A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals

Abstract

The composition of diet strongly affects acid–base homeostasis. Western diets abundant in acidogenic foods (meat and cheese) and deficient in alkalizing foods (fruits and vegetables) increase dietary acid load (DAL). A high DAL has been associated with numerous health repercussions, including cardiovascular disease and type-2-diabetes. Plant-based diets have been associated with a lower DAL; however, the number of trials exploring this association is limited. This randomized-controlled trial sought to examine whether an isocaloric vegan diet lowers DAL as compared to a meat-rich diet. Forty-five omnivorous individuals were randomly assigned to a vegan diet (n = 23) or a meat-rich diet (n = 22) for 4 weeks. DAL was determined using potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores at baseline and after 3 and 4 weeks, respectively. After 3 weeks, median PRAL (−23.57 (23.87)) and mean NEAPR (12.85 ± 19.71) scores were significantly lower in the vegan group than in the meat-rich group (PRAL: 18.78 (21.04) and NEAPR: 60.93 ± 15.51, respectively). Effects were mediated by a lower phosphorus and protein intake in the vegan group. Our study suggests that a vegan diet is a potential means to reduce DAL, whereas a meat-rich diet substantially increases the DAL burden.

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

“…Our study provides evidence that a high diet-dependent acid load is common in cancer survivors in the NHANES and emphasizes the need for additional research in this area of current oncological interest. It is of utmost importance to highlight that DAL is an easily modifiable risk factor, as dietary interventions promoting more plant-based diets were shown to reduce acid load from diet [ 5 , 68 , 69 ]. The fact that our results still revealed a higher acid load in cancer survivors (who most likely modified and improved their diet after diagnosis) as compared to the general population reinforces this call.…”

“…We described the employed methods for the calculation of DAL in our previous publications in detail [ 5 , 22 ]. In brief, we used the formulas developed by Remer & Manz and Frassetto et al to calculate Net Endogenous Acid Production (NEAP) [ 2 ] and Potential Renal Acid Load (PRAL) from diet [ 6 , 46 , 47 ].…”

“…Diet affects the human acid-base status [ 1 ], and may influence systemic pH, metabolism and acid–base homeostasis [ 2 , 3 ]. Dietary acid load (DAL) is determined by the balance of base-inducing foods (such as fruits and vegetables) and acid-inducing foods (including meats, eggs, and cheese) [ 4 , 5 ]. Plant foods are abundant in metabolizable organic anions and generally decrease DAL, with green leafy vegetables (celery, broccoli, spinach), raisins and berries having a particularly alkalinizing effect [ 5 , 6 ].…”

“…Dietary acid load (DAL) is determined by the balance of base-inducing foods (such as fruits and vegetables) and acid-inducing foods (including meats, eggs, and cheese) [ 4 , 5 ]. Plant foods are abundant in metabolizable organic anions and generally decrease DAL, with green leafy vegetables (celery, broccoli, spinach), raisins and berries having a particularly alkalinizing effect [ 5 , 6 ]. In contrast, the oxidation of sulfur-containing amino acids (methionine, cysteine and homocysteine) found in meat and meat products generates sulfate and thereby increases DAL [ 7 , 8 ].…”

Analysis of S-Adenosylmethionine and S-Adenosylhomocysteine: Method Optimisation and Profiling in Healthy Adults upon Short-Term Dietary Intervention

“…We hypothesized that SAM and SAH concentration in human plasma may vary upon transition from an omnivorous diet into a vegan or meat-rich diet. To test the effect of a plant-based diet on SAM and SAH metabolism, we examined SAM and SAH concentrations in the plasma and urine of a well-characterised cohort of healthy omnivorous adults participating in a randomised controlled trial (RCT) with an intervention with either a vegan or a meat-rich diet (VD and MD, respectively) for 4 weeks [ 36 , 37 , 38 , 39 ]. Our study revealed similar variations in SAM and SAH concentrations from baseline to end of trial in the plasma and urine of healthy adults, regardless of dietary pattern.…”