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Dietary Acid-Base Balance, Bone Resorption, and Calcium Excretion

Division of Rheumatology, Tufts-New England Medical Center (R.J.)
Bone Metabolism Laboratory (L.S., S.S.H., B.D.-H.)
Nutrition Services Department, Metabolic Research Unit (H.R.), Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts

Address correspondence to: Bess Dawson-Hughes, M.D., Bone Metabolism Laboratory at the Jean Mayer, USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St. Boston, MA 02111. E-mail: Bess.Dawson-Hughes{at}Tufts.edu

Objective: Metabolic studies reveal that acidogenic diets increase bone resorption acutely. This study was conducted to examine associations between diet-induced changes in net acid excretion (NAE) and changes in serum parathyroid hormone (PTH), bone resorption, and calcium excretion over a longer period of 60 days.

Methods: Forty healthy older men and women were given 0.75 g/kg of protein as meat, 600 mg of calcium, and 400 IU of vitamin D₃ daily and either cereal (acidogenic) or fruit and vegetable (alkalinogenic) foods as substitutes for some of the cereal in their usual diets. Blood and 24-hr urine measurements were made on days 14 (baseline), 44, and 74.

Results: In all subjects, change in renal NAE was correlated with changes in serum PTH (r = 0.358, P = 0.023), urinary N-telopeptide (NTX) (r = 0.367, P = 0.020), and urinary calcium excretion (r_p = 0.381, P = 0.020, after adjustment for diet group, change in PTH, and change in sodium excretion).

Conclusions: Diet changes that increase renal NAE are associated with increases in serum PTH, bone resorption, and calcium excretion over a 60-day period.

Key words: net acid excretion, calcium excretion, N-telopeptide, PTH

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