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medRxiv
MEDRXIV
medRxiv
Cold Spring Harbor Laboratory

10.1101/2023.09.09.23295298
preprint
2
Article
Dietary burden of phosphorus and aluminum in ready-to-eat wheat flour tortillas exceed that of corn tortillas: Implications for patients with renal or cardiovascular disease
Chiang Kate C. http://orcid.org/0000-0003-0999-7516

Yokel Robert A. http://orcid.org/0000-0001-5188-3972

Unrine Jason M. http://orcid.org/0000-0003-3012-5261

Kalantar-Zadeh Kamyar http://orcid.org/0000-0002-8666-0725

Gupta Ajay http://orcid.org/0000-0001-9182-3499

09 9 2024
2023.09.09.23295298https://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator.
http://medrxiv.org/lookup/doi/10.1101/2023.09.09.23295298
nihpp-2023.09.09.23295298.pdf
Abstract

Ready-to-eat, shelf-stable tortillas contain several phosphorus- and aluminum-containing additives that may increase the risk of adverse events in patients with chronic kidney disease (CKD). The present study analyzes and compares the elemental content of wheat flour and corn tortillas with special reference to dietary aluminum and phosphorus burden. Twenty-one elements were quantified by ICP-MS and ICP-OES in 14 corn and 13 wheat flour tortilla brands purchased from local supermarkets in Southern California. The aluminum and phosphorus concentrations of many ready-to-eat tortilla brands can present a daily dietary load of up to approximately 100 mg aluminum and 700 mg phosphorus based on an average daily tortilla intake of 330 grams. Ready-to-eat wheat flour tortillas generally had more phosphorus than corn tortillas. Tortillas with aluminum listed as a food additive contained a higher aluminum content than those without such listing, exceeding the tolerable weekly intake. Despite conventional wisdom that CKD patients should avoid phosphorus-rich corn tortillas, ready-to-eat wheat flour tortillas consistently had a higher aluminum and phosphorus content due to additives. CKD patients and healthcare providers should pay attention to food labels, and regulatory authorities should monitor the use of approved food additives and mandate food label warnings for patients at risk.
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pmc
