Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review.

Renata Carnauba,Ana Baptistella,Valéria Paschoal,Gilberti Hübscher

doi:10.3390/nu9060538

Abstract

Low-grade metabolic acidosis is a condition characterized by a slight decrease in blood pH, within the range considered normal, and feeding is one of the main factors that may influence the occurrence of such a condition. The excessive consumption of acid precursor foods (sources of phosphorus and proteins), to the detriment of those precursors of bases (sources of potassium, calcium, and magnesium), leads to acid-base balance volubility. If this condition occurs in a prolonged, chronic way, low-grade metabolic acidosis can become significant and predispose to metabolic imbalances such as kidney stone formation, increased bone resorption, reduced bone mineral density, and the loss of muscle mass, as well as the increased risk of chronic diseases such as type 2 diabetes mellitus, hypertension, and non-alcoholic hepatic steatosis. Considering the increase in the number of studies investigating the influence of diet-induced metabolic acidosis on clinical outcomes, this review gathers the available evidence evaluating the association of this disturbance and metabolic imbalances, as well as related mechanisms. It is necessary to look at the western dietary pattern of most countries and the increasing incidence of non-comunicable diseases for the balance between fruit and vegetable intake and the appropriate supply of protein, mainly from animal sources, so that it does not exceed the daily recommendations.

Highlights

Maintaining the acid-base balance is one of the most strongly regulated variables in human physiology
Studies have shown that diets with high values of net endogenous acid production (NEAP) and potential renal acid load (PRAL) may predispose to several metabolic damages, such as the stimulation of bone resorption associated with a decrease in bone mineral density and bone mass, leading to a higher risk of fractures
There are some interventional and observational studies showing that increasing fruit and vegetable consumption is associated with better bone outcomes, such as reduced reabsorption markers excretion, an increased bone mineral content, and lower fractures and osteoporosis risk [27,71,72,73]

Summary

Introduction

Maintaining the acid-base balance is one of the most strongly regulated variables in human physiology. Any change in blood pH, which is maintained within the range of 7.35–7.45, tends to be rapidly controlled by the body’s buffer systems in order to avoid acidaemia (pH lower than 7.35) or alkalosis (pH higher than 7.45) [1]. In parallel to the definitions of acidaemia and alkalosis, it is reported that there may be minimal changes in the value of plasma bicarbonate and blood pH within the range considered normal. This condition, when the pH is balanced at values close to the lower limit (7.35), is called low-grade metabolic acidosis. There are some factors that can lead to low-grade metabolic acidosis, and diet is one of the main factors that may influence the occurrence of this condition [3]

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Conclusion