Abstract
Modern Western diets, with higher contents of animal compared to fruits and vegetable products, have a greater content of acid precursors vs. base precursors, which results in a net acid load to the body. To prevent inexorable accumulation of acid in the body and progressively increasing degrees of metabolic acidosis, the body has multiple systems to buffer and titrate acid, including bone which contains large quantities of alkaline salts of calcium. Both in vitro and in vivo studies in animals and humans suggest that bone base helps neutralize part of the dietary net acid load. This raises the question of whether decades of eating a high acid diet might contribute to the loss of bone mass in osteoporosis. If this idea is true, then additional alkali ingestion in the form of net base-producing foods or alkalinizing salts could potentially prevent this acid-related loss of bone. Presently, data exists that support both the proponents as well as the opponents of this hypothesis. Recent literature reviews have tended to support either one side or the other. Assuming that the data cited by both sides is correct, we suggest a way to reconcile the discordant findings. This overview will first discuss dietary acids and bases and the idea of changes in acid balance with increasing age, then review the evidence for and against the usefulness of alkali therapy as a treatment for osteoporosis, and finally suggest a way of reconciling these two opposing points of view.
Highlights
In western society, aging is accompanied by a loss of bone mass indicative of the bone disorder, osteoporosis
The idea that osteoporosis might in part be due to dietary intake of acid precursors in excess of base precursors and that the consequent low-grade metabolic acidosis-induced bone mass reduction might be slowed or prevented by consuming a diet net base load was first proposed nearly 50 years ago by Wachman and Bernstein [1]
Modern Western diets, with higher contents of animal compared to fruits and vegetable products, have a greater content of acid precursors vs. base precursors, which results in a net acid load to the body [2,3]
Summary
In western society, aging is accompanied by a loss of bone mass indicative of the bone disorder, osteoporosis. (Cl), bicarbonate (HCO3 ))) in the form of alkaline salts of calcium (e.g., calcium hydroxyapatite, calcium carbonate) The concept that such bone base can be released to neutralize part of the dietary net acid load might be inferred from the finding from in vitro studies demonstrating that acids dissolve bone and from in vivo studies in animals and humans fed net acid-producing diets that bone dissolution occurs in conjunction with negative calcium balance (see references in Wachman and Bernstein [1]). Assuming that the data cited by both sides is correct, we suggest a way to reconcile the discordant findings This overview will first discuss dietary acids and bases and the idea of what can happen to acid balance with increasing age, review the evidence for and against the usefulness of alkali therapy as a treatment for osteoporosis and suggest a way of reconciling these two opposing points of view
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