineralization indicators. Available P release attributed to phytase was estimated using growth performance and found to be 0.170% for 600 FYT/kg and 0.206% for 1,000 FYT/kg. For the average of all bone measures, the estimated aP release was 0.120% for 600 FYT/kg and 0.125% for 1,000 FYT/kg. Results of this study indicate an increasing release of phytate-bound P with increasing additions of the novel phytase tested in nursery diets and confirm that additional P is needed for bone development compared to growth.

Digestibility of calcium in calcium-containing ingredients and requirements for digestible calcium by growing pigs.

The concentration of Ca in plant feed ingredients is low compared with the requirement for pigs and most Ca in diets for pigs is provided by limestone and Ca phosphate. To determine digestibility values for Ca that are additive in mixed diets, the standardized total tract digestibility (STTD) of Ca needs to be calculated, and the STTD of Ca by growing pigs in most Ca-containing ingredients has been reported. Although Ca is an inexpensive nutrient compared with P and amino acids, excess Ca needs to be avoided because excess dietary Ca results in reduced P digestibility, reduced feed intake, and reduced growth performance of pigs. Recent data indicate that most diets produced for pigs in the United States and Europe contain ~0.20 percentage units more Ca than formulated, which likely is because of the use of limestone as a carrier in feed additives or as a flow agent in other ingredients. An excess of this magnitude without a corresponding excess of P will result in a reduction in daily gain of growing pigs by 50 to 100 g. Greater emphasis, therefore, needs to be placed on determining the concentration of Ca in diets for pigs. Microbial phytase increases the digestibility of both Ca and P and it is, therefore, important that the release of both Ca and P by phytase is considered in diet formulation. However, due to the relationship between Ca and P in postabsorptive metabolism, diets need to be formulated based on a ratio between digestible Ca and digestible P. To maximize average daily gain, this ratio needs to be less than 1.40:1.0 in diets for weanling pigs, and the ratio needs to be reduced as the body weight of pigs increases. In contrast, to maximize bone ash, the digestible Ca to digestible P ratio needs to increase from 1.67:1.0 in 11 to 25 kg pigs to 2.33:1.0 in finishing pigs. Gestating sows have reduced STTD and retention of Ca and P compared with growing pigs and formulation of diets for sows based on digestibility values obtained in growing pigs will result in inaccuracies in the provision of Ca and P. There is, however, a lack of data for the digestibility of Ca and P by gestating and lactating sows, and responses to microbial phytase by sows are not fully understood. There is, therefore, a need for research to generate more data in this area. In the present review, a summary of data for the digestibility of Ca in feed ingredients for pigs and estimates for the requirement for digestible Ca by growing and finishing pigs are provided.

Concentration of Ca in most plant feed ingredients is low compared with the requirement for pigs and dietary Ca is, therefore, mostly provided by limestone and calcium phosphates. Although Ca is an inexpensive nutrient compared with P and amino acids, excess dietary Ca may result in reduced P digestibility, feed intake, and growth performance of pigs. Excretion of P from pigs is increased if dietary Ca is provided above the requirement, which may increase environmental pollution. Therefore, determination of the digestibility of Ca in dietary sources of Ca and formulation of diets based on the ratio between digestible Ca and digestible P are needed to reduce Ca and P excretions. This review provides a summary of values for the digestibility of Ca in feed ingredients and also provides estimates for the requirement for digestible Ca by weanling and growing-finishing pigs. Summarized data from experiments that determined the requirement for digestible Ca demonstrated that there are linear correlations between body weight of growing-finishing pigs and digestible Ca to digestible P ratios needed to maximize growth or bone ash.

Prevalence of Anemia and Associated Risk Factors among Pregnant Women in Semarang, Indonesia, during COVID-19 Pandemic.

Background: The coronavirus disease-2019 (COVID-19) pandemic has caused several changes that affect overall health, including the prevalence of anemia in pregnant women. Several risk factors, including iron deficiency during pregnancy, diabetes, maternal smoking, preterm birth, low birth weight, and multiple pregnancies, can influence poor iron intake in infants. This study aims to analyze the prevalence and factors associated with anemia in pregnant women during the COVID-19 pandemic. Methods: A cross-sectional study was conducted on 238 pregnant women from two districts in Semarang, Indonesia. The study population was selected using a cluster sampling technique. Trained enumerators collected data through interviews using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to estimate participants' food intake and anthropometric measurements. Additionally, hemoglobin levels were measured by trained nurses during antenatal care (ANC) visits. Univariate and multivariate analyses were performed using logistic regression to estimate the factors associated with anemia in pregnant women during the COVID-19 pandemic. Results: Among all participants, 14.3% (n=34) were anemic, with 32.3% and 67.6% having moderate and mild anemia, respectively. Moreover, study variables such as less compliance with ANC (antenatal care) guidelines (p = 0.020), excessive phosphorus intake (p = 0.039), inadequate zinc intake (p = 0.003), and inadequate calcium intake (p = 0.043) were associated with anemia among pregnant women. Conclusion: Anemia among pregnant women in Semarang, Indonesia, is a mild public health problem. Less compliance with ANC guidelines, excessive phosphorus intake, and inadequate zinc intake are significantly associated with anemia among pregnant women during the COVID-19 pandemic.

Effect of dietary calcium concentration and exogenous phytase on inositol phosphate degradation, mineral digestibility, and gut microbiota in growing pigs.

Variations in the dietary Ca concentration may affect inositol phosphate (InsP) degradation, and thereby, P digestibility in pigs. This study assessed the effects of dietary Ca concentration and exogenous phytase on InsP degradation, nutrient digestion and retention, blood metabolites, and microbiota composition in growing pigs with ileal cannulation. In a completely randomized row-column design with four periods, eight ileal-cannulated barrows (initial body weight 27 kg) were fed four corn-soybean- and rapeseed meal-based diets containing 5.5 or 8.5 g Ca/kg dry matter (DM), with or without 1,500 FTU of an exogenous hybrid-6-phytase/kg diet. No mineral P was added and the P concentration in the feed was 4.8 g P/kg DM. Prececal InsP6 disappearance in pigs fed diets containing exogenous phytase was lower (P = 0.022) with additional Ca than without. Concentrations of InsP2-4 isomers and myo-inositol in the distal ileal digesta and prececal P digestibility were greater (P < 0.001) with exogenous phytase than without exogenous phytase. In feces, InsP6 disappearance was lower (P < 0.002) and concentration of InsP5 and InsP4 isomers was higher (P ≤ 0.031) with additional Ca compared to without additional Ca. The prececal amino acid digestibility, energy digestibility, and hindgut disappearance of energy did not differ. The Shannon diversity index of the microbiota in the distal ileal digesta and feces was similar among the diets but was lower in the distal ileal digesta than in the feces (P < 0.001). Permutation analysis of variance revealed no dietary differences between the bacterial groups within the ileal digesta and fecal samples (P > 0.05). In conclusion, additional Ca reduced the effect of exogenous phytase on prececal InsP6 degradation. Endogenous InsP degradation was impaired by additional Ca only in the hindgut but the abundance of bacterial genera in feces was not affected.

The dietary calcium concentration can influence the release of phosphorus from phytate in growing pigs. This study assessed the effects of dietary calcium and exogenous phytase on inositol phosphate (InsP) degradation and nutrient digestibility in ileal-cannulated, growing pigs. The phosphorus, calcium, and myo-inositol concentrations in the blood, microbiota composition in the ileal digesta and feces, and volatile fatty acid concentrations in the feces were also evaluated. Additional dietary calcium decreased prececal inositol hexakisphosphate (InsP6) disappearance, but only with exogenous phytase. Concentrations of InsP2-4 isomers and myo-inositol in the ileal digesta and prececal phosphorus digestibility were greater with exogenous phytase, but not affected by dietary calcium concentration. In contrast, fecal InsP6 disappearance was lower and the concentration of InsP4-5 isomers in feces was greater with additional dietary calcium. Regarding microbiota, the Shannon diversity index was lower in ileal digesta than in feces but was unaffected by dietary calcium concentration or exogenous phytase. In conclusion, dietary calcium concentration is relevant for phytate disappearance in feces, but not in the ileal digesta. However, when exogenous phytase is used, the dietary calcium concentration is important because prececal phytate degradation is changed.