The institute of medicine's "dietary reference intake" for phosphorus: a critical perspective

J Am Coll Nutr. 2001 Aug;20(4):271-8. doi: 10.1080/07315724.2001.10719047.


Two questions relevant to the safety of phosphate additives have been raised in the literature: 1) Is the dietary ratio of calcium to phosphorus clinically significant in humans? Specifically, can a high-phosphorus, low-calcium diet cause hypocalcemia and/or secondary hyperparathyroidism in humans? 2) Does the growing use of phosphate-containing food additives increase the risk of low bone density and/or fracture in humans? In 1999, the Institute of Medicine published a monograph which addressed these two questions. This article critically reviews the findings and conclusions of the Institute of Medicine in the light of recent research.

Publication types

  • Review

MeSH terms

  • Bone Density
  • Bone and Bones / injuries
  • Calcium, Dietary / administration & dosage
  • Food Additives / adverse effects
  • Fractures, Bone / etiology
  • Humans
  • Hyperparathyroidism / chemically induced
  • Hypocalcemia / chemically induced
  • Nutrition Policy*
  • Phosphates / adverse effects
  • Phosphorus, Dietary / administration & dosage*
  • Phosphorus, Dietary / adverse effects
  • Risk Factors


  • Calcium, Dietary
  • Food Additives
  • Phosphates
  • Phosphorus, Dietary