scholarly journals U-Shaped Association between Dietary Acid Load and Risk of Osteoporotic Fractures in 2 Populations at High Cardiovascular Risk

2020 ◽  
Vol 151 (1) ◽  
pp. 152-161
Author(s):  
Jesús Francisco García-Gavilán ◽  
Alfredo Martínez ◽  
Jadwiga Konieczna ◽  
Rafael Mico-Perez ◽  
Ana García-Arellano ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Osteoporotic Fractures ◽  
Heart Association ◽  
Acid Base Balance ◽  
High Cardiovascular Risk ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load ◽  
Predimed Study

ABSTRACT Background Bone contributes to maintaining the acid-base balance as a buffering system for blood pH. Diet composition also affects acid-base balance. Several studies have linked an imbalance in the acid-base system to changes in the density and structure of bone mass, although some prospective studies and meta-analyses suggest that acid load has no deleterious effect on bone. Objective The aim of this study was to examine the associations between potential renal acid load (PRAL) and net endogenous acid production (NEAP) and the risk of osteoporotic fractures and bone mineral density (BMD) in 2 middle-aged and elderly Mediterranean populations. Methods We conducted a longitudinal analysis including 870 participants from the PREvención con DIeta MEDiterranea (PREDIMED) Study and a cross-sectional analysis including 1134 participants from the PREDIMED-Plus study. Participants were adults, aged 55–80 y, either at high cardiovascular risk (PREDIMED) or overweight/obese with metabolic syndrome (PREDIMED-Plus), as defined by the International Diabetes Federation, the American Heart Association, and the National Heart Association. PRAL and NEAP were calculated from validated food-frequency questionnaires. BMD was measured using DXA scans. Fracture information was obtained from medical records. The association between mean PRAL and NEAP and fracture risk was assessed using multivariable-adjusted Cox models. BMD differences between tertiles of baseline PRAL and NEAP were evaluated by means of ANCOVA. Results A total 114 new fracture events were documented in the PREDIMED study after a mean of 5.2 y of intervention and 8.9 y of total follow-up. Participants in the first and third PRAL and NEAP tertiles had a higher risk of osteoporotic fracture compared with the second tertile, showing a characteristically U-shaped association [HR (95% CI): 1.73 (1.03, 2.91) in tertile 1 and 1.91 (1.14, 3.19) in tertile 3 for PRAL, and 1.83 (1.08, 3.09) in tertile 1 and 1.87 (1.10, 3.17) in tertile 3 for NEAP]. Compared with the participants in tertile 1, the participants in the top PRAL and NEAP tertiles had lower BMD [PRAL: mean total femur BMD: 1.029 ± 0.007 and 1.007 ± 0.007 g/cm2; P = 0.006 (tertiles 1 and 3); NEAP: mean total femur BMD: 1.032 ± 0.007 and 1.009 ± 0.007 g/cm2; P = 0.017 (tertiles 1 and 3)]. Conclusions The results of our study suggest that both high and low dietary acid are associated with a higher risk of osteoporotic fractures, although only high dietary acid was found to have a negative relation to BMD in senior adults with existing chronic health conditions. This trial was registered at http://www.isrctn.com/ as ISRCTN3573963 (PREDIMED) and ISRCTN89898870 (PREDIMED-Plus).

scholarly journals Associations between Dietary Acid Load and Biomarkers of Inflammation and Hyperglycemia in Breast Cancer Survivors

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1913 ◽  
Author(s):  
Tianying Wu ◽  
Phoebe Seaver ◽  
Hector Lemus ◽  
Kathryn Hollenbach ◽  
Emily Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Acidosis ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Acid Base Balance ◽  
Acid Base ◽  
Dietary Acid Load ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load

Metabolic acidosis can lead to inflammation, tissue damage, and cancer metastasis. Dietary acid load contributes to metabolic acidosis if endogenous acid–base balance is not properly regulated. Breast cancer survivors have reduced capacities to adjust their acid–base balance; yet, the associations between dietary acid load and inflammation and hyperglycemia have not been examined among them. We analyzed data collected from 3042 breast cancer survivors enrolled in the Women’s Healthy Eating and Living (WHEL) Study who had provided detailed dietary intakes and measurements of plasma C-reactive protein (CRP) and hemoglobin A1c (HbA1c). Using a cross-sectional design, we found positive associations between dietary acid load and plasma CRP and HbA1c. In the multivariable-adjusted models, compared to women with the lowest quartile, the intakes of dietary acid load among women with the highest quartile showed 30–33% increases of CRP and 6–9% increases of HbA1c. Our study is the first to demonstrate positive associations between dietary acid load and CRP and HbA1c in breast cancer survivors. Our study identifies a novel dietary factor that may lead to inflammation and hyperglycemia, both of which are strong risk factors for breast cancer recurrence and comorbidities.

scholarly journals Keseimbangan asam-basa tubuh dan kejadian sindrom metabolik pada remaja obesitas

2017 ◽  
Vol 14 (1) ◽  
pp. 36
Author(s):  
Firdananda Fikri Jauharany ◽  
Nurmasari Widyastuti
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Acid Base Balance ◽  
Acid Base ◽  
Dietary Acid Load ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load

Background: The prevalence of metabolic syndrome increased in young population, indicated by the rise in obesity among children and adolescent. The Western dietary pattern was one of the causes. A Western diet rich in animal protein can produce acid during the metabolic process and may cause an acid-excess in the body (dietary acid load). This process was contributed to acid-base balance through the metabolism of sulfur-containing amino acids (cysteine and methionine) which produce H+ ions as well as lowering the pH.Objective: To examine the association between acid-base balance and components of metabolic syndrome among obese adolescent.Method: A cross-sectional study was conducted on 40 obese adolescents in Semarang high school. We measured Potential Renal Acid Load (PRAL) score and pH urine as an acid-base indicator. MetS are defined ≥ 3 following risk factors: waist circumference ≥90th percentile, blood pressure ≥90th percentile, triglycerides ≥110 mg/dl, HDL levels ≤40 mg/dl, and fasting blood glucose levels ≥110 mg/dl. Normality test used the Shapiro-Wilk test (n <50). The bivariate analysis used Pearson test, Rank-Spearman test, and Chi-Square test. The multivariate analysis used Multivariate Linear Regression analysis of Backward.Results: PRAL score was associated with waist circumference (r=0,347; p=0,028), sistolic blood pressure (r=0,590; p=<0,001), diastolic blood pressure (r=0,668; p=<0,001), and triglyceride levels (r=0,362; p=0,022). pH urin was not associated with any risk factors of MetS.Conclusion: High dietary acid load may be a risk factor for the development of MetS.

Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0206-0217 ◽  
Author(s):  
Seyedeh-Elaheh Shariati-Bafghi ◽  
Elaheh Nosrat-Mirshekarlou ◽  
Mohsen Karamati ◽  
Bahram Rashidkhani
Keyword(s):  
Calcium Intake ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
Dietary Intakes ◽  
Iranian Women ◽  
Acid Base Balance ◽  
Mineral Density ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid

Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50 - 85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference - 0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

scholarly journals Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

2004 ◽  
Vol 58 (11) ◽  
pp. 1462-1471 ◽  
Author(s):  
C J Prynne ◽  
F Ginty ◽  
A A Paul ◽  
C Bolton-Smith ◽  
S J Stear ◽  
...  
Keyword(s):  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid

scholarly journals Urine pH is an indicator of dietary acid–base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study

2008 ◽  
Vol 99 (6) ◽  
pp. 1335-1343 ◽  
Author(s):  
Ailsa A. Welch ◽  
Angela Mulligan ◽  
Sheila A. Bingham ◽  
Kay-tee Khaw
Keyword(s):  
Fruit And Vegetables ◽  
Fruit And Vegetable ◽  
Acid Base Balance ◽  
Acid Base ◽  
Urine Ph ◽  
Alkaline Urine ◽  
Base Balance ◽  
Dietary Acid ◽  
Base Load ◽  
Prospective Investigation

Evidence exists that a more acidic diet is detrimental to bone health. Although more precise methods exist for measurement of acid–base balance, urine pH reflects acid–base balance and is readily measurable but has not been related to habitual dietary intake in general populations. The present study investigated the relationship between urine pH and dietary acid–base load (potential renal acid load; PRAL) and its contributory food groups (fruit and vegetables, meats, cereal and dairy foods). There were 22 034 men and women aged 39–78 years living in Norfolk (UK) with casual urine samples and dietary intakes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk FFQ. A sub-study (n 363) compared pH in casual samples and 24 h urine and intakes from a 7 d diary and the FFQ. A more alkaline diet (low PRAL), high fruit and vegetable intake and lower consumption of meat was significantly associated with a more alkaline urine pH before and after adjustment for age, BMI, physical activity and smoking habit and also after excluding for urinary protein, glucose, ketones, diagnosed high blood pressure and diuretic medication. In the sub-study the strongest relationship was found between the 24 h urine and the 7 d diary. In conclusion, a more alkaline diet, higher fruit and vegetable and lower meat intake were related to more alkaline urine with a magnitude similar to intervention studies. As urine pH relates to dietary acid–base load its use to monitor change in consumption of fruit and vegetables, in individuals, warrants further investigation.

scholarly journals THREE-STEP-REGULATION OF ACID-BASE BALANCE IN BODY FLUID AFTER ACID LOAD

1961 ◽  
Vol 11 (2) ◽  
pp. 109-125
Author(s):  
Hisato YOSHIMURA ◽  
Mamoru FUJIMOTO ◽  
Osamu OKUMURA ◽  
Jyunichi SUGIMOTO ◽  
Tsutomu KUWADA
Keyword(s):  
Body Fluid ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Acid Load

Renal regulation of acid-base balance in the bullfrog

1961 ◽  
Vol 201 (6) ◽  
pp. 980-986 ◽  
Author(s):  
Hisato Yoshimura ◽  
Masateru Yata ◽  
Minoru Yuasa ◽  
Robert A. Wolbach
Keyword(s):  
Carbonic Anhydrase ◽  
Ammonia Excretion ◽  
Respiratory Acidosis ◽  
Acid Base Balance ◽  
Acid Base ◽  
Urinary Ph ◽  
Base Balance ◽  
Chloride Excretion ◽  
Acid Load ◽  
Renal Carbonic Anhydrase

Renal mechanisms for the maintenance of acid-base balance were studied in the normal bullfrog, during metabolic and respiratory acidosis, and after carbonic anhydrase inhibition. Following intravenous administration of 0.3–12 mmole HCl/ kg, as 0.1 n HCl, urinary pH (initially pH 6.3–7.7) did not change significantly. However, urinary ammonia excretion increased more than twofold, and within 3–5 days the cumulative increase was equivalent to the acid load given. Despite the increased ammonia excretion, chloride excretion did not increase after acid loading. In both normal and acidotic bullfrogs ammonia excretion was correlated with an increase in urinary pH. Respiratory acidosis in the small frog, Rana limnocharis, produced by exposure to 6.4% CO2 in air, induced neither urinary acidification nor increased ammonia excretion; both urinary sodium and bicarbonate excretion increased. When renal carbonic anhydrase was inhibited by acetazoleamide injection, urine flow, sodium excretion, and bicarbonate excretion increased markedly, urinary pH increased slightly, and urinary ammonia excretion remained unchanged. These renal responses to acidosis are compared with those of the acidotic dog.

scholarly journals Erratum: Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

2004 ◽  
Vol 58 (11) ◽  
pp. 1558-1558 ◽  
Author(s):  
C J Prynne ◽  
F Ginty ◽  
A A Paul ◽  
C Bolton-Smith ◽  
S J Stear ◽  
...  
Keyword(s):  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid

Is urea formation regulated primarily by acid-base balance in vivo?

1986 ◽  
Vol 250 (4) ◽  
pp. F605-F612 ◽  
Author(s):  
M. L. Halperin ◽  
C. B. Chen ◽  
S. Cheema-Dhadli ◽  
M. L. West ◽  
R. L. Jungas
Keyword(s):  
Dietary Protein ◽  
Urea Synthesis ◽  
Acid Base Balance ◽  
Severe Metabolic Acidosis ◽  
Acid Base ◽  
Wide Range ◽  
Base Balance ◽  
Acid Load ◽  
Acid Base Status

Large quantities of ammonium and bicarbonate are produced each day from the metabolism of dietary protein. It has recently been proposed that urea synthesis is regulated by the need to remove this large load of bicarbonate. The purpose of these experiments was to test whether the primary function of ureagenesis in vivo is to remove ammonium or bicarbonate. The first series of rats were given a constant acid load as hydrochloric acid or ammonium chloride; individual rats received a constant nitrogen load at a time when their plasma acid-base status ranged from normal (pH 7.4, 28 mM HCO3) to severe metabolic acidosis (pH 6.9, 6 mM HCO3). Urea plus ammonium excretions and the blood urea, glutamine, and ammonium concentrations were monitored with time. Within the constraints of non-steady-state conditions, the rate of urea synthesis was constant and the plasma glutamine and ammonium concentrations also remained constant; thus it appears that the rate of urea synthesis was not primarily regulated by the acid-base status of the animal in vivo over a wide range of plasma ammonium concentrations. In quantitative terms, the vast bulk of the ammonium load was converted to urea over 80 min; only a small quantity of ammonium appeared as circulating glutamine or urinary ammonium. Urea synthesis was proportional to the nitrogen load. A second series of rats received sodium bicarbonate; urea synthesis was not augmented by a bicarbonate load. We conclude from these studies that the need to dispose of excess bicarbonate does not primarily determine the rate of ureagenesis in vivo. The data support the classical view that ureagenesis is controlled by the quantity of ammonium to be removed.

Effects of protein, methionine, or chloride on acid-base balance and on cysteine catabolism

1995 ◽  
Vol 269 (5) ◽  
pp. E910-E917 ◽  
Author(s):  
D. L. Bella ◽  
M. H. Stipanuk
Keyword(s):  
Adaptive Response ◽  
Sulfur Amino Acids ◽  
Acid Base Balance ◽  
Acid Base ◽  
Low Protein ◽  
Metabolic Compensation ◽  
Base Balance ◽  
Acid Load ◽  
Excess Sulfur ◽  
Intact Rats

Metabolism of cysteine to sulfate results in production of H+, whereas metabolism of cysteine to taurine does not. Rats were fed a basal low-protein diet or a diet with excess protein, methionine, or chloride for 2-3 wk, and effects of these treatments on acid-base homeostasis and on cysteine metabolism were determined. Hepatocytes from rats fed diets with excess methionine, but not from rats fed diets with excess protein or chloride, catabolized a high proportion of cysteine to taurine (32% vs. 4-7% for other groups), and intact rats fed excess methionine excreted more sulfur as taurine (51% of total sulfur vs. 1-6% for other groups). The formation of taurine vs. sulfate as the end product of cysteine catabolism provides a metabolic compensation that minimizes the acid load in rats fed excess sulfur amino acids. However, increased production of taurine vs. sulfate is not a general adaptive response to acidogenic diets.

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