Too much damages the kidneys in animal studies
In animal studies of phosphate additives, the main harm was calcium deposits in the kidneys and damage to the tiny tubes that filter blood. People with chronic kidney disease cannot clear extra phosphorus well, so it builds up in the blood, which worsens kidney damage and speeds up heart problems. Even in the general population, phosphate from many additives together can push daily totals higher than the kidneys handle easily.
Calcium deposits in the kidney and damage to its filtering tubes were the main harm seen in short, medium and long-term animal studies of phosphate additives.
2019Regulator reviewEFSA Panel on Food Additives and Flavourings (FAF) re-evaluation of phosphoric acid and phosphates E338-341, E343, E450-452
People with poor kidney function are at more risk from phosphate additives, because the kidneys are the main way the body gets rid of extra phosphorus. Reviewers asked for closer checks on intake in this group.
2019Regulator reviewEFSA Journal 2019;17(6):5674
Children can go over the daily limit
In 2019 European reviewers set a shared daily limit of 40mg of phosphorus per kg of body weight for all phosphate additives together. Their estimates found that many babies and children who eat the most go over it, because children eat more processed food for their size than adults. The gap between what they eat and the limit is narrow or gone.
Reviewers set a shared daily limit of 40mg of phosphorus per kg of body weight for phosphate additives (E338 to E452). Intake estimates showed many babies and children in several EU countries at high intake went over it.
2019Regulator reviewEFSA Journal 2019;17(6):5674
High blood phosphate is linked to heart disease
Studies of large groups have linked higher blood phosphate to more heart disease and more deaths from any cause. The link is strongest and most consistent in people with kidney disease, but it has also been seen in people with heart disease and normal-range kidney function. These are links, not proven causes.
Higher blood phosphate was linked to more deaths from heart disease in people on dialysis for kidney failure.
2004ObservationalBlock et al., Journal of the American Society of Nephrology
In people with coronary heart disease, higher blood phosphate within the normal range was linked to more heart events and more deaths from any cause.
2005ObservationalTonelli et al., Circulation
Bones need phosphorus and calcium in balance
Phosphorus and calcium work as a pair. Eating a lot of phosphate year after year, especially with little calcium, may weaken bones over time. This is about phosphorus from all food, including meat and dairy, not additives alone.
A diet high in phosphate compared with calcium may cut calcium absorption and raise the hormone that controls calcium, which could harm bone density over time.
2013ObservationalCalvo & Tucker, Nutrition Reviews