Journal of Renal Nutrition
Volume 18, Issue 5 , Pages 456-465 , September 2008

Estimated Net Acid Excretion Inversely Correlates With Urine pH in Vegans, Lacto-Ovo Vegetarians, and Omnivores

  • Lynne M. Ausman, DSc, RD

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • Tufts Medical Center, Boston, Massachusetts
    • Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
    • Corresponding Author InformationAddress reprint requests to Lynne Ausman, DSc, RD, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave., Boston, MA 02111.
    • ,
  • Lauren M. Oliver, MS, RD

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Tufts Medical Center, Boston, Massachusetts
    • ,
  • Barry R. Goldin, PhD

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • ,
  • Margo N. Woods, DSc

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • ,
  • Sherwood L. Gorbach, MD

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • Tufts Medical Center, Boston, Massachusetts
    • ,
  • Johanna T. Dwyer, DSc, RD

      Affiliations

    • Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
    • Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • Tufts Medical Center, Boston, Massachusetts
    • Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts

References 

  1. Sherman H, Gettler A. The balance of acid forming and base forming elements in foods and its relation to ammonia metabolism. J Biol Chem. 1912;11:323–338
  2. Blatherwick N. The specific role of foods in relation to the composition of urine. Arch Intern Med. 1914;14:409–450
  3. Blatherwick N, Long M. Studies on urinary acidity II: the increased acidity produced by eating prunes and cranberries. J Biol Chem. 1923;57:815–818
  4. Breslau NA, Brinkley L, Hill KD, et al. Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Endocrinol Metab. 1988;66:140–146
  5. Ball D, Maughan RJ. Blood and urine acid-base status of premenopausal omnivorous and vegetarian women. Br J Nutr. 1997;78:683–693
  6. Kersetter JE, Wall DE, O'Brien KO, et al. Meat and soy protein affect calcium homeostasis in healthy women. J Nutr. 2006;136:1890–1895
  7. Grases F, Costa-Bauza A, Prieto RM: Renal lithiasis and nutrition. Nutr J 5:23(1-7), 2006. Available at http://www.nutritionj.com/content/5/1/23. Accessed May 6, 2008
  8. Kamel KS, Shafiee MA, Cheema-Dhadi S, et al. Studies to identify the basis for an alkaline urine pH in patients with calcium hydrogen phosphate kidney stones. Nephrol Dial Transplant. 2007;22:424–431
  9. Reddy TS, Wang C, Sakhaee K, et al. Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis. 2002;40:265–274
  10. Lutz J. Calcium balance and acid-base status of women as affected by increased protein intake and by sodium bicarbonate ingestion. Am J Clin Nutr. 1984;39:281–288
  11. Feskanich D, Willett WC, Stampfer MJ, et al. Protein consumption and bone fractures in women. Am J Epidemiol. 1996;143:472–479
  12. Sellmeyer DE, Stone KL, Sebastian A, et al. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Am J Clin Nutr. 2001;73:118–122
  13. Jehle S, Zanetti A, Muser J, et al. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. J Am Soc Nephrol. 2006;17:3213–3222
  14. Lemann J, Litzow JR, Lennon EJ. The effects of chronic acid loads in normal man: further evidence for the participation of bone mineral in the defense against chronic metabolic acidosis. J Clin Invest. 1966;45:1608–1614
  15. Buclin T, Cosma M, Appenzeller M, et al. Diet acids and alkalis influence calcium retention in bone. Osteoporos Int. 2001;12:493–499
  16. Lemann J, Bushinsky D, Hamm LL. Bone buffering of acid and base in humans. Am J Physiol Renal Physiol. 2003;285:F811–F832
  17. Massey LK, Barzel US. Excess dietary protein can adversely affect bone. J Nutr. 1998;128:1051–1053
  18. Tucker KL, Hanna MT, Chen H, et al. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr. 1999;69:727–736
  19. New SA, Robins SP, Campbell MK, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?. Am J Clin Nutr. 2000;71:142–151
  20. Macdonald HM, New SA, Fraser WD, et al. Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women. Am J Clin Nutr. 2005;81:923–933
  21. Dwyer J, Foulkes E, Evans M, et al. Acid/alkaline ash diets: time for assessment and change. J Am Diet Assoc. 1985;85:841–845
  22. Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994;59:1356–1361
  23. Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc. 1995;95:791–797
  24. Remer T, Dimitriou T, Manz F. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr. 2003;77:1255–1260
  25. Michaud DS, Troiano RP, Subar AF, et al. Comparison of estimated renal net acid excretion from dietary intake and body size with urine pH. J Am Diet Assoc. 2003;103:1001–1007
  26. Woods M, Goldin B, Gorbach S, et al. The effect of diet on estrogen, vitamin D, and bone density. Fed Proc. 1984;43:822
  27. Nutri-Calc, [computer program], PCD Systems, Inc. New York: Penn Yan, 1982
  28. Nutritive value of foods. Home and Garden Bulletin, No. 72. Washington DC, Consumer and Food Economics Research Division, Agricultural Research Service, United States Department of Agriculture. Revised 1970
  29. Adams CF (ed): Agriculture Handbook No. 456. Nutritive value of American foods in common units. Washington, D.C., Agricultural Research Service, U.S. Department of Agriculture, 1975
  30. Watt BK, Merrill A (eds): Composition of foods—raw, processed, prepared. Washington, D.C., Consumer and Food Economics Research Division, U.S. Department of Agriculture, 1963
  31. In:  Pennington J,  Church H editor. Bowes and Church's food values of portions commonly used. 13th ed.. Philadelphia: J.B. Lippincott Co.; 1980;
  32. In:  Kirschmann JD editors. Nutrition almanac: revised edition. New York: McGraw-Hill Book Co.; 1979;
  33. Sammonds K: Massachusetts Nutrient Data Bank. Amherst, MA, University of Massachusetts, 1984. Available at: http://www.umass.edu/sphhs/nutrition/outreach/mndb.html. Accessed May 6, 2008
  34. In:  Souci SW,  Fachmann W,  Kraut H editor. Food composition and nutrition tables 1981/82. Stuttgart: Wissenschaftliche Verlagsgesellschaft GmbH; 1981;
  35. Koivistoinen P (ed.): Mineral composition of Finnish foods: N, K, Ca, Mg, P, S, Fe, Cu, Nm, Zn, Mo, Co, Ni, Cr, F, Se, Si, Rb, Al, B, Br, Hg, As, Cd, Pb, and ash. Acta Agric Scand, 22:1–171, 1980
  36. In:  Paul AA,  Southgate DA editor. McCance & Widdowson's the composition of foods. New York: Elsevier/North-Holland Biomedical Press; 1978;
  37. In:  Mattice MR editors. Bridges' food and beverage analyses. 3rd ed.. Philadelphia: Lea & Febiger; 1950;
  38. Amino acid content of foods and biological data on proteins. Rome, Italy: Food and Agriculture Organization of the United Nations; 1970;
  39. Orr ML, Watt BK (eds): Home Economics Research Report No. 4: Amino Acid Content of Foods. Washington, D.C., Agricultural Research Service, U.S. Department of Agriculture, 1957
  40. SAS Institute, Inc.: SAS, version 9.1. Cary, NC: SAS Institute, Inc.
  41. Willett WC. Nutritional epidemiology. New York: Oxford University Press; 1990;272-291
  42. Heymsfield SB, Arteaga C, McManus C, et al. Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr. 1983;37:478–494
  43. MedlinePlus Medical Encyclopedia: National Institutes of Health and U.S. National Library of Medicine. Available at: http://www.nlm.nih.gov/medlineplus/encyc/article/003583.htm, updated February 3, 2006
  44. Coresh J, Astor BC, Greene T, et al. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2003;41:1–12
  45. Frassetto LA, Morris RC, Sebastian A. Effect of age on blood acid-base composition in adult humans: role of age-related renal functional decline. Am J Physiol. 1996;40:1114–1122
  46. Hamilton D, Riley P, Miola U, et al. Total plasma clearance of 51Cr-EDTA: variation with age and sex in normal adults. Nucl Med Commun. 2000;21:187–192
  47. Berg U. Differences in decline in GFR with age between males and females: reference data on clearances of inulin and PAH in potential kidney donors. Nephrol Dial Transplant. 2006;21:2577–2582
  48. Frassetto LA, Todd MK, Morris CR, et al. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr. 1998;68:576–583

 Disclaimer: This material is based on work supported by contract CB 74104 from the Breast Cancer Task Force of the National Cancer Institute and by the U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors, and do not necessarily reflect the view of the U.S. Department of Agriculture.

PII: S1051-2276(08)00302-6

doi: 10.1053/j.jrn.2008.04.007

Journal of Renal Nutrition
Volume 18, Issue 5 , Pages 456-465 , September 2008

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