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The Official Newsletter of Bodyfatguide.com
updated October 2, 2016


Prevent Chronic Disease with a Phosphorus-Restricted 
Raw Vegan Diet

by Ron Brown, Ph.D., author of The Body Fat Guide 

"Ron Brown is a certified fitness trainer who doesn't have an inch of flab on his body. He'll tell you what you can do to become fit and trim too." 
TALK TO AMERICA,
Washington DC


PHOSPHORUS is one of the most common minerals consumed in the Western diet. Phosphorus is an essential nutrient in many metabolic activities, but excessive amounts of dietary phosphorus causes phosphate toxicity that is harmful to health (Razzaque, 2011). A phosphorus intake that is twice the adult recommended dietary allowance of 700 mg per day "is associated with increased mortality in a nationally representative, healthy US population," which researchers suggest has "important public health implications" (Chang et al., 2013). It was found that approximately 35% of the disease-free adult population consumed a daily average of 1400 mg or more of phosphorus. Mortality also increased when the phosphorus caloric density exceeded 700 mg phosphorus per 2,000 calories, or 0.35. The average phosphorus caloric density was 0.58.

A low-phosphorus diet is clinically effective in helping patients manage chronic kidney disease (Barsotti & Cupisti, 2005). Evidence suggests that dietary phosphorus restriction may reduce all-cause mortality by preventing other chronic diseases associated with phosphate toxicity, like osteoporosis, cardiovascular disease, and tumor formation. The first part of this article cites peer-reviewed research literature that examines the association between excess dietary phosphorus, tumor growth or tumorigenesis, and bone loss. The second part presents a practical strategy to reduce excessive levels of dietary phosphorus with a raw vegan diet. 

Today's cooked-starch Neolithic diet and less conventional flesh-based Paleolithic diet may be considered survival diets for our human species that originated and developed through biological natural selection during historical periods of climate change, continental drift, population migration, hunting, food gathering, and agricultural development. As modern transportation continues to provide a greater diversity of fresh imported plant-based foods to consumers, it is becoming much easier to consume a balanced raw vegan diet that is hypothesized to be closer to our original species-specific optimal diet, based on inter-species comparisons with human anatomical structure and complementary physiological function. If this hypothesis is correct, than the diet described in this article may have broad applications to restore and maintain optimal health in a wide variety of physical and mental conditions.

Phosphorus, Tumors, & Bone Loss

Many carcinogenic substances are associated with tumors and cancer. However, Dr. T. Colin Campbell (2009) pointed out that these substances only initiate the first stage of cancer development through cell mutation—the next stages involving promotion and progression of cancer seem to be much more dependent on other lifestyle factors, including diet. In other words, as Dr. Campbell demonstrated in his laboratory experiments, whether or not a carcinogen is promoted and progresses into cancer is largely a matter of nutrition.

Increasing phosphorus levels cause observed changed behavior and metabolism in cancer cells (Ramirez & Fiedler, 2014). High intake of dietary phosphorus has been found to stimulate tumor growth (Camalier et al., 2010; Jin et al., 2009). Phosphorus intake that was twice the Institute of Medicine's recommended dietary allowance of 700 mg/day was associated with "greater risk of overall prostate cancer and lethal and high-grade cancers" (Wilson, Ma, & Giovannucci, 2011). Cancer growth and regression in lab animals was associated with dietary intake of casein, a phospho-protein in cow milk (Campbell & Campbell, 2006). Cancer patients have been observed to retain and store phosphorus in tumors (Fenninger et al., 1953), and cancer cells accumulate twice as much phosphorus as normal cells (Elser et al., 2007; Rasmussen & Steinberg, 2012). 

The propensity of tumors to absorb high amounts of phosphorus led to the early use of radioactive phosphorus to locate brain tumors (Selverstone et al., 1949) and intraocular tumors (Dunphy et al., 1956). Using radioactive isotopes, researchers found that mammary carcinoma, lymphoma, and lymphosarcoma tissue had a higher and faster uptake up phosphorus with longer retention than normal tissue (Jones et al., 1940). More recently, cancer patients were found to have over twice the amount of phosphorus in their blood compared to patients without cancer (Papaloucas et al., 2014; Sivakumar & Mohankumar, 2012). As large tumors are forced apart (lyse) during conventional medical therapy they release high amounts of their accumulated phosphorus and other substances back into the blood stream, causing a toxic condition known as tumor lysis syndrome. In the reverse process, case studies have also shown that oncogenic hypophosphatemia is positively associated with tumor growth, indicating that extracellular phosphorus in the serum is removed and taken up by the growing tumor (Clunie, Fox, & Stamp, 2000, Matzner et al., 1981).

These facts support the hypothesis that tumor growth occurs as the body removes and stores excess phosphorus out of circulation when serum levels of phosphorus remain elevated (hyperphosphatemia), and that surplus phosphorus is released back into the serum when needed, causing the tumor to shrink. In other words, rather than generating useless tissue, tumorigenesis may be a type of phosphorus homeostatic mechanism or rebalancing action taken by the body to maintain internal stability under severe and chronic conditions, somewhat similar to the homeostatic effect of an acute inflammatory response to injury (Calder et al., 2009). In fact, tumorigenesis has been shown to be regulated by the inflammatory response through the release of cytokines (Zaki, Lamkanfi, & Kanneganti, 2011). Gradual changes occur in tissue structure (dysplasia) during chronic inflammation which eventually form tumor cells. The uptake and release of serum phosphorus into and out of tumors may be analogous to the uptake and release of dietary fat into and out of stored body fat. Just as restricting one's dietary fat intake below caloric maintenance levels will reduce adiposity, so too may sufficiently restricting dietary phosphorus intake reduce tumor size.

In biology, the fungal root system of plants (mycorrhiza) acquires phosphorus from the soil and sequesters it in the plant (Bünemann et al., 2010, p. 150). Perhaps a similar fungal mechanism operates in humans which acquires and sequesters excess phosphorus into tumor cells—i.e., a phosphorus sequestration theory of tumorigenesis. Hippocrates noted the crab-leg appearance of vessels attached to tumors from which the name cancer was applied. Like fungal roots in a plant, the tumor's blood and lymph vessel system spreads out to acquire phosphorus from extracellular tissue. An environment high in phosphorus has been found to induce tumor neovascularization and angiogensis, or new blood vessel formation (Lin et al. 2014). Fungal infections are common in cancer patients (Böhme et al., 2009). Just as fungi breakdown toxic contaminants in soil and emit volatile aromatic compounds which allow dogs to sniff out truffles, trained dogs are also able to sniff out cancer in early detection of malodorous dimethyl trisulfide from fungating cancer lesions (Shirasu et al., 2009). Mycotoxin fungus is sequestered in homes and villages of people with higher cancer incidence, (Gedek, 1976), possibly contaminating their drinking water. Farmers of Liuchong Village in the Hubei province of China claimed cancer cases increased in their village from drinking water contaminated by a nearby phosphate mine (Schmitz, 2013).

Describing his opinion of the "protective nature" of tumor formation, Shelton wrote in Orthopathy that "it prolongs life in the face of causes, which, except for the tumor-formation, would produce death much earlier." In other words, if hyperphosphatemia is not reduced by homeostatic responses such as tumor formation, death would soon result. Researchers verified that the immune system in mice actively protects tumor cells, blocking effector T-cells (TEFFS) from destroying tumor cells as they begin to form (Darrasse-Jeze et al., 2009). Canadian researchers discovered that white blood cells, which protect the body against infection, activated cancer cells and helped tumors proliferate in mice (Cools-Lartigue, 2013). The body actively supplies tumors with growth-promoting proteins (Goldstein et al., 2012), and chemotherapy, which often uses phosphorus-based toxins like cyclophosphamide (mustard gas), was found to promote "tumor cell survival and disease progression" (Sun et al, 2012). When prostate tumor cells were transplanted into 872 healthy mice, the tumor cells turned into healthy prostate cells (Roller & Heidelberger, 1967). All these findings provide strong evidence that the body does not treat tumor cells as foreign invaders—rather, the body initiates, strengthens, and supports tumorigenesis as a protective homeostatic function when systemic toxicity rises. This phosphate homeostasis hypothesis could lead to a paradigm shift in understanding the cause and treatment of cancer in humans.

Bone loss is another phosphorus homeostatic mechanism that regulates hyperphosphatemia. Calcium is removed (resorbed) from bone in response to excess serum phosphorus, which eventually leads to osteoporosis. The association of osteoporosis with cancer implies that phosphate homeostasis may contribute to the etiology of both diseases. For example, men with greater bone mineral density were found to have a reduced risk for prostate cancer (Farhat et al., 2009), although women with greater bone mineral density had increased risk for breast cancer likely due to confounding hormonal factors (American Cancer Society, 2012). The National Institutes of Health (2012) reported that breast cancer may stimulate bone loss, although it may be that bone loss and breast cancer are both initially stimulated by hyperphosphatemia.  Cancer risk increased 25% among osteoporosis patients the first year after hospitalization (Ji, Sundquist, & Sundquist, 2012), and bone is the most common site for metastasis in breast cancer (Pennery, 2005), suggesting that metastasis and bone pathology may both be caused by phosphate homeostasis. An analysis of male health professionals also found a significant association between cancer risk and periodontal disease that affects teeth and supporting bone (Michaud et al., 2008).

An association between higher serum phosphorus levels and risk for cancer was found in a population of over 397,000 male and females, except in cases of breast and endometrium cancer in women (Wulaningsih, et al., 2013). The researchers suggested that increased estrogen levels in women prevent phosphorus re-absorption in the kidneys in these exceptions, but this is based on studies of hormone replacement therapy. In the meantime, higher estrogen levels in women are associated with increased cancer risk, regardless of estrogen's ability to regulate serum phosphorus levels. It is important to note that normal serum phosphorus levels are not a good indicator of increasing "phosphate storage" within the body (Osuka & Razzaque, 2012). In a private correspondence to me, researcher Wulaningsih agreed that it is necessary to use additional biomarkers of phosphorus homeostasis other than serum levels. 

Another useful biomarker of phosphorus homeostasis is fibroblast growth factor-23 (FGF-23), a protein that prevents the kidneys from reabsorbing filtered phosphorus back into the blood, thereby mitigating or preventing hyperphosphatemia. Elevated levels of FGF-23 have been associated with increased risk for bone fractures in elderly men (Mirza et al., 2011) and with increased risk for colorectal tumors (Jacobs et al., 2011). FGF-23 levels are also elevated in late-stage ovarian cancer patients and in patients with tumor-induced osteomalacia (Berndt, Schiavi, & Kumar, 2005). Dietary phosphorus restriction lowered FGF-23 levels in healthy subjects and in patients with chronic kidney disease (Sigrist et al., 2012). Would a phosphorus restricted diet have the same effect in cancer patients?

Cancer is also associated with obesity, probably partially because obesity-related kidney disease impairs kidney filtration causing "phosphate toxicity" (Ohnishi, Kato, & Razzaque, 2011).  Fasting or calorie restriction improves kidney filtration (Bemieh et al., 2010 ), thus helping to reduce phosphate toxicity. As calorie intake is reduced, the body may also gradually breakdown tumors and other cellular deposits through autolysis, or self-digestion (Shelton, 1978). Shelton claimed that in autolysis "accumulations of superfluous tissues are overhauled and analyzed...the refuse is thoroughly and permanently removed." Cancer cell self-digestion is recognized in chemotherapy and is called autophagy (Marx, 2006). Cancer is associated with height in women as well (Kabat et al., 2013). A possible explanation is that, as in obesity, taller people have a greater caloric intake from a conventional diet that is high in phosphorus. Cancer remission is also associated with infectious fever (Kleef et al., 2001), which may be related to unintentional weight loss that occurs during the course of the infection.

Tumor lysis syndrome is avoided during fasting or calorie restriction as the body slowly and persistently self-digests the tumor and eliminates or reuses its contents—an amount Shelton estimated as "a few grams a day" (1978). Recent research verified that fasting breaks down tumor cells without harming normal cells in a process called differential stress resistance (Lee et al., 2012). Laviano and Fanelli (2012) explained: "In the absence of nutrients, normal cells switch their metabolism toward maintenance pathways, whereas tumor cells are unable to activate this protective response." Furthermore, tumor cells may actually assist in providing "maintenance pathways" to normal cells by breaking down into reusable substances. For example, as the fasting body continues to need phosphorus each day to maintain vital tissue, it is likely that a portion of phosphorus released from tumor cells is reused to nourish other cells. In this way, as Shelton claimed, less vital tissue nourishes vital tissue.

Calorie restriction and fasting in mice have been shown to reduce tumorigenesis (Moore et al., 2012 ) and "weaken" cancer, producing results superior to chemotherapy (Lee et al., 2012). Therefore, it may be possible that reduced food intake resulting from the adverse effect of lost appetite in chemotherapy is more responsible for reducing tumors than the therapeutic effect of chemotherapy itself. Camalier et al. (2010) suggested "reducing dietary phosphate as a novel target for chemoprevention" (cancer prevention). Physical activity also reduces cancer risk by affecting hormones, the immune system, and energy balance (American Cancer Society, 2007). Hursting (2012) wrote, "...the mechanisms underlying the energy balance-cancer link will facilitate the development of novel prevention and treatment strategies." A mathematic model suggests that reducing a tumor's phosphorus uptake in half would reduce tumor size by 75% (Kuang, Nagy, & Elser, 2004).

As the world struggles to find a cancer cure, the above findings support the hypothesis for a novel two-step cancer treatment & prevention intervention:

  1. Restrict dietary phosphorus to prevent new tumor growth. 
    (See below).
  2. Autolyze existing tumors with calorie restriction and exercise. 
    (See The Body Fat Guide to modify your energy balance).

Raw Vegan Dietary Phosphorus Restriction

Strategies for dietary phosphorus restriction used in chronic kidney disease patients include eliminating inorganic phosphorus from food additives and selecting grain sources with lower phosphate bioavailability (Gutierrez & Myles, 2010). Limitations of such strategies include lack of food additive knowledge, and reduced bioavailability of essential nutrients from grain consumption (Gutierrez & Myles, 2010). A raw vegan diet has potential as an efficacious dietary phosphorus restriction strategy to meet the needs of kidney patients and anyone interested in preventing kidney disease with associated bone disorders (osteodystrophy), vascular problems (calcification), and tumorigenesis. For more information on dietary phosphorus and bone disorders, see: Cows Don't Drink Milk: Unraveling the Calcium Paradox. For information on phosphorus and cardiovascular disease, see: How Cooking Clogs Your Arteries.

Vegetarian and vegan diets “are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases” (Craig & Mangels, 2009, p. 1266). Writing in Orthopathy, Shelton mentions that, "Cancers are found almost wholly among meat eating animals and only rarely among vegetarian and fruitarian animals." And, "Among races of men, cancer incidence is highest among the meat eating peoples, lowest among vegetarian peoples." Vegan diets tend to be lower in bioavailable phosphorus and may be useful in disease prevention (McCarty, 2003). Vegetarian protein lowered serum phosphorus levels in chronic kidney disease patients more effectively than meat protein (Moe et al., 2011). 

Most phosphorus consumed in the Western diet comes from dairy, meat, fish, fowl, and grain products (Calvo & Park, 1996). High blood levels of omega-3s from consuming oily fish, which is high in phosphorus, was associated with a 43% increased overall prostate cancer risk and 71% increased aggressive prostate cancer risk (Braksy et al., 2013). Conventional diets are also high in sulfur and chloride which are acid-forming elements like phosphorus. Vegan diets are used to proscribe animal-based foods including flesh from mammal, fish, and fowl, eggs, and dairy products, thus reducing dietary phosphorus and sulfur intake significantly. A raw vegan diet also eliminates processed foods high in sodium chloride.

Testifying before a hearing by the United States Senate (1946) on the Gerson Diet for cancer treatment, Dr. Miley, Medical Director of Gotham Hospital, New York City stated, "The diet consists chiefly of large amount of fresh fruit and fresh vegetables and does not allow any meat, milk, alcohol, canned or bottled foods." The Gerson Diet, according to Dr. Miley, normalizes blood serum ratios of sodium, potassium, and phosphorus, thereby correcting "abnormal chemistry of the whole body." Dr. Miley said, "Cancer is primarily a disease of abnormal body chemistry."

As well as eliminating animal-based foods, a raw vegan diet also eliminates cooked plant-based foods such as grain, corn, legumes, and starchy tubers like potatoes which contribute significant amounts of dietary phosphorus per calorie, especially in the large amounts they are usually consumed. Two cups of cooked lentils has 712 mg of phosphorus, and 1,000 calories of potatoes has 826 mg phosphorus compared to only 220 mg phosphorus in 1,000 calories of low-phosphorus fruit—almost four times less phosphorus per calorie. Ross Horne (1988), who worked closely with Nathan Pritikin, described how patients who followed Pritikin's cooked-grain and starch-based vegan diet developed cancer and arthritis. Dr. Ruth Cilento said, "When later reviewing the results of my cancer patients' different dietary programs, I realized that none of the patients on the strict Pritikin Program were recovering." Breast cancer recurrence was also found to increase as female survivors increased their starch intake (Emond, Patterson, & Pierce, 2011), and patients in a clinical trial who drank a soy beverage daily showed no decrease in prostate cancer recurrence (Bosland et al, 2013). In contrast to traditional fermentation methods that produce "stinky" tofu, modern methods of hydrolysis produce free glutamic acid or monosodium glutamate (MSG), a neurotoxin that is hidden in tofu and in other manufactured soy and vegetable protein products. Tofu consumption in a middle-aged population was associated with cognitive decline (White et al., 2000). 

A raw vegan diet that consists predominately of uncooked, low-phosphorus plant-based foods may be used as an effective dietary phosphorus restriction strategy while providing essential nutrients and energy. A phosphorus restricted raw vegan diet also has potential to increase patient compliance through the diet’s convenience, palatability, and satiety. In addition, a diet of natural, unprocessed plant-based foods eliminates phosphate food additives, and, if organic foods are used, reduces intake of organophosphate pesticides that have been related to Attention-Deficit/Hyperactivity Disorder, ADHD (Bouchard et al., 2010). A phosphorus restricted diet has been found effective in reducing symptoms of ADHD (Hafner, 2001). When sugary soft drink and fruit juice intake was studied, only soft drinks, which generally contain phosphoric acid, were associated with pancreatic cancer (Mueller et al., 2010). Carrigan et al. (2014) found that phosphorus additives in processed food increased the total phosphorus content in the average diet in the United States by 60%. This may help explain why cancer rates have steady increased along with intake of processed foods.

Raw vegan diets that include generous quantities of high-protein and high-phosphorus nuts and seeds are not effective for dietary phosphorus restriction.  Used in limited amounts, however, coconuts and macadamia nuts are examples of lower-phosphorus nuts that supply needed concentrated sources of energy and protein in a raw vegan phosphorus restricted diet. Although the absolute amount of phosphorus by weight in coconuts and macadamia nuts is similar to flesh foods and grains, coconuts and macadamia nuts are much lower in phosphorus when measured by calorie. Table 1 shows that phosphorus in macadamia nuts measured by calorie is over 5-6 times lower than lean cuts of beef, chicken, and fish, and over 11 times lower than no-fat cow milk. Macadamia nuts are more than 3 times lower in phosphorus per calorie than whole wheat bread or potatoes, and about 4 times lower than corn. 

TABLE 1.

Phosphorus mg/100g

Phosphorus mg/calorie

Date

62

0.22

Macadamia Nut

188

0.26

Coconut

113

0.32

Avocado

52

0.33

Whole Wheat
Bread

202

0.81

Potato

57

0.83

Corn

89

1.03

Beef, Lean 198 1.39
Tilapia Fish 170 1.77
Chicken Breast 196 1.78

No-Fat Cow Milk

101

2.97

Adapted from USDA National Nutrient Database for Standard Reference. Retrieved from http://www.nal.usda.gov/fnic/foodcomp/search/

Protein in coconut has been found to exceed meat, milk, and eggs in promoting tissue growth (Johns, Finks, & Paul, 1919). An advantage of supplying protein in raw nuts is that none of the amino acid content of the protein has been destroyed (deaminated) as occurs in cooked food, and there is less coagulation of protein that prevents pepsin digestion. Therefore, the body requires less protein from coconuts and other natural raw foods to meet growth and maintenance needs. 

 

Concerns about saturated fat and overall fat levels in coconuts and other nuts as a cause of dyslipidemia and chronic disease have been refuted by numerous investigators (Assunção, Ferreira, dos Santos, Cabral, & Florêncio, 2009; Griel et al., 2008; Prior, Davidson, Salmond, & Czochanska, 1981; Sabaté, Oda, & Ros, 2010). Also, "About 40 per cent of the calories in a typical American diet are derived from fats, which is almost equal to the calories derived from carbohydrates. Therefore, the use of fats by the body for energy is as important as the use of carbohydrates is" (Guyton & Hall, 2006, p.842).

Coconuts and macadamia nuts are higher in phosphorus when measured by weight than by calories (see Table 1) and should be used in strictly controlled amounts to maintain low absolute dietary phosphorus levels. Nut milks made by blending coconut or macadamia nuts with water are versatile replacements for dairy products and can be used in soups, dressings, toppings, smoothies, and dips. 

Avocados are another example of a low-phosphorus plant-based food that can be used to supply a concentrated energy source in a raw vegan phosphorus restricted diet (see Table 1). Dates and other dried fruit also have low amounts of phosphorus measured by calories (see Table 1) and are a rich dietary source of energy and nutrients (Vinson, Zubik, Bose, Samman, & Proch, 2005). Coincidently, dates, coconuts, coconut water, and edible young buds, shoots, leaves, and heart-of-palm all grown on tropical palm trees probably provided an original source of fruit, nuts, and vegetables for our species. 

Oils processed from nuts, seeds, and other foods lack phosphorus, which probably explains why diets high in fat and oil, such as ketogenic diets, have been associated with tumor inhibition (Freedland et al., 2008). Nevertheless, oils are not whole foods, and they should be used sparingly, if at all. Providing a concentrated source of calories along with some of the fat-soluble vitamins, oils lack many other vitamins, minerals, and fiber necessary to provide satiety—they are mostly empty-calorie foods. 

The balance of the phosphorus restricted raw vegan diet should consist of an abundance of fresh whole foods like raw fruit and vegetables, particularly raw dark leafy greens with high calcium-phosphorus ratios such as collards, kale, radish leaves, and bok choy. Greens may be made more palatable blended in a green smoothie with sweet fruit (Boutenko, 2009). Smaller amounts of other raw nuts and seeds like almonds, walnuts, filberts, etc. may also be added to the diet. No sodium in the form of sodium chloride (table salt) should be consumed, neither added on to food nor as an ingredient processed into the food. Spices and condiments should be avoided. No vitamin or mineral supplements are recommended, and only purified or distilled water should be consumed. Patients should keep a spreadsheet of their daily nutrient intake to ensure compliance with phosphorus restriction while maintaining an overall nutrient balance on a raw vegan diet. See Diet Analyzer

Fruits, nuts, and vegetables lowest in phosphorus per calorie are:

TABLE 2.

Phosphorus mg/calorie  

Pineapple Juice 0.15 Kaki 0.24
Pineapple 0.16 Banana 0.25
Mango 0.17 Macadamia 0.26
Casaba Melon 0.18 Durian 0.27
Fig 0.19 Dried Fig 0.27
Pear 0.19 Dried Plum 0.29
Pomegranate Juice 0.20 Grapes 0.29
Persimmon 0.20 Dried Apricot 0.29
Blueberry 0.21 Orange 0.30
Apple 0.21 Honeydew 0.31
Dried Banana 0.21 Coconut Milk  0.31
Grapefruit Florida Red 0.21 Coconut Meat 0.32
Date 0.22 Avocado 0.33
Papaya 0.23 Cherry 0.33

Adapted from USDA National Nutrient Database for Standard Reference. Retrieved January 18, 2013 from http://www.nal.usda.gov/fnic/foodcomp/search/

A sample menu includes blended soups, salads, and smoothies made with:

250 g apple 300 g pineapple
200 g papaya 120 g kale
650 g orange 150 g coconut milk
120 g collards 100 g avocado
250 g banana 250 g pear
100 g dried fig 35 g macadamia nuts
45 g arugula 25 g walnuts

According to the USDA nutrient database, this menu supplies 2,137 calories, 6% protein, 31% fat, 64% carbohydrates, 1220 mg calcium, and 700 mg phosphorus with a calcium-phosphorus weight ratio of 1.74:1. Calories and carbohydrates may be increased in this menu by including more foods lowest in phosphorus per calorie. Research suggests a calcium-phosphorus ratio between 1.6:1 and 1.8:1 is optimal for growth and development in infants (Mize et al., 1995), and a 1.5:1 ratio is found in human bone (Huttenen, 2007). The Institute of Medicine's Recommended Dietary Allowance for a 50-year-old adult's intake of calcium (1200 mg) and phosphorus (700 mg) provides a calcium-phosphorus ratio of 1.71:1. Note that some foods with high calcium-phosphorus ratios like oranges and kale, or foods with low amounts of phosphorus per calorie like macadamia nuts, also have fairly high absolute amounts of phosphorus, so you need to watch the amount of these foods in your diet as your overall calorie intake increases.

Reducing your phosphorus intake at one meal to an amount below that required to maintain normal serum levels will NOT allow you to compensate at the next meal and increase your phosphorus intake above the amount required to maintain normal serum levels, even if the combined amount of phosphorus of the two meals is normal. The reason is because the kidneys automatically compensate and conserve phosphorus by excreting less phosphorus when you eat less of it. Therefore, overly increasing your phosphorus intake at subsequent meals causes serum levels to rise above normal which lowers serum calcium and triggers the parathyroid glands to release calcium from bone into the blood, regardless how much calcium is consumed. This explains why foods high in phosphorus, like dairy products, are counterproductive for bone health if they are consumed in the high amounts usually recommended. As excess calcium released from bone accumulates in the blood it unites with excess phosphorus to form a calcium-phosphate product that contributes to kidney stones, arthritis, cardiovascular disease, and other pathological conditions.  Avoid this problem by distributing your phosphorus intake evenly, meal by meal, throughout the day. For example, three meals including breakfast, lunch, and dinner should be limited to about 233 mg of phosphorus per meal on a 700-mg phosphorus diet.

In conclusion, this article presented peer-reviewed evidence supporting the hypothesis that dietary phosphate restriction commonly used in managing chronic kidney disease may be effective in managing other chronic diseases like tumorigenesis and bone disease, and that a properly balanced raw vegan diet may be used for phosphorus restriction. Future research in medical nutrition therapy should test the clinical results based on this hypothesis. Research may show that preventing and perhaps even reversing chronic diseases related to phosphate toxicity such as cancer, osteoporosis, and soft tissue calcification in atherosclerosis and in other age-related diseases requires no medical treatment other than basing one's diet on the Institute of Medicine's Recommended Dietary Allowances for calcium (1200 mg) and phosphorus (700 mg) in people 50 years and older. Such a diet requires a radical change in eating habits which is not possible on the conventional Western diet.

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