Phosphorus, the Magic Bullet For Fat Loss and Against the YoYo-Effect? P. Restores Thermogenesis, Enhances Satiety

This is not the first study to suggest that as little as 12.5% of the suggested upper limit for phosphorus can make a big difference when it comes to weight loss and the ease of weight loss when you battle reduced diet-induced thermogenesis & increased appetite.

I guess those of you who have been reading every SuppVersity article will remember my January article "Phosphorus, an Anti-Obesity Agent? 3x375 mg With Each Meal Strip Almost 4 cm Off Obese Waists in Only 12 Weeks" (re-read it). You liked that one? Well, I guess you will also like the fact that the evidence that there's some use in phosphorus supplements is accumulating.

Recently, scientists from the Lebanese American University in Beirut, Lebanon (Bassil. 2016), have observed that "P supplementation recovers the blunted diet-induced thermogenesis in overweight and obese subjects and enhances their postprandial satiety" (Bassil. 2016).

Phosphates have also been touted as buffer for athletes, but apper less effective than NaHCO3:

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Yes, that's right: This means that phosphorus aka "P" supplementation will address two of the main reasons for weight regain aka the YoYo-effect - a diet- / weight-loss-induced reduction in diet-induced thermogenesis and a decrease of the satiety effects of the foods you consume.

Since diet-induced thermogenesis (DIT) is believed to be largely related to ATP production, which is dependent on phosphorus (P) availability, Bassil and Omar speculated that supplementing extra phosphorus to lean and overweight/obese healthy subjects should have beneficial effects on their diet-induced thermogenesis. Accordingly, they measured the latter with or without P in 10 lean and 13 overweight/obese adults in a double-blind randomized cross-over pilot study with a one week washout period that was meant to exclude any possible interference of the previous trial.

Figure 1:  Diet-induced thermogenesis after drinking 75 g glucose solution with and without phosphorus supplementation in lean and obese subjects. (A) Resting metabolic rate at baseline and over 3 h (180 min) after drinking 75 g glucose solution in lean and obese subjects with phosphorus (solid lines) or placebo (dashed lines); (B) Total area under the curve of RMR with phosphorus (solid bars) or placebo (dashed bars) in lean and obese subjects (Bassil. 2016).

The "problem" is that the subjects were healthy, sedentary non-smokers whose body weight had been stable for the past 3 months. As I will elaborate in the bottom line, the significance of the results for reduced-obese individuals, i.e. people who have lost a significant of body weight and are now facing an increased risk of yoyo-ing backup, is limited... but as I said: more about that later.

Correlation between daily dietary P intake and subjects' BMI (Bassil. 2016).

Additional evidence: Phosphorus intakes correlate negatively with BMI -- Next to the previously cited study by Ajoub, et al. (read more), the study at hand does also provide additional evidence that high(er) phosphorus intakes could have an obesity protective effect. After all, the data in the figure to the left clearly indicates that there is a linear, inverse correlation between obesity / BMI (in normal people a good measure of obesity) and the individual's habitual phosphorus intakes. Since fasting serum P is tightly controlled in healthy humans and is not affected by diet, so that the effect of dietary P is only evident post-prandially, this differential DIT response of lean and obese individuals (see Figure 1).

Speaking of explanations... a 2006 study by Mataix, et al. shows that Spaniards who consume more energy than they'd need have an increased risk of suboptimal phosphate intakes. The same goes for people with low education (Mataix. 2006). Both could point to phosphate intakes as a correlate not a cause of reduced obesity risks. Furthermore, we must not forget that US citizens with the highest phosphorus intakes happen to have an increased risk of mortality (Chang. 2014). This association with mortality risk, however, well be unrelated to phosphorus and a simple result of the high amounts of phosphates you will also find in processed foods. In this case, phosphorus would rather be a marker of increased junk food intake, which in turn could be the actual reason for an increase in mortality risk - an increased risk that may, however, eventually be a result of a messed up balance between phosphorus, calcium and magnesium.

I the study at hand, the DIT, as well as the subjects' resting metabolic rate, respiratory quotient, and substrate utilization (ratio of fat and glucose oxidation) were measured after a 10 h overnight fast at fasting and every 30 min for 3 h after subjects drank a standardized glucose solution, with P (500 mg from potassium phosphate, 23% monobasic and 18% dibasic | considering the results of previous studies, it is, by the way, unlikely that the potassium in KP did the trick) or placebo (cellulose) pills.

Figure 2: Subjective appetite scores of lean (gray) and obese (black) subjects, 3 h after drinking 75 g glucose solution with phosphorus (solid bars) or placebo (dashed bars) supplementation (Bassil. 2016).

To assess the subjects' hunger/satiety response, the researchers used the classic validated visual analog scale (VAS) questionnaires we all know from other studies - with quite intriguing results.

• Overweight/obese subjects had a blunted DIT with placebo. 
• P supplementation induced a 23% increase in their DIT area under the curve (p < 0.05).
• The increase in DIT was associated with an increase in carbohydrate oxidation. 
• All subjects, obese or lean had lower appetite following P supplementation.
• The decrease was expressed as a significantly (p = 0.02) lower desire to eat a meal (4.0 ± 0.7 cm) compared with placebo (5.8 ± 0.9 cm). 

At least during/before a diet, the co-consumption of phosphorus with glucose-containing meals could thus, as the scientists point out, be a valid means to recover the blunted diet-induced thermogenesis in overweight and obese subjects and enhances their postprandial satiety.

High phosphorus intakes and/or supplementation accelerated the fat loss in a previous study sign.

So, will this actually prevent the YoYo-effect? That is possible, but nothing the study at hand can prove. Rather than that, it provides new evidence of the usefulness of phosphorus supplements during weight loss interventions. A usefulness that has been previously confirmed by Ajoub, et al. (read more), but does not necessarily mean that the same beneficial effects will be observed in reduced-obese (=formerly obese) individuals whose DIT and appetite response have been shown to be significantly depressed in the post-dieting period. Until this study has been done, we still have the evidence of its usefulness for overweight individuals trying to shed body fat.

Everyone? Well, I guess another two qualifications have to be made: (a) If the effect is, indeed, as the scientists speculate, mediated by ATP, it is not unlikely that the benefits depend on the co-consumption of glucose or rather carbohydrates. Accordingly, low carbers may benefit less, maybe even not at all. And (b) low carbers have another "disadvantage" with respect to phosphorus supplementation: With plenty of the foods you see in the photo at the top-right, their phosphorus intake usually is already very high - increasing it, even more, may thus have no effect irrespective of the glucose intake. Plus: Eventually, you must keep an eye on the balance between phosphorus, calcium, and magnesium. While a healthy kidney helps to balance serum imbalances out, adding another 1,500 mg of phosphorus or 37,5% of the upper intake limit for phosphorus (4g/day) to your diet with the 500mg extra phosphorus you'd take with e.g. three daily meals could increase your long-term calcium and magnesium requirements to a certain degree - a degree that you will probably cover automatically if you get your phosphorus from foods, not supplements, because only the former (e.g. dairy) come packaged with all important co-factors | Comment!

References:

• Bassil, Maya S., and Omar A. Obeid. "Phosphorus Supplementation Recovers the Blunted Diet-Induced Thermogenesis of Overweight and Obese Adults: A Pilot Study." Nutrients 8.12 (2016): 801.
• Chang, Alex R., et al. "High dietary phosphorus intake is associated with all-cause mortality: results from NHANES III." The American journal of clinical nutrition 99.2 (2014): 320-327.
• Mataix, José, et al. "Factors influencing the intake and plasma levels of calcium, phosphorus and magnesium in southern Spain." European journal of nutrition 45.6 (2006): 349-354.