Diet-induced metabolic acidosis
- PMID: 21481501
- DOI: 10.1016/j.clnu.2011.03.008
Diet-induced metabolic acidosis
Abstract
The modern Western-type diet is deficient in fruits and vegetables and contains excessive animal products, generating the accumulation of non-metabolizable anions and a lifespan state of overlooked metabolic acidosis, whose magnitude increases progressively with aging due to the physiological decline in kidney function. In response to this state of diet-derived metabolic acidosis, the kidney implements compensating mechanisms aimed to restore the acid-base balance, such as the removal of the non-metabolizable anions, the conservation of citrate, and the enhancement of kidney ammoniagenesis and urinary excretion of ammonium ions. These adaptive processes lower the urine pH and induce an extensive change in urine composition, including hypocitraturia, hypercalciuria, and nitrogen and phosphate wasting. Low urine pH predisposes to uric acid stone formation. Hypocitraturia and hypercalciuria are risk factors for calcium stone disease. Even a very mild degree of metabolic acidosis induces skeletal muscle resistance to the insulin action and dietary acid load may be an important variable in predicting the metabolic abnormalities and the cardiovascular risk of the general population, the overweight and obese persons, and other patient populations including diabetes and chronic kidney failure. High dietary acid load is more likely to result in diabetes and systemic hypertension and may increase the cardiovascular risk. Results of recent observational studies confirm an association between insulin resistance and metabolic acidosis markers, including low serum bicarbonate, high serum anion gap, hypocitraturia, and low urine pH.
Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Similar articles
-
Urinary pH and stone formation.J Nephrol. 2010 Nov-Dec;23 Suppl 16:S165-9. J Nephrol. 2010. PMID: 21170875 Review.
-
Urine anion gap in patients with chronic renal insufficiency.Nihon Jinzo Gakkai Shi. 1991 Sep;33(9):857-62. Nihon Jinzo Gakkai Shi. 1991. PMID: 1774842
-
Urinary stone formers with hypocitraturia and 'normal' urinary pH are at high risk for recurrence.Urol Int. 2012;88(3):294-7. doi: 10.1159/000335441. Epub 2012 Mar 7. Urol Int. 2012. PMID: 22398801
-
Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women.J Clin Endocrinol Metab. 1997 Jan;82(1):254-9. doi: 10.1210/jcem.82.1.3663. J Clin Endocrinol Metab. 1997. PMID: 8989270
-
Correction of metabolic acidosis to ameliorate wasting in chronic kidney disease: goals and strategies.Semin Nephrol. 2009 Jan;29(1):67-74. doi: 10.1016/j.semnephrol.2008.10.009. Semin Nephrol. 2009. PMID: 19121476 Review.
Cited by
-
Protein Intake and Oral Health in Older Adults-A Narrative Review.Nutrients. 2022 Oct 25;14(21):4478. doi: 10.3390/nu14214478. Nutrients. 2022. PMID: 36364741 Free PMC article. Review.
-
Maternal dietary patterns during pregnancy in relation to offspring forearm fractures: prospective study from the Danish National Birth Cohort.Nutrients. 2015 Apr 2;7(4):2382-400. doi: 10.3390/nu7042382. Nutrients. 2015. PMID: 25849947 Free PMC article.
-
The association between dietary acid load and adiposity measures among children and adolescents.BMC Pediatr. 2022 Aug 13;22(1):484. doi: 10.1186/s12887-022-03541-6. BMC Pediatr. 2022. PMID: 35962430 Free PMC article.
-
Association of Higher Intake of Plant-Based Foods and Protein With Slower Kidney Function Decline in Women With HIV.J Acquir Immune Defic Syndr. 2023 Nov 1;94(3):203-210. doi: 10.1097/QAI.0000000000003269. J Acquir Immune Defic Syndr. 2023. PMID: 37850979 Free PMC article.
-
Ameliorating Chronic Kidney Disease Using a Whole Food Plant-Based Diet.Nutrients. 2020 Apr 6;12(4):1007. doi: 10.3390/nu12041007. Nutrients. 2020. PMID: 32268544 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous
