International Dietary Phosphorus Consensus Conference
Phosphorus
in Food and Preservatives and its Role in Diseases of Kidney and Heart, Bone
and Mineral Disorders and Cancer
Tuesday, June 26, 2012,
Hilton Hawaiian Village, Honolulu, Hawaii, USA
OBJECTIVES
Phosphorus, an abundant element in
nature, is an important component of food proteins and other nutrients. In form
of phosphate or other chemical compounds, phosphorus plays an instrumental role
in the structure and function of enzymes and vital metabolic pathways of living
organisms including in human body. Adequate dietary phosphorus is required to
survive and to remain healthy. However, emerging research suggests that the
contemporary nutrition in form of processed food contains too much unnatural
phosphorus. The inorganic phosphorus contained in most food preservatives is by
far more absorbable and can lead to deleterious consequences. High dietary
phosphorus burden may engender or aggravate diseases of the endocrine system,
bones and kidneys and may be a risk factor for cardiovascular disease and
malignancies. In contrast, phosphorus in non-processed plant foods including
legumes, nuts, fruits and vegetables including phytates
are less absorbable in humans. Other important sources of natural phosphorus
are animal proteins, which are in different types with wide ranges of
phosphorus to protein ratios.
This consensus conference serves as a
pioneering expert panel meeting related to phosphorus in food and its impact on
health and disease. The topics and discussions will be presented by recognized
experts in the field and provide broad review of phosphorus homeostasis and its
biology and pathophysiology. Disease states that are most affected by dietary
phosphorus have dedicated sessions including kidney disease and its
complications, bone and mineral disorders, cardiovascular disease and arterial
calcification, and malignant disorders. Nutritional aspects of phosphorus
compounds including the role of processed and enhanced food in the contemporary
burden of dietary phosphorus will be discussed. Natural sources of phosphorus
in plant and animal proteins and the role of different types of food on
phosphorus digestibility will be reviewed in the context of contemporary data.
Additional discussion will be devoted to toxicological
aspects of natural and added phosphorus compounds in foods, health policies
pertaining to regulation of dietary phosphorus, special issues with hidden
forms of phosphorus in the diet with focus on chronic kidney disease epidemic,
and technical aspects of measuring phosphorus in food. The traditional and
emerging roles of phosphorus binders in the management of kidney diseases and
the potential roles in earlier stages of chronic kidney disease will be
reviewed.
.
Topics:
1.
The
story of phosphorus and phosphate: Nature, element, history
2.
Broad
overview of phosphorus homeostasis: renal, bone, and intestinal physiology
3.
Phosphorus
and kidney disease and phosphorus lowering interventions,
4.
Phosphorus
binders: Current and future
5.
Phosphorus
and bone disease, cardiovascular diseases, malignancies, and other disease
states
6.
Phosphorus
and nutrition: Phosphorus compounds in foods and organic phosphate, naturally
occurring phosphates: animal vs. plant compounds
7.
Phosphorus
compounds in foods: Inorganic forms: added phosphates, types (biochemistry),
major uses (pH stabilization, leavening, hydration, anti-microbial properties,
etc.)
8.
Nutritional
(beneficial) aspects of phosphorus compounds in foods: Use of phosphates in
animal feeds, veterinary, plant applications,
9.
Recommended
daily intake of phosphorus and the recommended calcium: phosphate ratio in
humans (adults vs. children), phosphates used for mineral supplementation in
human diets: reasons and perceived benefits (iron enrichment, calcium
enrichment, etc.)
11.
Toxicological aspects of natural and added phosphorus compounds in food
12.
Regulation of natural and added phosphate compound intake in human diets
13. Special
issues with hidden forms of phosphorus in the diet: kidney disease
14. Technical
aspects of measuring phosphorus in food
15.
Phosphorus deficiency in health and disease
.
Contact persons
Kamyar Kalantar-Zadeh,
MD, MPH, PhD (Los Angeles, CA), kamkal@ucla.edu
Ken-Ichi Miyamoto, PhD
(Japan)
Geoffrey Block, MD (Denver, CO)
International Dietary
Phosphorus Consensus Conference
Tuesday,
June 26, 2012, Hilton Hawaiian Village, Honolulu, Hawaii, USA
.
8:00-8:10 AM: Welcome and Program Overview. Geoffrey A Block, Ken-ichi Miyamoto, Kam Kalantar-Zadeh
(10 min)
.
Morning Session 1: Dietary
Phosphorus (8:10-10:00 AM)
Chairs: Ashwini Sehgal, Joseph Vassalotti
8:10-8:30 AM: 1.a. Introduction to phosphorus and
its association with outcomes. Geoffrey A Block
(20 min =15+5)
8:30-8:50 AM: 1.b. Sources of dietary phosphorus. Jaimie Urribari (20 min =15+5)
8:50-9:10 AM: 1.c. Phosphorus in food additives and
preservatives. Mona Calvo
(20 min =15+5)
9:10-9:30 AM: 1.d. Foods with low and high phosphorus. Richard Sherman (20 min=15+5)
9:30-9:50 AM: 1.e. Socio-economic status and dietary
phosphorus exposure. Orlando
Gutierrez (20 min =15+5)
9:50-10:00 AM:
1.f. Additional discussion (10 min)
.
10-10:15 AM:
Break (15 min)
.
Morning Session 2:
Phosphorus Management and Clinical Outcomes (10:15 AM-12:00 noon)
Chairs: Ken-ichi Miyamoto, Harold
Franch
10:15-10:30 AM: 2.a. Risks and benefits of protein
intake restriction for management of phosphorus in CKD. Steven Brunelli (15
min =10+5)
10:30-10:45 AM: 2.b. Phosphorus digestibility of plant
vs. animal proteins and impact of cooking. Janeen Leon (15 min =10+5)
10:45-11:00 AM: 2.c. Phosphorus in health and disease:
Cardiovascular, bone, endocrine, mental. Rajnish
Mehrotra (15 min =10+5)
11:00-11:59 AM: 2.e. Countries report: Food labeling,
government regulations and added phosphorus: Brazil, China, France, Germany,
Israel, Italy, Japan, Korea, Mexico, USA Presenters:
Miguel Riella (Brazil), Angela Wang (China), Denis
Fouque (France), Eberhardt Ritz (Germany), Itzchak
Slotki (Israel), Vincenzo Savica (Italy), Hiroko Segawa (Japan), Youngjoo Kwon (Korea), Alejandro Treviņo-Becerra (Mexico), Lisa Gutekunst (USA) (each 5-7 min, total 60 min)
.
12:00-12:15: break for lunch, followed by working lunch (15 min)
.
Working Lunch Session (12:15-1:30
PM) (75 min)
Moderators: Alp Ikizler, Bryan Kestenbaum
12:15-1:00 PM: Working lunch: Q&A by Industry
affiliates and observants: What are the
expectations? (45
min)
1:00-1:30 PM:
Legal implications of added dietary phosphorus and approach to food
label change, Ricardo Carvajal (30 min= 20+10)
.
Afternoon Breakout Sessions
(1:30-3:15 PM)
(each 2 HRS 15 MIN)
Project
1. Phosphorus containing
additives and their dietary implications
Moderators: Lisa Gutekunst, Mona Calvo, Participants:
Jaimei Uribari, Ricardo Carvajal, Joseph
Vassalotti, Ricardo Carvajal, Hiroko Segawa
Project
2. Plant vs. animal protein
based phosphorus and impact of cooking
Moderators: Ashwini Sehgal, Janeen
Leon, Participants: Amit Sharma, Angela Wang, Youngjoo Kwon, Richard Sherman, Adamasco Cupisti
Project
3. Impact of socio-economic
status and poverty on dietary phosphorus exposure
Moderators: Joachim Ix, Orlando
Gutierrez, Participants: Csaba P. Kovesdy,
Bryan Kestenbaum, John Sim, Ken-ichi
Miyamoto, Itzchak J Slotki
Project
4. Role of dietary phosphorus
in health and disease: Cardiovascular, bone, endocrinologic,
mental and renal disorders.
Moderators: Rajnish Mehrotra,
Geoffrey Block, Participants: Masafumi Fukagawa, Eiji
Takeda, Eberhardt Ritz, Vincenzo Savica, Harold Franch
Project
5. Risks and benefits of
protein intake restriction for phosphorus management in CKD
Moderators: T. Alp Ikizler,
Steven Brunelli, Participants: Kam Kalantar-Zadeh, Jing Chen, Miguel Riella,
Denis Fouque, Alejandro Treviņo-Becerra
.
3:15-3:30 PM: break (15 min)
.
Afternoon Action Plans and
Conclusion Session (3:30-5:00 PM)
Chairs: Csaba P. Kovesdy, Bryan
Kestenbaum
3:30-4:45 PM: Presentations and plans by the five
breakout groups (75 min, each 10-15 min)
4:45- 5:00 PM: Wrapping up, future plans and
conclusions: Geoffrey
A Block, Ken-ichi Miyamoto, Kam
Kalantar-Zadeh (15 min)
.
5:00 PM: Adjourn
.
6:00 PM: Aloha Reception, XVI International Congress on
Nutrition and Metabolism in Renal Disease
.
International Dietary
Phosphorus Consensus Conference
Tuesday,
June 26, 2012, Hilton Hawaiian Village, Honolulu, Hawaii, USA
.
Invited Faculty
|
1 |
Block |
Geoffry A |
USA |
Denver Nephrology |
Denver, CO |
|
|
2 |
Brunelli |
Steven M |
USA |
Harvard Brigham |
Boston, MA |
|
|
3 |
Calvo |
Mona |
USA |
FDA |
Washington, DC |
|
|
4 |
Carvajal |
Ricardo |
USA |
Law Firm, Washington DC |
Hyman,
Phelps & McNamara, P.C. |
|
|
5 |
Chen |
Jing |
China |
Shanghai, Univ. |
Shanghai, China |
|
|
6 |
Cupisti |
Adamasco |
Italy |
Pizza Univ. |
Pizza, Italy |
|
|
7 |
Fouque |
Denis |
France |
Lyon Univ. |
Lyon, France |
|
|
8 |
Franch |
Harold |
USA |
Emory Univ. |
Atlanta, GA |
|
|
9 |
Fukagawa |
Masafumi |
Japan |
Tokai Univ., Isehara |
Isehara, Japan |
|
|
10 |
Gutekunst |
Lisa M. |
USA |
Cleve-Hill
Dialysis |
Buffalo, NY |
|
|
11 |
Gutierrez |
Orlando |
USA |
Univ. Birmingham |
Birmingham, AL |
|
|
12 |
Ikizler |
T. Alp |
USA |
Vanderbilt Univ. |
Nashville, TN |
|
|
13 |
Ix |
Joachim |
USA |
UCSD |
San Diego, CA |
|
|
14 |
Kalantar-Zadeh |
Kamyar |
USA |
Harbor-UCLA |
Irvine, CA |
|
|
15 |
Kestenbaum |
Bryan |
USA |
Univ. Washington |
Seattle, WA |
|
|
16 |
Kwon |
Youngjoo |
Korea |
Seoul, Korea |
Seoul, Korea |
|
|
17 |
Kovesdy |
Csaba P. |
USA |
Univ. Virginia |
Salem, VA |
|
|
18 |
Leon |
Janeen |
USA |
Case-Western Reserve |
Cleveland, OH |
|
|
19 |
Mehrotra |
Rajnish |
USA |
Univ. Washington |
Seattle, WA |
|
|
20 |
Miyamoto |
Ken-ichi |
Japan |
Tokushima Univ. |
miyamoto@nutr.med.tokushima-u.ac.jp |
Tokushima, Japan |
|
21 |
Riella |
Miguel C |
Brazil |
Curitiba |
Curitiba, Brazil |
|
|
22 |
Ritz |
Eberhardt |
Germany |
Heidelberg |
Heidelberg, Germany |
|
|
23 |
Savica |
Vincenzo |
Italy |
Univ. Messina |
Messina, Italy |
|
|
24 |
Segawa |
Hiroko |
Japan |
Tokushima Univ. |
Tokushima, Italy |
|
|
25 |
Sehgal |
Ashwini |
USA |
Case-Western Reserve |
Cleveland, OH |
|
|
26 |
Sharma |
Amit |
USA |
Boise Kidney |
Boise, Idaho |
|
|
27 |
Sherman |
Richard |
USA |
UMDNJ |
Orange, New Jersey |
|
|
28 |
Sim |
John J |
USA |
Kaiser Permanente |
Los Angeles, CA |
|
|
29 |
Slotki |
Itzchak |
Israel |
Jerusalem |
Jerusalem, Israel |
|
|
30 |
Takeda |
Eiji |
Japan |
Univ. of Tokushima |
Tokushima, Japan |
|
|
31 |
Treviņo-Becerra |
Alejandro |
Mexico |
Mexico |
Monterey, Mexico |
|
|
32 |
Uribarri |
Jaime |
USA |
Mount Sinai |
New York, NY |
|
|
33 |
Vassalotti |
Joseph A. |
USA |
NKF |
New York, NY |
|
|
34 |
Wang |
Angela Y. |
China |
Hong Kong |
Hong Kong, China |
.
