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Comparison of Alkaline and Acid Base Diet Profiles and its Correlation with Bone Mineral Density: A Cross Sectional Investigation

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.

Identiferoai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/603559
Date23 March 2016
CreatorsAguayo, Izayadeth
ContributorsThe University of Arizona College of Medicine - Phoenix, Johnston, Carol PhD
PublisherThe University of Arizona.
Source SetsUniversity of Arizona
Languageen_US
Detected LanguageEnglish
TypeThesis
RightsCopyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.

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