Search Results (6)

Acid–base balance is critical to human health and can be significantly influenced by dietary choices. The Western diet, characterized by high meat and cheese consumption, induces excess acidity, highlighting the need for strategies to mitigate this. Recent studies have focused on bicarbonate-rich mineral water as a viable solution. In this context, the present narrative review synthesizes the findings from recent scientific studies on bicarbonate-rich mineral water, specifically those with bicarbonate levels over 1300 mg/L and medium or low PRAL values. This water has been shown to exert beneficial effects on both urinary and blood parameters. The key effects include an increase in the urine pH and a profound reduction in net acid excretion as a sign for a reduced acid load. Additionally, bicarbonate mineral water has been shown to decrease the excretion of nephrolithiasis-related constituents, including calcium and oxalates, as well as inhibitory substances such as magnesium and citrates. In blood, bicarbonate-rich water has been demonstrated to stabilize pH and increase bicarbonate levels, thereby enhancing systemic buffering capacity. Clinically, these changes have been associated with a lowered risk of calcium oxalate stone formation and improved kidney health. Furthermore, bicarbonate-rich water has been shown to support bone health by reducing bone resorption markers. Consequently, the integration of bicarbonate-rich mineral water into the diet has the potential to enhance urinary and blood parameters, mitigate the risk of kidney stones, and strengthen skeletal integrity, thereby serving as a promising strategy for health promotion and disease prevention. While promising, these findings underscore the need for further research to establish long-term recommendations. Future interventional studies should be designed with rigorous randomization, larger sample sizes, cross-over methodologies, and comprehensive dietary assessments to address the methodological limitations of previous research. Full article

This study aimed to investigate the ability of highly trained athletes to consistently perform at their highest level during a simulated three-day 400 m race and to examine the impact of an alkaline diet associated with chronic consumption of bicarbonate-rich water or placebo on their blood metabolic responses before and after the three races. Twenty-two highly trained athletes, divided into two groups—one with an alkalizing diet and placebo water (PLA) and the other with an alkalizing diet and bicarbonate-rich water (BIC)—performed a 400 m race for three consecutive days. Performance metrics, urine and blood samples assessing acid-base balance, and indirect markers of neuro-muscular fatigue were measured before and after each 400 m race. The evolution of the Potential Renal Acid Load (PRAL) index and urinary pH highlights the combination of an alkalizing diet and bicarbonate-rich hydration, modifying the acid-base state (p < 0.05). Athletes in the PLA group replicated the same level of performance during three consecutive daily races without an increase in fatigue-associated markers. Athletes experienced similar levels of metabolic perturbations during the three 400 m races, with improved lactate clearance 20 min after the third race compared to the first two (p < 0.05). This optimization of the buffering capacity through ecological alkaline nutrition and hydration allowed athletes in the BIC group to improve their performance during the third 400 m race (p < 0.01). This study highlights athletes’ ability to replicate high-level performances over three consecutive days with the same extreme level of metabolic disturbances, and an alkaline diet combined with bicarbonate-rich water consumption appears to enhance performance in a 400 m race. Full article

Both veganism and high dietary acid load are linked to unfavorable bone health. However, the specific role of dietary alkali or acid load for the bone health of vegans is so far unknown. Thus, the renal biomarker for dietary acid or alkali load, i.e., urinary potential renal acid load (uPRAL), was measured in 24 h urine samples of 34 vegans and 35 omnivores (50.7% males). Bone health was assessed via calcaneal quantitative ultrasound. Associations between uPRAL and bone health indices were examined using multivariable general linear models. Compared to omnivores, vegans had a significantly lower uPRAL (mean difference = −34.5 mEq/24 h, p < 0.0001), a lower 24 h urinary phosphate excretion (p = 0.0004), a lower 24 h urinary sulfate excretion (p = 0.01), and a higher urine pH value (p < 0.0001). Broadband ultrasound attenuation (BUA) was lower among vegans versus omnivores (p = 0.037), yet it was not associated with uPRAL irrespective of adjustments. This study confirms different acid-base profiles of vegans and omnivores, with a pronounced alkaline excess among vegans and a rather low acid load among a group of omnivores with moderate protein intake. Within this spectrum of alkaline to low acid load, no association with bone health was found. Full article

Diets rich in fruits and vegetables, like the Dietary Approaches to Stop Hypertension (DASH)-diet, are usually characterized by high potassium intake and reduced dietary acid load, and have been shown to reduce blood pressure (BP). However, the relevance of potential renal acid load (PRAL) for BP has not been compared with the relevance to BP of urinary biomarker (K-urine)- and dietary food frequency questionnaire (K-FFQ)-based estimates of potassium intake in a general adult population sample. For 6788 participants (aged 18–79 years) of the representative German Health-Interview and Examination Survey for Adults (DEGS1), associations of PRAL, K-urine, and K-FFQ with BP and hypertension prevalence were cross-sectionally examined in multivariable linear and logistic regression models. PRAL was significantly associated with higher systolic BP (p = 0.0002) and higher hypertension prevalence (Odds ratio [OR] high vs. low PRAL = 1.45, p = 0.0004) in models adjusted for age, sex, body mass index (BMI), estimated sodium intake, kidney function, relevant medication, and further important covariates. Higher estimates of K-FFQ and K-urine were related to lower systolic BP (p = 0.04 and p < 0.0001) and lower hypertension prevalence (OR = 0.82, p = 0.04 and OR = 0.77, p = 0.02) as well as a lower diastolic BP (p = 0.03 and p = 0.0003). Our results show, for the first time in a comparative analysis of a large representative population sample, significant relationships of BP and hypertension prevalence with questionnaire- and biomarker-based estimates of potassium intake and with an estimate of dietary acid load. Full article

Background: Metabolic acidosis is a common complication of chronic kidney disease; current guidelines recommend treatment with alkali if bicarbonate levels are lower than 22 mMol/L. In fact, recent studies have shown that an early administration of alkali reduces progression of CKD. The aim of the study is to evaluate the effect of fruit and vegetables to reduce the acid load in CKD. Methods: We conducted a case-control study in 146 patients who received sodium bicarbonate. Of these, 54 patients assumed very low-protein diet (VLPD) and 92 were controls (ratio 1:2). We calculated every three months the potential renal acid load (PRAL) and the net endogenous acid production (NEAP), inversely correlated with serum bicarbonate levels and representing the non-volatile acid load derived from nutrition. Un-paired T-test and Chi-square test were used to assess differences between study groups at baseline and study completion. Two-tailed probability values ≤0.05 were considered statistically significant. Results: At baseline, there were no statistical differences between the two groups regarding systolic blood pressure (SBP), diastolic blood pressure (DBP), protein and phosphate intake, urinary sodium, potassium, phosphate and urea nitrogen, NEAP, and PRAL. VLPD patients showed at 6 and 12 months a significant reduction of SBP (p < 0.0001), DBP (p < 0.001), plasma urea (p < 0.0001) protein intake (p < 0.0001), calcemia (p < 0.0001), phosphatemia (p < 0.0001), phosphate intake (p < 0.0001), urinary sodium (p < 0.0001), urinary potassium (p < 0.002), and urinary phosphate (p < 0.0001). NEAP and PRAL were significantly reduced in VLPD during follow-up. Conclusion: VLPD reduces intake of acids; nutritional therapy of CKD, that has always taken into consideration a lower protein, salt, and phosphate intake, should be adopted to correct metabolic acidosis, an important target in the treatment of CKD patients. We provide useful indications regarding acid load of food and drinks—the “acid load dietary traffic light”. Full article

Increased consumption of vegetables/herbs/fruit may reduce bone turnover and urinary calcium loss in post-menopausal women because of increased intake of polyphenols and potassium, but comparative human studies are lacking. The main aim was to compare bone turnover markers and urinary calcium excretion in two randomised groups (n = 50) of healthy post-menopausal women consuming ≥9 servings of different vegetables/herbs/fruit combinations (three months). Group A emphasised a generic range of vegetables/herbs/fruit, whereas Group B emphasised specific vegetables/herbs/fruit with bone resorption-inhibiting properties (Scarborough Fair Diet), with both diets controlled for potential renal acid load (PRAL). Group C consumed their usual diet. Plasma bone markers, urinary electrolytes (24 h) and estimated dietary PRAL were assessed at baseline and 12 weeks. Procollagen type I N propeptide (PINP) decreased (−3.2 μg/L, p < 0.01) in the B group only, as did C-terminal telopeptide of type I collagen (CTX) (−0.065 μg/L, p < 0.01) in women with osteopenia compared to those with normal bone mineral density (BMD) within this group. Intervention Groups A and B had decreased PRAL, increased urine pH and significantly decreased urinary calcium loss. Urinary potassium increased in all groups, reflecting a dietary change. In conclusion, Group B demonstrated positive changes in both turnover markers and calcium conservation. Full article