Dietary acid load (DAL) is recognized as a risk factor for several chronic disorders, including obesity, diabetes, and osteoporosis. Recent evidence suggests that an elevated DAL, as measured by the ...validated potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores, could also increase the risk for several cancers. This narrative review summarizes the potential role of DAL in Uruguayan cancer patients and outlines the potentially involved pathophysiological pathways that mediate the role of DAL in both cancer development and growth. Although Uruguay is a developing country, its average diet is a heavily meat-based Western one, translating into a supraphysiological acid burden from diet. In recent years, we have published epidemiologic evidence based on ten case-control studies involving 3736 cancer cases and 9534 hospital-based controls. Odds ratios and 95% confidence intervals were estimated for each interest variable to analyze the association between the exposure levels of DAL scores and cancer, calculated by unconditional logistic regression. In a majority of the cases, the highest DAL scores tended to double the cancer risk as compared to the lowest category. We also found high risks for methionine intake, an acidifying amino acid found in higher concentrations in animal-based foods, which may increase cancer risks at least by a joint action based on the pH and the proliferation enhancing properties of the amino acid itself.
The dietary acid load (DAL) is a novel marker of overall diet quality, which has been associated with overweight, type 2 diabetes and altered glucocorticoid secretion. A potential association with ...sex hormones is thus not inconceivable. We investigated whether DAL was associated with serum total testosterone concentrations of men in the National Health and Nutrition Examination Survey. The DAL scores, including the potential renal acid load (PRAL) and net endogenous acid production (NEAP), were estimated and compared between participants with low and normal testosterone levels. The investigated sample encompassed
= 377 males with a mean age of 49.50 years. Approximately 73% of the sample were of Non-Hispanic White origin. None of the examined DAL scores showed significant associations with serum testosterone levels. We observed no significant differences in the crude DAL scores between individuals with low testosterone levels and individuals with normal testosterone levels. Multivariate regression models adjusting for covariates confirmed the lack of associations between the PRAL and serum testosterone. Our results are of particular importance for those individuals who wish to lower their DAL in light of the presumable health effects of a more alkaline diet. Our data suggest that diet modifications toward a lower intake of animal protein and refined grains (which consecutively translates into a lower DAL) may not negatively affect men's testosterone levels.
Key information necessary to upload a report include the precise elective destination (e.g. country, city, hospital name), the elective year, the elective discipline and duration, a subjective ...elective rating (ranging from 1 to 6, whereby 1 is the best and 6 is the worst grade), and a short comment allowing a brief narrative summary of the elective experience. Many students were surprised that students are denied hands-on experience in Japan by law prior to graduation, although this is usually explicitly mentioned on the elective program homepages. ...n=5 students (13.89%) expressed their appreciation for the high technical standard in Japanese hospitals, particularly in terms of medical equipment and workflow. Hosting elective students is time-consuming and requires human resources.
The gluten-free diet (GFD) ensures improvement of clinical symptoms in the vast majority of celiac disease (CD) patients. Despite stable CD rates in many countries, an increasing number of healthy ...individuals are adopting gluten-free diets, believing that this diet is an inherently healthier choice. The health effects of gluten-free diets are controversial, and a recent study added to the debate by reporting a lower acidogenic potential of this diet. The effects of the GFD on potential renal acid load (PRAL) and net endogenous acid production (NEAP)—two important markers of dietary acid load (DAL)—are poorly understood, and have never been examined in a Western population. Using cross-sectional data from the National Health and Nutrition Examination Surveys, we estimated DAL in U.S. individuals reporting a GFD and contrasted the results to the general U.S. population consuming gluten and denying special diets. The GFD was associated with significantly lower crude DAL scores, and after adjustments for confounders in multivariate regression, the results remain significant. Yet, our study could not confirm the reported alkalizing properties of the GFD. Although overall DAL scores were significantly lower in the GFD group, they were comparable to Western diets producing 50–75 mEq of acid per day.
Dietary acid load (DAL) is an important determinant of systemic pH and acid–base homeostasis. Diets abundant in acidogenic foods, such as meat and meat products, induce a low‐grade metabolic acidosis ...state that has been associated with cardiovascular disease, type‐2‐diabetes, and an increased cancer risk. Fruits and vegetables have alkalizing properties and beneficially affect DAL. It has thus been suggested that a plant‐based diet (restricting or excluding animal products) may be a powerful tool in reducing DAL; yet studies in that particular field are scarce. To explore these associations in greater detail, we examined DAL in self‐identified vegetarians from the United States National Health and Nutrition Examination Survey (2007–2010). We compared dietary intake and two widely used markers of DAL (PRAL (potential renal acid load) and NEAP (net endogenous acid production; NEAPF and NEAPR)) among 8,398 nonvegetarians and 191 lacto‐ovo‐vegetarians with reliable dietary intake aged 18 years or older. Vegetarians had a more favorable body mass index and consumed fewer calories (1862.31 kcal/d) than nonvegetarians (2041.12 kcal/d). Vegetarians consumed fewer protein (34.17 g/1000 kcal) and phosphorus compared to nonvegetarians (39.50 g of protein/1000 kcal) but had a higher intake of magnesium and potassium. Nonvegetarians exhibited higher median DAL scores (PRAL: 11.90 mEq/d, NEAPF: 53.59 mEq/d, NEAPR: 55.67 mEq/d) than vegetarians (PRAL: −0.44 mEq/d, NEAPF: 39.60 mEq/d, NEAPR: 41.30 mEq/d). Vegetarians had more favorable DAL scores compared to nonvegetarians in this descriptive epidemiologic study. Future (interventional) trials are warranted to examine the varying acid load in different plant‐based dietary patterns.
This study demonstrated that a vegetarian diet is associated with a lower dietary acid load burden. In light of the various health repercussions of a high dietary acid load, our study suggests that plant‐based diets might be a potential strategy to lower systemic acid load.
Dietary acid load (DAL) is an important determinant of the acid-base balance in humans and has been associated with several chronic non-communicable diseases. Plant-based diets, including vegetarian ...and vegan diets, decrease DAL-although their alkalizing potential varies substantially. Their net effect on common DAL scores, including potential renal acid load and net endogenous acid production, has been insufficiently quantified and is poorly understood-particularly in populations outside of Europe and North America. We assessed the associations between three plant-based dietary patterns (flexitarian vs. lacto-ovo-vegetarian vs. vegan diet) and DAL scores in a healthy Venezuelan population in the metropolitan area of Puerto La Cruz, Venezuela. Substantial differences in DAL scores were observed, whereby the vegan diet yielded the highest alkalizing potential, followed by the lacto-ovo-vegetarian and the flexitarian diet. DAL scores were substantially lower in comparison to European and North American plant-based populations, probably due to the higher potassium intake (exceeding 4000 mg/d in vegans), the higher magnesium intake (390.31 ± 1.79 mg/d in vegans) and the lower intake of protein in vegans and lacto-ovo-vegetarians. Additional studies in other non-industrialized populations are warranted to allow for a better understanding of the (numeric) impact of plant-based dietary patterns on DAL scores, potentially allowing for an establishment of reference ranges in the near future.
With the increasing adoption of plant-based diets in the United States, more and more individuals replace cow milk with plant-based milk alternatives. Soy milk is a commonly used cow milk substitute, ...which is characterized by a higher content of polyunsaturated fatty acids and fibers. Despite these favorable characteristics, little is known about the current prevalence of soy milk consumption the United States. We used data from the National Health and Nutrition Examination Surveys (NHANES) to assess soy milk usage in the United States and identified potential predictors for its consumption in the US general population. The proportion of individuals reporting soy milk consumption in the NHANES 2015-2016 cycle was 2%, and 1.54% in the NHANES 2017-2020 cycle. Non-Hispanic Asian and Black ethnicities (as well as other Hispanic and Mexican American ethnicities in the 2017-2020 cycle) significantly increased the odds for soy milk consumption. While a college degree and weekly moderate physical activity were associated with significantly higher odds for consuming soy milk (OR: 2.21 and 2.36, respectively), sex was not an important predictor. In light of the putative health benefits of soy milk and its more favorable environmental impact as compared to cow milk, future investigations should attempt to identify strategies that may help promote its consumption in selected populations.
Atrial fibrillation is the most prevalent cardiac arrhythmia in the clinical setting affecting approximately 34 million individuals worldwide. The disease is associated with a significant burden of ...morbidity and mortality resulting from stroke, heart failure, and acute coronary syndrome. Atrial fibrillation is now a major public health problem with tremendous implications on the economy and the world's healthcare systems. Numerous risk factors and clinical conditions that are associated with the development and progression of atrial fibrillation have been identified in the past. Within the last decades, a shift in awareness toward modifiable conditions has been observed and risk factor management has gained significant momentum. In light of this, dietary approaches are of paramount importance. Whole‐food plant‐based diets emphasizing grains, legumes, vegetables, fruits and nuts and excluding most (or all) animal products have recently experienced a significantly increased interest. The purpose of this review is to present evidence suggestive of a plant‐based diet being a valuable tool in atrial fibrillation risk factor management. The effects of a plant‐based diet on both established and emerging risk factors, such as inflammation and subclinical atherosclerosis, are reviewed in this article. A special focus is put on cardiovascular and metabolic risk factors including hypertension, coronary artery disease, diabetes, and obesity.
The market for plant-based milk alternatives has been growing continuously within the last years, and numerous new food items including almond, oat, and soy milk are nowadays commercially available. ...The impact of said foods on the acid-base balance in humans has been rarely assessed but is of great importance for individuals who adopt an alkaline diet for health reasons. Using the Potential Renal Acid Load (PRAL) score as a measurement of the amount of acid or base a certain food produces in the human body, we analyzed n = 39 plant-based milk items available on the German market. For this cross-sectional study, we used manufacturer-derived data and aimed to compare the PRAL values of different plant-based milks. The median PRAL score for all plant-based milk alternatives was −0.23 (2.14) mEq/100 ml, and indicated a slightly alkalizing potential. Soy milks yielded, on average, the lowest PRAL score (−1.11 ± 1.14 mEq/100 ml), whereas mixed milks were slightly acidifying (mean PRAL score: 0.19 ± 0.39 mEq/100 ml). When compared to the PRAL value of cow's milk, plant-based milk alternatives were slightly more alkaline. Our results allow for a better characterization of plant-based milk alternatives and are useful for individuals and researchers that aim to estimate the potential renal acid load from a growing group of food items.
Dietary fiber is of paramount importance in the prevention of large-bowel diseases, yet fiber intake in many high income countries is well below daily recommendations. Vegetarian diets high in ...fiber-rich plant-foods have been associated with a higher frequency of bowel movements and softer stools. Thus, vegetarians appear to suffer less frequently from constipation and other bowel disorders. The number of studies investigating these associations, however, is limited. The present study sought to investigate bowel health and constipation prevalence in a self-identified vegetarian population from the U.S. National Health and Nutrition Examination Survey (2007−2010). Bowel health assessment included Bristol Stool Scale (BSS), Bowel Movement (BM) frequency and Fecal Incontinence Severity Index (FISI). The present study included 9531 non-vegetarians and 212 vegetarians. We found no associations between vegetarian status and all examined bowel health items (BM frequency, BSS and FISI). Vegetarians consumed significantly more fiber than omnivores (21.33 vs. 16.43 g/d, p < 0.001) but had a lower moisture intake (2811.15 vs. 3042.78 g/d, p = 0.045). The lack of an association of vegetarian status and bowel health is surprising, and may be a result of the relatively low fiber intake in this particular vegetarian cohort, which did not meet the daily fiber recommendations.
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