Organic and inorganic dietary phosphorus and its management in chronic kidney disease

Dietary phosphorus control is often a main strategy in the management of patients with chronic kidney disease. Dietary protein is a major source of phosphorus intake. Recent data indicate that imposed dietary phosphorus restriction may compromise the need for adequate protein intake, leading to protein-energy wasting and possibly to increased mortality. The two main sources of dietary phosphorus are organic, including animal and vegetarian proteins, and inorganic, mostly food preservatives. Animal-based foods and plant are abundant in organic phosphorus. Usually 40% to 60% of animal-based phosphorus is absorbed; this varies by degree of gastrointestinal vitamin-D-receptor activation, whereas plant phosphorus, mostly associated with phytates, is less absorbable by human gastrointestinal tract. Up to 100% of inorganic phosphorus in processed foods may be absorbed; ie, phosphorus in processed cheese and some soda [cola] drinks. A recent study suggests that a higher dietary phosphorus-protein intake ratio is associated with incremental death risk in patients on long-term hemodialysis. Hence, for phosphorus management in chronic kidney disease, in addition to absolute dietary phosphorus content, the chemical structure [inorganic versus organic], type [animal versus plant], and phosphorus-protein ratio should be considered. We recommend foods and supplements with no or lowest quantity of inorganic phosphorus additives, more plant-based proteins, and a dietary phosphorus-protein ratio of less than 10 mg/g. Fresh [nonprocessed] egg white [phosphorus-protein ratio less than 2 mg/g] is a good example of desirable food, which contains a high proportion of essential amino acids with low amounts of fat, cholesterol, and phosphorus

[Effect of date on blood sugar in patients with type1 diabetes mellitus]

The importance of feed controlling has been proved in metabolic control of diabetic patients. An appropriate metabolic control prevents later complications. Patients with diabetes mellitus are deprived from eating sweat foods. Considering the effect of different carbohydrates on blood sugar, physicians and patients confront a lot of questions about eating these foods. The aim of this study was to compare the effect of sugar cube and Date consumption on blood sugar in patients with type 1 diabetes. As a clinical-trial, we selected 20 patients with type I diabetes mellitus sequentially. They were divided into two groups with 10 subjects in each group. The patient's blood sugar was measured in 2 days with one week interval, before and after eating a Date [10gr] and a sugar cube [5gr]. We measured blood sugar at 30, 60, 90 and 120 minutes after consumption. Data analysis was performed by SPSS software version 11, and the results were compared by paired t test. There was no significant difference between the blood sugar after eating Date and sugar cube. We also compared the surface under the curve of blood sugar after eating date and sugar cube in 2 hours, which was 1619.4 +/- 614 mg.min/dL and 1572 +/- 967 mg.min/dL for sugar cube and Date respectively, which the difference was not significant. Rising in blood sugar after Date consumption has not significant difference in comparison with sugar cube consumption in patients with type I diabetes. So, eating Date in diabetic patients is not preferable to eating sugar cube