# Dietary phosphorus intake and its association with metabolic syndrome and its components: a cross-sectional analysis of the UK national diet and nutrition survey (NDNS)

## TL;DR

This study found that higher dietary phosphorus intake is linked to a lower risk of metabolic syndrome and improved markers like triglycerides and blood pressure in UK adults.

## Contribution

The study provides new evidence on the inverse association between dietary phosphorus and metabolic syndrome prevalence and its components.

## Key findings

- Higher phosphorus intake was associated with a 56% lower risk of metabolic syndrome.
- Triglyceride levels decreased by 10.4 mg/dl with increasing phosphorus intake quintiles.
- Diastolic blood pressure decreased by 2.1 mmHg with higher phosphorus intake.

## Abstract

Phosphorus plays a critical role in carbohydrate and energy metabolism, yet its relationship with metabolic health outcomes remains underexplored. This study aimed to investigate the association between dietary phosphorus intake and the prevalence of metabolic syndrome (MetS), as well as individual MetS components, using data from the UK National Diet and Nutrition Survey.

Data from adults aged 19 years and older were analyzed. Dietary phosphorus intake was assessed using four-day food diaries. MetS was defined based on established clinical criteria. Logistic regression models evaluated the association between phosphorus intake quintiles and MetS occurrence, adjusting for demographic, anthropometric, dietary, and lifestyle factors. Associations between phosphorus intake and individual MetS components were examined based on both total phosphorus intake and phosphorus density.

Individuals in the highest phosphorus intake quintile (> 1509 mg/day) exhibited a 56% lower risk of MetS compared to those in the lowest quintile (OR = 0.44, p  = 0.0004). Higher phosphorus intake was associated with a decrease of 10.4 mg/dl in triglyceride levels from quintile 1 to quintile 5 (mean ± SD: 118.6 ± 87.5 vs. 108.2 ± 61.7, p =  0.002), as well as a 2.1 mmHg reduction in diastolic blood pressure (mean ± SD: 74.6 ± 11.1 vs. 72.5 ± 10.7, p = 0.001). Additionally, modest variations in HDL cholesterol and waist circumference were observed.

Higher dietary phosphorus intake was associated with a lower risk of MetS and beneficial differences in certain MetS components, supporting a potential protective role of phosphorus in metabolic health.

The online version contains supplementary material available at 10.1007/s00394-025-03882-9.