Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents

Remer, Thomas; Dimitriou, Triantafillia; Manz, Friedrich

doi:10.1093/ajcn/77.5.1255

Cited by 292 publications

(320 citation statements)

References 37 publications

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“…Acid-base balance Net acid excretion (NAE ind ) of the subjects was estimated indirectly from the diet by the method of Remer and Manz (Remer et al, 2003): Sodium and chlorine were not included in the calculation as salt intake was not measured and these elements tend to balance each other. Calcium was also omitted as it has the smallest impact on acid-base balance (Remer et al, 2003). The subjects were grouped in fifths of NAE ind (both sexes combined), in order to examine the other characteristics of their diet for each fifth.…”

Section: Coding and Nutrient Analysismentioning

confidence: 99%

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Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

et al. 2004

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Objectives: To evaluate the diet of 16-18-y-old boys and girls with particular reference to intakes of nutrients believed to affect bone health and dietary acid-base balance. Design: A 7-day food diary was completed between the months of October and December. Setting: Cambridge, UK Subjects: A total of 111 boys and 101 girls aged 16-18 y who were recruited into the Cambridge Bone Studies. Main outcome measures: Mean daily intakes of foods and selected nutrients (protein, calcium, phosphorus, magnesium, potassium, vitamins C and K) were calculated. Two estimates of acid-base balance were calculated from the diet using the formulae of Remer (net acid excretion, estimated indirectly; NAE ind ) and Frassetto (protein/potassium ratio). Results: Mean calcium and phosphorus intakes were above the UK Reference Nutrient intake (RNI). In all, 39% of the boys and 36% of the girls had vitamin K intakes lower than 1 mg/kg body weight/day. Calcium intake was positively correlated with all other nutrients except vitamins C and K. Boys had a significantly higher estimated net acid excretion (NAE ind ) than girls (Po0.001). Although a strong correlation (r ¼ 0.76, Po0.001) was found between the two methods, at higher acid levels a divergence was observed. A significant positive correlation was found between NAE ind and the weight consumed per day of milk, cheese, meat and cereal foods and a negative correlation was found with the weight of potatoes and fruit. Diet composition is such that a lower NAE ind is accompanied by a lower calcium intake. Conclusions: The interpretation of the effects of calcium and other nutrients on bone cannot be considered in isolation from the other components of the diet. These results challenge some of the accepted perceptions about what constitutes an optimal diet for the promotion of bone health in adolescents.

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Section: Coding and Nutrient Analysismentioning

confidence: 99%

“…The method of Remer and Manz takes into account the range of nutrients previously described and it adjusts for nutrient absorption and body size (Manz et al, 1984). This method has also been validated against renal net acid excretion in adults and adolescents (Remer & Manz, 1994;Remer et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

et al. 2004

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“…Montenegro-Bethancourt (2013) provided, for the first time, evidence for an association between fruit and vegetables intake and children hydration status. Although other authors (26,27) speculated that fruit and vegetables were an essential predictor of hydration status, we also assessed the association with other food groups such as "milk and dairy products", and "coffee, barley, sodas, juices and water". Nonetheless, our findings revealed that only high "fruit and vegetables" intake was significantly associated with a better hydration status.…”

Section: Discussionmentioning

confidence: 99%

Dietary intake according to hydration status in 9-10 year-old soccer players

et al. 2016

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Introduction: Children have an increased risk of voluntary dehydration especially during physical activity which may increase the risk of non-compensating water losses. Objectives: The aim of this study was to assess the hydration status and its relation to food intake in a children group of soccer players. Method: A sample of 36 boys aged 9-10 years was included in this study; 30 completed a 24 h urine collection. Participants completed a 24 h urine collection; a 24 hours food recall corresponding to the day of urine collection was applied, weight and height were measured and parents/caregivers fi lled a lifestyle and socio-demographic questionnaire. The free water reserve (FWR [ml/24 h] = urine volume [ml/24 h] -obligatory urine volume [ml/24 h]) was used to assess the hydration status. Food and beverage groups were created and models of unconditional logistic regression were fi tted in order to estimate the magnitude of the association between the hydration status and diet. Results: Forty three per cent of participants were classifi ed as at risk of hypohydration. Children who reported a high fruit and vegetables intake (above the median) were at decreased risk of hypohydration (OR = 0.19, 95% CI 0.04-0.94, p = 0.041), compared to children who reported a low fruit and vegetables intake. Conclusions: Almost half of the children were at risk of hypohydration. Our results suggested that water food sources such as fruit and vegetables may contribute to euhydration.

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“…Assessment of dietary acid load scores and dietary patterns PRAL and NEAP scores were derived from estimations of several nutrient intakes [17] Quartiles of the scores were used for statistical analysis. A second strategy to identify diabetes cases used first information exclusively from the drug reimbursement database (n =1,216 participants, who did not self-report any information on diabetes, and had at least one diabetes drug reimbursed).…”

Section: Assessment Of Dietary Informationmentioning

confidence: 99%

Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study

et al. 2013

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Aims/hypothesis The objective of this study was to evaluate the prospective relationship between dietary acid load, assessed with both the potential renal acid load (PRAL) and the net endogenous acid production (NEAP) scores, and type 2 diabetes risk. Methods A total of 66,485 women from the E3N-EPIC cohort were followed for incident diabetes over 14 years. PRAL and NEAP scores were derived from nutrient intakes. HRs for type 2 diabetes risk across quartiles of the baseline PRAL and NEAP scores were estimated with multivariate Cox regression models. Results During follow-up, 1,372 cases of incident type 2 diabetes were validated. In the overall population, the highest PRAL quartile, reflecting a greater acid-forming potential, was associated with a significant increase in type 2 diabetes risk, compared with the first quartile (HR 1.56, 95% CI 1.29, 1.90). The association was stronger among women with BMI <25 kg/m 2 (HR 1.96, 95% CI 1.43, 2.69) than in overweight women (HR 1.28, 95% CI 1.00, 1.64); statistically significant trends in risk across quartiles were observed in both groups ( p trend <0.0001 and p trend =0.03, respectively). The NEAP score provided similar findings. Conclusions/interpretationWe have demonstrated for the first time in a large prospective study that dietary acid load was positively associated with type 2 diabetes risk, independently of other known risk factors for diabetes. Our results need to be validated in other populations, and may lead to promotion of diets with a low acid load for the prevention of diabetes. Further research is required on the underlying mechanisms.

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Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents

Cited by 292 publications

References 37 publications

Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

Dietary acid–base balance and intake of bone-related nutrients in Cambridge teenagers

Dietary intake according to hydration status in 9-10 year-old soccer players

Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study

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