Chronic Sub-Clinical Systemic Metabolic Acidosis – A Review with Implications for Clinical Practice

Abstract

When arterial serum pH remains near the lower pH limit of 7.35 for protracted periods of time, a low-grade, sub-clinical form of acidosis results, referred to in this review as chronic, sub-clinical, systemic metabolic acidosis (CSSMA). This narrative review explores the scientific basis for CSSMA, its consequences for health, and potential therapeutic interventions. The major etiology of CSSMA is the shift away from the ancestral, alkaline diet which was rich in fruit and vegetables, toward the contemporary, acidogenic ‘Westernized’ diet characterized by higher animal protein consumption and lack of base forming minerals. Urine pH is reduced with high dietary acid load and may be a convenient marker of CSSMA. Evidence suggests further that CSSMA negatively influences cortisol levels potentially contributing significantly to the pathophysiology thereof. Both CSSMA and high dietary acid load are associated with the risk and prognosis of various chronic diseases. Clinical trials show that CSSMA can be addressed successfully through alkalizing the diet by increasing fruit and vegetable intake and/or supplementing with alkaline minerals. This review confirms the existence of a significant body of evidence regarding this low-grade form of acidosis as well as evidence to support its diverse negative implications for health, and concludes that CSSMA is a condition warranting further research.

Summatory Effects of Anaerobic Exercise and a ‘Westernized Athletic Diet’ on Gut Dysbiosis and Chronic Low-Grade Metabolic Acidosis

“…Nutrition is a fundamental aspect of balancing the acidic state of exercise with foods with a higher bicarbonate content and a lower amount of animal protein. These types of foods include an ‘alkaline diet’ regime rich in vegetables and fruits and a reduced intake of animal protein and soy (of high biological value) [ 146 ]. The study of Naude et al [ 146 ] proposed these recommendations, among others, such as reducing sodium intake or not adding salt because it has a very acidifying effect on the diet.…”

“…These types of foods include an ‘alkaline diet’ regime rich in vegetables and fruits and a reduced intake of animal protein and soy (of high biological value) [ 146 ]. The study of Naude et al [ 146 ] proposed these recommendations, among others, such as reducing sodium intake or not adding salt because it has a very acidifying effect on the diet. In athletes, carbonated drinks can be very acidic due to their carbonic acid content, which lowers the pH.…”