The response of bone to metabolic acidosis in man

Reidenberg, Marcus M.; Haag, Burritt; Channick, Bertram J.; Shuman, Charles R.; Wilson, TE

doi:10.1016/0026-0495(66)90021-7

Cited by 50 publications

(12 citation statements)

References 13 publications

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“…Table III shows the arterial oxygen, carbon dioxide, glucose, lactate, pyruvate, FFA, AcAc, and P-OHB, and serum insulin concentrations during progressive starvation. The oxygen, lactate, and pyruvate concentrations which remained relatively constant throughout the fast are comparable to those in overnight-fasted subjects and the decreased C02 concentration observed at 3 and 24 days is consistent with the ketoacidosis of starvation (14,(25)(26)(27) and as given in White, Handler, and Smith (28), and as reviewed by Oliva (29). Glucose was decreased after 3 or 24 days of fasting.…”

Section: Resultssupporting

confidence: 85%

Human forearm metabolism during progressive starvation

Owen¹,

Reichard²

1971

J. Clin. Invest.

170

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A B S T R A C T Forearm muscle metabolism was studied in eight obese subjects after an overnight, 3 and 24 day fast. Arterio-deep-venous differences of oxygen, carbon dioxide, glucose, lactate, pyruvate, free fatty acids, acetoacetate, and P-hydroxybutyrate with simultaneous forearm blood flow were measured. Rates of metabolite utilization and production were thus estimated. Oxygen consumption and lactate and pyruvate production remained relatively constant at each fasting period. Glucose, initially the major substrate consumed, showed decreased consumption after 3 and 24 days of fasting. Acetoacetate and P-hydroxybutyrate consumption after an overnight fast was low. At 3 days of fasting with increased arterial concentrations of acetoactate and P-hydroxybutyrate, consumption of these substrates rose dramatically. At 24 days of fasting, despite further elevation of arterial levels of acetoacetate and P-hydroxybutyrate, the utilization of acetoacetate did not increase further and if anything decreased, while five out of eight subjects released P-hydroxybutyrate across the forearm. Acetoacetate was preferentially extracted over P-hydroxybutyrate. At 24 days of starvation, free fatty acids were the principal fuels extracted by forearm muscle; at this time there was a decreased glucose and also ketone-body consumption by skeletal muscle.

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Section: Resultssupporting

confidence: 85%

Human forearm metabolism during progressive starvation

Owen¹,

Reichard²

1971

J. Clin. Invest.

170

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“…Others have shown this for sodium [1,3] and the present results indicate that the same is true for magnesium and calcium. In general, mineral cation excretion continues after the 6th day of fasting at a reduced rate compared with days 3-5, but in the case of calcium, excretion remains high for a longer period, a special feature which may be related to the effects of the acidosis of fasting on bone [13].…”

Section: Discussion Cation Excretion Patterns During Fastingmentioning

confidence: 99%

Effect of Carbohydrate Intake on the Urinary Excretion of Magnesium, Calcium and Sodium in Fasting Obese Patients

Fleming¹,

Stewart²

1976

Nephron

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The urinary excretion of magnesium, calcium and sodium has been measured in 19 obese patients undergoing 12 days on complete fast (days 1–12) followed by 6 days of carbohydrate supplementation (days 13–18), while receiving no mineral supplements or either calcium, magnesium or sodium supplements. Magnesium and calcium followed different excretion patterns during the 12 days fast. The oral administration of 107 g carbohydrate daily during days 13–19 resulted in a marked decrease in the urinary excretion of magnesium, calcium and sodium by the non-, calcium- and sodium-supplemented patients, but there was no carbohydrate-induced reduction in magnesium excretion in the magnesium-supplemented patients. The kidney appears capable of selectively influencing calcium and sodium reabsorption, without magnesium excretion being affected. It is suggested that involvement in increased renal gluconeogenesis during fasting renders the renal tubule incapable of maximally conserving both divalent and monovalent ions. The increased tubular reabsorption of urinary constituents induced by carbohydrate administration probably stems from the concomitant reduction in gluconeogenesis.

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“…diabetic acidosis) and experimental (e.g. NH4CI ingestion) states of acid loading and acidosis, an association exists with both hypercalciuria and negative Ca balance (Gastineau et al 1960;Reidenberg et al 1966). The pioneering work of Lemann (Lemann et al 1966) and Barzel (1969) over three decades ago showed extensively the effects of 'acid' from the diet on bone mineral in both man and animals.…”

Section: Fundamentals Of Acid-base Maintenance: Criticality To Healthmentioning

confidence: 99%

Nutrition Society Medal Lecture: The role of the skeleton in acid—base homeostasis

New

2002

Proc. Nutr. Soc.

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Nutritional strategies for optimising bone health throughout the life cycle are extremely important, since a dietary approach is more popular amongst osteoporosis sufferers than drug intervention, and long-term drug treatment compliance is relatively poor. As an exogenous factor, nutrition is amenable to change and has relevant public health implications. With the growing increase in life expectancy, hip fractures are predicted to rise dramatically in the next decade, and hence there is an urgent need for the implementation of public health strategies to target prevention of poor skeletal health on a population-wide basis. The role that the skeleton plays in acid-base homeostasis has been gaining increasing prominence in the literature; with theoretical considerations of the role alkaline bone mineral may play in the defence against acidosis dating as far back as the late 19th century. Natural, pathological and experimental states of acid loading and/or acidosis have been associated with hypercalciuria and negative Ca balance and, more recently, the detrimental effects of ‘acid’ from the diet on bone mineral have been demonstrated. At the cellular level, a reduction in extracellular pH has been shown to have a direct enhancement on osteoclastic activity, with the result of increased resorption pit formation in bone. A number of observational, experimental, clinical and intervention studies over the last decade have suggested a positive link between fruit and vegetable consumption and the skeleton. Further research is required, particularly with regard to the influence of dietary manipulation using alkali-forming foods on fracture prevention. Should the findings prove conclusive, a “fruit and vegetable” approach to bone health maintenance may provide a very sensible (and natural) alternative therapy for osteoporosis treatment, which is likely to have numerous additional health-related benefits.

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The response of bone to metabolic acidosis in man

Cited by 50 publications

References 13 publications

Human forearm metabolism during progressive starvation

Human forearm metabolism during progressive starvation

Effect of Carbohydrate Intake on the Urinary Excretion of Magnesium, Calcium and Sodium in Fasting Obese Patients

Nutrition Society Medal Lecture: The role of the skeleton in acid—base homeostasis

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