A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Previous studies suggest that dietary patterns that promote acidosis may have a negative effect on bone density, whereas a more alkaline‐based profile would be associated with better bone health. Thus, the aim of this study was to assess, in omnivores, vegetarians, and vegans bone mineral density using Dual‐energy X‐ray absorptiometry (DEXA) and compare it to their acid‐base status as indicated by urinary pH, Potential Renal Acid Load (PRAL) and serum anion gap. Our hypothesis was that plant‐based diets would be associated with a more alkaline acid‐base profile than omnivorous diets, and thus have a higher bone mineral density. Methods: We conducted a cross‐sectional study where we compared plant based vs. omnivorous diets. Eighty‐two subjects were enrolled in the study (27 omnivores, 27 vegetarians, and 28 vegans). Subjects were asked to fill out a medical history form and a 24‐ hour diet recall, and to complete a 24‐hour urine collection. After a few weeks, subjects returned to the test site to complete a DEXA scan. Acid base‐balance and bone health were determined using PRAL, urine pH, and anion gap as biomarkers for pH, and DEXA as an indicator of bone density. Our results showed that bone mineral density did not differ significantly between groups, although lacto‐ovo and vegan diets were more alkaline compared to meat based diets (6.5  0.4, 6.7  0.4, and 6.2  0.4 pH respectively, p = 0.003). Protein intake was found to be reduced by ~30% in individuals adhering to a lacto‐ovarian or vegan diet; yet protein was only associated with bone mineral density in those following vegan diets. Conversely, urinary pH was associated with bone mineral density only in those following a meat‐based diet. The significance of this study is that it provides knowledge in the area of osteoporosis prevention and perhaps specific recommendations based on diet groups: increased fruit and vegetable intake for those with high meat consumption, to improve the acid‐base homeostasis, and increased plant protein intake for individuals who follow a plant-based diet.