Journal
FOOD SCIENCE & NUTRITION
Volume 10, Issue 6, Pages 2091-2100Publisher
WILEY
DOI: 10.1002/fsn3.2825
Keywords
dietary acid load; epidemiology; NEAP; NHANES; nutrition; plant-based diet; PRAL; vegetarian
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Dietary acid load (DAL) plays a significant role in maintaining pH balance in the body. Diets high in acid-producing foods are associated with health risks, while plant-based diets, such as vegetarian diets, can help reduce acid load.
Dietary acid load (DAL) is an important determinant of systemic pH and acid-base homeostasis. Diets abundant in acidogenic foods, such as meat and meat products, induce a low-grade metabolic acidosis state that has been associated with cardiovascular disease, type-2-diabetes, and an increased cancer risk. Fruits and vegetables have alkalizing properties and beneficially affect DAL. It has thus been suggested that a plant-based diet (restricting or excluding animal products) may be a powerful tool in reducing DAL; yet studies in that particular field are scarce. To explore these associations in greater detail, we examined DAL in self-identified vegetarians from the United States National Health and Nutrition Examination Survey (2007-2010). We compared dietary intake and two widely used markers of DAL (PRAL (potential renal acid load) and NEAP (net endogenous acid production; NEAP(F) and NEAP(R))) among 8,398 nonvegetarians and 191 lacto-ovo-vegetarians with reliable dietary intake aged 18 years or older. Vegetarians had a more favorable body mass index and consumed fewer calories (1862.31 kcal/d) than nonvegetarians (2041.12 kcal/d). Vegetarians consumed fewer protein (34.17 g/1000 kcal) and phosphorus compared to nonvegetarians (39.50 g of protein/1000 kcal) but had a higher intake of magnesium and potassium. Nonvegetarians exhibited higher median DAL scores (PRAL: 11.90 mEq/d, NEAP(F): 53.59 mEq/d, NEAP(R): 55.67 mEq/d) than vegetarians (PRAL: -0.44 mEq/d, NEAP(F): 39.60 mEq/d, NEAP(R): 41.30 mEq/d). Vegetarians had more favorable DAL scores compared to nonvegetarians in this descriptive epidemiologic study. Future (interventional) trials are warranted to examine the varying acid load in different plant-based dietary patterns.
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