A comprehensive review of studies on the impact of low-grade metabolic acidosis was published this year. The compiled research demonstrates the serious and wide-ranging negative health impacts of an acidifying diet.
In this article, we will review the findings of this new report and explain the mechanics behind metabolic acidosis. You'll learn about the factors that make a diet alkalizing or acidifying and how acidification can undermine your health and degrade the density and quality of your bones.
A pH-balanced diet is a core component of the Osteoporosis Reversal Program, and the latest research confirms its importance for maintaining strong bones and good health.
Dietary Acid Load And Low Grade Metabolic Acidosis
The new review, published in Pflügers Archiv: European Journal of Physiology, analyzes and presents findings from previous studies on how a high dietary acid load can lead to low-grade metabolic acidosis and cause a variety of health problems.
Dietary acid load (DAL) measures the acidification caused by diet. The foods we eat are metabolized into base components which may have an acidifying or alkalizing effect on the serum blood pH. These base component compounds are called acid or base precursors.
A high dietary acid load occurs when acid precursor foods (sources of phosphorus and proteins) outweigh base precursor foods (sources of potassium, calcium, and magnesium) in the diet.1
“Current Western diets are characterized by a high DAL, due to large amounts of animal protein and processed foods. A chronic low-grade metabolic acidosis can occur following a Western diet and is associated with increased morbidity and mortality.”1
Chronic low-grade metabolic acidosis, associated with increased morbidity, can manifest as various chronic health conditions, including osteoporosis.
Next, we'll review those health conditions and how low-grade metabolic acidosis contributes to their development.
Synopsis
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Dietary acid load (DAL) measures the acidification caused by a diet. Western diets tend to have a high DAL, which can lead to chronic low-grade metabolic acidosis associated with increased morbidity and mortality.
Low Grade Metabolic Acidosis And Osteoporosis
The body must ensure that blood pH remains within a particular range. When dietary acid load (DAL) is high, the body takes immediate action to balance out blood serum pH.
The first line of defense is the kidneys. They remove acidic compounds from the blood, which are then excreted in the urine. However, the kidneys have a limited capacity for acid-removal. If the DAL is too high and the kidneys can't keep up, the body resorts to more extreme measures.
Bones are composed of alkalizing minerals. In response to a high DAL, if the body cannot excrete enough acidifying compounds to restore balance, then it resorbs bone tissue and uses the alkalizing minerals from the bones to rebalance blood pH.
This is a critically important survival mechanism, but if one's diet is continually acidifying, then the body continually degrades the bones for alkalizing minerals. This bone loss contributes to osteoporosis.
The state caused by a perpetually high DAL, in which the body continually takes measures to prevent full acidosis, is called low-grade metabolic acidosis.2
This new study notes that, “As DAL is typically high in Western Diets, it has been hypothesized that this continuous acid stress will reduce bone mass..the ingestion of an acidifying diet is associated with the reduction of mineralization and bone mass, and a higher risk of fractures.”1
With age, kidney function declines, reducing the ability to excrete acid. This creates a vicious cycle of acidification and bone loss that can accompany aging. Avoiding low grade metabolic acidosis is crucial to preserving bone mass and preventing or reversing osteoporosis.
Synopsis
To maintain the correct blood serum pH the kidneys filter acidic components from the blood for excretion in the urine. If this process can't excrete enough acid, the body will resorb alkalizing minerals from bone to balance the pH. A continually high dietary acid load causes low-grade metabolic acidosis and bone loss.
Chronic Kidney Disease And Acidosis
Chronic kidney disease (CKD), in which the function of the kidneys declines dramatically, is a major cause of morbidity and mortality worldwide. An impairment of kidney function lasting three or more months qualifies as chronic kidney disease.
The condition is generally progressive and irreversible. One of its impacts is the reduction of the body's ability to regulate the acid-base balance, resulting in metabolic acidosis. Metabolic acidosis, in turn, can lead to muscle and bone loss, chronic inflammation, and mortality.
This study found that dietary acid load serves as a predictor of CKD, and the researchers noted the importance of considering interventions that include the frequent consumption of base-producing foods, such fruit and vegetables.1
Preventing chronic kidney disease also protects bone, since the kidneys prevent bone loss by regulating blood serum pH by removing acids.
Synopsis
High dietary acid load has been linked to the onset of chronic kidney disease. With the decline of kidney function, metabolic acidosis can develop and cause muscle loss, bone disease, chronic inflammation, and mortality. Kidney disease also endangers bone density and health.
Diabetes And Acidosis
The review analyzed several studies which found associations between a high dietary acid load and insulin resistance— even when excluding participants with diabetes or other metabolic disorders.1
The exact mechanism linking dietary acid load diabetes risk has not yet been conclusively determined. However, researchers have suggested that the maintenance of blood pH closer to the acidic limit of normal range may lead to a decrease in the uptake of glucose by muscle, the disruption of insulin binding to its receptor, and the inhibition of the insulin signaling pathway.
These impacts may lead to peripheral insulin resistance, which is the primary risk factor for the development of type 2 diabetes.
Synopsis
High dietary acid load has been linked to the development of type 2 diabetes. A blood pH consistently on the acidic end of the normal range, as occurs with low grade chronic acidosis, impacts glucose uptake and insulin binding and signaling, leading to insulin resistance.
Muscle Loss And Acidosis
The review of studies found evidence indicating that a high dietary intake of alkalizing potassium is associated with greater preservation of muscle mass in elderly individuals.2
Conversely, a high DAL diet contributes to muscle loss. The mechanism behind this effect likely involves a DAL-related increase in cortisol production. Cortisol, also known as the stress hormone, stimulates the degradation of amino acids– the building blocks of protein– for release into the blood stream.2 This harms the body's ability to maintain muscle.
Sarcopenia, the condition of reduced muscle mass and strength, can develop. This loss of muscle impacts bone because muscle stimulates bone production. As muscle decreases, so does bone mass, and the combination of factors increases the chance of both falls and fractures.
Synopsis
High dietary acid load contributes to muscle loss, which can cause sarcopenia (the state of reduced muscle mass and strength). Since muscle stimulates bone production, muscle loss contributes to bone loss.
Dietary Acid Load And Cancer
The review notes that multiple studies and other reviews have established a role for diet in cancer risk and mortality. The researchers site one large-scale prospective cohort study with 197,426 participants that identified an increased risk of overall cancer incidence in individuals adhering to a high ultra-processed food diet. Such a diet would have a very high dietary acid load.
The mechanism behind the incidence of DAL and cancer is unclear. It's possible that low grade metabolic acidosis may not be the cause of the cancer, but rather that both are caused by different facets of diet.
However, the researchers do state that, “a high DAL has been associated with increased insulin resistance which is suggested to be a driving force behind cancer development, especially in combination with increased (low-grade) inflammation and production of reactive oxygen species (ROS)”.1
One of the benefits of many alkalizing foods– such as fruits and vegetables– is that they tend to be rich in antioxidants that combat reactive oxygen species. This reduction of oxidative stress also protects the bone remodeling process from oxidative damage, rendering additional benefits to bone health.
Synopsis
DAL has been linked to increased incidence of cancer. While the mechanism is undetermined, researchers suggest it is related to increased insulin resistance, especially in combination with low grade inflammation and oxidative damage.
Reducing Dietary Acid Load
The researchers concluded their review with the following summation.
“From a population perspective, the importance of DAL is notable given that contemporary Western diets, characterized by a high intake of processed foods, animal protein, and salt, predominantly result in elevated DAL. While the body can effectively buffer transient elevations in DAL, chronic exposure may lead to (low-grade) metabolic acidosis. Such a state is recognized to elevate the risk of cardiometabolic diseases and cancer, thereby significantly affecting morbidity and mortality…
In order to lower DAL, dietary patterns rich in plant-based proteins, fruits, vegetables, and nuts are advisable. Examples of such dietary patterns are DASH and the Mediterranean diet.”1
Both of the diets named in the study are very close in practice to the Osteoporosis Reversal Program's 80/20 pH-balanced diet. The ORP's dietary plan is simpler to follow than those diets, and offers the same benefits.
In fact, the 80/20 pH-balanced diet is specifically designed to reduce your dietary acid load by organizing meals around a healthy balance of acidifying and alkalizing foods. By eating within the dietary acid load range that your body can easily manage, you can avoid low grade metabolic acidosis, and reduce your risk of the health problems associated with that condition.
Synopsis
The researchers concluded that in order to lower DAL, dietary patterns rich in plant-based proteins, fruits, vegetables, and nuts are advisable. The dietary pattern they describe overlaps closely with the Osteoporosis Reversal Program's 80/20 pH-balanced diet, which is designed to reduce DAL and prevent the bone loss that attends low-grade metabolic acidosis.
What This Means To You
Follow an 80/20 pH-balanced diet to reduce your dietary acid load, avoid low-grade metabolic acidosis, and protect your bones from resorption.
The Save Institute created Bone Appétit to make that easy to do. Bone Appétit is a cookbook and meal planner filled with pH-balanced and 100% alkalizing recipes that are easy to make and hard to resist.
From smoothies to entrees and breakfasts to desserts, Bone Appétit has all of your culinary needs covered. There's even a meal planner to help you take full advantage of the bone-building potential of the 80/20 pH-balanced diet.
The scientific consensus continues to grow around the dangers of low-grade metabolic acidosis and how eating right can help us live healthier longer lives.
Thanks Vivian, always a great read. I’ve been receiving your emails for many years; and following your program. In November I’ll be 93years old. My health is good; memory, eyesight too; I walk unaided (slowly); unfortunately at 80, I noticed I had scoliosis; it’s progressed and although I have no pain my back is weak- and it’s sufficient to stand straight. Mostly others shop and cook for me; I’m eating more bread and scones and biscuits; in the last 6 months my knees and fingers have become painful . I attend a GYM twice weekly (owned by my Great Nephew); since my knees became painful he had written a new program for me; but I know I need to reduce the bread.Blessings.
Thank you also.
You’re very welcome, Sandra! I’m thrilled to keep Savers informed about bone health and overall health!
Is apple cider vinegar acidic food to avoid? I started adding to vegetable to reduce blood sugar spike.
Julie, apple cider vinegar is alkalizing 🙂
Thank you always.
You’re welcome!
Thank you for all of the helpful information. I have gone from osteopenia to normal bone density. But I’ve also noticed that I have more energy, I don’t catch all of the sickness that goes around, and I feel like I did when I was much younger. Everything in this article is so true. Thank you again, you have been a life changer for me.
Thank you
My pleasure, Cheryl!
Thank you , Ita.
You’re very welcome, Ita!