High phosphate diet impacts nervous system, induces hypertension
UTSW researchers uncover brain signaling pathway that links high blood pressure with additives found in processed foods
What’s high in phosphate additives? Some foods on this list may surprise you
Phosphate/phosphorus is generally listed among the ingredients in food products as additives including dicalcium phosphate, disodium phosphate, monosodium phosphate, trisodium phosphate, sodium tripolyphosphate, or tetrasodium pyrophosphate.
- Beverages: Dark colas, beer/ale, cocoa, drinks made with milk, canned iced teas, chocolate drinks
- Dairy products: Cheese, ice cream, pudding, custard, cream soups, yogurt
- Packaged, prepared foods: Snacks, frozen meals, pre-cooked items
- Processed meats: Sandwich meat, hot dogs, sausage, bacon
- Fast foods: Burgers, chicken nuggets, fish sandwiches, french fries, and other fast foods, which often contain phosphate additives for preservation and texture
- Others: Pizza, chocolate, caramel
Source: National Kidney Foundation
DALLAS – June 30, 2025 – Diets rich in phosphate additives, commonly found in processed foods, can increase blood pressure by triggering a brain signaling pathway and overactivating the sympathetic nervous system that regulates cardiovascular function, UT Southwestern researchers discovered. Their findings could lead to treatment strategies for patients with hypertension caused by overconsumption of foods containing high levels of phosphates.
“This research uncovers a previously unrecognized brain-mediated mechanism by which high dietary phosphate intake promotes hypertension and sympathetic overactivation, highlighting central fibroblast growth factor receptor signaling as a novel therapeutic target,” said the study’s first author, Han Kyul Kim, Ph.D., Assistant Professor of Internal Medicine in the Division of Cardiology at UT Southwestern.
Inorganic phosphate is often used as a preservative or flavor enhancer in packaged foods, processed meats, and other dietary staples. As a result, the study reports, the average adult in developed countries consumes phosphate far above the recommended daily allowance.
Following excessive phosphate intake, circulating fibroblast growth factor-23 (FGF23) can enter the brain and induce hypertension, Dr. Kim and his colleagues report in their study, published in Circulation. The research outlines a new paradigm for this previously unclear mechanism and identifies a potential target for developing treatment strategies.
Hypertension occurs when the pressure that pushes against a patient’s arterial walls is too high. Affecting nearly half of the U.S. population, according to the U.S. Centers for Disease Control and Prevention, hypertension increases the risk of life-threatening medical events such as heart attack and stroke.
UTSW researchers ran a series of tests that measured and compared FGF23 protein levels, mean arterial pressure, and renal sympathetic nerve activity in rats receiving a high (1.2%) phosphate diet and another group on a normal (0.6%) phosphate diet. The measurement was repeated during stress response to exercise by stimulation of the spinal cord.
Researchers found that those on the high phosphate diet showed increased levels of FGF23 protein in their serum, cerebrospinal fluid, and brain stem, and that FGF23 proteins were able to cross the blood-brain barrier, causing high blood pressure both at rest and during physical stress.
“FGF23 can cross into the brain and influence the brain stem centers that control blood pressure,” said senior corresponding author Wanpen Vongpatanasin, M.D., Professor of Internal Medicine at UT Southwestern and Director of the Hypertension Section in the Division of Cardiology and the Hypertension Fellowship Program.
Analysis also revealed that inhibiting fibroblast growth factor receptor 4 (FGFR4) during simulated exercise dampened the negative effects of a high phosphate diet, suggesting a connection between FGFR4 and overactivation. Inhibition of FGFR1 did not have the same effect.
Given these results, researchers explored the role of FGFR4 and found that activation of this receptor contributes to an exaggerated increase in blood pressure during simulated exercise. FGFR4 activation caused by an excess of dietary phosphate was accompanied by an increase in the protein calcineurin A and brain stem activity that may contribute to elevated blood pressure and overactivation of the sympathetic nervous system during simulated exercise.
Other UTSW researchers who contributed to this study are Orson Moe, M.D., Professor of Internal Medicine and Physiology and Director of the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research; Scott Smith, Ph.D., Chair and Professor of Applied Clinical Research and Associate Dean for Research in the School of Health Professions and Professor of Internal Medicine; Beverly Rothermel, Ph.D., Professor of Internal Medicine in the Division of Cardiology and of Molecular Biology and co-Director in the Wellstone Muscular Dystrophy Cooperative Research Center; Masaki Mizuno, Ph.D., Associate Professor of Applied Clinical Research and Internal Medicine; Teppei Fujikawa, Ph.D., Associate Professor of Internal Medicine and member of the Center for Hypothalamic Research; Laurent Gautron, Ph.D., Assistant Professor of Internal Medicine and member of the Center for Hypothalamic Research; Ayumi Fukazawa, Ph.D., Postdoctoral Fellow; Johanne Pastor, Senior Scientist; Marco Galvan, Research Assistant; and Isabelle Carroll, Clinical Research Coordinator.
Dr. Vongpatanasin holds the Fredric L. Coe Professorship in Nephrolithiasis Research in Mineral Metabolism and the Norman and Audrey Kaplan Chair in Hypertension.
This research was supported by the National Institutes of Health Heart, Lung, and Blood Institute (R01HL133179, R01HL159994, and R01HL151632), the National Institute of Child Health and Development (R01HD101006), the Pak Center for Mineral Metabolism and Clinical Research Grant, the Seldin Professorship in Clinical Research, the UT Southwestern O’Brien Kidney Research Core Center (P30DK079328), the Pittsburgh O’Brien Kidney Research Core Center (P30 DK079307), and a UTSW Nutrition & Obesity Research Center grant from the National Institute of Diabetes, Digestive, and Kidney Disease (P30DK127984).
About UT Southwestern Medical Center 
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 23 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 140,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5.1 million outpatient visits a year.