Performance of Predictive Equations and Biochemical Measures Quantifying Net Endogenous Acid Production and the Potential Renal Acid Load

Parmenter, Benjamin H.; Dymock, Michael; Banerjee, Tanushree; Sebastián, Anthony; Slater, Gary; Frassetto, Lynda

doi:10.1016/j.ekir.2020.07.026

Cited by 19 publications

(20 citation statements)

References 34 publications

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“…The reader is referred to the work of Parmenter et al for additional background information on all three employed formulas [ 48 , 49 ]. Negative DAL scores (PRAL R < 0 mEq/d) indicate an alkaline-forming potential, whereas positive scores (PRAL R > 0 mEq/d) indicate an acid-forming potential.…”

Section: Methodsmentioning

confidence: 99%

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Storz

Ronco

2022

BMC Nutr

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Background Diet is an important determinant of systemic pH and acid–base regulation. A frequent consumption of acid-inducing foods (including processed meats and cheese) combined with a low intake of base-inducing foods (such as fruits, legumes and vegetables) increases Dietary Acid Load (DAL), which has been associated with an increased risk for certain cancers. DAL also appears to be of paramount importance in cancer survivors, in whom it was associated with increased mortality and poor overall physical health. Literature on DAL in cancer survivors, however, is scarce and limited to a few studies. Methods Using cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES), we sought to quantify DAL in U.S. cancer survivors and contrasted the results to the general population. DAL was estimated using established formulas (Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP)). Results Our study comprised 19,413 participants, of which 1444 were self-reported cancer survivors. Almost 63% of cancer survivors were female (weighted proportion) with a mean age of 61.75 (0.51) years. DAL scores were consistently higher in cancer survivors (as compared to the general population) after adjustment for confounders in multivariate regression models. These differences, however, were not statistically significant (p = 0.506 for NEAPF, 0.768 for PRALR and 0.468 for NEAPR, respectively). Notably, DAL scores were positive throughout (> 0 mEq/d) in cancer survivors, suggesting an acidifying diet. Specific examples include mean PRALR scores > 11 mEq/d in cancer survivors aged 55 years and mean NEAPF scores > 50 mEq/d in cancer survivors aged 40–60 years). Conclusions The acidifying diet in this sample of cancer survivors warrants caution and requires further investigation. Comparably high DAL scores have been associated with adverse health outcomes and an increased mortality in previous studies in breast cancer survivors. Thus, increased awareness as well as additional clinical trials in this field are urgently warranted.

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Section: Methodsmentioning

confidence: 99%

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Storz

Ronco

2022

BMC Nutr

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“…We refer the reader to the work of Parmenter et al, for additional background information on all scores [ 14 , 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…However, the authors neither reported total energy intake nor protein intake [ 13 ]. Both are important determinants of DAL and necessary to understand the effects of a particular diet on acid–base homeostasis [ 14 , 15 , 16 ]. Replacing cereals with other cereals per se does hypothetically not affect DAL ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Dietary Acid Load in Gluten-Free Diets: Results from a Cross-Sectional Study

Storz

Ronco

Lombardo³

2022

Nutrients

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The gluten-free diet (GFD) ensures improvement of clinical symptoms in the vast majority of celiac disease (CD) patients. Despite stable CD rates in many countries, an increasing number of healthy individuals are adopting gluten-free diets, believing that this diet is an inherently healthier choice. The health effects of gluten-free diets are controversial, and a recent study added to the debate by reporting a lower acidogenic potential of this diet. The effects of the GFD on potential renal acid load (PRAL) and net endogenous acid production (NEAP)—two important markers of dietary acid load (DAL)—are poorly understood, and have never been examined in a Western population. Using cross-sectional data from the National Health and Nutrition Examination Surveys, we estimated DAL in U.S. individuals reporting a GFD and contrasted the results to the general U.S. population consuming gluten and denying special diets. The GFD was associated with significantly lower crude DAL scores, and after adjustments for confounders in multivariate regression, the results remain significant. Yet, our study could not confirm the reported alkalizing properties of the GFD. Although overall DAL scores were significantly lower in the GFD group, they were comparable to Western diets producing 50–75 mEq of acid per day.

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“…The secondary mechanism that the body uses to deal with a longer term excessively acidic state is to excrete acids via the kidneys (in urine), via saliva, and through the skin (in sweat) [11,18] and to reabsorb bicarbonate. If excess alkalinity is present, the kidneys excrete more bicarbonate into the urine [16,17,19,20].…”

Section: Basic Acid-base Issuesmentioning

confidence: 99%

“…Table 1 provides a categorized list of foods and drinks based on the effect they are thought to have on body pH (based on likely impact of metabolic residues). In each case, we have chosen the most reliable available data in the literature and performed a qualitative comparison based on agreements between the different references [19,20,41,42,46,52,53,71]. However, most of these data came from sources which used measurement methods that have not been verified.…”

Section: Determining Whether Foods Are Acid or Alkaline Formingmentioning

confidence: 99%

The Alkaline Diet and the Warburg Effect

Bahrami¹,

Greiner²

2021

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The changing diets accompanying our modern life style have increased the content of foods that form acidic metabolic waste residues in the body. Wastes from these metabolic processes are released into the interstitial fluids and the blood, slightly changing their pH temporarily. This link may in turn have an impact on the incidence of non-communicable diseases (NCDs). According to Warburg effect theory, an acidic cellular and circulatory environment may cause various specific health problems such as hypoxia and cancer, whereas an oxygen-rich optimum-alkaline environment could retain healthy cells. However, the mechanisms by which the diet may be influential on blood pH-related parameters and on health have remained largely unknown. This paper begins with a detailed presentation of the concepts, issues and the existing evidence regarding alkaline and acid forming diets, and summarizes the three main mechanisms by which the diet influences the acid-base balance in the body. It then presents the findings of a small exploratory study in which one author (HB) followed diets traditionally thought to produce alkaline or acidic residues. After each diet period of one month (with a two-month wash out period), pH, oxygen saturation, and carbon dioxide partial pressure were measured for arterial and for venous blood. The resulting data indicated that the diets followed changed blood pH-related parameters in the expected directions according to the acid-base theory of health. Increased intake of acid-forming foods resulted in a slightly lower pH level, but a significant reduction of oxygen saturation in the blood, whereas increased consumption of alkaline forming foods maintained the high oxygen saturation in the blood that, according to Warburg effect theory, may, if maintained, reduce the incidence of NCDs. Further cross-over research of this kind is needed, utilizing large samples and testing various dietary modifications.

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Performance of Predictive Equations and Biochemical Measures Quantifying Net Endogenous Acid Production and the Potential Renal Acid Load

Cited by 19 publications

References 34 publications

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Dietary Acid Load in Gluten-Free Diets: Results from a Cross-Sectional Study

The Alkaline Diet and the Warburg Effect

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