2. Role of Phosphorus in Human Health

3. Introduction Second Most Abundant mineral.
This mineral lays the foundation of a strong skeletal structure to ensure health and functional living.
One of the recent discoveries of phosphorous also link it to heart health, meaning that with a proper intake, you can better protect yourself from a range of cardiovascular diseases.

4. Phosphorous P At. No. 15 Atomic Mass: 30.77

5. PHOSPHORUS

6. Learning Objectives Total body contents and Distribution
Important functions
Dietary sources
Daily Requirements
Absorption and excretion
How its level is maintained
Deficiency diseases

7. Body Distribution in adult human
Phosphorus
Body Distribution in adult human
Total Content kg
80 % is bones and teeth as Hydroxyapatite which is an insoluble crystalline mineral
20 % is in Soft Tissues and ECF and blood

8. Normal Plasma contain inorganic Phosphate
mg/dl in adults
mg/dl in infant
Plasma Phosphate exists in Three forms
Free inorganic PO %
Phosphate complexed with cations ( Na, K , Ca ) 50 %
Phosphate bound with proteins 10 %

9. Function
1. Along with Calcium is required for mineralization of bones and teeth

10. Functions
2. Component of many compounds involved in many metabolic reactions.
3. Sugar – PO4 linkage in DNA and RNA
4. Phospholipids  Transport of fat in blood
Phospholipids  cell membrane control transport of substances into and out of cell

11. Function
5. Is required for the formation of various bio organic substances like :
Coenzymes NAD, NADP, FAD, FMN, TPP, PP
Nucleotides ( UDP, CDP , AMP , ADP, GTP )
Second Messengers (cAMP and c GMP)

12. Functions 6. Phosphorylation
Necessary for glucose absorption from intestine
Glucose uptake by individual cells
Resorption of glucose by kidney

13. Functions
Monosaccharides are Phosphorylated several times during metabolic break down to yield energy.
Involved in storage and release of Energy through high energy phosphate bond of ATP and ADP.

14. Functions 7 Essential part of body’s delicate buffer system
8. Many B vitamins becomes active only when combine with phosphate.

15. Important Sources of Phosphorus
Widely distributed in both animal and plant foods.
Food items like Meat, Fish , Eggs and Milk and Milk products.
Nuts, legumes, rice, potatoes, broccoli and peas are amongst Phosphorus rich food and
Soft drinks specially Coke and Pepsi

16. Dietary Source
Present in all foods, Dietary deficiency is therefore unknown.
Distribution is similar to Ca++ Adequate, intake of one ensures that of the other
Best sources (Milk and milk products)
Lean meat is also a good source.

17. Recommended Dietary Allowance
Infants Up to 6 months mg
6 m – 1.0 year mg
Children 1 – mg
4 – mg
7 – mg

18. Recommended Dietary Allowance
Adults (Male/Females)
11 – mg
15 – mg
19 – mg
23 – mg mg
Pregnant and lactating women should take an additional 400 mg.

19. Digestion
Phosphorus plays an important role in facilitating effective digestion in the human body.
It does this by stimulating the digestion of riboflavin and niacin in an efficient way.
These two vitamins are also essential for human health, so any way that their uptake can be maximized is a good thing.
These two varieties of vitamin B are responsible for everything from energy metabolism to neurological and emotional response systems.

20. Absorption and Metabolism
Most of phosphorus in food is in combined form, absorption requires splitting off of PO4 by intestinal enzymes (Phosphatases).
Organic phosphate in food is hydrolyzed in GIT by Pancreatic & intestinal enzymes.
Inorganic phosphorus is released and absorbed
Normally about 70% of dietary P is absorbed
(For calcium 10 – 30%).

21. Absorption and Metabolism
Absorption and Excretion depend upon Ca : P ratio in diet.
Excess of either one causes, an increased excretion of other.
Mid jejunum is the main site of absorption for free PO4 .
In ileum absorption occurs via active process.

22. Absorption and Metabolism
Its absorption decreases during period of increased utilization of carbohydrate

23. Absorption and Metabolism
Factors affecting Ca++ absorption also apply to Phosphorus, like enhancement by Vit D and PTH and inhibition by binding agents i.e. Iron and Aluminium.

24. Excretion Phosphate level is regulated by urinary excretion
3.5 mg / dl is the renal thresh hold
500 mg / day is excreted in urine

25. EXCRETION P is mainly excreted in Urine (60%) and 40 % in feces.
Fecal excretion is increased when intake is increased.
Intestinal absorption is decreased then
In Hyperparathyroidism excretion is more.
PTH effect on PO4

26. Excretion General factors affecting intestinal absorption
Plasma concentration and Hydrolysis of PO4 esters by phosphatases in the kidney.
Decrease Ca++ intake will increase urinary PO4 excretion

27. Ratio of P : Ca, Ideal 1 : 1
Specially during the period of rapid growth (childhood), pregnancy and lactation.
Ratio in other age groups if different, have no serious adverse effect

28. In Infants
Care should be exercised as kidneys can’t handle high phosphate load.
For Prevention of hypocalcemic tetany Ca : P ratio be 1.5 : 1
Ratio should be reduced to 1:1 by age 1 yr

29. Hypo-Phosphatemia Diminished Supply: Starvation Malnutrition
Vit D – Deficiency
Increased excretion / loss
Hyperparathyroidism
Hyper thyroidism
Renal defects

30. Hypo-Phosphatemia Intracellular shift of phosphorus
Glucose induced
Insulin induced
Respiratory alkalosis
Electrolytes administration
Hypercalcaemia
Hypomagnesimia

31. Deficiency Symptoms of Phosphorus
The most significant deficiency symptoms of phosphorus include weak bones and discomfort in various body joints.
Phosphorus acts in a similar way as calcium does in providing strength to bones, so a deficiency of phosphorus may lead to weakness, tooth decay, rickets and other related bone problems.
People may also experience a loss of appetite and diminished body stamina to perform routine activities.

32. Deficiency Symptoms of Phosphorus
A deficiency of phosphorus may also invite numbness, anxiety, tremors, weight loss and stunted growth.
It is an essential part of our diet, particularly as children, when the most growth and development occurs, and needs to happen regularly and with a full backing of the proper nutrients.

33. Hyper-Phosphatemia Endocrine disease 2. Renal Diseases
Increased growth hormones (acromegaly)
Hypo parathyroidism low calcium
Pseudo hypo parathyroidism
2. Renal Diseases
Chronic renal insufficiency
Acute renal failure

34. Hyper-Phosphatemia 3. Catabolic states Excess intake or Absorption
Stress or injury
Chemotherapy for malignant disease
Excess intake or Absorption
Laxatives or Enemas containing phosphate
Hyper vitaminosis – D

35. Clinical Importance

36. Regulation of Plasma Phosphorus
Like Calcium PTH and Vitamin D regulates it in blood.
Vit D maintains the normal Po4 level in hypophoshtemic state.
Low plasma PO4 level stimulates the renal enzyme hydoxylase which enhances the conversion of Calcidiol to Calcitriol.
It effects the intestine to absorb more P, on bones to release more P and on kidneys to reduce excretion.

38. These benefits of phosphorous make it an important constituent of our diet.
Healthy bone formation
Improved digestion
Regulated excretion
Protein formation
Hormonal balance
Improved energy extraction
Cellular repair
Optimized chemical reactions and
Proper nutrient utilization.

39. Beyond the uptake of vitamins and minerals, phosphorous directly clears up digestion and constipation diarrhea, and generally tones up the digestive system for regular, healthy bowel movements.
This increases the health of the digestive system, as well as that of the kidneys, since the toxins are being eliminated from the body, rather than recycling through the kidneys and stressing that system.

40. Thanks