The many faces of Fluoride

And none of them are pretty.

Fluoride is either a fluorine ion, or a compound containing fluorine.

 

There are four types of fluorine compounds.

• Sodium fluoride (NaF)

• sodium monofluorophosphate (Na₂PO₃F)

• Stannous fluoride (SnF2)

• Amine fluoride, or Olaflor (C₂₇H₆₀F₂N₂O₃ )

What’s the difference between stannous fluoride vs sodium fluoride?

Sodium fluoride (NaF) is one of the three additives approved for use in community water fluoridation in the United States and is a type of fluoride also used in toothpastes. Like stannous fluoride, it helps fight cavities and strengthens enamel, but it doesn’t address the antimicrobial and anti-hypersensitivity benefits in the same manner as stannous fluoride is able to.

Sodium fluoride and stannous fluoride are the two major active ingredients in modern toothpastes, with sodium fluoride by far the most common.Both prevent cavities. Stannous fluoride’s advantage is its  antimicrobial effect versus the bacteria which cause gum disease – but note that any toothpaste will remove gum disease bacteria mechanically through good brushing and flossing.  The negative of stannous fluoride is tooth staining, which can be difficult or impossible to remove.

Amine Fluoride

Amine fluoride covers the tooth surfaces with a homogeneous molecular layer. This continuous film prevents rapid rinsing off by the saliva. The amine fluorides are thus available as an active agent for a longer period.

This seems good, but since salivea repairs teeth, it actually sabotages tooth repair.

Saliva plays an essential role in maintaining the integrity of the oral structures, in personal relationships, in the digestion and in controlling oral infection. The part that saliva plays in protecting teeth from caries can be summarised under four aspects: diluting and eliminating sugars and other substances, buffer capacity, balancing demineralisation/remineralisation and antimicrobial action.

Fluoride has been shown to induce osteoclastogenesis in mice. 

Osteoclasts are cells that degrade bone.

The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable.

So amine fluoride not only dissolves teeth, it keeps slaivea from repairing teeth!

Olaflor is an amine fluoride,

AmF compounds result in a marked increase in enamel micro hardness when compared to NaF.

From Dr Axe

7 Side Effects of Consuming Fluoride You Should Know About

• Tooth Discoloration. Consumption of too much of fluoride leads to yellowed or browned teeth. …
• Tooth Decay. High intake fluoridated water can lead to the weakening of enamel. …
• Skeletal Weakness. …
• Neurological Problems. …
• High Blood Pressure. …
• Acne. …
• Seizures.

6 Researched Dangers of Fluoride

1. May cause damage to the brain and central nervous system

One major cause of concern when ingesting fluoride is the potential it may have to negatively affect the central nervous system (CNS). A famed study by Phyllis Mullenix was one of the first occasions on which this CNS effect was quantified. In fact, you couldn’t discover any arguments on the pros and cons of fluoridation that do not include Mullenix’ discovery.

This well-designed study, using the latest technology available at the time, was conducted in the mid-1990s on rats. Emphasis on the study came from reports from China that high levels of fluoride in drinking water (multiples of any current levels in the U.S.) had been seen to affect the CNS preceding skeletal fluorosis. The animals were given varying levels of fluoride at multiple stages of development and compared with controls.

Mullenix discovered that fluoride treatment during fetal, weanling and adult development all had pronounced behavioral effects, even when the plasma (blood) levels of fluoride did not seem to be all that elevated. Prenatal exposures seemed to result in hyperactivity symptoms, whereas weanling/adult exposures both resulted in “cognitive deficits.” (56)

Another brain-related danger of fluoride is the potential that it may result in lower IQ’s. Studies have found varying degrees of IQ disparity, from a 2.5-point drop to a 7-point difference in children exposed to fluoridated water versus those who are not. (57)

The meta-analysis that reflected a 7-point change in IQ was conducted by researchers at the Harvard School of Public Health. Although the results were highly suggestive, the scientists were quick to state that the studies they examined were not conclusive enough to draw any sort of cause-and-effect relationship and, in some cases, reflected fluoride levels in water far above what anyone in the U.S. is generally exposed to. (59)

However, they were intrigued enough by their results to begin a pilot study in China to garner more information. This is the first of what is said to be many follow-up studies regarding fluoride and intelligence. In the 51 human study participants, it was found that moderate-to-severe dental fluorosis was correlated with poorer scores on two types of intelligence tests. (60)

Some are also concerned that the combination of aluminum and fluoride exposure might be a contributing factor to the development of Alzheimer’s disease. (61) In animal studies, rats given sodium fluoride (NaF) had significantly higher tissue aluminum levels and “alterations of cerebrovascular and neuronal integrity.” (62) As there is a large amount of evidence to suggest that aluminum plays a role in the development of Alzheimer’s, it’s an avenue worth looking into deeper. (63, 64)

Since fluoride crosses the blood-brain barrier, there are a number of effects it could have that are currently unknown. However, we do know, according to studies listed above, that fluoride might disrupt circadian rhythms and does alter the levels of certain neurotransmitters that are vital to healthy brain chemistry.

2. Has been associated with moderate cancer risk

Another hotly debated potential risk of fluoride is its potential to influence the risk of certain cancers. (65)

A 1977 study comparing the 10 largest fluoridated and unfluoridated cities at that time found an increase in cancer-related deaths of 18 percent in the fluoridated cities compared to those that weren’t, equating to about 3,000 more cancer deaths per 10 million persons in 1969, the studied year. (66)

A similar study, published earlier in 1977, detailed a review of cancer death rates over 17 years, between 1952–1969. No difference in the rates was discovered in persons up to 44 years of age between fluoridated and unfluoridated communities. In those between 45–64 years of age, an additional 1,500 cancer deaths per 10 million people was recorded in fluoridated cities, and the number rose to 3,500 more cancer deaths per 10 million people when observing those over 65. (67)

One review of cancer instances between 1978–1992 found that:

Cancers of the oral cavity and pharynx, colon and rectum, hepato-biliary and urinary organs were positively associated with FD [fluoridated drinking water]. This was also the case for bone cancers in male, in line with results of rat experiments. Brain tumors and T-cell system Hodgkin’s disease, Non-Hodgkin lymphoma, multiple myeloma, melanoma of the skin and monocytic leukaemia were also correlated with FD.

In that study, four types of cancers were actually correlated with a decreased risk in persons exposed to fluoridated water. (68)

Of particular interest in the fluoride debate is the instances of osteosarcoma, a rare form of bone cancer. A relatively small study was published in 1993 finding a 6.9 times increased risk of osteosarcoma among males under 20 years of age in the most fluoridated parts of a 3-county area. (69)

The Harvard School of Dental Medicine also conducted a study about this risk and found similar results of an increased risk for young males of osteosarcoma when drinking fluoridated water. (70)

However, other follow-up studies have found no link or at least no significant increase in osteosarcoma cases between fluoridated and unfluoridated communities. (71, 72, 73)

3. Could increase risk of bone fractures

Unlike what was originally assumed, it seems the ingestion of fluoride does not have a positive impact on bone health, and may actually have a pronounced negative effect.

A study conducted in Mexico found an increase in bone fractures and major tooth damage in children exposed to fluoridated water. (74)

Other studies have found an increase in hip fracture risk among the elderly when consistently drinking water fluoridated at 1 ppm. (75) Other sources find no link between fluoridation and bone fractures. (76)

It’s true that the rate of hip fractures related to osteoporosis has increased in the elderly over the same period of time as the dawn of water fluoridation, but there is not yet evidence to suggest this could be attributed in any way to fluoride, as the causative factors behind such a disease are vast and not usually just one toxin or risk factor. (77)

4. Associated with hypothyroidism

Possibly related to the association between fluoride and hormonal function is the evidence that fluoride may be linked to hypothyroidism. In a study comparing fluoridated and unfluoridated areas of the U.K., researchers discovered that those living in unfluoridated areas were almost two times less likely to develop hypothyroidism. (78)

5. May interfere with sexual development

Remember that fluoride has been found to collect in the pineal gland? This may have further-reaching effects than just the interference with circadian rhythms. A 1997 study using gerbils discovered that fluoride was associated with faster sexual development in the females in the study. (79)

While these results haven’t been tested further in humans, it could be a very important point, as early puberty may possibly lead to issues ranging from short stature to an increased risk of breast cancer.

6. Associated with diabetes risks

As diabetes diagnoses are at an all time high, a great deal of research is focused on the ways we can reduce the impact of this reversible condition. (80) A literature review of the connection between fluoride and diabetes, conducted by Dr. Geoff Pain, an Australian chemistry specialist, left the scientist in no doubt of the results. Pain stated, (81)

There is strong evidence that fluoride causes diabetes … Diabetics are a “sensitive subpopulation” or “vulnerable group” and no attempt has been made by Australian health authorities to warn diabetics about fluoride toxicity or protect them from harmful exposure.

However, this review does not equate to convincing proof that diabetes truly is caused by fluoride exposure. While it warrants further investigation, another study found that low levels of fluoride, like those found in water in the U.S., actually helps to improve insulin resistance and aids in glucose homeostasis. (82)

There hasn’t been a single US study of fluoridation, prenatal exposure and natal development,”

Side effects

skin rash, itching or hives, swelling of the face, lips, or tongue. mottled or discolored teeth. sores in the mouth or on the lips.

Is Fluoride Bad for You? It’s Not Just in the Water

Calcium Fluoride versus Industrial Fluoride

There is a big difference between naturally occurring Calcium fluoride and Industrial fluoride. Natural calcium fluoride is considered insoluble (to 8–10 ppm fluoride maximum depending on water pH). But industrial synthetic fluorides are fully soluble and are all toxic calcium chelators.

J Environ Public Health. 2013; 2013: 439490.Published online 2013 Jun 6. doi: 10.1155/2013/439490PMCID: PMC3690253PMID: 23840230

Physiologic Conditions Affect Toxicity of Ingested Industrial Fluoride

Natural calcium fluoride is considered insoluble (to 8–10 ppm fluoride maximum depending on water pH). But industrial synthetic fluorides are fully soluble and are all toxic calcium chelators.

Synthetic industrial fluoride compounds lack calcium and are listed toxic substances 

Calcium fluoride CaF₂ is found in natural minerals and is not labeled a toxic compound because of the comparatively high lethal oral acute dose of the purified compound when tested in mammals (LD₅₀ ~ 3,750 mg/kg).

The fluoride compounds, sodium fluoride NaF and fluorosilicic acid H₂SiF₆, added into municipal water for human ingestion purposes are synthesized artificially by industrial reaction and have been used as rodenticides, insecticides, and pediculicides, with acute oral lethal doses in experimental animals comparable to arsenic and lead (LD₅₀ ~ 125 mg/kg) (The Merck Index [4]) due to the fluoride at ~60–90 mg/kg.

Fluoride is not a normal constituent of the mammalian bloodstream (Merck manual for Health Care Professionals [6]). It has no nutritive value [7] or physiologic function but has been believed by some to be useful for teeth based on an initial correlation with natural calcium fluoride in drinking water [1, 8]. The chief ingredient in normal teeth enamel is hydroxyapatite that contains calcium phosphate, not fluoride.

The reported adverse consequences of adding fluoride lacking calcium into public water supplies include effects on man, animals, and the environment [1, 8–12]. Ingested industrial fluoride incorporates chiefly into bone with an ion exchange process that is irreversible and thus not physiologic. Normal biochemical effects of nutrient minerals are saturable and readily reversible. Fluorine leads all elements in electronegativity and is extremely reactive and not found in nature. But fluoride is permanent because the ion has no electronegativity, cannot be reduced further, or oxidized by any known substance. Fluoride instead associates with positive charged ions in particular aluminum, calcium, and iron. Thus its toxicity depends on the environment in which it resides.

Soluble fluoride at 60 mg/kg single oral dose without calcium causes acute heart failure in research animals (CDC [5]) and caused lethal heart failure reported in a child after swallowing concentrated dental gel [13]. Twenty-five ppm artificial fluoridated water leads to chronic heart failure in research animals [5] which compares with levels during accidental overfeeds where kidney dialysis patients died (Gessner et al. [14]). At lower concentrations (~1 ppm), artificially fluoridated water supplies are documented to have caused horses, frogs, chinchillas, and alligators to die prematurely that consumed treated water continuously for extended periods of time (Spittle [12]). Discharged fluoride into the Columbia River to ~0.3 ppm blocked salmon navigation upstream to spawn (Damkaer and Dey [15]). Even though natural fluoride at 1 ppm is in the world’s oceans with substantial calcium and magnesium salts, this arrangement is normal and harmless to aquatic species.

Natural calcium fluoride is considered insoluble (to 8–10 ppm fluoride maximum depending on water pH). But industrial synthetic fluorides are fully soluble and are all toxic calcium chelators. The degree of absorption of any fluoride compound after ingestion is correlated with its solubility (Goodman and Gilman [16]). Industrial fluorides are completely absorbed, but natural fluoride minerals cryolite (Na₃AlF₆) or fluorite (mineral fluorspar with CaF₂) are poorly absorbed (see Endnote 1). The dietary cations calcium and iron retard absorption by forming complexes in the GI tract. Although large populations are reported to safely consume 1 ppm fluoride in water for long periods of time, this is when it exists naturally at this level.

In what was considered unthinkable, in Hooper Bay, Alaska, in 1994 an industrial fluoridation overfeed of calcium-deficient Yukon River drinking water caused fatal heart block in an otherwise healthy 41 year old male. This is the largest known poisoning in the U.S. from a fluoridated water supply. Approximately 300 people with severe gastrointestinal pain survived the incident (Gessner et al. [14]). Electronic feeding equipment is now employed to prevent overfeeds and acute poisoning. But chronic effects of industrial fluoridation of public water supplies on humans, animals, and the environment require further study if fluoridation of fresh water supplies continues. Many countries require great expenditures to remove endogenous natural fluoride from drinking water that causes skeletal and other pathology at 8–10 ppm even when water contains substantial antidote calcium to minimize assimilation of the ingested fluoride [5]. The present study investigates conditions involved in acute and chronic fluoride toxicity and environmental effects of industrial fluorides added into public water.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690253/

Calcium fluoride is the inorganic compound of the elements calcium and fluorine with the formula CaF₂. It is a white insoluble solid. It occurs as the mineral fluorite (also called fluorspar), which is often deeply coloured owing to impurities.

The mineral fluorite is abundant, widespread, and mainly of interest as a precursor to HF. Thus, little motivation exists for the industrial production of CaF₂. High purity CaF₂ is produced by treating calcium carbonate with hydrofluoric acid:^[10]CaCO₃ + 2 HF → CaF₂ + CO₂ + H₂O

Fluorite (also called fluorspar) is the mineral form of calcium fluoride, CaF₂. It belongs to the halide minerals. It crystallizes in isometric cubic habit, although octahedral and more complex isometric forms are not uncommon.

Applications

Main article: Fluorite

Naturally occurring CaF₂ is the principal source of hydrogen fluoride, a commodity chemical used to produce a wide range of materials. Calcium fluoride in the fluorite state is of significant commercial importance as a fluoride source.^[11] Hydrogen fluoride is liberated from the mineral by the action of concentrated sulfuric acid:^[12]CaF₂ + H₂SO₄ → CaSO₄(solid) + 2 HF

Niche uses

Calcium fluoride is used to manufacture optical components such as windows and lenses, used in thermal imaging systems, spectroscopy, telescopes, and excimer lasers. It is transparent over a broad range from ultraviolet (UV) to infrared (IR) frequencies. Its low refractive index reduces the need for anti-reflection coatings. Its insolubility in water is convenient as well. Doped calcium fluoride, like natural fluorite, exhibits thermoluminescence and is used in thermoluminescent dosimeters. It forms when fluorine combines with calcium.

Safety

CaF₂ is classified as “not dangerous”, although reacting it with sulfuric acid produces very toxic hydrofluoric acid. With regards to inhalation, the NIOSH-recommended concentration of fluorine-containing dusts is 2.5 mg/m³ in air.^[10]

https://en.wikipedia.org/wiki/Calcium_fluoride

Fluorine Toxicity in Plants

Fluorine is a chemical element with the symbol F and atomic number 9. It is the lightest halogen and exists at standard conditions as a highly toxic, pale yellow diatomic gas. As the most electronegative element, it is extremely reactive, as it reacts with all other elements, except for argon, neon, and helium.

In general, soil fluoride is not available to plants. Roots take up small amounts of soil fluoride by diffusion, which results in a low background concentration in the plant foliage. There are exceptions such as tea plants that are natural accumulators of fluoride. Gaseous uptake of fluoride by leaves is rapid due to its high solubility.

A wide variety of plants are sensitive to fluoride toxicity (Table 1). Typical indoor foliage plants include Dracaena, Tahitian Bridal Veil (Gibasis pellucida),and the spider plant (Chlorophytum comosum). Both Dracaena deremensis and D. fragrans (corn plant) are very sensitive to fluoride toxicity. Fruits such as apricot, blueberry, grape, peach, and plums are also sensitive.Conifers that are sensitive include Douglas-fir, western larch, most pines, and blue spruce. Sensitive flowering plants include gladiolus, lily, tulip, and yucca.Domestic water that contains chlorine and/or fluoride is usually not harmful to poinsettias.

Avoiding fluorine toxicity starts with knowing which plants are sensitive. Avoid fluoridated water, high phosphate fertilizers, and low soil pH. An exception would be low pH-loving plants like blueberry. High calcium levels in the soil or rooting medium, such as use of dolomite, can help tie up fluoride and prevent injury.

Table 1. Plants sensitive to fluoride.*
Common Name	Scientific Name	Notes
Apricot	Prunus armeniaca	Some cultivars are intermediate insensitivity.
Box Elder	Acer negundo
Blueberry	Vaccinium corymbosum
Sweet corn	Zea mays
Douglas-fir	Pseudotsuga menziesii
Gladiolus	Gladiolus sp.	Bract and leaf injury.
Grape	Vitis vinifera	V. labrusca is intermediate.
Oregon Grape	Mahonia aquifolium
Western Larch	Larix occidentalis
Peach	Prunus persica	Soft suture or red suture disease of the fruit.
Pine	Pinus sp.	Eastern white pine, lodgepole, scotch, Mugo, ponderosa
Plum	Prunus domestica	Flowering plums are resistant.
Blue Spruce	Pice pungens
Tulip	Tulipa sp.
Corn plant	Dracaena sp.	Most species and cultivars.
Yucca	Yucca sp.
Spider plant	Chlorophytum comosum
Tahitian Bridal Veil	Gibasis pellucida
Lily	Lilium spp.
* Plant are considered sensitive when injury has been observed on most of the species and when leaf analysis revealed a fluoride content less than 50 ppm.

https://pnwhandbooks.org/plantdisease/pathogen-articles/nonpathogenic-phenomena/fluorine-toxicity-plants

Olaflor

Olaflur (INN, or amine fluoride 297) is a fluoride-containing substance that is an ingredient of toothpastes and solutions for the prevention of dental caries.^[1] It has been in use since 1966. Especially in combination with dectaflur, it is also used in the form of gels for the treatment of early stages of caries, sensitive teeth, and by dentists for the refluoridation of damaged tooth enamel.^[2]

Overdosage leads to irritation of the oral mucosa. In especially sensitive persons, even standard doses of olaflur can cause irritation.^[2] Like other fluoride salts, olaflur is toxic when given in high doses over an extended period of time. Especially in children, before the development of the permanent teeth, overdosage can lead to dental fluorosis, a discolouring and weakening of the enamel.^[3] In acute cases of overdosage, for example when an olaflur containing preparation is swallowed, calcium in any oral form serves as an antidote. Often milk is used because it is usually at hand.^[2]

Interactions

Because calcium fluoride is practically insoluble in water, calcium-containing drugs and food inhibit the action of olaflur.^[2]

Chemistry and mechanism of action

Olaflur is a salt consisting of an alkyl ammonium cation and fluoride as the counterion. With a long lipophilic hydrocarbon chain, the cation has surfactant properties. It forms a film layer on the surface of teeth, which facilitates incorporation of fluoride into the enamel. The top layers of the enamel’s primary mineral, hydroxylapatite, are converted into the more robust fluorapatite. The fluoridation reaches only a depth of a few nanometres, which has raised doubts whether the mechanism really relies on the formation of fluorapatite.^[4]

Synthesis[edit]

The synthesis of olaflur starts from cattle’s tallow.^[5] The contained fatty acids, mainly stearic acid (C₁₇H₃₅COOH), are obtained by hydrolysis, and then converted to the corresponding amides, which in turn are reduced catalytically to the primary amines (largely octadecylamine). Addition of acrylonitrile, followed by another reduction, yields N-alkyl-1,3-propanediamines. The two nitrogen atoms react with ethylene oxide to form tertiary amines. Finally, hydrofluoric acid is added to give the end product. Because olaflur is produced from a mixture of fatty acids, some molecules have side chains that are longer or shorter than 18 carbon atoms. Other byproducts of the reaction include hydroxyethyl ethers resulting from addition of ethylene oxide to the free hydroxyl groups. The presence of these side products is clinically irrelevant.^[5]

https://en.wikipedia.org/wiki/Olaflur

Dokter Hans Moolenburgh sr. over de illegale fluoridering in Curaçao

Gepubliceerd op 23 mei 2016

Rudolf de Wit interviewt Dokter Moolenburgh over de illegale fluoridering van het drinkwater in Curaçao, sinds 1976 ongrondwettelijk, en de ernstige gevolgen die dit enzymgif voor de volksgezondheid kan hebben, terwijl het beweerde nut (voor een kleine doelgroep van kinderen) nooit afdoend bewezen is. De dwangmedicatie is een overtreding van de Mensenrechten. Lees meer op https://www.dodelijkeleugens.nl/schending-mensenrechten-massamedicatie/

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Schending mensenrechten door illegale massamedicatie

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Mensenrechten geschonden door onwettige massamedicatie met fluoride

door C.F. van der Horst

Sinds 1962 wordt het drinkwater in Curaçao gefluorideerd; de maatregel werd in 2006 in  de Landsverordening Drinkwater  officieel vastgelegd, terwijl de aanleiding voor Artikel 11 van de  Nederlandse Grondwet (van kracht sinds 1983) en het daarop gebaseerde Artikel 13 van de Staatsregeling van Curaçao  juist het voorkomen van massamedicatie zoals fluoridering was. De fluoridering is daarom illegaal en zoals u hieronder zult lezen, een overtreding van de Mensenrechten.

Is het niet vreemd dat Nederland Mensenrechten hoog in het vaandel heeft, maar deze schending door massamedicatie in het eigen Koninkrijk ongemoeid laat, terwijl sinds 1983 fluoridering zelfs een overtreding van de Grondwet is?

Neurotoxine

De veronderstelde noodzaak voor de dwang- en massamedicatie is dat fluoride het tandglazuur zou verharden waardoor cariës (tandbederf) bij kinderen wordt teruggedrongen. Dit nut staat echter niet vast. Zo stelde het CDC (Centers for Disease Control and Prevention, het Amerikaanse agentschap belast met het opsporen en onderzoeken van de volksgezondheid trends): “Het aantreffen van tandbederf in een populatie is niet omgekeerd evenredig met de concentratie van fluoride in het tandglazuur en een hogere concentratie aan fluoride in het tandglazuur is niet noodzakelijkerwijs doeltreffend in het voorkomen van tandcariës.” Tegenstanders beweren dat als er al voordelen zouden zijn, deze niet opwegen tegen de bewezen giftigheid. Het gerenommeerde Britse artsenblad The Lancet berichtte in 2014 dat fluoride als een neurotoxine wordt beschouwd en dat de stof als zodanig  bij kinderen neurologische ontwikkelingsstoornissen zoals autisme, hyperactiviteit, dyslexie en andere cognitieve stoornissen kan veroorzaken, zoals het uit zo’n 50 andere onafhankelijke studies gebleken significant dalen van het IQ bij kinderen die aan fluoride blootgesteld zijn.

Los van de discussie over veiligheid en effectiviteit schendt de gebruikersdwang bij de preventieve gezondheidsmaatregel die fluoridering beweerd wordt te zijn, essentiële wetten en rechten.

Geen voedings- maar geneesmiddel

Fluoride is een lichaamsvreemde stof. Het maakt geen deel uit van enig stofwisselingsproces en het is daarom geen voedingsmiddel. Dit is de conclusie van zowel de Europese voedselwaakhond EFSA als de Amerikaanse FDA. Tandbederf ontstaat NIET als gevolg van een gebrek aan fluoride. Fluoridering van het drinkwater is derhalve geen aanvulling van een tekort in het dieet, zoals soms vitaminen en mineralen die aan voedingsmiddelen worden toegevoegd. Integendeel, fluoride (met inbegrip van de fluoridezouten die aan water worden toegevoegd, hexafluorkiezelzuur en natriumsilicofluoride) wordt geclassificeerd als een medicijn. Deze vaststelling maakt de toevoeging van fluoride aan drinkwater tot massamedicatie.

Fluoride is een medicijn

Schending van de Grondwet en Staatsregeling

Artikel 11 van het Statuut voor het Koninkrijk der Nederlanden luidt:

“1. Voorstellen tot verandering in de Grondwet, houdende bepalingen betreffende aangelegenheden van het Koninkrijk, raken Aruba, Curaçao en Sint Maarten.”

De aanpassing van de Nederlandse Grondwet op 19 januari 1983 is tot op heden echter in Curaçao genegeerd. Het gaat om Artikel 11, getiteld Grondrecht, onaantastbaarheid menselijk lichaam:

“Ieder heeft, behoudens bij of krachtens de wet te stellen beperkingen, recht op onaantastbaarheid van zijn lichaam.”

Ofschoon de Staatsregeling van Curaçao (de nationale grondwet van het eiland) Artikel 11 van de Nederlandse Grondwet in zijn geheel en ongewijzigd overgenomen heeft in haar Artikel 13, gaat de Landsverordening Drinkwater hier volledig aan voorbij. De Memorie van Toelichting behorende bij de Staatsregeling meldt nota bene:

“Bij het recht op onaantastbaarheid van het lichaam gaat het om het recht op afweer van invloeden van buitenaf op het lichaam. Het bevat twee terreinen: het recht te worden gevrijwaard van schendingen van en inbreuken op het lichaam door anderen en het recht zelf over het lichaam te beschikken.”

De massamedicatie door fluoridering schendt de onaantastbaarheid van het lichaam al 33 jaar. Derhalve is de Landsverordening Drinkwater van 2006 (een wet ondertekend door Minister Smith van Volksgezondheid en Sociale Ontwikkeling, Minister Dick van Justitie en Minister Leeflang van Algemene Zaken en Buitenlandse betrekkingen) die de gebruikersdwang van fluoride oplegt in strijd met zowel de Grondwet als de Staatsregeling!

Ex-Minister van Volksgezondheid en Sociale Ontwikkeling, Sandra Smith, tekende in 2006 een illegale wet in overtreding van de Mensenrechten en de Staatsregeling van Curaçao

Jurisprudentie

Er bestaat jurisprudentie inzake massamedicatie en fluoridering in het Koninkrijk der Nederlanden. Artikel 11 in de Grondwet hervorming van 1983 was een direct gevolg van de fluorideringskwestie die in de 60er en 70er jaren in Nederland speelde. Auteur Dr. Dennis Edeler schreef hierover: “In vervolg op het Fluorideringsarrest van de Hoge Raad [op 22 juni 1973] is in 1983 met de algehele wijziging van de Grondwet ook het sociale grondrecht opgenomen van de persoonlijke integriteit. Op grond van de jurisprudentie tast fluoridering het menselijk lichaam aan en is vanuit dit perspectief strijdig met de onaantastbaarheid.”

Desgevraagd meldt dokter Hans Moolenburgh sr.: “Artikel 11 is opgesteld door professor Auke Bloembergen, voormalig hoogleraar Burgerlijk Recht aan de Rijksuniversiteit Leiden en lid van de Hoge Raad, en het VVD kamerlid mr. Annelien Kappeyne van de Coppello op initiatief van mr. Hector van Fenema (oud-burgemeester van Zandvoort), mr. Foppe Oberman, advocaat, en mijzelf, destijds hoofd van de landelijke anti-fluorideringsbeweging.” Hiermee is bewezen dat de fluoridering aanleiding is geweest tot dit Grondwet Artikel.

Mensenrechten met voeten getreden

Niet alleen de Grondwet en Staatsregeling maar ook de Mensenrechten worden door de massamedicatie met fluoride met voeten getreden. De Universele Verklaring van de Rechten van de Mens  zegt o.a.:

Artikel 3

Een ieder heeft het recht op leven, vrijheid en onschendbaarheid van zijn persoon.

Artikel 19

Een ieder heeft recht op vrijheid van mening en meningsuiting. Dit recht omvat de vrijheid om zonder inmenging een mening te koesteren en om door alle middelen en ongeacht grenzen inlichtingen en denkbeelden op te sporen, te ontvangen en door te geven.

Dwangmedicatie met fluoride is een schending van iemands persoon en gaat volledig aan zijn of haar mening voorbij.

Art. 43 van het Statuut Koninkrijk, waarborg mensenrechten Nederland/Ned. Antillen/Aruba luidt:

“1. Elk der landen draagt zorg voor de verwezenlijking van de fundamentele menselijke rechten en vrijheden, de rechtszekerheid en de deugdelijkheid van het bestuur.”

Vanuit regeringswege zou men derhalve op de mensenrechten moeten toezien. Dat fluoridering in 2006 in een Landsverordening vastgelegd is, laat onverlet dat het om een schending van de Mensenrechten gaat.

Schending van de Code van Neurenberg

De Code van Neurenberg werd in 1947 in het leven geroepen om de vreselijke medische experimenten die Nazi-artsen hadden uitgevoerd, te voorkomen. Het zonder medisch toezicht en zonder controle op de individuele dosis jarenlang toedienen maakt de massamedicatie door fluoridering tot een slecht opgezet en uitgevoerd medisch experiment. Artikel 1 van de Code van Neurenberg zegt over medische experimenten: “De vrijwillige toestemming van de proefpersoon is absoluut noodzakelijk.” En voorts dat het individu “zonder tussenkomst van enig element van geweld, fraude, bedrog, pressie, misleiding of enige andere verborgen vorm van beperking of dwang” kan worden gevraagd om aan het experiment deel te nemen. Door iedereen te verplichten aan het medisch experiment van gefluorideerd water mee te doen (gebruikersdwang) wordt de Code op grove wijze overtreden.

Het Reformatorisch Dagblad van 9 maart 1976 waarschuwde al voor de gedwongen massamedicatie van fluoride in drinkwater en de giftigheid ervan.

Voorzorgsbeginsel

Wat betreft gezondheidsrisico’s zou het voorzorgsbeginsel te allen tijde van toepassing moeten zijn. Populair gezegd komt het neer  op voorkomen is beter dan genezen. In opdracht van de Gezondheidsraad, het hoogste adviesorgaan voor de Nederlandse regering, is in 2003 een studie naar het voorzorgsprincipe uitgevoerd. Daarin zegt men o.a.: “In het algemeen wordt het voorzorgbeginsel toepasbaar geacht als er potentiële risico’s zijn dat non-negligible damage wordt veroorzaakt.” Dat is zeker het geval bij fluoride waar verschillende onafhankelijke wetenschappers hebben gewaarschuwd tegen gevaren voor de gezondheid. Deze variëren van ziekteverschijnselen die al kort na de fluoridering optreden, zoals zweertjes in de mond, huidafwijkingen, hoofdpijnen, visuele storingen, etc., tot de veel gevaarlijkere op de lange termijn optredende, zoals botafwijkingen, aandoeningen van het centrale zenuwstelsel, ADHD, autisme, diabetes, migraine, hartfalen en kanker. De bezorgdheid over deze risico’s is nog nooit afdoend weggenomen.

Daarbij is het onmogelijk een standaard dosis voor ieder afzonderlijk persoon te bepalen en stelt men door de gebruikersdwang van fluoride zelfs kwetsbare leeftijdsgroepen (zuigelingen, peuters en ouderen) aan de massamedicatie bloot.

Uit voorzorg moet men alle lichaamsvreemde stoffen, en om de bovengenoemde associaties zeker fluoride, uit water en voeding weren.

Volwaardige voeding: een risicoloos alternatief

De voornaamste doelgroep van fluoridering zijn kinderen, met name in de lagere inkomensklassen. Dat iedereen wordt gedwongen fluoride in te nemen terwijl slechts een klein gedeelte van de bevolking baat erbij zou hebben, is bevreemdend.

Bovendien is bewezen dat cariës uitsluitend wordt veroorzaakt door het geraffineerde voedingspakket (men leze het werk van tandarts Weston Price). Een causale (oorzakelijke) benadering van een kwestie is natuurlijk veel beter dan een symptomatische. Derhalve zou — in plaats van dwangmedicatie voor iedereen — gerichte aandacht aan de juiste doelgroepen voor juiste voeding een veel logischer en veiliger oplossing zijn.

Mensen die desalniettemin voor fluoride kiezen kunnen hiervoor terecht bij hun tandarts of een gefluorideerde mondspoeling aanschaffen.

Het boek Dodelijke leugens. Artsen en patiënten misleid beschrijft de ontdekkingen van een aantal wetenschappers over de schadelijkheid van fluoride en wat men zelf kan ondernemen om kinderen te helpen sterke tanden te krijgen en houden.

Tot slot: dokter H.C. Moolenburgh sr.

Dokter Hans Moolenburgh voerde met zijn artsengroep in de zeventiger jaren dubbelblinde proeven uit naar de effecten van gefluorideerd drinkwater op de menselijke gezondheid. De dokters vonden diverse klachten — zoals heel nare buikpijn (vooral de hele nacht gillende baby’s waren opvallend), hoofdpijn en astmatische verschijnselen — die alleen en blijvend verdwenen door het drinken van ongefluorideerd water. De tomeloze inzet van de medicus en zijn kleine groep toegewijde medewerkers voor de Rechten van de Mens heeft ertoe geleid dat de dwangmedicatie in Nederland in 1976 werd stopgezet. Om gebruikersdwang door de toevoeging van fluoride of enige andere medicatie aan het drinkwater te voorkomen, heeft hij daarenboven — zoals eerder vermeld — zich sterk gemaakt voor de uitbreiding van de Grondwet.

Dokter Moolenburgh heeft dit artikel gelezen en zijn volledige goedkeuring eraan gehecht. In de video hieronder wordt de fluoride expert geïnterviewd door Rudolf de Wit, de oprichter van de Komishón Anti-Fluoride op Curaçao.

Meer informatie vindt u op FLUORIDE: ZEGEN OF VLOEK? en in het boek Dodelijke leugens. Artsen en patiënten misleid.

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Hoe kan een illegale maatregel als fluoride in het drinkwater zo maar worden ingevoerd? Wat is het zogenaamde “draaideur” fenomeen? Wat kunt u doen om u te wapenen tegen fluoride en soortgelijke “gezondheidsbevorderende” maatregelen?

Krijg de feiten. Koop en lees nu het boek Dodelijke leugens. Artsen en patiënten misleid.

Wilt u allereerst een kennismaking? Vraag nu gratis het eerste hoofdstuk aan!

Children Tend to Suffer the Greatest Health Effects

Water fluoridation came about as the result of a massively successful PR campaign, originally aimed to protect aluminum and steel producers from lawsuits against the fluorine pollution coming from their plants. Fluoride is in fact a toxic substance that accumulates in the human body over time, where it has been shown to wreak havoc with enzymes and produce a number of serious adverse health effects, including neurological and endocrine dysfunction. No less than 25 human studies have also linked fluoride with lowered IQ in children, including recent research from Harvard. Approximately 50 percent of the fluoride that you ingest each day ends up accumulating in your bones over a lifetime.

Making matters worse, water fluoridation disproportionately harms young children, as they tend to suffer the greatest health effects. One important point to remember, which few pediatricians, dentists or other health professionals stress, is that you should NOT use fluoridated water when mixing infant formula.

According to Dr. David Kennedy, who produced and directed the documentary film Fluoridegate — An American Tragedy:

“One of California’s highest paid and most prolific Fluoridation advocate admits that giving an infant a formula made with fluoridated tap water will overdose the baby and cause the teeth to come in spotted and fluorotic. One can only wonder why such insanity persists in our country when it has been banned in so many other more advanced democracies.”

http://articles.mercola.com/sites/articles/archive/2013/04/11/portland-fluoridation.aspx

Hidden fluoride in tea and other foods and beverages

Can certain tea preparations be hiding potentially toxic levels of fluoride? You may want to warn your patients with heavy tea habits to consider their overall exposure.Cathy Hester Seckman, RDHMay 1st, 2019

© Natthapon Ngamnithiporn – Dreamstime.com

Dental hygienists are pretty knowledgeable about fluoride. We apply fluoride treatments under ADA guidelines during recare appointments. We recommend different levels of at-home fluoride therapy depending on circumstances and need. We know the approved parts per million in community water supplies. Beyond that, we know which communities in our practice areas have fluoridated water supplies, and which do not have that benefit. We’re aware of fluorosis and its causes.

But did you know fluoride can be present in potentially toxic levels in tea? I was leafing through one of my mother’s less-than-reputable women’s magazines when I read that fluoride found in instant tea mixes can be more than 200% of the recommended safe level. According to the magazine, we should drink only green tea, because fluoride levels in green tea are much lower than in black and instant teas.

Being a typical hygienist, I went straight home to look it up. A cursory Internet search turned up PubMed studies, USDA research papers, and newspaper articles on high fluoride levels in tea. I started wondering about the possible links between tea’s high fluoride levels and fluorosis.

Suppose you have a tea-drinking patient who is in her 50s, with a family history of osteoporosis, and lives in a fluoridated community. On a daily basis, she drinks large quantities of iced tea made from mixes at her favorite coffee shop. This article will give you the background you need to discuss her tea consumption.

How does it get there?

How, exactly, does fluoride get into tea? It all starts with tea plants. Camellia sinensis (var. sinensis) and Camellia sinensis (var. assamica)are the varieties usually grown today. All types of tea—white, yellow, green, oolong, dark, black, and pu-erh—come from these two plants. (Remember that herbal teas are not made from tea plants, but from herbs.) The age of the tea leaves and the fermenting processing differ for each kind of tea. Dark, black, and pu-erh tea would typically be made from older leaves.¹

Tea plants are known as fluoride hyperaccumulators, which means they absorb potential toxins and heavy metals to a greater concentration than is in the soil surrounding them.² The older individual tea leaves get, the more fluoride they can absorb. The fluoride is then released during tea infusion. Bioavailability is close to 100%, because the GI tract readily absorbs soluble fluoride.³

Older tea leaves are also used to make less expensive tea.⁴ An article in ScienceDirect described a study in the United Kingdom of economy supermarket-branded teas. It was determined that drinking these cheaper teas made from older leaves carried a risk of high exposure to fluoride, up to 150% of the dietary reference intake level.⁵

Other sources of fluoride

Other fluoride hyperaccumulators include fruit juice, crab, fish, chicken, and rice, but the amounts of fluoride in those foods are much less than in tea.⁶

We already know our fluoride intake comes from naturally occurring and community fluoridated water, plus toothpastes and mouthwashes, plus recommended supplements. The Public Health Service recommends community water fluoridation at optimum levels ranging from 0.7 ppm to 1.2 ppm (1 ppm is equal to 1 mg/L). The U.S. Environmental Protection Agency has set maximum allowable fluoridation at 4 ppm with a secondary limit at 2 ppm. The American Dental Association, American Academy of Pediatric Dentistry, and the American Academy of Pediatrics jointly recommend guidelines that range from none for infants to 1 mg/day for adults, depending on availability of fluoridated water. The Institute of Medicine recommends a tolerable upper intake at 10 mg/day for those over nine years old.⁷

The USDA National Fluoride Database of Selected Beverages and Foods, Release 2, offers a comprehensive look at fluoride levels in foods and beverages.⁸ Here are some examples in parts per million:

• Strained applesauce baby food – 0.01
• Blueberry muffin – 0.39
• Light beer – 0.45
• Coffee, brewed – 0.91
• Chamomile herb tea, brewed – 0.13
• Black tea, brewed – 3.73
• Green tea, brewed – 1.15
• Instant tea powder, unsweetened, dry – 897.72
• Instant tea powder, unsweetened, prepared – 3.35

You can see that many foods and beverages have trace amounts of fluoride, but that there are frightening amounts in dry instant tea. Also notice the difference in black and green teas.

Effects of excessive fluoride

Now consider the effects of a heavy tea-drinking habit on fluoride accumulation in body tissues. We know that dental fluorosis caused by excess fluoride is a risk only in childhood, since fluorosis occurs during tooth formation. Children probably aren’t likely to drink tea in large amounts, so dental fluorosis from that source isn’t common. There have, however, been documented cases of skeletal fluorosis linked to tea. This type of fluorosis, caused by chronic consumption of fluoride, can be a crippling condition in which bones become weak and joints are stiff and painful. Deformities are seen in severe cases. There can also be neurological complications.⁹

A 2011 study in the Journal of Clinical Endocrinology and Metabolism concluded that skeletal fluorosis “can result from chronic consumption of large volumes of brewed tea” and that “daily consumption of 1-2 gallons of instant tea can lead to skeletal fluorosis.”¹⁰

A 2016 study done in the Republic of Ireland, home of serious tea drinkers, assessed the risks of fluoride intake in tea.³ The authors concluded that in all age groups, daily tea consumption can be higher than the maximum tolerable intake and result in chronic fluoride intoxication. That can contribute, they suggest, to the country’s high incidence of musculoskeletal disorders and undiagnosed skeletal fluorosis. Another concern they identified was for people with reduced renal function, since in that case fluoride can’t be easily excreted and is more damaging.

Tea is supposed to be good for us. It has flavonoids, a mild amount of caffeine, and has been shown to reduce risk for cardiovascular disease, high cholesterol, hypertension, and type 2 diabetes. It’s an anti-inflammatory and an antioxidant.¹¹ Now, it appears, it could also be dangerous in certain circumstances. We, as hygienists, are the health-care workers patients trust to keep them informed about fluoride. When you discover a heavy tea habit in a patient, be sure they’re aware of the risks to their overall health.

References

1. Wikipedia. Camellia sinensis. https://en.wikipedia.org/wiki/Camellia_sinensis
2. Collins English Dictionary. Definition of hyperaccumulator. https://www.collinsdictionary.com/dictionary/english/hyperaccumulator
3. Waugh DT, Potter W, Limeback H, Godfrey M. Risk assessment of fluoride intake from tea in the Republic of Ireland and its implications for public health and water fluoridation. Int J Environ Res Public Health. 2016 Mar; 13(3): 259.
4. NHS. Do fluoride levels in cheap tea pose a health risk? July 25, 2013. https://www.nhs.uk/news/food-and-diet/do-fluoride-levels-in-cheap-tea-pose-a-health-risk/
5. Chan L, Mehra A, Saikat S, Lynch P. Human exposure assessment of fluoride from tea (Camellia sinensis L.): A UK based issue? Food Res Int. 2013 May;51(2):564-570. https://www.sciencedirect.com/science/article/pii/S0963996913000446
6. Oregon State University. Linus Pauling Institute. Fluoride. https://lpi.oregonstate.edu/mic/minerals/fluoride#food-beverage-sources
7. Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the United States. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm#tab1
8. US Department of Agriculture. USDA National Fluoride Database of Selected Beverages and Foods, Release 2. https://www.ars.usda.gov/ARSUserFiles/80400525/Data/Fluoride/F02.pdf
9. ScienceDirect. Skeletal fluorosis. https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/skeletal-fluorosis
10. Izuora K, Twombly JG, Whitford GM, Demertzis J, Pacifici R, Whyte MP. Skeletal fluorosis from brewed tea. J Clin Endocrinol Metab. 2011 Aug;96(8):2318-24.
11. Oregon State University. Linus Pauling Institute. Tea. https://lpi.oregonstate.edu/mic/food-beverages/tea#cardiovascular-disease-prevention

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Cathy Hester Seckman, RDH, worked in dentistry 32 years, including 12 years as a pediatric hygienist. Officially retired from clinical hygiene, she still fills in occasionally at the same pediatric practice. She is multipublished in dental magazines, works part-time as an indexer, and is the author of three novels, more than a dozen short stories, and an Arcadia Publishing history of her hometown. Her new book, Ohio Day Trips, will be published by AdventureKEEN on March 1.

We know cavities can be prevented without the use of fluoride, which can cause other health issues. Keep reading to find out our top 4 tips for fighting cavities without the need for fluoride.

#1: Maintain Excellent Oral Hygiene

Brushing and flossing are crucial aspects of a healthy smile, and these habits are perhaps even more important if you are choosing not to use a fluoride toothpaste (make sure the kind you choose explicitly says “no fluoride,” as most do contain the mineral). Brush your teeth for two minutes, at least twice a day and floss daily. You may want to start brushing after every meal for added help in cavity prevention.

#2: Eat a Nutritious Diet (And Hydrate)

What you eat plays as big of a role in your oral health as it does in how you feel. When you regularly consume a diet based in highly nutritious fruits, vegetables, and whole grains, it is easier for your oral health to stay in perfect harmony and protected against tooth decay and gum disease. Work on drinking plenty of water throughout the day, too, which will keep your mouth hydrated and able to naturally wash away the sugars and acids that cause tooth decay.

#3: Rinse After Eating Sugar

Few people can completely eliminate sugar from their diets, especially around certain times of the year. When you do indulge, you can protect your teeth without fluoride by rinsing your mouth out with water to remove left-behind residue or bacteria. Make sure you are using filtered water instead of that from the tap, as most tap water sources in the United States have been treated with fluoride.

#4: Visit a Holistic Dentist

Your holistic dentist is your #1 ally in a fluoride-free cavity fighting effort. Regular visits to the dentist can help to ensure your teeth and gums stay healthy and clean, and that any weak spots of tooth enamel are detected as soon as possible. Dr. Thomas will partner with you to prevent cavities the natural way — without the common overuse of fluoride that could be dangerous to your and your family’s health.

About Dr. Thomas

Dr. Preetha Thomas is the dentist in Southlake offering comprehensive, holistic dental care for patients of all ages. If you are interested in learning more about eliminating fluoride from your oral hygiene routine or to schedule an appointment for holistic dental care, please do not hesitate to get in touch with Enclave Dental at (817) 803-5816.

The U.S. National Academy of Sciences Institute of Medicine has recommended an Adequate Intake of fluoride from all sources as 0.05 mg F/kg body weight/day, defined as the estimated intake that has been shown to reduce the occurrence of dental caries maximally in a population without causing unwanted side effects 

Sources

4 Steps for Preventing Cavities (Without Fluoride!)

Click to access nutfluoride.pdf

Age	Male	Female	Pregnancy	Lactation
Birth to 6 months	0.01 mg	0.01 mg
7–12 months	0.5 mg	0.5 mg
1–3 years	0.7 mg	0.7 mg
4–8 years	1 mg	1 mg
9–13 years	2 mg	2 mg
14–18 years	3 mg	3 mg	3 mg	3 mg
19+ years	4 mg	3 mg	3 mg	3 mg

Sources of Fluoride

Food
Brewed tea typically contains higher levels of fluoride than most foods, depending on the type of tea and its source, because tea plants take up fluoride from soil [1,3]. Fluoride levels can range from 0.3 to 6.5 mg/L (0.07 to 1.5 mg/cup) in brewed tea made with distilled water [3].

Fluoride concentrations in breast milk are so low that they cannot always be detected; when these levels can be measured, they range from less than 0.002 to 0.01 mg/L, even when mothers live in communities with fluoridated water [3]. Fluoride concentrations in cow’s milk are also very low, ranging from 0.007 to 0.086 mg/L [3]. Fluoride levels in infant formulas in the United States vary, depending on the type of formula and the fluoride content of the water used to prepare the formula [3]. The typical fluoride concentration is less than 0.2 mg/L in milk-based infant formula and 0.2 to 0.3 mg/L in soy-based infant formula (not including contributions from tap water used to prepare the formula).

Only trace amounts of fluoride are naturally present in most foods, and most foods not prepared with fluoridated water provide less than 0.05 mg/100 g [1,6].

A variety of types of foods and their fluoride levels per serving are listed in Table 2.

Food	Milligrams per Serving
Tea, black, brewed, 1 cup	0.07 to 1.5*
Coffee, brewed, 1 cup	0.22*
Bottled water with added fluoride, 1 cup	0.19 to 0.24*
Shrimp, canned, 3 ounces	0.17
Raisins, ¼ cup	0.08
Oatmeal, cooked, ½ cup	0.08*
Grapefruit juice, ¾ cup	0.08
Potatoes, russet, baked, 1 medium	0.08
Rice, cooked, ½ cup	0.04*
Cottage cheese, ½ cup	0.04
Pork chop, baked, 3 ounces	0.03
Yogurt, plain, low-fat, 1 cup	0.03
Lamb chop, cooked, 3 ounces	0.03
Tortilla, flour, 1 tortilla, approx. 10” diameter	0.02
Corn, canned, ½ cup	0.02
Beef, cooked, 3 ounces	0.02
Tuna, light, canned in water, 3 ounces	0.02
Cheese, cheddar, 1½ ounces	0.01
Bread, white or whole wheat, 1 slice	0.01
Asparagus, cooked, 4 spears	0.01
Chicken, cooked, 3 ounces	0.01
Milk, fat-free or 1%, 1 cup	0.01
Apple, raw, with skin, 1 medium	0.01
Avocado, raw, ½ cup sliced	0.01
Macaroni, plain, cooked, ½ cup	0.00*
Tomato, raw, 1 medium	0.00
Bananas, 1 medium	0.00
Egg, cooked, 1 large	0.00
Carrots, raw, 1 medium	0.00
Peanut butter, 1 tbsp	0.00

*Amounts of fluoride might vary by levels in the water used to prepare these foods and beverages.

Fluoridated drinking water
Since 1962, the U.S. Public Health Service has recommended the addition of fluoride to drinking (tap) water to reduce the risk and severity of dental caries, one of the most common chronic diseases in children [7]. Many countries around the world now adjust the fluoride concentration of community drinking water supplies to the level recommended for the prevention of dental caries [8].

Although the U.S. Public Health Service recommended fluoride concentrations of 0.7 in warmer climates (where children were expected to drink more water) to 1.2 mg/L in cooler climates to prevent dental caries in 1962, it amended its recommended level in 2015 to 0.7 mg/L to maintain the ability to prevent caries while minimizing the risk of dental fluorosis [7,9]. In 1986, guidelines from the U.S. Environmental Protection Agency (EPA) established a maximum allowable concentration of 4.0 mg/L fluoride in public drinking water systems to prevent adverse effects from fluoride exposure (such as bone disease) and a recommended maximum concentration of 2.0 mg/L to prevent dental fluorosis [3,10]. A review of this regulation is a currently a low priority for the EPA [11].

Fluoridated municipal drinking water—including water that people drink as well as foods and beverages prepared using municipal drinking water—accounts for about 60% of fluoride intakes in the United States [3,7]. In 2016, 62.4% of the U.S. population had access to a fluoridated community water system [12]. The fluoride additives used to fluoridate drinking water in the United States are fluosilicic acid, sodium fluosilicate, and sodium fluoride [13]. The Centers for Disease Control and Prevention publishes fluoride levels in tapwater by county [14]. Because of differences in amounts of fluoride in groundwater, private water sources (including well water) have variable fluoride concentrations [10].

Fluoride is not typically added to bottled drinking waters. However, when fluoride is added, the bottle’s label is not required to list the amount unless the label makes a claim about the product’s fluoride content [15]. By law, the amount of fluoride added to bottled water cannot exceed 1.7 mg/L [3]. In 2019, FDA proposed revising the quality standard for bottled water and thereby limiting the amount of fluoride to no more than 0.7 mg/L, but this rule has not yet been finalized [16].

Dietary supplements
Only a few dietary supplements contain fluoride, usually in the form of sodium fluoride [17]. Most of these products are multivitamin/multimineral supplements, multivitamins plus fluoride, or supplements containing trace minerals only. Some fluoride supplements, usually intended for children, are in the form of drops. The most common amount of fluoride in supplements is 0.25 mg, although a few products contain 0.5 or 1 mg [17].

Dental products
Most toothpaste sold in the United States contains fluoride in the form of sodium fluoride or monofluorophosphate, most commonly at a level of 1,000 to 1,100 mg/L (about 1.3 mg in a quarter teaspoon, a typical amount of toothpaste used for one brushing) [3]. The amount of fluoride ingested from toothpaste depends on the amount used, the person’s swallowing control, and how often the person uses toothpaste. Estimated typical amounts of fluoride ingested daily from toothpaste are 0.1 mg to 0.25 mg for infants and children aged 0 to 5 years, 0.2 to 0.3 mg for children aged 6–12 years, and 0.1 mg for adults [3]. Fluoride in toothpaste, regardless of its form, is well absorbed [1].

Other dental products that provide fluoride include mouth rinses for home use, topical fluoride preparations applied in dentists’ offices or through school-based programs, and dental devices (e.g., orthodontic bracket adhesives, glass-ionomer and some composite resin dental restorative materials, and some dental sealants and cavity liners) [3,18]. Gels used by dentists are typically applied one to four times a year and can lead to ingestions of 1.3 to 31.2 mg fluoride each time; varnishes are least likely to produce a high bolus of fluoride [3].

Medications
Medications can contain fluoride. For example, voriconazole (VFEND or Vfend) is an oral antifungal medication used to treat several infectious conditions, including invasive aspergillosis, candidemia, and candidiasis [19]. Typical doses of voriconazole provide 65 mg/day fluoride. Long-term use (e.g., for 4 months or more) of this medication can lead to high fluoride concentrations in serum [20,21]. The prescribing information for voriconazole advises discontinuation of voriconazole if skeletal fluorosis and periostitis (inflammation of the membrane surrounding and protecting the bones) develop [19].

Fluoride Intakes and Status

Most people in the United States consume adequate amounts of fluoride through foods containing naturally occurring fluoride, fluoridated tap water, and food products made with fluoridated tap water. According to the EPA, typical daily fluoride intakes in the United States from foods and beverages (including fluoridated drinking water) are 1.2 to 1.6 mg for infants and toddlers younger than 4 years, 2.0 to 2.2 mg for children aged 4–11 years, 2.4 mg for those aged 11–14 years, and 2.9 mg for adults [10].

Fluoride and Health

This section focuses on two conditions in which fluoride might play a role: dental caries and bone fractures.

Dental caries
Dental caries occurs when cariogenic bacteria in the mouth ferment foods and produce acids that dissolve tooth mineral [22]. Over time, this tooth decay can cause pain and tooth loss. Without treatment, dental caries can cause infections, impair growth, lead to weight gain, affect school performance, impair quality of life, and possibly result in death [23-26]. Adequate fluoride intakes reduce the risk of dental caries in its initial stages by inhibiting demineralization and the activity of bacteria in dental plaque and by enhancing tooth remineralization [24].

Impact of water fluoridation on dental caries: Water fluoridation protects teeth in two main ways—by preventing the development of caries through ingestion of drinking water during the tooth-forming years and through direct contact of fluoride with teeth throughout life [27,28].

A 2015 Cochrane review included 20 prospective observational studies (most conducted before 1975) [8]. The results showed that water fluoridation reduces the risk of decay and fillings, as well as of premature loss of primary (baby) teeth, by 35% and loss of permanent (adult) teeth by 26% in children receiving fluoridated water in comparison with children receiving unfluoridated water. Fluoridation also increases the number of children with no decay in their baby teeth by 15% and the number of children with no decay in their permanent teeth by 14%. The authors concluded that water fluoridation is effective for reducing dental caries rates in both primary and permanent teeth in children. However, the reviewers were unable to assess the effectiveness of water fluoridation for preventing caries in adults because no evidence met the review’s inclusion criteria (which required studies to include at least two groups, one receiving fluoridated water and one receiving unfluoridated water).

The Cochrane review’s findings were confirmed by a 2018 cross-sectional study on the associations between fluoridated community water and dental caries in the United States [29]. The authors analyzed data on 7,000 children aged 2 to 8 years and 12,604 children and adolescents aged 6 to 17 years who participated in the National Health and Nutrition Examination Study (NHANES) from 1999 to 2004 and 2011 to 2014, respectively. The results showed that living in a county in which 75% or more of the drinking water contained at least 0.7 mg/L fluoride was associated with a 30% reduction in the rate of caries in primary teeth and a 12% reduction in the rate of caries in permanent teeth.

Some evidence shows that the addition of fluoride to drinking water can also prevent dental caries in adults. An observational study included 3,779 individuals in Australia aged 15 and older who participated in the Australian 2004–2006 National Survey of Adult Oral Health [30]. In adults exposed to fluoridated community water supplies for at least 14 years, rates of decayed, missing, or filled teeth were 11–12% lower than in adults whose drinking water during this period had negligible amounts of fluoride. An earlier study in 876 Australian Defence Force members aged 17–56 years found that the average rate of decayed, missing, and filled teeth was 24% lower in those with access to water containing 0.5 to 1 mg/L fluoride for at least half of their lifetime than in those exposed for less than 10% of their lifetime [31].

These findings show that fluoridated drinking water can prevent dental caries in children and adults.

Impact of fluoride dietary supplements on dental caries in children: Some studies have assessed the impact of fluoride supplements on caries development in children. For example, a 2011 Cochrane review of 11 randomized or quasi-randomized studies in a total of 7,196 children (most living in communities lacking access to fluoridated drinking water) found that 0.25–1 mg/day supplemental fluoride for 24–55 months reduced rates of decayed, missing, and filled tooth surfaces by 24% [32]. The authors concluded that fluoride supplements were associated with a lower caries incidence rate in permanent teeth. A 2013 systematic review found an even greater preventive effect of fluoride supplements on the basis of one randomized and four nonrandomized clinical trials in children [25]. The results showed that 0.25–1 mg/day fluoride supplementation reduced caries incidence rates in primary teeth by 48–72% in areas where water fluoridation levels were lower than 0.6 mg/L. In two of these trials that monitored the children for 6–10 years, supplements were associated with a 33–80% reduction in the incidence of caries at ages 7–10 years.

The U.S. Preventive Services Task Force (USPSTF) and the American Dental Association have issued fluoride supplement recommendations for children whose water supply contains little or no fluoride [23]. These recommendations are summarized in Table 3.

Source	Age Range	Recommendation
USPSTF [23]	6 months and older	• Fluoride supplement (dose not specified) for children whose water supply contains little or no fluoride*
American Dental Association [33]**	6 months to 3 years	• Fluoride supplement (0.25 mg/day) for children whose water supply contains less than 0.3 ppm (0.3 mg/L) fluoride
	3–6 years	• Fluoride supplement (0.5 mg/day) for children whose water supply contains less than 0.3 ppm (0.3 mg/L) fluoride • Fluoride supplement (0.25 mg/day) for children whose water supply contains 0.3 to 0.6 ppm (0.3 to 0.6 mg/L) fluoride
	6–16 years	• Fluoride supplement (1 mg/day) for children whose water supply contains less than 0.3 ppm (0.3 mg/L) fluoride • Fluoride supplement (0.5 mg/day) for children whose water supply contains 0.3 to 0.6 ppm (0.3 to 0.6 mg/L) fluoride

*No studies have addressed the dosage or duration of oral fluoride supplementation in this population.
**Recommended doses are based on poor-quality evidence.

Overall, the available evidence suggests that dietary supplements containing fluoride can reduce rates of dental caries in children who lack access to fluoridated drinking water. No studies have assessed the impact of fluoride supplements on caries development in adults.

Fluoride dietary supplements in pregnant women: Like other nutrients, fluoride is transferred from a pregnant woman to her fetus, so a few studies have evaluated the use of fluoride supplements by pregnant women to prevent dental caries in their children. However, the authors of a 2017 Cochrane review found only one randomized controlled trial published in 1997 that met the review’s inclusion criteria [34]. This study assessed caries rates in 798 3-year-old children whose mothers had received 1 mg/day fluoride during the last 6 months of pregnancy [35]. The results showed no significant difference in the proportions of children who had decayed or filled primary tooth surfaces or who had caries. The authors of the Cochrane review concluded that the 1997 study was of very low quality and that no evidence shows that fluoride supplementation in pregnant women prevents dental caries in their offspring.

Bone fractures
Because fluoride helps stimulate the formation of new bone, researchers have hypothesized that fluoride supplements might reduce bone fracture risk. However, research to date has provided only limited evidence supporting this hypothesis [36-38].

The findings of observational studies on the impact of fluoride levels in water on bone mineral density (BMD) and fracture risk have been mixed. A study of 7,129 white women found no significant differences in bone mineral density or risk of hip, vertebral, wrist, or humerus fracture between those exposed and those not exposed to fluoridated water between 1950 and 1994 [37]. In contrast, in a study in 8,266 Chinese residents aged 50 years or older, people with access to water fluoride levels of approximately 1 mg/L had a lower overall risk of fractures, but not of hip fractures, than those with access to water containing negligible fluoride levels [38].

Clinical trials have also had conflicting findings about the efficacy of fluoride dietary supplements to prevent bone fractures. For example, a meta-analysis of 25 randomized controlled trials in a total of 954 participants (four of the studies included people with osteoporosis) showed a significant reduction in vertebral and nonvertebral fracture risk with daily doses of up to 20 mg fluoride (in the form of monofluorophosphate or sodium fluoride), but not with higher doses [39]. A more recent randomized controlled trial found that 2.5, 5, or 10 mg/day fluoride for 1 year in 180 postmenopausal women did not change BMD at any site assessed [40].

Health Risks from Excessive Fluoride

Long-term ingestion of excess fluoride in infancy and childhood, when the teeth are being formed, can lead to dental fluorosis [41]. The characteristics of this chronic condition usually vary from almost imperceptible white lines or flecks to white or brown stains on teeth [2]. Severe dental fluorosis can lead to pitting in tooth enamel. The risk of dental fluorosis increases with fluoride intakes above recommended amounts [42]. Severe enamel fluorosis is very rare, and no evidence indicates that recommended levels of community water fluoridation lead to severe dental fluorosis [3,28].

Analysis of 1999–2004 NHANES data showed that 22.8% of persons aged 6–49 had dental fluorosis, although less than 1% had severe fluorosis and less than 2% had moderate fluorosis [41]. The prevalence rate of dental fluorosis was highest, 41%, in adolescents and lowest, 8.7%, in those aged 40–49. A more recent analysis of NHANES data in 2001–2002 and 2011–2012 found that rates of dental fluorosis (from very mild to severe) increased during this 10-year period, from 29.7% to 61.3% [43].

High doses of fluoride (typically from rare accidents resulting in excessively high levels of fluoridation of water, unintentional ingestion of fluoride products intended for topical use in dentists’ offices, or fluoride supplements inappropriately given to children) can result in nausea, vomiting, abdominal pain, diarrhea, periostitis, and even death in rare cases [3,19,44]. According to one estimate, the acute dose that could cause serious systemic toxicity for fluoride is 5 mg/kg (e.g., 375 mg for someone who weighs 75 kg [165 pounds]) [44]. This dose would be virtually impossible to achieve from water or toothpaste containing standard levels of added fluoride.

Chronic, excess intakes of fluoride are also associated with skeletal fluorosis, although this condition is extremely rare in the United States. Its effects can range from occasional joint pain or stiffness to osteoporosis, muscle wasting, and neurological defects [1,45].

In addition to the potential to damage teeth and bones, some evidence suggests that higher fluoride intakes during early development, including during gestation, might be associated with a lower IQ and other cognitive impairments (e.g., delays in cognitive development) in children [46-49]. However, many experts consider this evidence to be weak and methodologically flawed [50-58].

The FNB has established ULs for fluoride from all sources for healthy individuals (Table 4) based on levels associated with dental and skeletal fluorosis [1].

Age	Male	Female	Pregnancy	Lactation
Birth to 6 months	0.7 mg	0.7 mg
7–12 months	0.9 mg	0.9 mg
1–3 years	1.3 mg	1.3 mg
4–8 years	2.2 mg	2.2 mg
9–13 years	10 mg	10 mg
14–18 years	10 mg	10 mg	10 mg	10 mg
19-51 years	10 mg	10 mg	10 mg	10 mg
51+ years	10 mg	10 mg

Interactions with Fluoride

Fluoride has no known, clinically relevant interactions with medications [59].

Fluoride and Healthful Diets

The federal government’s 2020–2025 Dietary Guidelines for Americans notes that “Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. … In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy).”

For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture’s MyPlate.

The Dietary Guidelines for Americans describes a healthy dietary pattern as one that:

• Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.
• Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products.
• Limits foods and beverages higher in added sugars, saturated fat, and sodium.
• Limits alcoholic beverages.
• Stays within your daily calorie needs.

References

1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academies Press; 1997.
2. Touger-Decker R, Radler DR, Depaola DP. Nutrition and dental medicine. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2014:1016-40.
3. National Research Council. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. The National Academies Press, 2006.
4. Pessan JP, Buzalaf MR. Historical and recent biological markers of exposure to fluoride. Monogr Oral Sci 2011;22:52-65. [PubMed abstract]
5. Rango T, Vengosh A, Jeuland M, Whitford GM, Tekle-Haimanot R. Biomarkers of chronic fluoride exposure in groundwater in a highly exposed population. Sci Total Environ 2017;596-597:1-11. [PubMed abstract]
6. U.S. Department of Agriculture. USDA National Fluoride Database of Selected Beverages and Foods, Release 2. U.S. Department of Agriculture, 2005.
7. U. S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Public Health Reports 2015;130:318-31. [PubMed abstract]
8. Iheozor-Ejiofor Z, Worthington HV, Walsh T, O’Malley L, Clarkson JE, Macey R, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015:Cd010856. [PubMed abstract]
9. U.S. Department of Health, Education, and Welfare. Public Health Service drinking water standards, revised 1962. Washington, DC: PHS Publication No. 956; 1962.
10. U.S. Environmental Protection Agency. Fluoride: Exposure and Relative Source Contribution Analysis. 2010.
11. U.S. Environmental Protection Agency. Review of the Fluoride Drinking Water Regulation. 2019.
12. Centers for Disease Control and Prevention. Water Fluoridation Data & Statistics. 2016.
13. Centers for Disease Control and Prevention. Water Fluoridation Additives. 2014.
14. Centers for Disease Control and Prevention. My Water’s Fluoride. 2020.
15. U.S. Food and Drug Administration. Small Entity Compliance Guide: Revision of the Nutrition and Supplement Facts Labels. 2020.
16. U.S. Food and Drug Administration. FDA Announces Proposed Ruling on Fluoride in Bottled Water. 2019.
17. National Institutes of Health. Dietary Supplement Label Database. 2020.
18. Cressey P, Gaw S, Love J. Estimated dietary fluoride intake for New Zealanders. J Public Health Dent 2010;70:327-36. [PubMed abstract]
19. U.S. Food and Drug Administration. VFEND Prescribing Information 2015.
20. Barajas MR, McCullough KB, Merten JA, Dierkhising RA, Bartoo GT, Hashmi SK, et al. Correlation of Pain and Fluoride Concentration in Allogeneic Hematopoietic Stem Cell Transplant Recipients on Voriconazole. Biology of Blood and Marrow Transplantation 2016;22:579-83. [PubMed abstract]
21. Tan I, Lomasney L, Stacy GS, Lazarus M, Mar WA. Spectrum of Voriconazole-Induced Periostitis With Review of the Differential Diagnosis. American Journal of Roentgenology 2018;212:157-65. [PubMed abstract]
22. Featherstone JD. Dental caries: a dynamic disease process. Australian Dental Journal 2008;53:286-91. [PubMed abstract]
23. Moyer VA, Force USPST. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics 2014;133:1102-11. [PubMed abstract]
24. Institute of Medicine. Advancing Oral Health in America. National Academy of Science, 2011.
25. Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation. Pediatrics 2013;132:332-50. [PubMed abstract]
26. Kim JK, Baker LA, Davarian S, Crimmins E. Oral health problems and mortality. J Dent Sci 2013;8. [PubMed abstract]
27. National institute of Dental and Craniofacial Research. Fluoride & Dental Health. 2020.
28. Community Preventive Services Task Force. Dental Caries (Cavities): Community Water Fluoridation. 2013.
29. Slade GD, Grider WB, Maas WR, Sanders AE. Water Fluoridation and Dental Caries in U.S. Children and Adolescents. Journal of dental research 2018;97:1122-8. [PubMed abstract]
30. Slade GD, Sanders AE, Do L, Roberts-Thomson K, Spencer AJ. Effects of fluoridated drinking water on dental caries in Australian adults. J Dent Res 2013;92:376-82. [PubMed abstract]
31. Mahoney G, Slade GD, Kitchener S, Barnett A. Lifetime fluoridation exposure and dental caries experience in a military population. Community Dent Oral Epidemiol 2008;36:485-92. [PubMed abstract]
32. Tubert-Jeannin S, Auclair C, Amsallem E, Tramini P, Gerbaud L, Ruffieux C, et al. Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children. Cochrane Database Syst Rev 2011:Cd007592. [PubMed abstract]
33. Rozier RG, Adair S, Graham F, Iafolla T, Kingman A, Kohn W, et al. Evidence-based clinical recommendations on the prescription of dietary fluoride supplements for caries prevention: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2010;141:1480-9. [PubMed abstract]
34. Takahashi R, Ota E, Hoshi K, Naito T, Toyoshima Y, Yuasa H, et al. Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children. Cochrane Database Syst Rev 2017;10:Cd011850. [PubMed abstract]
35. Leverett DH, Adair SM, Vaughan BW, Proskin HM, Moss ME. Randomized clinical trial of the effect of prenatal fluoride supplements in preventing dental caries. Caries research 1997;31:174-9. [PubMed abstract]
36. Nasman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study. J Dent Res 2013;92:1029-34. [PubMed abstract]
37. Phipps KR, Orwoll ES, Mason JD, Cauley JA. Community water fluoridation, bone mineral density, and fractures: prospective study of effects in older women. Bmj 2000;321:860-4. [PubMed abstract]
38. Li Y, Liang C, Slemenda CW, Ji R, Sun S, Cao J, et al. Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. J Bone Miner Res 2001;16:932-9. [PubMed abstract]
39. Vestergaard P, Jorgensen NR, Schwarz P, Mosekilde L. Effects of treatment with fluoride on bone mineral density and fracture risk–a meta-analysis. Osteoporos Int 2008;19:257-68. [PubMed abstract]
40. Grey A, Garg S, Dray M, Purvis L, Horne A, Callon K, et al. Low-dose fluoride in postmenopausal women: a randomized controlled trial. J Clin Endocrinol Metab 2013;98:2301-7. [PubMed abstract]
41. Beltran-Aguilar ED, Barker L, Dye BA. Prevalence and severity of dental fluorosis in the United States, 1999-2004. NCHS Data Brief 2010:1-8. [PubMed abstract]
42. Bhagavatula P, Curtis A, Broffitt B, Weber-Gasparoni K, Warren J, Levy SM. The relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth. J Public Health Dent 2018;78:165-74. [PubMed abstract]
43. Wiener RC, Shen C, Findley P, Tan X, Sambamoorthi U. Dental Fluorosis over Time: A comparison of National Health and Nutrition Examination Survey data from 2001-2002 and 2011-2012. J Dent Hyg 2018;92:23-9. [PubMed abstract]
44. Whitford GM. Acute toxicity of ingested fluoride. Monogr Oral Sci 2011;22:66-80. [PubMed abstract]
45. Gutteridge DH, Stewart GO, Prince RL, Price RI, Retallack RW, Dhaliwal SS, et al. A randomized trial of sodium fluoride (60 mg) +/- estrogen in postmenopausal osteoporotic vertebral fractures: increased vertebral fractures and peripheral bone loss with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral fractures. Osteoporos Int 2002;13:158-70. [PubMed abstract]
46. Green R, Lanphear B, Hornung R, Flora D, Martinez-Mier EA, Neufeld R, et al. Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada. JAMA Pediatr 2019;173:940-8. [PubMed abstract]
47. Grandjean P. Developmental fluoride neurotoxicity: an updated review. Environ Health 2019;18:110. [PubMed abstract]
48. Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health. Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects. 2019.
49. Valdez Jimenez L, Lopez Guzman OD, Cervantes Flores M, Costilla-Salazar R, Calderon Hernandez J, Alcaraz Contreras Y, et al. In utero exposure to fluoride and cognitive development delay in infants. Neurotoxicology 2017;59:65-70. [PubMed abstract]
50. Canadian Agency for Drugs and Technologies in Health. Community Water Fluoridation: A Review of Neurological and Cognitive Effects. 2019.
51. Aghaji QN, Nwabuo CC. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:210-1. [PubMed abstract]
52. Berezow AB. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatr 2019;174:210-7. [PubMed abstract]
53. Bledsoe J, Breiger D, McKeever J. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:213. [PubMed abstract]
54. Farrow S, Joffe AR. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:214. [PubMed abstract]
55. Gehani CP, Pollick H, Stevenson RA. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:215-6. [PubMed abstract]
56. Gong CX, James NE. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:212-3. [PubMed abstract]
57. Ritchie SJ, Morris AJ, McConway K. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:213-4. [PubMed abstract]
58. Waugh D. Association Between Maternal Fluoride Exposure and Child IQ. JAMA Pediatrics 2020;174:211-2. [PubMed abstract]
59. Natural Medicines. Fluoride. 2019.

Dental Fluorosis

The Role of Fluoride in Caries Reversal

Dental caries is an infectious disease caused by the complex interaction of cariogenic (caries-causing) bacteria with carbohydrates (i.e., sugars) on the tooth surface over time. Cariogenic bacteria metabolize carbohydrates for energy and produce organic acids as byproducts. The acids lower the pH in the plaque biofilm.⁴⁷

The hydroxyapatite of tooth enamel is primarily composed of phosphate ions (PO₄^3–) and calcium ions (Ca²⁺). Under normal conditions, there is a stable equilibrium between the calcium and phosphate ions in saliva and the crystalline hydroxyapatite that comprises 96% of tooth enamel. When the pH drops below a critical level (5.5 for enamel, and 6.2 for dentin), it causes the dissolution of tooth mineral (hydroxyapatite) in a process called demineralization. When the natural buffer capacity of saliva elevates pH, minerals are reincorporated into the tooth through the process of remineralization.⁴⁷

The initial stage of the caries process results in white spot formation, a result of acid penetration and solubilization of some (but not all) of the subsurface mineral (Figure 11A). Left untreated, this subsurface damage can progress to a point where the crystal can no longer provide sufficient support to the enamel surface structure, and the surface collapses (cavitates).

The caries process can be affected in several ways. One of the most effective methods to prevent caries is by promoting remineralization and slowing down demineralization. This can be accomplished with fluoride therapy. It is widely accepted that the regular use of fluoride, such as in dentifrice and drinking water, is extremely effective at preventing dental caries. In 1999, the US Center for Disease Control (CDC) issued a statement that water fluoridation is one of the 10 most important public health measures of the 20th century.⁴⁸ Fluoride’s presence in low concentration and high frequency is more effective at preventing caries than high levels of fluoride used in low frequency. Because water fluoridation is not available in many countries, dentifrice is considered to be one of the most important sources of fluoride globally.

When fluoride is present in oral fluids (i.e., saliva), fluorapatite, rather than hydroxyapatite, forms during the remineralization process. Fluoride ions (F^–) replace hydroxyl groups (OH^–) in the formation of the apatite crystal lattice (Figure 11B), resulting in a stronger, fluoridated tooth mineral (fluorapatite). Fluorapatite is less soluble than hydroxyapatite, even under acidic conditions. Because fluorapatite is less soluble than hydroxyapatite, it is also more resistant to subsequent demineralization when acid challenged.

Caries is generally considered to be a sub-surface phenomenon. With fluoride treatment, a non-cavitated lesion can be remineralized with fluorapatite and have greater resistance to subsequent demineralization than hydroxyapatite. Even at very low concentrations, fluoride is effective as an anticaries agent.⁴⁹

In the US, there are three commonly used sources of fluoride in oral care products; sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and stannous fluoride (SnF₂). All three of these fluoride sources provide the important F^– ion, which both inhibits demineralization and promotes remineralization of damaged tooth mineral. In addition, SnF₂ is considered to have unique properties, as it provides efficacy against bacterial acids in addition to its fluoridating benefits.Figure 11.A) Demineralization – the caries formation process. Damage occurs in subsurface regions of the enamel, leaving an intact outer layer on the enamel surface. B) Remineralization – the caries reversal process. Caries is reversed through the process of remineralization, in which calcium, phosphate and fluoride are incorporated in the areas damaged due to demineralization processes, resulting in a stronger, fluoridated mineral.

https://www.dentalcare.com/en-us/professional-education/ce-courses/ce517/the-role-of-fluoride-in-caries-reversal

Sources:

Dental Fluorosis: Much Ado about Nothing

https://www.dentalcare.com/en-us/professional-education/ce-courses/ce517/the-role-of-fluoride-in-caries-reversal

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690253/

https://pnwhandbooks.org/plantdisease/pathogen-articles/nonpathogenic-phenomena/fluorine-toxicity-plants

https://en.wikipedia.org/wiki/Calcium_fluoride

Formerly Bijlage 143 Scentses.isgezond.nl

https://en.wikipedia.org/wiki/Olaflur

https://en.wikipedia.org/wiki/Amine_fluoride

https://my.clevelandclinic.org/health/drugs/20076-stannous-fluoride-dental-rinse

https://pubmed.ncbi.nlm.nih.gov/16878065/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144112/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856465/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923889/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698581/

https://www.nature.com/articles/d41586-021-02924-6

Is Fluoride Bad for You? It’s Not Just in the Water

https://www.greaterbostondentist.com/blog/stannous-fluoride-vs-sodium-fluoride-yes-there-is-a-difference

https://www.colgate.com/en-us/oral-health/fluoride/stannous-fluoride-toothpaste-pros-cons-and-alternatives#

https://en.wikipedia.org/wiki/Fluoride

What Is Fluoride? Fluoride vs Fluorine

https://www.britannica.com/science/fluorine

http://ichemey.blogspot.com/2013/01/ionic-bonding.html

https://www.webelements.com/compounds/sodium/sodium_fluoride.html

https://fr.wikipedia.org/wiki/Monofluorophosphate_de_sodium

https://chem.nlm.nih.gov/chemidplus/rn/7783-47-3

https://pubchem.ncbi.nlm.nih.gov/compound/Olaflur

https://harmonydentaltx.com/7-side-effects-of-consuming-fluoride-you-should-know-about/

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Phosphorus

What is Phosphorus?

What is its function in our body?

What are the consequences of too little?

What are the consequences of too much?

What are the best combinations for optimal absorption?

How much do you need of it a day?

What are the best food sources?

Those questions are answered in the summary at the end.

The rest is a compilation of all the information from studies on phosphorus I found.

When you order the information, the disonnect between the functions of phosphorus and the usual lists of consequences of too little and too much phosphorous, the information gaps become apparent. Here those gaps are closed with the most recent research.

Conclusion: Phosphorus is much more important, and the consequences of too little are much more serious than the usual articles claim.

Table of Contents

Phosphorus 1

What Is Phosphorus? 2

What are really the health benefits of phosphorus and the consequences of too little or too much? 2

Function of Phosphorus 2

Risks of Not Getting Enough Phosphorus 3

The normally listed Symptoms of too little phosphorus: 4

Let’s complete the list 4

What are the consequences of blood pH imbalance? 4

Nerve disorders 8

Osteomalacia 8

Rhabdomyolysis 8

 Peripheral neuropathy 9

Risks of Too Much Phosphorus 9

Symptoms of too much phosphorus are: 9

Consequences of Alkalosis 10

Treating alkalosis 10

The ideal ratio of calcium to phosphorus 10

How Can I Control the Amount of Phosphorus I Get? 11

Foods With Phosphorus 12

Summary: 18

Milligrams of Phosphorus per 100 grams 22

What Is Phosphorus?

Phosphorus is an essential mineral that your body uses to build healthy bones, create energy and make new cells¹.

You have more of this mineral in your body than any other except calcium. Sulfur, calcium², and phosphorus are the three most abundant minerals in the human body³.

“Phosphorus” comes from the Greek word phosphorous, which means “bringer of light.”

In drug or supplement form, it’s called phosphate⁴.

What are really the health benefits of phosphorus and the consequences of too little or too much?

In the information I find on phosphorus I observe a disconnect between the function of phosphorus and what the consequences are of too little phosphorus. You can read it here:

Function of Phosphorus

• Phosporus plays an important role in keeping you healthy, so it’s an important part of your diet⁵.
• One of its main tasks is to serve as a building block for healthy teeth and bones⁶.You may think that’s calcium’s job. But calcium needs phosphorus to make your teeth and bones strong⁷ and create healthy bones⁸ create energy and make new cells⁹ .
• Phosphorus also helps your nerves and muscles do their jobs¹⁰.
• It’s a buffer that keeps the pH level in your blood balanced¹¹.
• Phosphorus also helps you turn fat, carbs, and protein ¹²into energy.

Risks of Not Getting Enough Phosphorus¹⁴

Phosphorus deficiency is rare in developed countries, as most adults eat more than the recommended amounts every day¹⁵, ¹⁶.

• if you have alcohol¹⁷use disorder,
• a blood acid condition called diabetic ketoacidosis¹⁸,
• certain inherited disorders¹⁹.
• Starvation
• anorexia²⁰.
• Antacids that contain aluminum can drain your body of phosphorus²¹.

The normally listed Symptoms of too little phosphorus:

• you may not feel like eating,
• have muscle weakness,
• bone pain, or
• numbness or tingling in your arms and legs²².

Let’s complete the list

But what about the function of phosphorus to regulate bood pH? Does lack of phosphorous then not cause blood pH imbalance, and what is the consequence of that? And what about the role of phosphorus in creating string teeth and bones? Does lack of phorporus not cause weak bones and bad teeth? And what about the role of phosphorus in transforming fat, proteins and carbohydrates into energy? Does lackof phosphorus then not cause lethargy and weight gain?

Let’s take a look

What are the consequences of blood pH imbalance?

A blood pH imbalance can lead to two conditions: acidosis and alkalosis. Acidosis refers to having blood that’s too acidic, or a blood pH of less than 7.35. Alkalosis refers to having blood that’s too basic, or a blood pH of higher than 7.45²³.

Consequences of Acidosis

The glycolytic enzyme phosphofructokinase is pH dependent, as its activity decreases with decreasing pH, and thus glucose utilization in brain cells is impaired.

Therefore, the clinical consequences of decreasing blood pH are 

fatigue and weakness

loss of appetite

nausea and vomiting

headache

fast heartbeat

heavy breathing²⁴

drowsiness,

stupor,

coma, and

death in coma²⁵.

Acidosis is characterized by primary reduction in bicarbonate and pH revealed during arterial blood gas analysis²⁶.

Treatment of acidosis

For more than 50 years, standard care of patients suffering metabolic acidosis, whatever its cause, has included iv administration of the base sodium bicarbonate to correct the acidosis²⁷.

But look at the name of the study: Sodium bicarbonate: basically useless therapy²⁸.

It states:

“This review examines the history of sodium bicarbonate use in neonatology and the evidence that refutes the clinical practice of administering sodium bicarbonate during cardiopulmonary resuscitation or to treat metabolic acidosis in the NICU²⁹.”

Perhaps phosphorus supplementation would be a better idea. And indeed, this is what the literature confirms³⁰.

Phosphorus aids in weight loss

And if phosphporus helps turn fat,carbs and protein into energy, you would expect that it aids in weight loss, and that low phosphorus can lead to weight gain.

And indeed, this is the case:

Low phosphorus status has been positively associated with increased body weight³¹.

Bones and Teeth

Since Phosphorus plays a role in healthy teeth and strong bones, you would expect lack of it to result in bad teeth and weak bones.

Without phosphorus, your body can’t use calcium well, even with Vitamin D. The results include bone brittleness and teeth that chip easily³²

Phosphorus is abundant in all cells and tissues as an important component of DNA, RNA and phospholipids, a source of high-energy bonds in adenosine triphosphates (ATP), a substrate for various kinases and phosphatases, and a regulator of intracellular signaling. Phosphate homeostasis on a cellular level is therefore a significant aspect of normal function for most tissues and organs. Approximately 85% of phosphorus, the second most abundant mineral in the human body, is in bone, primarily compounded with calcium (Ca2+), the most abundant mineral, in hydroxyapatite (HAP) crystals deposited on the collagen matrix (Broadus, 2003). Other mineralized tissues such as teeth also contain calcium phosphate as HAP. The remainder is in soft tissue with only about 1% in extracellular fluids (Drezner, 2002). Therefore, maintenance of “normal” phosphate (inorganic or orthophosphate, Pi) homeostasis is essential for normal development, maintenance, and repair of teeth and skeletal tissues³³.

Natural foods contain substantial quantities of phosphorus. Deficiency can occur as a result of severe starvation, intake of Pi binders that prevent absorption in the gut, or in diseases associated with renal Pi wasting. Dietary Pi is absorbed in the small intestine where the impact of hormonal regulation, mediated by the active form of vitamin D, 1,25 (OH)2 vitamin D3 (referred to herein as Vit D), is minor relative to dietary load. From blood, phosphorus is taken into cells, incorporated into mineralized tissue matrices, or excreted from the body in urine. Hormonal regulation is critical to the homeostasis of absorbed Pi, with the primary locus being the kidney, as much of the absorbed Pi is excreted in the urine. Consequently, hormonal regulation of Pi excretion and reabsorption, more so than absorption, maintains circulating plasma concentrations (Drezner, 2002). This “parathyroid-kidney-intestine-bone/tooth” axis of Ca2+ and Pi balance is exhibited in Figure 1, with further description of the factors of interest featured in section II³⁴.

Figure 1

Serum calcium (Ca2+) and phosphate (Pi) levels regulate gene expression in the parathyroid-kidney-intestine- tooth axis

Decreases in serum Ca2+ induce the calcium sensing receptor in the parathyroid glands, embedded in the thyroid gland, to secrete PTH into the bloodstream. PTH stimulates the activity of 1-α-hydroxylase in the kidney which catalyzes the formation of the active 1,25 dihydroxy form of Vit D (line 1). PTH potently stimulates osteoclast activity to release Ca2+ from bone. Active Vit D increases intestinal absorption of Ca2+ via the TRPV6 Ca2+ channel and of Pi through the Npt2b ion channel. Renal reabsorption of Pi is increased by Vit D through increased Npt2c activity (line 2). PTH acts to reduce Pi reabsorbtion by down-regulation of Npt2a, while the induced increase in serum Ca2+ reduces secretion of PTH. Vit D has effects on tooth mineralization as evidenced by dentin defects under Vit D deficient states. Vit D acts to increase the expression of FGF23 in bone and the FGF23 receptor binding partner Klotho in the kidney (line 3). FGF23 reduces the activity of 1-α-hydroxylase, decreasing the formation of active Vit D (line 4), closing the loop began by PTH demonstrated by the lines numbered 1-4. SIBLING protein expression in bones and teeth are affected by Pi levels. Mutations in Phex induce expression of FGF23 in osteocytes and ameloblasts and odontoblasts, with concurrent increases in MEPE expression and ASARM formation. Loss of function mutations in Dmp1 induce an increase in FGF23 and decrease in DSPP expression levels. The gene expression changes in these mutations result in decreased mineralization in bones and teeth. The hyperphosphatemia in the FGF23 loss of function mutant may induce the observed increased expression of DMP1 in bone and tooth in a compensatory attempt to increase mineralization³⁵..

Kidney stones

Low phosphorus may also cause kidney stones:

“Alterations in phosphorus homeostasis also may contribute to calcium kidney stones. In one cross-sectional study of 207 calcium stone formers and 105 controls, mean serum phosphate was 9% lower and fractional excretion of phosphate was 29% higher in stone formers . Other investigators also have reported lower values of serum phosphate in smaller series of patients with kidney stones . More recent data have led to speculation that higher plasma fibroblast growth factor 23 (FGF23), an osteocyte-derived phosphaturic hormone, may contribute to calcium kidney stone formation ³⁶.

Nerve disorders

If phosphorus is important for nerves, you would expectnervoussystem disorders to occur when there is lack of phosphorus, and according to to the following study, this is indeed the case:

“Severe hypophosphataemia, when combined with phosphorus depletion, has been known to cause a number of clinical conditions, including haematological impairment, metabolic acidosis, osteomalacia, central nervous system dysfunction, myocardial dysfunction, rhabdomiolysis and peripheral neuropathy”³⁷.

Osteomalacia

Osteomalacia refers to a marked softening of your bones,. The softened bones of children and young adults with osteomalacia can lead to bowing during growth, especially in weight-bearing bones of the legs. Osteomalacia in older adults can lead to fractures³⁸.

Rickets is the clinical consequence of impaired mineralization of bone matrix throughout the growing skeleton, whilst osteomalacia is the result of this disturbance after the growth plates have fused in adults³⁹.

Rhabdomyolysis

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure. This means the kidneys cannot remove waste and concentrated urine. In rare cases, rhabdomyolysis can even cause death. However, prompt treatment often brings a good outcome. Here’s what you need to know about rhabdomyolysis.

The “classic triad” of rhabdomyolysis symptoms are: muscle pain in the shoulders, thighs, or lower back;  muscle weakness or trouble moving arms and legs; and dark red or brown urine or decreased urination. Half of people with the condition may have no muscle-related symptoms.

Other common signs of rhabdomyolysis include:

• Abdominal pain
• Nausea or vomiting
• Fever, rapid heart rate
• Confusion, dehydration, fever, or lack of consciousness⁴⁰

 Peripheral neuropathy

Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other areas and body functions including digestion, urination and circulation⁴¹

Risks of Too Much Phosphorus

While phosphorus is beneficial for most people, it can be harmful when consumed in excess. People with kidney disease can have trouble removing it from their blood and may need to limit their phosphorus intake ⁴².

• Symptoms of too much phosphorus are:

High levels of phosphorus.can cause

• your bones to lose calcium or
• calcium deposits to form in your blood vessels, eyes, heart, and lungs.
• If you have too much phosphorus in your body for a long period of time, your chance of a heart attack⁴⁵ or stroke ⁴⁶goes up⁴⁷.

High phosphate levels cause calcium levels in the blood to drop.

Symptoms of low calcium include:

• muscle cramps or spasms
• numbness and tingling around the mouth
• bone and joint pain
• weak bones
• rash
• itchy skin⁴⁸
•  diarrhea⁴⁹ and stomach cramps⁵⁰⁵¹.

Low calcium levels can cause blood pH levels to rise.

Acidosis reduces, and alkalosis increases the binding of calcium to albumin, causing increased or decreased levels of ionized calcium, respectively⁵².

So acidosis reduces the binding of calcium to albumin, causing increased levels of ionized calcium,

and alkalosis increases the binding of calcium to albumin, causing decreased levels of ionized calcium.

Consequences of Alkalosis

When blood pH levels can become too high, and thus the blood too alkaline it is calles alkalosis. Metabolic alkalosis can have central nervous system manifestations ranging from confusion to coma, peripheral neuropathic symptoms of tremor, tingling and numbness, muscle weakness and twitching, and arrhythmias, particularly when associated with hypokalemia and hypocalcemia⁵³.

Treating alkalosis

Metabolic alkalosis is usually treated by replacing water and electrolytes (sodium and potassium) while treating the cause. Rarely, when metabolic alkalosis is very severe, dilute acid is given intravenously. In respiratory alkalosis, the first step is to ensure that the person has enough oxygen⁵⁴.

The ideal ratio of calcium to phosphorus

The ideal calcium to phosphorus ratio is 1-2:1⁵⁵

For calcium sources and combinations, look here⁵⁶,

How Can I Control the Amount of Phosphorus I Get?

• Calcium phosphate
• Phosphoric acid
• Sodium acid pyrophosphate⁵⁸

How Much Phosphorus Do I Need?

The recommended daily intake (RDI) for adults is 700 mg, but growing teens and pregnant women need more. The daily value (DV) was estimated to be 1,000 mg, but was recently updated to 1,250 mg to cover the needs of these groups⁵⁹.

• Up to 6 months: 100 milligrams
• 7 months-1 year: 275 milligrams
• 1-3 years: 460 milligrams
• 4-8 years: 500 milligrams
• 9-13 years: 1,250 milligrams
• 14-18 years: 1,250 milligrams
• 19 years and older: 700 milligrams⁶⁰

Foods With Phosphorus

• Meats and other proteins: beef, chicken, fish, and organ meat like liver
• Milk and dairy foods: eggs, cottage cheese, and ice cream
• Beans: navy, kidney, pinto, and garbanzo
• Grains: bran and wheat germ
• Nuts and seeds: almonds, cashews, peanut butter, and sunflower seeds⁶²

Phosphorus is found in most foods, but some foods are especially good sources. This article lists 12 foods that are particularly high in phosphorus⁶⁴.

Dairy

It is estimated that 20–30% of phosphorus in the average American diet comes from dairy ⁶⁵products like cheese, milk, cottage cheese and yogurt⁶⁶

Just one ounce (28 grams) of Romano cheese contains 213 mg of phosphorus (30% of the RDI), and one cup (245 grams) of skim milk contains 35% of the RDI⁶⁷.

Low-fat and non-fat dairy products, like yogurt and cottage cheese, contain the most phosphorus, while whole-fat dairy products contain the least⁶⁸.

Low-fat dairy products like milk, cottage cheese and yogurt are excellent sources of phosphorus, providing at least 30% of the RDI per serving⁶⁹.

100 grams of cottage cheese has 128 mg of phosphorus⁷⁰.

Romano cheese: 100 grams has 760 mg of phosphorus⁷¹.

Low fat yoghurt: 100 grams has 93 mg of phosphorus⁷².

Whole fat yoghurt: 100 grams has 109 mg of phosphorus⁷³.

Skim milk: 100 grams has 112mg mg of phosphorus⁷⁴.

Whole milk:100 grams has 85 mg of phosphorus⁷⁵.

Buttermilk: 100 grams has 85 mg of phosphorus⁷⁶.

Milk kefir: 100 grams of has 228 mg mg of phosphorus⁷⁷.

Sunflower and Pumpkin Seeds

Sunflower and pumpkin seeds also contain large amounts of phosphorus.

One ounce (28 grams) of roasted sunflower or pumpkin seeds ⁷⁸contains roughly 45% of the RDI for phosphorus ⁷⁹.

100 grams of pumpkin seeds have  1233 mg of phosphorus⁸⁰.

However, up to 80% of the phosphorus found in seeds is in a stored form called phytic acid⁸¹, or phytate, which humans cannot digest ⁸².

Soaking seeds until they sprout can help break down phytic acid, releasing some of the phosphorus for absorption⁸³ . Like seeds, most of the phosphorus in nuts is stored as phytic acid, which is not digestible by humans. Soaking may help, though not all studies agree⁸⁴.

So don’t overdo it with the soaking, because phytic acid has its benefits and fighs cancer⁸⁵. Just soak those nutrients that are inedible otherwise, not the others.

Pumpkin and sunflower seeds can be enjoyed as a snack, sprinkled on salads, blended into nut butters or used in pesto, and are a great alternative for people who are allergic to peanuts or tree nuts.Sunflower and pumpkin seeds contain large amounts of the storage form of phosphorus called phytic acid, which humans can’t digest. Sprouting the seeds can help make the phosphorus available for absorption⁸⁶.

100 grams of sunflower seeds have 1158 mg of phosphorus⁸⁷

Nuts

Most nuts are good sources of phosphorus, but Brazil nuts top the list. Just a 1/2-cup (67 grams) of Brazil nuts provides more than 2/3 of the RDI for adults

Brazil nuts have 725mg Phosphorus, per 100 grams⁸⁸.

Other nuts containing at least 40% of the RDI per 1/2-cup (60–70 grams) include cashews⁸⁹, almonds⁹⁰, pine nuts⁹¹ and pistachios ⁹²  .

They are also great sources of plant-based protein, antioxidants and minerals. Eating them regularly is linked with better heart health⁹³.

Many nuts, and especially Brazil nuts, are good sources of phosphorus, containing at least 40% of the RDI per 1/2-cup (67-gram) serving⁹⁴.

Mg of Phosphorus per 100 grams:

Nuts, cashew nuts, raw : 593mg
Nuts, cashew nuts, oil roasted, without salt added : 531mg
Nuts, cashew nuts, oil roasted, with salt added : 531mg Nuts, cashew nuts, dry roasted, without salt added : 490mg
5. Nuts, cashew nuts, dry roasted, with salt added : 490mg ⁹⁵

1. Nuts, brazilnuts, dried, unblanched : 725mg
2. Nuts, cashew nuts, raw : 593mg
3. Nuts, pilinuts, dried : 575mg
4. Nuts, pine nuts, dried : 575mg
5. Nuts, cashew nuts, oil roasted, without salt added : 531mg
6. Nuts, cashew nuts, oil roasted, with salt added : 531mg
7. Nuts, walnuts, black, dried : 513mg
8. Nuts, almond butter, plain, without salt added : 508mg
9. Nuts, almond butter, plain, with salt added : 508mg
10. Nuts, cashew nuts, dry roasted, without salt added : 490mg
11. Nuts, pistachio nuts, raw : 490mg
12. Nuts, cashew nuts, dry roasted, with salt added : 490mg
13. Nuts, almonds : 484mg
14. Nuts, almonds, blanched : 481mg
15. Nuts, almonds, dry roasted, without salt added : 470mg
16. Nuts, almonds, dry roasted, with salt added : 470mg
17. Nuts, pistachio nuts, dry roasted, without salt added : 469mg
18. Nuts, pistachio nuts, dry roasted, with salt added : 469mg
19. Nuts, almonds, oil roasted, without salt added : 466mg
20. Nuts, almonds, oil roasted, with salt added : 466mg ⁹⁶

Almonds: 100 grams have 71 mg of phosphorus⁹⁷

Whole Grains

Many whole grains contain phosphorus, including wheat, oats and rice.

Spelt contains the most phosphorus (291 mg or 194 grams per cooked cup⁹⁸), followed by oats (180 mg or 234 grams per cooked cup⁹⁹) and rice (162 mg or 194 grams per cooked cup¹⁰⁰).

100 grams of cooked spelt has 150 mg of phosphorus¹⁰¹

100 grams of oats have 458 mg of phosphorus¹⁰²

100 grams of brown rice has 333 mg of phosphorus¹⁰³

100 grams of white rice has 71 mg of phosphorus¹⁰⁴

The percentage of the recommended daily allowance (RDA) for phosphorus is based on a 1000 mg RDA level for a mature adult.

Top three whole wheat bread products high in phosphorus

The amount or level of phosphorus in 100g.

1. Bread, whole-wheat, commercially prepared, toasted : 303mg (
2. Bread, whole-wheat, prepared from recipe, toasted : 205mg
3. Bread, whole-wheat, commercially prepared : 202mg ¹⁰⁵

1. Buckwheat : 347mg
2. Buckwheat flour, whole-groat : 337mg
3. Buckwheat groats, roasted, dry : 319mg ¹⁰⁶

Most of the phosphorus in whole grains is found in the outer layer of the endosperm, known as the aleurone, and the inner layer, called the germ¹⁰⁷.

These layers are removed when grains are refined, which is why whole grains¹⁰⁸ are good sources of phosphorus¹⁰⁹ and why refined grains are not¹¹⁰.

However, like seeds, most of the phosphorus in whole grains is stored as phytic acid, which is hard for the body to digest and absorb.

Soaking, sprouting or fermenting the grains can break down some of the phytic acid and make more of the phosphorus available for absorption¹¹¹, ¹¹², ¹¹³.

Whole grains like wheat, oats and rice contain a lot of phosphorus. Soaking, sprouting or fermenting the grains may make it more available for absorption¹¹⁴.

Amaranth and Quinoa

While amaranth and quinoa ¹¹⁵are often referred to as “grains,” they are actually small seeds and are considered pseudocereals.

One cup (246 grams) of cooked amaranth contains 52% of the recommended daily intake of phosphorus for adults¹¹⁶ and the same volume of cooked quinoa¹¹⁷ contains 40% of the RDI .

100 grams of amaranth has 557 mg of phosphorus¹¹⁸.

100 grams of quinoa has 158 mg of phosphorus¹¹⁹

Both of these foods are also good sources of fiber, minerals and protein, and are naturally gluten-free¹²⁰, ¹²¹ .

Like other seeds, soaking, sprouting and fermenting can increase phosphorus availability¹²².

Ancient grains like amaranth and quinoa are highly nutritious and are good sources of phosphorus. One cooked cup (246 grams) contains at least 40% of the recommended daily intake¹²³.

Beans and Lentils

Beans and lentils ¹²⁴also contain large amounts of phosphorus, and eating them regularly is associated with lower risk of many chronic diseases, including cancer¹²⁵ ,¹²⁶, ¹²⁷.

Just one cup (198 grams) of boiled lentils contains 51% of the recommended daily intake and over 15 grams of fiber¹²⁸, ¹²⁹.

100 grams of lentils have 451 milligrams of phosphorus¹³⁰.

Beans are also rich in phosphorus, especially Great Northern, chickpeas, navy and pinto beans, which all contain at least 250 mg per cup (164 to 182 grams)¹³¹,  ¹³², ¹³³, ¹³⁴, ¹³⁵.

Availability of the [hospherus in beans can be increased by soaking, sprouting and fermenting the beans¹³⁶, ¹³⁷ , ¹³⁸.

Beans and lentils, especially when soaked, sprouted or fermented, are rich sources of phosphorus, containing at least 250 mg per cup (roughly 160–200 grams)¹³⁹.

Summary:

What is Phosphorus

Phosphorus is the second most abundant mineral in the body, the first being Calcium.

Function of phosphorus

Phosporus plays an important role in keeping you healthy, so it’s an important part of your diet¹⁴⁰.

• Phosphorus helps your nerves and muscles do their jobs¹⁴¹.
• Phosphorus is a buffer that keeps the pH level in your blood balanced¹⁴².
• Phosphorus helps you turn fat, carbs, and protein ¹⁴³into energy.

Calcium needs phosphorus

• to make your teeth and bones strong¹⁴⁴
• to create healthy bones¹⁴⁵
• to create energy and
• make new cells¹⁴⁶ .

Symptoms of too little phosphorus:

bone brittleness ¹⁴⁷

teeth that chip easily¹⁴⁸

loss of apetite

muscle weakness,

bone pain,

numbness or tingling in arms and legs¹⁴⁹.

urinary tract infections

calcium stones in the urinary tract¹⁵⁰.

Kidney stones ¹⁵¹.

Low phosphorus status has been positively associated with increased body weight¹⁵².

Low phosphorus causes the blood pH level to become unstable. If the pH level becomes to ow, and thus the blood becomes to acidic, it is called Acidosis.

The glycolytic enzyme phosphofructokinase is pH dependent, as its activity decreases with decreasing pH, and thus glucose utilization in brain cells is impaired.

Therefore, the clinical consequences of decreasing blood pH are 

fatigue and weakness

loss of appetite

nausea and vomiting

headache

fast heartbeat

heavy breathing¹⁵³

drowsiness,

stupor,

coma, and

death¹⁵⁴.

haematological impairment,

metabolic acidosis,

osteomalacia,

central nervous system dysfunction,

myocardial dysfunction,

rhabdomiolysis and

peripheral neuropathy¹⁵⁵.

 Peripheral neuropathy

Peripheral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet. It can also affect other areas and body functions including digestion, urination and circulation¹⁵⁶

Symptoms of too much phosphorus are:

High phosphorus levels cause calcium levels in the blood to drop.

Symptoms of low calcium include:

• muscle cramps or spasms
• numbness and tingling around the mouth
• bone and joint pain
• weak bones
• rash
• itchy skin¹⁵⁷
• Metabolic alkalosis can have central nervous system manifestations ranging from
• confusion to
• coma,
• peripheral neuropathic symptoms of tremor, tingling and numbness,
• muscle weakness and twitching, and
• arrhythmias, particularly when associated with hypokalemia and hypocalcemia¹⁵⁸.

The ideal ratio of calcium to phosphorus

The ideal calcium to phosphorus ratio is 1-2:1¹⁵⁹

For calcium sources and combinations, look here¹⁶⁰,

Recommended Daily Allowance of Phosphorus

How much phosphorus you need depends on your age.

Women who are pregnant or breastfeeding need the same amount as other adults.

• Up to 6 months: 100 milligrams
• 7 months-1 year: 275 milligrams
• 1-3 years: 460 milligrams
• 4-8 years: 500 milligrams
• 9-13 years: 1,250 milligrams
• 14-18 years: 1,250 milligrams
• 19 years and older: 700 milligrams¹⁶¹

Milligrams of Phosphorus per 100 grams

Grains, Nuts and Seeds

Pumpkin seeds: 100 grams of have  1233 mg of phosphorus¹⁶².

Sunflower seeds:100 grams have 1158 mg of phosphorus¹⁶³

Brazil nuts :100 grams have 725mg Phosphorus ¹⁶⁴

Sesame seeds: 100 grams have 667 mg of phosphorus¹⁶⁵

Flaxseeds:100 grams have 642 mg of phosphorus¹⁶⁶

Amaranth :100 grams has 557 mg of phosphorus¹⁶⁷.

Cashews, raw: 100 grams have 593mg of phosphorus¹⁶⁸

Cashews, roasted : 100 grams have 593mg of phosphorus¹⁶⁹

Nuts, cashew nuts, dry roasted, without salt added : 490mg
5. Nuts, cashew nuts, dry roasted, with salt added : 490mg ¹⁷⁰

1. Nuts, brazilnuts, dried, unblanched : 725mg
2. Nuts, cashew nuts, raw : 593mg
3. Nuts, pilinuts, dried : 575mg
4. Nuts, pine nuts, dried : 575mg
5. Nuts, cashew nuts, oil roasted, without salt added : 531mg
6. Nuts, cashew nuts, oil roasted, with salt added : 531mg
7. Nuts, walnuts, black, dried : 513mg
8. Nuts, almond butter, plain, without salt added : 508mg
9. Nuts, almond butter, plain, with salt added : 508mg
10. Nuts, cashew nuts, dry roasted, without salt added : 490mg
11. Nuts, pistachio nuts, raw : 490mg
12. Nuts, cashew nuts, dry roasted, with salt added : 490mg
13. Nuts, almonds : 484mg
14. Nuts, almonds, blanched : 481mg
15. Nuts, almonds, dry roasted, without salt added : 470mg
16. Nuts, almonds, dry roasted, with salt added : 470mg
17. Nuts, pistachio nuts, dry roasted, without salt added : 469mg
18. Nuts, pistachio nuts, dry roasted, with salt added : 469mg
19. Nuts, almonds, oil roasted, without salt added : 466mg
20. Nuts, almonds, oil roasted, with salt added : 466mg ¹⁷¹

Oats: 100 grams of have 458 mg of phosphorus¹⁷²

Lentils: 100 grams have 451 mg of phosphorus¹⁷³.

Peanuts: 100 grams have 388 mg of phosphorus¹⁷⁴

Walnuts:100 grams of walnuts have 346 grams of phosphorus¹⁷⁵.

1. Buckwheat : 347mg
2. Buckwheat flour, whole-groat : 337mg
3. Buckwheat groats, roasted, dry : 319mg ¹⁷⁶

Brown Rice: 100 grams has 333 mg of phosphorus¹⁷⁷

1. Bread, whole-wheat, commercially prepared, toasted : 303mg (
2. Bread, whole-wheat, prepared from recipe, toasted : 205mg
3. Bread, whole-wheat, commercially prepared : 202mg ¹⁷⁸

Hazelnuts: 100 grams have 290 mg of phosprus¹⁷⁹

Quinoa: 100 grams has 158 mg of phosphorus¹⁸⁰

Spelt, cooked: 100 grams has 150 mg of phosphorus¹⁸¹

White Rice :100 grams has 71 mg of phosphorus¹⁸²

Banana’s:100 grams have 22 mg of phosphorus¹⁸³

Figs¹⁸⁴

Meat , and seafood sources of phosphorus:

Chicken: 100 grams has 335 mg of phosphorus¹⁸⁵

Salmon, 100 grams has 261 mg of phosphorus¹⁸⁶

Dairy sources:

Romano cheese: 100 grams has 760 mg of phosphorus¹⁸⁷.

Milk kefir: 100 grams has 228 mg mg of phosphorus¹⁸⁸.

Brie: 100 grams has 188 mg of phosphorus¹⁸⁹

Skim milk: 100 grams has 112mg mg of phosphorus¹⁹⁰.

Cottage cheese: 100 grams has 128 mg of phosphorus¹⁹¹.

Whole fat yoghurt: 100 grams has 109 mg of phosphorus¹⁹².

Low fat yoghurt: 100 grams has 93 mg of phosphorus¹⁹³.

Whole milk: 100 grams has 85 mg of phosphorus¹⁹⁴.

Buttermilk: 100 grams has 85 mg of phosphorus¹⁹⁵.

Amount of phosphorus in 100 grams of the followng cheeses:

1. Cheese, pasteurized process, cheddar or American, fat-free : 936mg
2. Cheese spread, pasteurized process, American : 875mg
3. Cheese product, pasteurized process, American, vitamin D fortified : 855mg
4. Cheese product, pasteurized process, American, reduced fat, fortified with vitamin D : 829mg
5. Cheese product, pasteurized process, cheddar, reduced fat : 829mg
6. Cheese, pasteurized process, American, low fat : 827mg
7. Cheese, pasteurized process, swiss, low fat : 827mg
8. Cheese, parmesan, low sodium : 807mg
9. Cheese, pasteurized process, swiss : 762mg
10. Cheese, romano : 760mg
11. Cheese, pasteurized process, cheddar or American, low sodium : 745mg
12. Cheese, pasteurized process, pimento : 744mg
13. Cheese, parmesan, shredded : 735mg
14. Cheese, parmesan, grated : 729mg
15. Cheese, goat, hard type : 729mg
16. Cheese, parmesan, dry grated, reduced fat : 729mg
17. Cheese, american cheddar, imitation : 712mg
18. Cheese, parmesan, hard : 694mg
19. Cheese, mozzarella, nonfat : 656mg
20. Cheese, pasteurized process, American, fortified with vitamin D : 641mg ¹⁹⁶

References

1Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

28 Fast Facts About Calcium, Healthline,Updated on August 14, 2018, Summer Fanous , Medically reviewed by Natalie Butler, R.D., L.D. https://www.healthline.com/health/8-fast-facts-about-calcium

3Are we getting enough sulfur in our diet? PubMed, November 6, 2007, Nimni ME, Han B, Cordoba F. Are we getting enough sulfur in our diet? Nutr Metab (Lond). 2007 Nov 6;4:24. doi: 10.1186/1743-7075-4-24 PMID: 17986345 PMCID: PMC2198910, Marcel E Nimni, 1 Bo Han,1 and Fabiola Cordoba2 , 1Departments of Surgery and Biochemistry and Molecular Biology, Keck School of Medicine, University of Southern California, Los Angeles, CA. 90032, USA

2Pediatrics Medical Group, San Juan, 00907, Puerto Rico

corresponding authorCorresponding author.

Marcel E Nimni: moc.loa@700inmin; Bo Han: ude.csu@nahob; Fabiola Cordoba: moc.loa@abodrocaloibaf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2198910/

4Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

5Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

6Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

7Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

8What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride?PubMed,February 2009, Bergman C, Gray-Scott D, Chen JJ, Meacham S. What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride? Crit Rev Food Sci Nutr. 2009 Feb;49(2):136-44. doi: 10.1080/10408390701764468. PMID: 18989832.,https://pubmed.ncbi.nlm.nih.gov/18989832/

9What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride?PubMed,February 2009, Bergman C, Gray-Scott D, Chen JJ, Meacham S. What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride? Crit Rev Food Sci Nutr. 2009 Feb;49(2):136-44. doi: 10.1080/10408390701764468. PMID: 18989832.,https://pubmed.ncbi.nlm.nih.gov/18989832/

10Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

11Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

12Good Protein Sources, Fitness and Exercise, January 13, 2022, Kathleen M. Zelman, MPH, RD, LD, https://www.webmd.com/fitness-exercise/guide/good-protein-sources

13Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

14Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

15Assessing the health impact of phosphorus in the food supply: issues and considerations, Calvo MS, Moshfegh AJ, Tucker KL. Assessing the health impact of phosphorus in the food supply: issues and considerations. Adv Nutr. 2014 Jan 1;5(1):104-13. doi: 10.3945/an.113.004861

. PMID: 24425729; PMCID: PMC3884091C, Mona S Calvo 1, Alanna J Moshfegh, Katherine L Tucker

.https://pubmed.ncbi.nlm.nih.gov/24425729/

16Dietary Sources of Phosphorus among Adults in the United States: Results from NHANES 2001-2014, PubMed, JMcClure ST, Chang AR, Selvin E, Rebholz CM, Appel LJ. Dietary Sources of Phosphorus among Adults in the United States: Results from NHANES 2001-2014. Nutrients. 2017 Jan 30;9(2):95. doi: 10.3390/nu9020095. PMID: 28146091; PMCID: PMC5331526. Scott T McClure 1 2, Alex R Chang 3 4 5, Elizabeth Selvin 6 7 8, Casey M Rebholz 9 10, Lawrence J Appel 11 12 13, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21205, USA. smcclur7@jhu.edu.

• Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. smcclur7@jhu.edu.
• Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21205, USA. achang@geisinger.edu.
• Division of Nephrology, Johns Hopkins University, Baltimore, MD 21205, USA. achang@geisinger.edu.
• Division of Nephrology, Geisinger Health System, Danville, PA 17822, USA. achang@geisinger.edu.
• Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21205, USA. eselvin@jhu.edu.
• Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. eselvin@jhu.edu.
• Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. eselvin@jhu.edu.
• Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21205, USA. crebhol1@jhu.edu.
• Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. crebhol1@jhu.edu.
• Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21205, USA. lappel@jhmi.edu.
• Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. lappel@jhmi.edu.
• Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. lappel@jhmi.edu.

https://pubmed.ncbi.nlm.nih.gov/28146091/

17Quiz: Alcohol Myths and Facts, WebMD,September 04, 2020, Medicinaal Reviewed by Kathleen M. Zelman, RD, LD, MPH https://www.webmd.com/food-recipes/rm-quiz-alcohol-myths-facts

18Diabetic Ketoacidosis, ARTICLES ON

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19Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

20Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

21Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

22Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

23What’s a Normal Blood pH and What Makes It Change? Healthline,August 16, 2019 ,Noreen Iftikhar, MD , Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA https://www.healthline.com/health/ph-of-blood#causes-of-abnormalities

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25Dangers of very low blood pH, PMC, Rosival V. Dangers of very low blood pH. Indian J Crit Care Med. 2011 Jul;15(3):194. doi: 10.4103/0972-5229.84887 ,PMID: 22013317; PMCID: PMC3190476.  Viktor Rosival, Department of Laboratory Medicine, SYNLAB, Dérer’s Hospital, Bratislava, Slovakia, Correspondence: Dr. Viktor Rosival, Department of Laboratory Medicine, SYNLAB, Dérer’s Hospital, Limbová 5, SK-833 05 Bratislava, Slovakia, Europe. E-mail: moc.liamtoh@vlavisor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190476/

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27https://acutecaretesting.org/en/journal-scans/correcting-metabolic-acidosis

28Sodium bicarbonate: basically useless therapy, Aschner JL, Poland RL, PubMed, October 2018, Sodium bicarbonate: basically useless therapy. Pediatrics. 2008 Oct;122(4):831-5. doi: 10.1542/peds.2007-2400, PMID: 18829808, Judy L Aschner 1, Ronald L Poland , https://pubmed.ncbi.nlm.nih.gov/18829808/

29Sodium bicarbonate: basically useless therapy, Aschner JL, Poland RL, PubMed, October 2018, Sodium bicarbonate: basically useless therapy. Pediatrics. 2008 Oct;122(4):831-5. doi: 10.1542/peds.2007-2400, PMID: 18829808, Judy L Aschner 1, Ronald L Poland , https://pubmed.ncbi.nlm.nih.gov/18829808/

30Hypophosphatemia and metabolic acidosis, PubMed, May 2005, Palmese S, Pezza M, De Robertis E. Hypophosphatemia and metabolic acidosis. Minerva Anestesiol. 2005 May;71(5):237-42. English, Italian. PMID: 15834352, S Palmese 1, M Pezza, E De Robertis, Intensive Care Unit, University of Naples Federico II, Naples, Italy. salvatore.palmese@libero.it https://pubmed.ncbi.nlm.nih.gov/15834352/

31Effect of phosphorus supplementation on weight gain and waist circumference of overweight/obese adults: a randomized clinical trial, PMC, December 21, 2015, Ayoub JJ, Samra MJ, Hlais SA, Bassil MS, Obeid OA. Effect of phosphorus supplementation on weight gain and waist circumference of overweight/obese adults: a randomized clinical trial. Nutr Diabetes. 2015 Dec 21;5(12):e189. doi: 10.1038/nutd.2015.38 PMID: 26690287 PMCID: PMC4735052, J J Ayoub,1,4 M J A Samra,1,4 S A Hlais,2 M S Bassil,3 and O A Obeid1,* 1Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon 2Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon 3Department of Natural Sciences, Faculty of Arts and Sciences, Lebanese American University, Beirut, Lebanon *Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107 2020, Lebanon. E-mail: bl.ude.bua@diebo.ramohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735052/

324 Minerals That Matter to Your Teeth, Michael G. Landy DDS, July 15 2020, https://www.drmlandy.com/4-minerals-that-matter-to-your-teeth

33Phosphate: Known and potential roles during development and regeneration of teeth and supporting structures, PMC, December 2008, Foster BL, Tompkins KA, Rutherford RB, Zhang H, Chu EY, Fong H, Somerman MJ. Phosphate: known and potential roles during development and regeneration of teeth and supporting structures. Birth Defects Res C Embryo Today. 2008 Dec;84(4):281-314. doi: 10.1002/bdrc.20136 , PMID:  19067423 PMCID: PMC4526155, B.L. Foster,*,1,2 K.A. Tompkins,*,1 R.B. Rutherford,2 H. Zhang,3 E.Y. Chu,1,2 H. Fong,4 and M.J. Somerman1,2 , 1Department of Periodontics, University of Washington School of Dentistry, Seattle, WA, US 2Department of Oral Biology, University of Washington School of Dentistry, Seattle, WA, USA,3Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA, 4Department of Materials Science and Engineering, University of Washington, Seattle, WA, USA, Corresponding Author: Dr. Martha J. Somerman, DDS, PhD, 1959 NE Pacific, Box 357444, University of Washington, Seattle, WA 98195-7444, Tel: (206) 685-2129; Fax: (206) 616-7478, ude.notgnihsaw.u@namremos, *These authors contributed equally to this review, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526155/

34Phosphate: Known and potential roles during development and regeneration of teeth and supporting structures, PMC, December 2008, Foster BL, Tompkins KA, Rutherford RB, Zhang H, Chu EY, Fong H, Somerman MJ. Phosphate: known and potential roles during development and regeneration of teeth and supporting structures. Birth Defects Res C Embryo Today. 2008 Dec;84(4):281-314. doi: 10.1002/bdrc.20136 , PMID:  19067423 PMCID: PMC4526155, B.L. Foster,*,1,2 K.A. Tompkins,*,1 R.B. Rutherford,2 H. Zhang,3 E.Y. Chu,1,2 H. Fong,4 and M.J. Somerman1,2 , 1Department of Periodontics, University of Washington School of Dentistry, Seattle, WA, US 2Department of Oral Biology, University of Washington School of Dentistry, Seattle, WA, USA,3Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA, 4Department of Materials Science and Engineering, University of Washington, Seattle, WA, USA, Corresponding Author: Dr. Martha J. Somerman, DDS, PhD, 1959 NE Pacific, Box 357444, University of Washington, Seattle, WA 98195-7444, Tel: (206) 685-2129; Fax: (206) 616-7478, ude.notgnihsaw.u@namremos, *These authors contributed equally to this review, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526155/

35Phosphate: Known and potential roles during development and regeneration of teeth and supporting structures, PMC, December 2008, Foster BL, Tompkins KA, Rutherford RB, Zhang H, Chu EY, Fong H, Somerman MJ. Phosphate: known and potential roles during development and regeneration of teeth and supporting structures. Birth Defects Res C Embryo Today. 2008 Dec;84(4):281-314. doi: 10.1002/bdrc.20136 , PMID:  19067423 PMCID: PMC4526155, B.L. Foster,*,1,2 K.A. Tompkins,*,1 R.B. Rutherford,2 H. Zhang,3 E.Y. Chu,1,2 H. Fong,4 and M.J. Somerman1,2 , 1Department of Periodontics, University of Washington School of Dentistry, Seattle, WA, US 2Department of Oral Biology, University of Washington School of Dentistry, Seattle, WA, USA,3Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA, 4Department of Materials Science and Engineering, University of Washington, Seattle, WA, USA, Corresponding Author: Dr. Martha J. Somerman, DDS, PhD, 1959 NE Pacific, Box 357444, University of Washington, Seattle, WA 98195-7444, Tel: (206) 685-2129; Fax: (206) 616-7478, ude.notgnihsaw.u@namremos, *These authors contributed equally to this review, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526155/

36Calcium and Phosphorus Regulatory Hormones and Risk of Incident Symptomatic Kidney Stones, PMC, April 7, 2015, Taylor EN, Hoofnagle AN, Curhan GC. Calcium and phosphorus regulatory hormones and risk of incident symptomatic kidney stones. Clin J Am Soc Nephrol. 2015 Apr 7;10(4):667-75. doi: 10.2215/CJN.07060714 Epub 2015 Jan 26. PMID: 25623233 ; PMCID: PMC4386254. Eric N. Taylor, *† Andrew N. Hoofnagle,‡ and Gary C. Curhan**Channing Division of Network Medicine and§Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts; †Division of Nephrology and Transplantation, Maine Medical Center, Portland, Maine;‡Departments of Medicine and Laboratory Medicine, University of Washington School of Medicine, Seattle, Washington; andDepartment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, Correspondence: Dr. Eric N. Taylor, Division of Nephrology and Transplantation, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102. Email: gro.srentrap@rolyatnhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386254/

37Hypophosphataemic neuropathy in a patient who received intravenous hyperalimentation, PMC, October 2007, Iguchi Y, Mori K, Koike H, Mano K, Goto Y, Kato T, Nakano T, Furukawa D, Sobue G. Hypophosphataemic neuropathy in a patient who received intravenous hyperalimentation. J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1159-60. doi:  10.1136/jnnp.2006.108720 PMID: 17878199 PMCID: PMC2117536.Yohei Iguchi, Keiko Mori, Haruki Koike, Kazuo Mano, Yoji Goto, Takashi Kato, Tomonobu Nakano, Daisuke Furukawa, and Gen Sobue, Yohei Iguchi, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanKeiko Mori, Haruki Koike, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanKazuo Mano, Yoji Goto, Takashi Kato, Tomonobu Nakano, Department of Neurology, Japanese Red Cross Nagoya First Hospital, Nagoya, JapanDaisuke Furukawa, Department of Gastroenterology, Japanese Red Cross Nagoya First Hospital, Nagoya, JapanGen Sobue, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanCorrespondence to: Professor Gen Sobue
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39Rickets and osteomalacia, https://www.sciencedirect.com/science/article/abs/pii/S135730391300217X

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41Peripheral neuropathy, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

42Phosphorus and the kidney: What is known and what is needed, PubMed, January 2014, Nadkarni GN, Uribarri J. Phosphorus and the kidney: What is known and what is needed. Adv Nutr. 2014 Jan 1;5(1):98-103. doi: 10.3945/an.113.004655, PMID: 24425728; PMCID: PMC3884106, Girish N Nadkarni 1, Jaime Uribarri, Department of Medicine, Mount Sinai School of Medicine, New York, NY., https://pubmed.ncbi.nlm.nih.gov/24425728/

43Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

44Kidney Disease, WebMD, August 08, 2020 ,https://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information

45Heart Attack, WebMD,November 08, 2020, Medically Reviewed by James Beckerman, MD, FACC https://www.webmd.com/heart-disease/guide/heart-disease-heart-attacks

46Your Guide to Stroke, WebMD, https://www.webmd.com/stroke/default.htm

47Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

48Hyperphosphatemia, Healthline, Updated on November 12, 2018, Stephanie Watson , Medically reviewed by Daniel Murrell, M.D. https://www.healthline.com/health/hyperphosphatemia#symptoms

49Diarrhea, WebMD, Medically Reviewed by Amita Shroff, MD on September 23, 2021 https://www.webmd.com/digestive-disorders/digestive-diseases-diarrhea

50Stomach Cramps: Causes and Treatments, WebMD, August 20, 2021,Alyson Powell Key, Medically Reviewed by Melinda Ratini, DO, MS https://www.webmd.com/digestive-disorders/stomach-cramps

51Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

52Hypocalcemia, NIH, August 8, 2021. Abhinav Goyal; Catherine Anastasopoulou; Michael Ngu; Shikha Singh. 1 Einstein Medical Center

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53Alkalosis, NCBI (The National Center for Biotechnology Information), Updated  January 4, 2022, Moushumi Sur; Ankur D. Shah., https://www.ncbi.nlm.nih.gov/books/NBK545269/

54https://www.msdmanuals.com/home/hormonal-and-metabolic-disorders/acid-base-balance/alkalosi

55Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: Possible implications for bone health, PMC, July 13, 2017, Loughrill E, Wray D, Christides T, Zand N. Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: Possible implications for bone health. Matern Child Nutr. 2017 Jul;13(3):e12368. doi: 10.1111/mcn.12368, Epub 2016 Sep 9. PMID: 27612307; PMCID: PMC6865864, Emma Loughrill 1, David Wray 1, Tatiana Christides 1, Nazanin Zand 1 , Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent, ME4 4TB, UK., https://pubmed.ncbi.nlm.nih.gov/27612307/

56Vitamin D, Calcium, Magnesium, Vitamin K2, Vitamin B5, Co enzyme A, Cholesterol and Sunlight, Scentses4d, May 29, 2019, Anna Elize, https://scentses4d.wordpress.com/2019/05/29/vitamin-d-calcium-magnesium-and-vitamin-k/

57Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

58Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

59Food Labeling: Revision of the Nutrition and Supplement Facts Labels. Final rule,Food and Drug Administration, HHS. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. Final rule. Fed Regist. 2016 May 27;81(103):33741-999. PMID: 27236870.https://pubmed.ncbi.nlm.nih.gov/27236870/

60Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

61Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

62Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

63Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

64Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

65All You Need to Know About Dairy in Your Diet, Healthline, Updated on November 19, 2021, Ariane Lang, BSc, MBA — Medically reviewed by Sade Meeks, MS, RD, Nutrition, https://www.healthline.com/nutrition/is-dairy-bad-or-good

66Contributions to total phosphorus intake: all sources considered, PubMed, December 23, 2012, Calvo MS, Uribarri J. Contributions to total phosphorus intake: all sources considered. Semin Dial. 2013 Jan-Feb;26(1):54-61. doi: 10.1111/sdi.12042, Epub 2012 Dec 23. PMID: 23278245.Mona S Calvo 1, Jaime Uribarri https://pubmed.ncbi.nlm.nih.gov/23278245/

67Cheese, romano, Nutrition Data, https://nutritiondata.self.com/facts/dairy-and-egg-products/37/2

68Whole-Fat or Reduced-Fat Dairy Product Intake, Adiposity, and Cardiometabolic Health in Children: A Systematic Review, PMC, March 2, 2020, O’Sullivan TA, Schmidt KA, Kratz M. Whole-Fat or Reduced-Fat Dairy Product Intake, Adiposity, and Cardiometabolic Health in Children: A Systematic Review. Adv Nutr. 2020 Jul 1;11(4):928-950. doi: 10.1093/advances/nmaa011 . PMID:  32119732 PMCID: PMC7360438, Therese A O’Sullivan, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia;Contributor Information. Address correspondence to TAOS (e-mail: ua.ude.uce@navilluso.t), Therese A O’Sullivan, Kelsey A Schmidt, and Mario Kratz https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360438/

69Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

70Amount of Phosphorus in Cottage cheese, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cottage-cheese.php

71Amount of Phosphorus in Cheese, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cheese.php

72Amount of Phosphorus in Low fat yogurt, Diet and Fitness, Today, http://www.dietandfitnesstoday.com/phosphorus-in-low-fat-yogurt.php

73Amount of Phosphorus in Yogurt, Diet and Fitness Today, \http://www.dietandfitnesstoday.com/phosphorus-in-yogurt.php

74Amount of Phosphorus in Skim milk, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-skim-milk.php

75Amount of Phosphorus in Whole milk, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-whole-milk.php

76Amount of Phosphorus in Whole milk, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-whole-milk.php

77MILK KEFIR NUTRITIONAL PROFILE, Yemous Nourishing Cultures, https://www.yemoos.com/pages/milk-kefir-nutritional-profile

78Top 11 Science-Based Health Benefits of Pumpkin Seeds, September 24, 2018 , Mary Jane Brown, PhD, RD (UK),https://www.healthline.com/nutrition/11-benefits-of-pumpkin-seeds

79Nutrition facts label for Cheese, romano ,https://nutritiondata.self.com/facts/dairy-and-egg-products/37/2

80Amount of Phosphorus in Pumpkin seeds, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-pumpkin-seeds.php

81Phytic Acid 101: Everything You Need to Know, Healthline, Updated on April 6, 2022,, Written by Atli Arnarson BSc, PhD — Medically reviewed by Grant Tinsley, PhD, Nutrition, https://www.healthline.com/nutrition/phytic-acid-101

82Minerals and phytic acid interactions: is it a real problem for human nutrition?International journal of food science & technology 2002 v.37 no.7, https://pubag.nal.usda.gov/catalog/1445089

83Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains, PMCC, April 24 , 2013. Gupta RK, Gangoliya SS, Singh NK. Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. J Food Sci Technol. 2015 Feb;52(2):676-84. doi: 10.1007/s13197-013-0978-y Epub 2013 Apr 24. PMID: 25694676 ; PMCID: PMC4325021. Raj Kishor Gupta, Shivraj Singh Gangoliya, and Nand Kumar Singh , Motilal Nehru National Institute of Technology, Allahabad, Uttar Pradesh India, Nand Kumar Singh, Email: moc.liamg@dnanhgnis., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325021/r.

84The effects of ‘activating’ almonds on consumer acceptance and gastrointestinal tolerance, PubMed, December 2018, Taylor H, Webster K, Gray AR, Tey SL, Chisholm A, Bailey K, Kumari S, Brown RC. The effects of ‘activating’ almonds on consumer acceptance and gastrointestinal tolerance. Eur J Nutr. 2018 Dec;57(8):2771-2783. doi: 110.1007/s00394-017-1543-7

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85Phytic acid, Phytate, Phytase, Oxalic Acid and Lectins, Scentses4d,April 13, 2019, Anna Elize, https://scentses4d.wordpress.com/phytic-acid/

86Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

87Amount of Phosphorus in Sunflower seeds, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-sunflower-seeds.php

88Brazil nuts,Food data Central, U.S. DEPARTMENT OF AGRICULTURE,https://fdc.nal.usda.gov/fdc-app.html#/food-details/1100514/nutrients

89Nuts, cashew nuts, dry roasted, without salt added, Nutrition Data, https://nutritiondata.self.com/facts/nut-and-seed-products/3093/2

90Nuts, almonds, dry roasted, without salt, Nutrition Data, https://nutritiondata.self.com/facts/nut-and-seed-products/3087/2

91Nuts, pine nuts, dried,Nutrition Data, https://nutritiondata.self.com/facts/nut-and-seed-products/3133/2

92Nuts, pistachio nuts, dry roasted, without salt added, Nutrition Data,https://nutritiondata.self.com/facts/nut-and-seed-products/3136/2

93Health Benefits of Nut Consumption, PMC, June 24, 2010,Ros E. Health benefits of nut consumption. Nutrients. 2010 Jul;2(7):652-82. doi:  10.3390/nu2070652 Epub 2010 Jun 24. PMID: 22254047; PMCID: PMC3257681,Lipid Clinic, Endocrinology and Nutrition Service, Institutd’Investigacions Biomèdiques August Pii Sunyer, Hospital Clínic, Barcelona and Ciber Fisiopatología de la Obesidady Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Spain; Email: se.bu.cinilc@sore;Tel.: +34 93 2279393; Fax: +34 93 4537829 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257681/

94Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

95Amount of Phosphorus in Cashews, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cashews.php

96Amount of Phosphorus in Rice, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-rice.php

97Amount of Phosphorus in Rice, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-rice.php

98Spelt, cooked, Nutrition Data, https://nutritiondata.self.com/facts/cereal-grains-and-pasta/10356/2

99Cereals, oats, regular and quick and instant, unenriched, cooked with water (includes boiling and microwaving), without salt [oatmeal, cooked], Nutrition Data, https://nutritiondata.self.com/facts/breakfast-cereals/1598/2

100Rice, brown, long-grain, cooked, Nutrition Data, https://nutritiondata.self.com/facts/cereal-grains-and-pasta/5707/2

101Spelt, cooked Nutrition Facts, http://www.freenutritionfacts.com/spelt-cooked/

102Amount of Phosphorus in Oats, Nutrition Data,http://www.dietandfitnesstoday.com/phosphorus-in-oats.php

103Amount of Phosphorus in Brown rice, Nutrition Data, http://www.dietandfitnesstoday.com/phosphorus-in-brown-rice.php

104Amount of Phosphorus in Rice, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-rice.php

105Amount of Phosphorus in Whole wheat bread, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-whole-wheat-bread.php

106Amount of Phosphorus in Whole wheat Buckwheat, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-buckwheat.php

107Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis, PubMed, September 2009,Schlemmer U, Frølich W, Prieto RM, Grases F. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective roleand analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. doi: 10.1002/mnfr.200900099, PMID: 19774556, Ulrich Schlemmer 1, Wenche Frølich, Rafel M Prieto, Felix Grases https://pubmed.ncbi.nlm.nih.gov/19774556/

1089 Health Benefits of Eating Whole Grains, Healthline, Updated on April 26, 2019,Kerri-Ann Jennings, MS, RD, https://www.healthline.com/nutrition/9-benefits-of-whole-grains

109Wheat flour, whole-grain, Nutrition Data,https://nutritiondata.self.com/facts/cereal-grains-and-pasta/5744/2

110Wheat flour, white, all-purpose, unenriched, Nutrition Data, https://nutritiondata.self.com/facts/cereal-grains-and-pasta/5821/2

111Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis,PubMed, September 2009, Schlemmer U, Frølich W, Prieto RM, Grases F. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective roleand analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. doi: 10.1002/mnfr.200900099, PMID: 19774556, Ulrich Schlemmer 1, Wenche Frølich, Rafel M Prieto, Felix Grases https://pubmed.ncbi.nlm.nih.gov/19774556/

112Strains of lactic acid bacteria isolated from sour doughs degrade phytic acid and improve calcium and magnesium solubility from whole wheat flour, PubMed, June 2000,Lopez HW, Ouvry A, Bervas E, Guy C, Messager A, Demigne C, Remesy C. Strains of lactic acid bacteria isolated from sour doughs degrade phytic acid and improve calcium and magnesium solubility from whole wheat flour. J Agric Food Chem. 2000 Jun;48(6):2281-5. doi: 1 10.1021/jf000061g, PMID: 10888537. H W Lopez 1, A Ouvry, E Bervas, C Guy, A Messager, C Demigne, C Remesy, Unité de Laboratoire sur l’Innovation des Céréales (ULICE), ZAC Les Portes de Riom , Riom, France. lopez@clermont.inra.fr https://pubmed.ncbi.nlm.nih.gov/10888537/

113A review of phytate, iron, zinc, and calcium concentrations in plant-based complementary foods used in low-income countries and implications for bioavailability, PubMed, June, 2010, Gibson RS, Bailey KB, Gibbs M, Ferguson EL. A review of phytate, iron, zinc, and calcium concentrations in plant-based complementary foods used in low-income countries and implications for bioavailability. Food Nutr Bull. 2010 Jun;31(2 Suppl):S134-46. doi: 10.1177/15648265100312S206, PMID: 20715598. Rosalind S Gibson 1, Karl B Bailey, Michelle Gibbs, Elaine L Ferguson, Department of Human Nutrition, University of Otago, Union Street, PO Box 56, Dunedin 9015, New Zealand. Rosalind.Gibson@Stonebow.Otago.AC.NZ, https://pubmed.ncbi.nlm.nih.gov/20715598/

114Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

1158 Evidence-Based Health Benefits of Quinoa, Healthline, Updated on January 5, 2022, Jillian Kubala, MS, RD and Kris Gunnars, BSc, Medically reviewed by Katherine Marengo LDN, R.D., Nutrition — https://www.healthline.com/nutrition/8-health-benefits-quinoa

116Amaranth grain, cooked, Food Data,https://nutritiondata.self.com/facts/cereal-grains-and-pasta/10640/2

117Quinoa, cooked,Food Data, https://nutritiondata.self.com/facts/cereal-grains-and-pasta/10352/2

118Nutritional Functional Value and Therapeutic Utilization of Amaranth, Submitted: April 3rd, 2019Reviewed: May 17th, 2019Published: August 29th, 2019, Manuel Soriano-García and Isabel Saraid Aguirre-Díaz , DOI: 10.5772/intechopen.86897, https://www.intechopen.com/chapters/67741

119Amount of Phosphorus in Quinoa, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-quinoa.php

120Quinoa (Chenopodium quinoa Willd.): composition, chemistry, nutritional, and functional properties,PubMed, 2009, Abugoch James LE. Quinoa (Chenopodium quinoa Willd.): composition, chemistry, nutritional, and functional properties. Adv Food Nutr Res. 2009;58:1-31. doi: 10.1016/S1043-4526(09)58001-1, PMID: 19878856, Lilian E Abugoch James 1, Departamento Ciencia de los Alimentos y Tecnología Química, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Vicuña Mackenna 20, Santiago, Chile. https://pubmed.ncbi.nlm.nih.gov/19878856/

121The revival of Amaranth as a third-millennium food, PubMed, PubMed, 2012, Pavlik V. The revival of Amaranth as a third-millennium food. Neuro Endocrinol Lett. 2012;33 Suppl 3:3-7. PMID: 23353837, Vladimir Pavlik 1 ,
Department of Military Hygiene, University of Defence, Hradec Králové, Czech Republic. pavlik@pmfhk.cz , https://pubmed.ncbi.nlm.nih.gov/23353837/

122Processing of quinoa (Chenopodium quinoa, Willd): effects on in vitro iron availability and phytate hydrolysis, PubMed, May 1999, Valencia S, Svanberg U, Sandberg AS, Ruales J. Processing of quinoa (Chenopodium quinoa, Willd): effects on in vitro iron availability and phytate hydrolysis. Int J Food Sci Nutr. 1999 May;50(3):203-11. Doi: 10.1080/096374899101247, PMID: 10627836, S Valencia 1, U Svanberg, A S Sandberg, J Ruales , Instituto de Investigación Tecnológica, Escuela Politécnica Nacional, Quito, Ecuador. .https://pubmed.ncbi.nlm.nih.gov/10627836/

123Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

124The 9 Healthiest Beans and Legumes You Can Eat, Healthline, December 1, 2017, Ruairi Robertson, PhD , https://www.healthline.com/nutrition/healthiest-beans-legumes

125Legume consumption and risk of all-cause, cardiovascular, and cancer mortality in the PREDIMED study, Pub Med,January 9, 2018, Papandreou C, Becerra-Tomás N, Bulló M, Martínez-González MÁ, Corella D, Estruch R, Ros E, Arós F, Schroder H, Fitó M, Serra-Majem L, Lapetra J, Fiol M, Ruiz-Canela M, Sorli JV, Salas-Salvadó J. Legume consumption and risk of all-cause, cardiovascular, and cancer mortality in the PREDIMED study. Clin Nutr. 2019 Feb;38(1):348-356. doi: 10.1016/j.clnu.2017.12.019, Epub 2018 Jan 9. PMID: 29352655. https://pubmed.ncbi.nlm.nih.gov/29352655/

126Nutritional and health benefits of pulses, Pub Med,June 13, 2014, Mudryj AN, Yu N, Aukema HM. Nutritional and health benefits of pulses, Appl Physiol Nutr Metab. 2014 Nov;39(11):1197-204. doi: 10.1139/apnm-2013-0557, Epub 2014 Jun 13. PMID: 25061763, https://pubmed.ncbi.nlm.nih.gov/25061763/

127Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

128Lentils, mature seeds, cooked, boiled, with salt, Nutrition Data, https://nutritiondata.self.com/facts/legumes-and-legume-products/4439/2

129Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

130Amount of Phosphorus in Lentils, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-lentils.php

131Beans, great northern, mature seeds, cooked, boiled, without salt, Nutrition Data,https://nutritiondata.self.com/facts/legumes-and-legume-products/4294/2

132Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

133Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt, Nutrition Data, https://nutritiondata.self.com/facts/legumes-and-legume-products/4326/2

134Beans, navy, mature seeds, cooked, boiled, without salt, Nutrition Data,https://nutritiondata.self.com/facts/legumes-and-legume-products/4307/2

135Beans, pinto, mature seeds, cooked, boiled, without salt, Nutrition Data, , https://nutritiondata.self.com/facts/legumes-and-legume-products/4312/2

136Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis,PubMed, September 2009, Schlemmer U, Frølich W, Prieto RM, Grases F. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective roleand analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. doi: 10.1002/mnfr.200900099, PMID: 19774556, Ulrich Schlemmer 1, Wenche Frølich, Rafel M Prieto, Felix Grases https://pubmed.ncbi.nlm.nih.gov/19774556/

137Changes in phytates and HCl extractability of calcium, phosphorus, and iron of soaked, dehulled, cooked, and sprouted pigeon pea cultivar (UPAS-120), PubMed, September 2009, Schlemmer U, Frølich W, Prieto RM, Grases F. Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food Res. 2009 Sep;53 Suppl 2:S330-75. doi: 10.1002/mnfr.200900099, PMID: 19774556, Ulrich Schlemmer 1, Wenche Frølich, Rafel M Prieto, Felix Grases , Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Federal Research Instituteof Nutrition and Food, Karlsruhe, Germany, ulrich.schlemmer@mri.bund.de, https://pubmed.ncbi.nlm.nih.gov/19774556/

138Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

139Top 12 Foods That Are High in Phosphorus, Healthline, July 3, 2018 , Erica Julson, MS, RDN, CLT, https://www.healthline.com/nutrition/foods-high-in-phosphorus#TOC_TITLE_HDR_11

140Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

141Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

142Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

143Good Protein Sources, Fitness and Exercise, January 13, 2022, Kathleen M. Zelman, MPH, RD, LD, https://www.webmd.com/fitness-exercise/guide/good-protein-sources

144Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

145What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride?PubMed,February 2009, Bergman C, Gray-Scott D, Chen JJ, Meacham S. What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride? Crit Rev Food Sci Nutr. 2009 Feb;49(2):136-44. doi: 10.1080/10408390701764468. PMID: 18989832.,https://pubmed.ncbi.nlm.nih.gov/18989832/

146What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride?PubMed,February 2009, Bergman C, Gray-Scott D, Chen JJ, Meacham S. What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride? Crit Rev Food Sci Nutr. 2009 Feb;49(2):136-44. doi: 10.1080/10408390701764468. PMID: 18989832.,https://pubmed.ncbi.nlm.nih.gov/18989832/

1474 Minerals That Matter to Your Teeth, Michael G. Landy DDS, July 15 2020, https://www.drmlandy.com/4-minerals-that-matter-to-your-teeth

1484 Minerals That Matter to Your Teeth, Michael G. Landy DDS, July 15 2020, https://www.drmlandy.com/4-minerals-that-matter-to-your-teeth

149Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

150Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

151Calcium and Phosphorus Regulatory Hormones and Risk of Incident Symptomatic Kidney Stones, PMC, April 7, 2015, Taylor EN, Hoofnagle AN, Curhan GC. Calcium and phosphorus regulatory hormones and risk of incident symptomatic kidney stones. Clin J Am Soc Nephrol. 2015 Apr 7;10(4):667-75. doi: 10.2215/CJN.07060714 Epub 2015 Jan 26. PMID: 25623233 ; PMCID: PMC4386254. Eric N. Taylor, *† Andrew N. Hoofnagle,‡ and Gary C. Curhan**Channing Division of Network Medicine and§Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts; †Division of Nephrology and Transplantation, Maine Medical Center, Portland, Maine;‡Departments of Medicine and Laboratory Medicine, University of Washington School of Medicine, Seattle, Washington; andDepartment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, Correspondence: Dr. Eric N. Taylor, Division of Nephrology and Transplantation, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102. Email: gro.srentrap@rolyatnhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386254/

152Effect of phosphorus supplementation on weight gain and waist circumference of overweight/obese adults: a randomized clinical trial, PMC, December 21, 2015, Ayoub JJ, Samra MJ, Hlais SA, Bassil MS, Obeid OA. Effect of phosphorus supplementation on weight gain and waist circumference of overweight/obese adults: a randomized clinical trial. Nutr Diabetes. 2015 Dec 21;5(12):e189. doi: 10.1038/nutd.2015.38 PMID: 26690287 PMCID: PMC4735052, J J Ayoub,1,4 M J A Samra,1,4 S A Hlais,2 M S Bassil,3 and O A Obeid1,* 1Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon 2Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon 3Department of Natural Sciences, Faculty of Arts and Sciences, Lebanese American University, Beirut, Lebanon *Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Beirut 1107 2020, Lebanon. E-mail: bl.ude.bua@diebo.ramohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735052/

153What’s a Normal Blood pH and What Makes It Change? Healthline,August 16, 2019 ,Noreen Iftikhar, MD , Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA https://www.healthline.com/health/ph-of-blood#causes-of-abnormalities

154Dangers of very low blood pH, PMC, Rosival V. Dangers of very low blood pH. Indian J Crit Care Med. 2011 Jul;15(3):194. doi: 10.4103/0972-5229.84887 ,PMID: 22013317; PMCID: PMC3190476.  Viktor Rosival, Department of Laboratory Medicine, SYNLAB, Dérer’s Hospital, Bratislava, Slovakia, Correspondence: Dr. Viktor Rosival, Department of Laboratory Medicine, SYNLAB, Dérer’s Hospital, Limbová 5, SK-833 05 Bratislava, Slovakia, Europe. E-mail: moc.liamtoh@vlavisor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190476/

155Hypophosphataemic neuropathy in a patient who received intravenous hyperalimentation, PMC, October 2007, Iguchi Y, Mori K, Koike H, Mano K, Goto Y, Kato T, Nakano T, Furukawa D, Sobue G. Hypophosphataemic neuropathy in a patient who received intravenous hyperalimentation. J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1159-60. doi:  10.1136/jnnp.2006.108720 PMID: 17878199 PMCID: PMC2117536.Yohei Iguchi, Keiko Mori, Haruki Koike, Kazuo Mano, Yoji Goto, Takashi Kato, Tomonobu Nakano, Daisuke Furukawa, and Gen Sobue, Yohei Iguchi, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanKeiko Mori, Haruki Koike, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanKazuo Mano, Yoji Goto, Takashi Kato, Tomonobu Nakano, Department of Neurology, Japanese Red Cross Nagoya First Hospital, Nagoya, JapanDaisuke Furukawa, Department of Gastroenterology, Japanese Red Cross Nagoya First Hospital, Nagoya, JapanGen Sobue, Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanCorrespondence to: Professor Gen Sobue
65 Tsurumaicho, Showaku, Nagoya 466‐8550, Japan; sobueg@med.nagoya‐u.ac.jp https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2117536/

156Peripheral neuropathy, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

157Hyperphosphatemia, https://www.healthline.com/health/hyperphosphatemia#symptoms

158Alkalosis, NCBI (The National Center for Biotechnology Information), Updated  January 4, 2022, Moushumi Sur; Ankur D. Shah., https://www.ncbi.nlm.nih.gov/books/NBK545269/

159Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: Possible implications for bone health, PMC, July 13, 2017, Loughrill E, Wray D, Christides T, Zand N. Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: Possible implications for bone health. Matern Child Nutr. 2017 Jul;13(3):e12368. doi: 10.1111/mcn.12368, Epub 2016 Sep 9. PMID: 27612307; PMCID: PMC6865864, Emma Loughrill 1, David Wray 1, Tatiana Christides 1, Nazanin Zand 1 , Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent, ME4 4TB, UK., https://pubmed.ncbi.nlm.nih.gov/27612307/

160Vitamin D, Calcium, Magnesium, Vitamin K2, Vitamin B5, Co enzyme A, Cholesterol and Sunlight, Scentses4d, May 29, 2019, Anna Elize, https://scentses4d.wordpress.com/2019/05/29/vitamin-d-calcium-magnesium-and-vitamin-k/

161Phosphorus in Your Diet,WebMD, June 25, 2020 Danny Bonvissuto, Medically Reviewed by Brunilda Nazario, MD https://www.webmd.com/vitamins-and-supplements/what-is-phosphorus

162Amount of Phosphorus in Pumpkin seeds, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-pumpkin-seeds.php

163Amount of Phosphorus in Sunflower seeds, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-sunflower-seeds.php

164Brazil nuts,Food data Central, U.S. DEPARTMENT OF AGRICULTURE,https://fdc.nal.usda.gov/fdc-app.html#/food-details/1100514/nutrients

165Amount of Phosphorus in Sesame seeds, Diet and Fitness Today, , http://www.dietandfitnesstoday.com/phosphorus-in-sesame-seeds.php

166Amount of Phosphorus in Flaxseed, Diet and Fitness Today,, http://www.dietandfitnesstoday.com/phosphorus-in-flaxseed.php

167Nutritional Functional Value and Therapeutic Utilization of Amaranth, Submitted: April 3rd, 2019Reviewed: May 17th, 2019Published: August 29th, 2019, Manuel Soriano-García and Isabel Saraid Aguirre-Díaz , DOI: 10.5772/intechopen.86897, https://www.intechopen.com/chapters/67741

168Amount of Phosphorus in Cashews, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cashews.php

169Amount of Phosphorus in Cashews, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cashews.php

170Amount of Phosphorus in Cashews, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cashews.php

171Amount of Phosphorus in Rice, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-rice.php

172Amount of Phosphorus in Oats, Nutrition Data,http://www.dietandfitnesstoday.com/phosphorus-in-oats.php

173Amount of Phosphorus in Lentils, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-lentils.php

174Amount of Phosphorus in Peanuts, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-peanuts.php

175Amount of Phosphorus in Walnuts, Diet and Fitness Today,, http://www.dietandfitnesstoday.com/phosphorus-in-walnuts.php

176Amount of Phosphorus in Whole wheat Buckwheat, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-buckwheat.php

177Amount of Phosphorus in Brown rice, Nutrition Data, http://www.dietandfitnesstoday.com/phosphorus-in-brown-rice.php

178Amount of Phosphorus in Whole wheat bread, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-whole-wheat-bread.php

179Amount of Phosphorus in Hazelnuts,Nutrition Data, , http://www.dietandfitnesstoday.com/phosphorus-in-hazelnuts.php

180Amount of Phosphorus in Quinoa, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-quinoa.php

181Spelt, cooked , Nutrition Facts, http://www.freenutritionfacts.com/spelt-cooked/

182Amount of Phosphorus in Rice, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-rice.php

183Amount of Phosphorus in A banana, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-a-banana.php

184Amount of Phosphorus in Figs, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-figs.php

185Amount of Phosphorus in Chicken, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-chicken.php

186Amount of Phosphorus in Salmon, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-salmon.php

187Amount of Phosphorus in Cheese, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cheese.php

188MILK KEFIR NUTRITIONAL PROFILE, Yemous Nourishing Cultures, https://www.yemoos.com/pages/milk-kefir-nutritional-profile

189Amount of Phosphorus in Cheese, Diet and Fitness Today,http://www.dietandfitnesstoday.com/phosphorus-in-cheese.php.

190Amount of Phosphorus in Skim milk, Diet and Fitness Today,,http://www.dietandfitnesstoday.com/phosphorus-in-skim-milk.php

191Amount of Phosphorus in Cottage cheese, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cottage-cheese.php

192Amount of Phosphorus in Yogurt, Diet and Fitness Today,, \http://www.dietandfitnesstoday.com/phosphorus-in-yogurt.php

193Amount of Phosphorus in Low fat yogurt, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-low-fat-yogurt.php

194Amount of Phosphorus in Whole milk, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-whole-milk.php

195Amount of Phosphorus in Whole milk, Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-whole-milk.php

196Amount of Phosphorus in Cheese. Diet and Fitness Today, http://www.dietandfitnesstoday.com/phosphorus-in-cheese.php

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