Beyond Osteoporosis: Health Repercussions Of Metabolic Acidosis Besides Osteoporosis - Save Our Bones

The foods we consume play a crucial role in maintaining the acid-base balance in our blood. This simple fact is the key to understanding how the Osteoporosis Reversal Program uses diet to prevent and reverse osteoporosis.

In a state of low-grade metabolic acidosis, where the balance skews too acidic, the body begins to dissolve bone mass. That’s because the minerals in bone are alkalizing, and the body must maintain its alkaline pH.

Nonetheless, an excessively acidic pH does more than merely cause bone loss. Today we’ll look at some of the other health repercussions of metabolic acidosis and you’ll learn how to avoid them.

Dietary Acid Load

Diet is pivotal in maintaining the acid-base balance. As our bodies break down the foods we eat, the compounds and molecules that comprise those foods are released. Some compounds have an acidifying or alkalizing effect as they interact with our digestive system.

These compounds are termed as acid or alkali precursors. Acid precursors include phosphorus and some proteins. Alkali precursors include potassium, magnesium, and calcium.

The foods we consume determine the balance of acid and alkali precursors in our digestive system, which determines the pH levels of our blood.1

Our kidneys have a significant role in upholding healthy pH levels. They metabolize acid and alkali precursors and eliminate excess acid through urine. The measurement of this excess excreted acid is called net acid production (NEAP) and it can evidence an imbalance of dietary acid and alkali precursors.

The effect of a particular food or meal on our net acid production is termed as potential renal acid load (PRAL). Every food has a PRAL score that indicates whether it will acidify or alkalize the serum pH. Scientists have developed systems for assessing the potential renal acid load (PRAL) of a person’s diet and using PRAL to estimate their net acid production (NEAP). This illustrates the direct link between diet and pH levels.

A diet with a high PRAL score will correlate with a high NEAP level and indicates some degree of metabolic acidosis.1


Food contains acid and base precursors, which acidify or alkalize our blood pH levels. The measure of excess excreted acid is net acid production (NEAP), and the measurement of a food's impact on pH levels is potential renal acid load (PRAL). Diet directly impacts blood pH levels.

The Health Effects Of Metabolic Acidosis

Diets rich in acid-producing compounds and deficient in alkali-producing compounds like potassium, calcium, and magnesium can cause low-grade metabolic acidosis. Metabolic acidosis can lead to many disorders and harmful changes in your body.1

  • Increased Cortisol Levels – Cortisol, the stress hormone, is linked to increased inflammation. A chronically high cortisol level and the inflammation it causes contribute to many of the other health impacts of acidosis.
  • Sarcopenia – Sarcopenia refers to the loss of muscle mass. It's likely caused by cortisol increases that inhibit the production of protein for building muscle. This loss of muscle mass correlates to a loss of strength and increases the risk of frailty. Sarcopenia also impacts the ability to build bone, since muscle stimulates bone formation.
  • Hypertension – Hypertension denotes high blood pressure. Cortisol increases vasoconstriction, which raises blood pressure. Hypertension can lead to heart disease and stroke.
  • Diabetes and Insulin Resistance – Metabolic acidosis alters the expression of insulin receptors, causing insulin sensitivity. The sensitivity to insulin is a leading risk factor that leads to diabetes.
  • Non-Alcoholic Fatty Liver Disease – Another impact of insulin resistance is an increase in available free fatty acids, leading to non-alcoholic fatty liver disease. Over time inflammation and scarring of the liver can occur, which can lead to liver failure.
  • Chronic Kidney Disease – Metabolic acidosis can trigger an early and irreversible stage of chronic kidney disease. Once renal damage has developed, acidifying diets accelerate the progression of the disease.
  • Cardiovascular Disease and Death – Several of the impacts previously listed are risk factors for cardiovascular disease. Cardiovascular disease can be deadly, and in fact, is the leading cause of death worldwide. Studies in Japan found that participants with high-PRAL diets had a 16% increased likelihood of cardiovascular mortality, and a 13% increased likelihood of general mortality.1
  • Bone Loss – As Savers know, an acid blood pH causes bone loss. Metabolic acidosis both decreases the bone-building activity of osteoblasts and increases the bone resorption of osteoclasts. This may result in a decrease in bone mineralization and an increase in fractures.1


Metabolic acidosis can lead to a variety of health conditions, including hypertension, diabetes, insulin resistance, non-alcoholic fatty liver disease, chronic kidney disease, cardiovascular disease, and early death. Many of these are attributed to increases in cortisol caused by metabolic acidosis.

How To Avoid Metabolic Acidosis

As an acidifying diet primarily causes metabolic acidosis, adopting a pH-balanced diet is a direct and uncomplicated method to prevent it. The PRAL scoring system provides a precise and numerical way to measure how acidifying or alkalizing a food is.

Potential renal acid load describes the excretion of excess acid, so negative PRAL scores indicate a reduction in acid load, and positive scores indicate an increase in acid load. Below are a few examples of the PRAL scores of 100 grams of alkalizing and acidifying foods:1

*Foundation Food

Fruits and vegetables tend to be alkalizing, and most other foods tend to be acidifying. However, that doesn’t mean that acidifying foods are bad for you. It’s all about balance.

The Osteoporosis Reversal Program contains a complete list of alkalizing and acidifying foods to use when constructing pH-balanced meals. Every meal should contain about 80% alkalizing foods and 20% acidifying. The ORP's pH-balanced diet goes beyond improving your bone health, it also helps protect you from all of the ailments described above.

The system is user-friendly, requiring only a glance at your plate's composition, and offers enough flexibility to incorporate all your favorite foods in moderation.


You can avoid metabolic acidosis by eating a pH-balanced diet. The Osteoporosis Reversal program contains a complete list of alkalizing and acidifying foods and guidance on the 80/20 pH-balanced diet.

What This Means To You

Although the repercussions of an acidifying diet might require time for recovery, the acidification can be addressed rather swiftly. Our blood is constantly pumping, and our diet is continually altering our blood pH levels. Start eating a pH-balanced diet today to help your body get on track.

The Save Institute has created a special program to jumpstart your progress: the Osteoporosis Fresh Start Cleanse. It’s a 7-day program that fast-tracks your body’s ability to heal itself and grow stronger bones. With six simple steps, it will help you restore healthy pH levels and begin the journey to better health and stronger bones.

Consume a diverse and tasty pH-balanced diet that not only prevents acidosis but also promotes bone health, ensuring a long, independent life.



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Comments on this article are closed.

  1. Melinda

    Thank you for your most helpful information. I have your book and am following it, everything that you have told us is true. Thank you for information that the doctors won’t tell us.

    • Vivian Goldschmidt, MA

      You’re very welcome, Melinda 🙂

  2. Ann

    Very useful and needed information

    • Vivian Goldschmidt, MA

      My pleasure!

  3. Diana

    Outstanding information on how to influence healing from osteoporosis. I’m more confused as I was told recently to add more animal protein into my diet to help my bones. Would you please write an article on how to balance a diet higher in animal protein while remaining alkaline? Thank you Diana

    • Vivian Goldschmidt, MA

      I appreciate your kind words, Diana. To answer your question, acidifying animal protein contains all 9 essential amino acids and that’s what most likely prompted the advice you received. However, certain alkalizing foods, such as quinoa and soybeans also contain them. And a combination of foods can also provide those amino acids, such as rice and beans.

      Additionally, as explained in the ORP, what we really need are all the amino acids, but they don’t have to come from one source of food.

  4. K. Gopal Rao

    Veryinformative! Thx for Sharing.

    • Vivian Goldschmidt, MA

      You’re very welcome!

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