Review Article The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? PDF
Preview Review Article The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?
HindawiPublishingCorporation JournalofEnvironmentalandPublicHealth Volume2012,ArticleID727630,7pages doi:10.1155/2012/727630 Review Article The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? GerryK.Schwalfenberg UniversityofAlberta,SuiteNo.301,9509-156Street,Edmonton,AB,CanadaT5P4J5 CorrespondenceshouldbeaddressedtoGerryK.Schwalfenberg,[email protected] Received3July2011;Accepted8August2011 AcademicEditor:JanetteHope Copyright©2012GerryK.Schwalfenberg. Thisisanopenaccess articledistributedunder theCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Thisreviewlooksattheroleofanalkalinedietinhealth.PubmedwassearchedlookingforarticlesonpH,potentialrenalacid loads,bonehealth,muscle,growthhormone,backpain,vitaminDandchemotherapy.Manybookswritteninthelayliterature onthealkalinedietwerealsoreviewedandevaluatedinlightofthepublishedmedicalliterature.Theremaybesomevaluein consideringanalkalinedietinreducingmorbidityandmortalityfromchronicdiseasesandfurtherstudiesarewarrantedinthis areaofmedicine. 1.Background decrease in potassium (K) compared to sodium (Na) and an increase in chloride compared to bicarbonate found in Life on earth depends on appropriate pH levels in and thediet[6].Theratioofpotassiumtosodiumhasreversed, around living organisms and cells. Human life requires a K/Na pre-viously was 10 to 1 whereas the modern diet has tightlycontrolledpHlevelintheserumofabout7.4(aslight- a ratio of 1 to 3 [7]. It is generally accepted that agricul- lyalkalinerangeof7.35to7.45)tosurvive[1]. tural humans today have a diet poor in magnesium and As a comparison, in the past 100 years with increasing potassium as well as fiber and rich in saturated fat, simple industrialization, the pH of the ocean has dropped from sugars, sodium, and chloride as compared to the pre-agri- 8.2 to 8.1 because of increasing CO2 deposition. This has a cultural period [6]. This results in a diet that may induce negative impact on life in the ocean [1, 2] and may lead to metabolic acidosis which is mismatched to the genetically the collapse of the coral reefs [3]. Even the pH of the soil determined nutritional requirements [8]. With aging, there in which plants are grown can have considerable influence is a gradual loss of renal acid-base regulatory function on the mineral content of the food we eat (as minerals are and a resultant increase in diet-induced metabolic acidosis used as buffers to maintain pH). The ideal pH of soil for while on the modern diet [9]. A low-carbohydrate high- thebestoverallavailabilityofessentialnutrientsisbetween6 pro-tein diet with its increased acid load results in very and7.AcidicsoilsbelowpHof6mayhavereducedcalcium little change in blood chemistry, and pH, but results in and magnesium, and soil above pH 7 may result in chemi- many changes in urinary chemistry. Urinary magnesium callyunavailableiron,manganese,copperandzinc.Adding levels,urinarycitrateandpHaredecreased,urinarycalcium, dolomiteandmanurearewaysofraisingpHinanacidsoil undissociated uric acid, and phosphate are in-creased. All environmentwhenthepHisbelow6[4]. of these result in an increased risk for kidney stones When it comes to the pH and net acid load in the [10]. human diet, there has been considerable change from the Much has been written in the lay literature as well as huntergathercivilizationtothepresent[5].Withtheagricul- manyonlinesitesexpoundingonthebenefitsofthealkaline tural revolution (last 10,000 years) and even more recently diet.Thispaperisanattempttobalancetheevidencethatis with industrialization (last 200 years), there has been an foundinthescientificliterature. 2 JournalofEnvironmentalandPublicHealth Table1:Phofselectedfluids,organs,andmembranes. Organ,fluidormembrane pH FunctionofpH (1)Skin NaturalpHisbetween4and6.5[17] Barrierprotectionfrommicrobes (2)Urine 4.6to8.0[18] Limitovergrowthofmicrobes (3)Gastric 1.35to3.5 Breakdownprotein (4)Bile 7.6to8.8 Neutralizestomachacid,aidindigestion (5)Pancreaticfluid 8.8 Neutralizestomachacid,aidindigestion (6)Vaginalfluid <4.7[13] Limitovergrowthofopportunisticmicrobes (7)Cerebrospinalfluid 7.3 Bathestheexteriorofthebrain (8)Intracellularfluid 6.0–7.2[19] Duetoacidproductionincells (9)Serumvenous 7.35 Tightlyregulated (10)Serumarterial 7.4 Tightlyregulated 2.TheRoleofpHinVariousCells,Organs, the urine with the modern diet over time could be as high andMembranes as almost 480gm over 20 years or almost half the skeletal mass of calcium [21]. However, urinary losses of cal-cium ThepHinourbodymayvaryconsiderablyfromoneareato are not a direct measure of osteoporosis. There are many anotherwiththehighestacidityinthestomach(pHof1.35 regulatoryfactorsthatmaycompensatefortheurinarycalci- to3.5)toaidindigestionandprotectagainstopportunistic um loss. When the arterial pH is in the normal range, a microbialorganisms.Buteveninthestomach,thelayerjust mild reduction of plasma bicarbonate results in a negative outside the epithelium is quite basic to prevent mucosal calcium balance which could benefit from supplementing injury. It has been suggested that decreased gastric lining bicarbonate in the form of potassium bicarbonate [22]. It secretionofbicarbonatesandadecreaseinthealkaline/acid has been found that bicarbonate, which increases the alkali secretion in duodenal ulcer patients may play a significant content of a diet, but not potassium may attenuate bone role in duodenal ulcers [11]. The skin is quite acidic (pH lossinhealthyolderadults[23].Thebonemineralsthatare 4–6.5) to provide an acid mantle as a protective barrier to wasted in the urine may not have complete compensation the environment against microbial overgrowth. There is a through intestinal absorption, which is thought to result in gradientfromtheouterhornylayer(pH4)tothebasallayer osteoporosis.However,adequatevitaminDwitha25(OH)D (pH6.9)[12].ThisisalsoseeninthevaginawhereapHof level of >80nmol/L may allow for appropriate intestinal lessthan4.7protectsagainstmicrobialovergrowth[13]. absorptionofcalciumandmagnesiumandphosphatewhen TheurinemayhaveavariablepHfromacidtoalkaline needed[24].Sadly,mostpopulationsaregenerallydeficient depending on the need for balancing the internal environ- in vitamin D especially in northern climates [25]. In ment. Acid excretion in the urine can be estimated by a chronic renal failure, correction of metabolic acidosis with formula described by Remer (sulfate + chloride + 1.8x bicarbonate significantly improves parathyroid levels and phosphate + organic acids) minus (sodium + potassium + levels of the active form of vitamin D 1,25(OH)2D [26]. 3 2xcalcium+2xmagnesium)mEq[14].Foodscanbecate- Recently, a study has shown the importance of phosphate gorizedbythepotentialrenalacidloads(PRALs)seeTable2. in Remer’s PRAL formula. According to the formula it Fruits, vegetables, fruit juices, potatoes, and alkali-rich and would be expected that an increase in phosphate should lowphosphorusbeverages(redandwhitewine,mineralsoda result in an increase in urinary calcium loss and a negative waters)havinganegativeacidload.Whereas,grainproducts, calcium balance in bone [27]. It should be noted that meats, dairy products, fish, and alkali poor and low phos- supplementation with phosphate in patients with bed rest phorusbeverages(e.g.,palebeers,cocoa)haverelativelyhigh reducedurinarycalciumexcretionbutdidnotpreventbone acidloads[15].MeasurementofpHoftheurine(reviewed loss [28]. The most recent systematic review and meta- in a recent study with two morning specimens done over a analysis has shown that calcium balance is maintained and five-yearspan)didnotpredictbonefracturesorlossofbone improved with phosphate which is quite contrary to the mineraldensity[16].However,thismaynotbereflectiveof acid-ash hypothesis [29]. As well a recent study looking at being on an alkaline or acid diet throughout this time. For soda intake (which has a significant amount of phosphate) moredetails,seeTable1. andosteoporosisinpostmenopausalAmericanfirstnations women did not find a correlation [30]. It is quite possible 3.ChronicAcidosisandBoneDisease thatthehighacidcontentaccordingtoRemer’sclassification needs to be looked at again in light of compensatory phos- Calciumintheformofphosphatesandcarbonatesrepresents phateintake.Thereisonlineinformationpromotinganalka- alargereservoirofbaseinourbody.Inresponsetoanacid linedietforbonehealthaswellasanumberofbooks.How- load such as the modern diet these salts are released into ever,arecentsystematicreviewoftheliteraturelookingfor thesystemiccirculationtobringaboutpHhomeostasis[7]. evidencesupportingthealkalinedietforbonehealthfound It has been estimated that the quantity of calcium lost in noprotectiveroleofdietaryacidloadinosteoporosis[31]. JournalofEnvironmentalandPublicHealth 3 Table2:Potentialrenalacidloads(PRALs)ofselectedfoods[20]. Foodorfoodgroup PRALmEqof:Cl+P0 +SO −Na−K−Ca−Mg 4 4 Dairy Parmesancheese 34.2 Processedcheeseplain 28.7 Cheddarreducedfat 26.4 Hardcheese(average) 19.2 Freshcheese(quark) 11.3 Cottagecheeseplain 8.7 Yogurtwholemilk 1.5 IceCream 0.8 Wholemilk 0.7 Buttermilk 0.5 Eggs Eggsyolk 23.4 Eggswhite 1.1 Eggschickenwhole 8.2 Meats Cornedbeef 13.2 Luncheonmeatcanned 10.2 Turkey 9.9 Veal 9.0 Leanbeef 7.8 Frankfurters 6.7 Sugars Sugarwhite −0.1 Honey −0.3 Vegetables Cucumber −0.8 Broccoli −1.2 Tomato −3.1 Eggplant −3.4 Celery −5.2 Spinach −14.0 FatsandOils Butter 0.6 Margarine −0.5 Oliveoil 0.0 Fruitsandnutsandfruitjuices Peanuts 8.3 Walnuts 6.8 Grapejuiceunsweetened −1.0 Orangejuiceunsweetened −2.9 Applesorapplejuiceunsweetened −2.2 Apricots −4.8 Banana −5.5 Blackcurrents −6.5 Raisins −21.0 Grainsandgrainproducts BrownRice 12.5 RolledOats 10.7 Spaghettiwholemeal 7.3 Spaghettiwhite 6.5 4 JournalofEnvironmentalandPublicHealth Table2:Continued. Foodorfoodgroup PRALmEqof:Cl+P0 +SO −Na−K−Ca−Mg 4 4 Cornflakes 6.0 Ricewhite 4.6 Breadryeflower 4.1 Breadwholewheat 1.8 Legumes Lentilsgreenandbrown 3.5 Greenbeans −3.1 Fish Troutbrown 10.8 Codfillets 7.1 Beverages Beerpale 0.9 Coca-Cola 0.4 Beerdraft −0.2 Winewhite −1.2 Coffeeinfusion −1.4 Winered −2.4 Anotherelementofthemoderndietistheexcessofsodi- prior to exhaustive exercise resulted in significantly less uminthediet.Thereisevidencethatinhealthyhumansthe acidosisinthebloodthanthosethatwerenotsupplemented increasedsodiuminthedietcanpredictthedegreeofhyper- withsodiumbicarbonate[42]. chloremic metabolic acidosis when consuming a net acid producingdiet[32].Aswell,thereisevidencethatthereare adverse effects of sodium chloride in the aging population. 5.AlkalineSupplementationand A high sodium diet will exacerbate disuse-induced bone GrowthHormone and muscle loss during immobilization by increasing bone resorption and protein wasting [33]. Excess dietary sodium It has long been known that severe forms of metabolic hasbeenshowntoresultinhypertensionandosteoporosisin acidosis in children, such as renal tubular acidosis, are as- women[34,35].Aswell,dietarypotassiumwhichislacking sociated with low levels of growth hormone with resultant in the modern diet would modulate pressor and hyper- short stature. Correction of the acidosis with bicarbonate calciuriceffectsofexcessofsodiumchloride[36]. [7]orpotassiumcitrate[43]increasesgrowthhormonesig- Excess dietary protein with high acid renal load may nificantly and improved growth. The use of enough pota- decreasebonedensityifnotbufferedbyingestionofsupple- ssium bicarbonate in the diet to neutralize the daily net ments or foods that are alkali rich [37]. However, adequate acidloadinpostmenopausalwomenresultedinasignificant protein is necessary for prevention of osteoporosis and increaseingrowthhormoneandresultantosteocalcin[44]. sarcopenia;therefore,increasingtheamountoffruitandveg- Improving growth hormone levels may improve quality of etablesmaybenecessaryratherthanreducingprotein[38]. life, reduce cardiovascular risk factors, improve body com- position,andevenimprovememoryandcognition[45].As wellthisresultsinareductionofurinarycalciumlossequi- 4.AlkalineDietsandMuscle valentto5%ofbonecalciumcontentoveraperiodof3years [46]. Asweage,thereisalossofmusclemass,whichmaypredis- pose to falls and fractures. A three-year study looking at a dietrichinpotassium,suchasfruitsandvegetables,aswell 6.AlkalineDietandBackPain as a reduced acid load, resulted in preservation of muscle mass in older men and women [39]. Conditions such as Thereissomeevidencethatchroniclowbackpainimproves chronicrenalfailurethatresultinchronicmetabolicacidosis with the supplementation of alkaline minerals [47]. With result in accelerated breakdown in skeletal muscle [40]. supplementationtherewasaslightbutsignificantincreasein Correction of acidosis may preserve muscle mass in condi- bloodpHandintracellularmagnesium.Ensuringthatthere tions where muscle wasting is common such as diabetic is enough intracellular magnesium allows for the proper ketosis,trauma,sepsis,chronicobstructivelungdisease,and functionofenzymesystemsandalsoallowsforactivationof renal failure [41]. In situations that result in acuteacidosis, vitaminD[48].Thisinturnhasbeenshowntoimproveback supplementing younger patients with sodium bicarbonate pain[49]. JournalofEnvironmentalandPublicHealth 5 7.AlkalinityandChemotherapy (2)The resultant increase in growth hormone with an alkalinedietmayimprovemanyoutcomesfromcar- The effectiveness of chemotherapeutic agents is markedly diovascularhealthtomemoryandcognition. influencedbypH.Numerousagentssuchasepirubicinand adriamycin require an alkaline media to be more effective. (3)Anincreaseinintracellularmagnesium,whichisre- quired for the function of many enzyme systems, is Others, such as cisplatin, mitomycin C, and thiotepa, are another added benefit of the alkaline diet. Available more cytotoxic in an acid media [50]. Cell death correlates magnesium, which is required to activate vitamin withacidosisandintracellularpHshiftshigher(morealka- D, would result in numerous added benefits in the line)afterchemotherapymayreflectresponsetochemother- vitaminDapocrine/exocrinesystems. apy[51].Ithasbeensuggestedthatinducingmetabolicalka- losismaybeusefulinenhancingsometreatmentregimesby (4)Alkalinity may result in added benefit for some using sodium bicarbonate, carbicab, and furosemide [52]. chemotherapeuticagentsthatrequireahigherpH. Extracellular alkalinization by using bicarbonate may result in improvements in therapeutic effectiveness [53]. There is Fromtheevidenceoutlinedabove,itwouldbeprudentto noscientificliteratureestablishingthebenefitofanalkaline consideranalkalinediettoreducemorbidityandmortality dietforthepreventionofcanceratthistime. of chronic disease that are plaguing our aging population. Oneofthefirstconsiderationsinanalkalinediet,whichin- cludes more fruits and vegetables, is to know what type of 8.Discussion soiltheyweregrowninsincethismaysignificantlyinfluence themineralcontent.Atthistime,therearelimitedscientific Thehumanbodyhasanamazingabilitytomaintainasteady studiesinthisarea,andmanymorestudiesareindicatedin pH in the blood with the main compensatory mechanisms regardstomuscleeffects,growthhormone,and interaction beingrenalandrespiratory.Manyofthemembranesinour withvitaminD. bodyrequireanacidpHtoprotectusandtohelpusdigest food.Ithasbeensuggestedthatanalkalinedietmayprevent anumberofdiseasesandresultinsignificanthealthbenefits. References Lookingattheabovediscussiononbonehealthalone,certain [1] A.WaughandA.Grant,AnatomyandPhysiologyinHealthand aspects have doubtful benefit. There does not seem to be Illness,ChurchillLivingstoneElsevier,Philadelphia,Pa,USA, enoughevidencethatmilkorcheesemaybeasdetrimentalas 10thedition,2007. Remer’sformulasuggestssincephosphatedoesbenefitbone [2] University,BirminghamoAa,“Oceansrevealfurtherimpacts health and result in a positive calcium balance. However, ofclimatechange,”ScienceDaily,2010. another mechanism for the alkaline diet to benefit bone [3] O.Hoegh-Guldberg,P.J.Mumby,A.J.Hootenetal.,“Coral healthmaybetheincreaseingrowthhormoneandresultant reefs under rapid climate change and ocean acidification,” increaseinosteocalcin.ThereissomeevidencethattheK/Na Science,vol.318,no.5857,pp.1737–1742,2007. ratio does matter and that the significant amount of salt in [4] J. Dam-ampai SO and C. Nilnond, “Effect of cattle manure ourdietisdetrimental.Evensomegovernmentsaredemand- anddolomiteonsoilpropertiesandplantgrowthinacidup- ing that the food industry reduce the salt load in our diet. landsoils,”SongklanakarinJournalofScienceandTechnologh, High-proteindietsmayalsoaffectbonehealthbutsomepro- vol.27,supplement3,pp.727–737,2005. [5] A. Stro¨hle, A. Hahn, and A. Sebastian, “Estimation of the tein is also needed for good bone health. Muscle wasting diet-dependent net acid load in 229 worldwide historically howeverseemstobereducedwithanalkalinedietandback studiedhunter-gatherersocieties,”AmericanJournalofClinical painmaybenefitfromthisaswell.Analkalineenvironment Nutrition,vol.91,no.2,pp.406–412,2010. mayimprovetheefficacyofsomechemotherapyagentsbut [6] A.Sebastian,L.A.Frassetto,D.E.Sellmeyer,R.L.Merriam, notothers. andR.C.MorrisJr.,“Estimationofthenetacidloadofthediet ofancestralpreagriculturalHomosapiensandtheirhominid ancestors,”AmericanJournalofClinicalNutrition,vol.76,no. 9.Conclusion 6,pp.1308–1316,2002. [7] L. Frassetto, R. C. Morris, Jr. R.C. Jr., D. E. Sellmeyer, K. Alkaline diets result in a more alkaline urine pH and may Todd, and A. Sebastian, “Diet, evolution and aging—the result in reduced calcium in the urine, however, as seen pathophysiologiceffectsofthepost-agriculturalinversionof in some recent reports, this may not reflect total calcium the potassium-to-sodium and base-to-chloride ratios in the balance because of other buffers such as phosphate. There humandiet,”EuropeanJournalofNutrition,vol.40,no.5,pp. isnosubstantialevidencethatthisimprovesbonehealthor 200–213,2001. protects from osteoporosis. However, alkaline diets may re- [8] M.KonnerandS.BoydEaton,“Paleolithicnutrition:twenty- sultinanumberofhealthbenefitsasoutlinedbelow fiveyearslater,”NutritioninClinicalPractice,vol.25,no.6,pp. 594–602,2010. [9] R.D.LindemanandR.Goldman,“Anatomicandphysiologic (1)Increased fruits and vegetables in an alkaline diet agechangesinthekidney,”ExperimentalGerontology,vol.21, wouldimprovetheK/Naratioandmaybenefitbone no.4-5,pp.379–406,1986. health, reduce muscle wasting, as well as mitigate [10] S.T.Reddy,C.Y.Wang,K.Sakhaee,L.Brinkley,andC.Y.Pak, other chronic diseases such as hypertension and “Effect of low-carbohydrate high-protein diets on acid-base strokes. balance,stone-formingpropensity,andcalciummetabolism,” 6 JournalofEnvironmentalandPublicHealth AmericanJournalofKidneyDiseases,vol.40,no.2,pp.265– [27] T. R. Fenton, A. W. Lyon, M. Eliasziw, S. C. Tough, and D. 274,2002. A.Hanley,“Phosphatedecreasesurinecalciumandincreases [11] Y. S. Malov and A. N. Kulikov, “Bicarbonate deficiency and calciumbalance:ameta-analysisoftheosteoporosisacid-ash duodenalulcer,”TerapevticheskiiArkhiv,vol.70,no.2,pp.28– diethypothesis,”NutritionJournal,vol.8,article41,2009. 32,1998. [28] S.B.Hulley,J.M.Vogel,C.L.Donaldson,J.H.Bayers,R.J. [12] H.OhmanandA.Vahlquist,“InvivostudiesconcerningapH Friedman,andS.N.Rosen,“Theeffectofsupplementaloral gradient in human stratum corneum and upper epidermis,” phosphateonthebonemineralchangesduringprolongedbed ActaDermato-Venereologica,vol.74,no.5,pp.375–379,1994. rest,”JournalofClinicalInvestigation,vol.50,no.12,pp.2506– [13] D.G.Ferris,S.L.Francis,E.D.Dickman,K.Miler-Miles,J.L. 2518,1971. Waller,andN.McClendon,“VariabilityofvaginalpHdeter- [29] T.R.Fenton,A.W.Lyon,M.Eliasziw,S.C.Tough,andD.A. minationbypatientsandclinicians,”JournaloftheAmerican Hanley,“Meta-analysisoftheeffectoftheacid-ashhypothesis BoardofFamilyMedicine,vol.19,no.4,pp.368–373,2006. of osteoporosis on calcium balance,” Journal of Bone and [14] T. Remer and F. Manz, “Estimation of the renal net acid MineralResearch,vol.24,no.11,pp.1835–1840,2009. excretion by adults consuming diets containing variable [30] J. D. Supplee, G. E. Duncan, B. Bruemmer, J. Goldberg, Y. amounts of protein,” American Journal of Clinical Nutrition, Wen,andJ.A.Henderson,“Sodaintakeandosteoporosisrisk vol.59,no.6,pp.1356–1361,1994. in postmenopausal American-Indian women,” Public Health [15] T.Remer,“Influenceofdietonacid-basebalance,”Seminarsin Nutrition,pp.1–7,2011. Dialysis,vol.13,no.4,pp.221–226,2000. [31] T. R. Fenton, S. C. Tough, A. W. Lyon, M. Eliasziw, and D. [16] T.R.Fenton,M.Eliasziw,S.C.Tough,A.W.Lyon,J.P.Brown, A.Hanley,“Causalassessmentofdietaryacidloadandbone andD.A.Hanley,“LowurinepHandacidexcretiondonot disease: a systematic review & meta-analysis applying Hill’s predictbonefracturesorthelossofbonemineraldensity:a epidemiologiccriteriaforcausality,”NutritionJournal,vol.10, prospectivecohortstudy,”BMCMusculoskeletalDisorders,vol. no.1,article41,2011. 11,article88,2010. [32] L. A. Frassetto, R. C. Morris Jr., and A. Sebastian, “Dietary [17] E. Boelsma, L. P. L. van de Vijver, R. A. Goldbohm, I. A. sodiumchlorideintakeindependentlypredictsthedegreeof A. Klo¨pping-Ketelaars, H. F. J. Hendriks, and L. Roza, “Hu- hyperchloremic metabolic acidosis in healthy humans con- manskinconditionanditsassociationswithnutrientconcen- suminganetacid-producingdiet,”AmericanJournalofPhysi- trationsinserumanddiet,”AmericanJournalofClinicalNutri- ology—RenalPhysiology,vol.293,no.2,pp.F521–F525,2007. tion,vol.77,no.2,pp.348–355,2003. [33] P.Frings-Meuthen,J.Buehlmeier,N.Baeckeretal.,“Highsod- [18] B.A.Ince,E.J.Anderson,andR.M.Neer,“Loweringdietary iumchlorideintakeexacerbatesimmobilization-inducedbone proteintoU.S.recommendeddietaryallowancelevelsreduces resorptionandproteinlosses,”JournalofAppliedPhysiology, urinary calcium excretion and bone resorption in young vol.111,no.2,pp.537–542,2011. women,” Journal of Clinical Endocrinology and Metabolism, [34] F. P. Cappuccio, E. Meilahn, J. M. Zmuda, and J. A. Cauley, vol.89,no.8,pp.3801–3807,2004. “Highbloodpressureandbone-minerallossinelderlywhite [19] W. F. Boron, “Regulation of intracellular pH,” Advances in women: a prospective study,” Lancet, vol. 354, no. 9183, pp. PhysiologyEducation,vol.28,pp.160–179,2004. 971–975,1999. [20] T.RemerandF.Manz,“Potentialrenalacidloadoffoodsand [35] A. Devine, R. A. Criddle, I. M. Dick, D. A. Kerr, and R. L. its influence on urine pH,” Journal of the American Dietetic Prince,“Alongitudinalstudyoftheeffectofsodiumandcal- Association,vol.95,no.7,pp.791–797,1995. cium intakes on regional bone density in postmenopausal [21] T. R. Fenton, M. Eliasziw, A. W. Lyon, S. C. Tough, and D. women,” American Journal of Clinical Nutrition, vol. 62, no. A.Hanley,“Meta-analysisofthequantityofcalciumexcretion 4,pp.740–745,1995. associated with the net acid excretion of the modern diet [36] R.C.MorrisJr.,O.Schmidlin,L.A.Frassetto,andA.Seba- under the acid-ash diet hypothesis,” American Journal of stian, “Relationship and interaction between sodium and ClinicalNutrition,vol.88,no.4,pp.1159–1166,2008. potassium,”JournaloftheAmericanCollegeofNutrition,vol. [22] A. Sebastian and R. C. Morris Jr., “Improved mineral 25,no.3,pp.262S–270S,2006. balance and skeletal metabolism in postmenopausal women [37] U.S.BarzelandL.K.Massey,“Excessdietaryproteinmaycan treatedwithpotassiumbicarbonate,”NewEnglandJournalof adverselyaffectbone,”JournalofNutrition,vol.128,no.6,pp. Medicine,vol.331,no.4,p.279,1994. 1051–1053,1998. [23] B.Dawson-Hughes,S.S.Harris,N.J.Palermo,C.Castaneda- [38] R.P.HeaneyandD.K.Layman,“Amountandtypeofpro-tein Sceppa,H.M.Rasmussen,andG.E.Dallal,“Treatmentwith influences bone health,” American Journal of Clinical Nutri- potassium bicarbonate lowers calcium excretion and bone tion,vol.87,no.5,pp.156S–157S,2008. resorption in older men and women,” Journal of Clinical [39] B.Dawson-Hughes,S.S.Harris,andL.Ceglia,“Alkalinediets EndocrinologyandMetabolism,vol.94,no.1,pp.96–102,2009. favorleantissuemassinolderadults,”AmericanJournalofCli- [24] R. P. Heaney, M. S. Dowell, C. A. Hale, and A. Bendich, nicalNutrition,vol.87,no.3,pp.662–665,2008. “Calcium absorption varies within the reference range for [40] G.Garibotto,R.Russo,A.Sofiaetal.,“Muscleproteinturn- serum25-hydroxyvitaminD,”JournaloftheAmericanCollege overinchronicrenalfailurepatientswithmetabolicacidosis ofNutrition,vol.22,no.2,pp.142–146,2003. or normal acid-base balance,” Mineral and Electrolyte Meta- [25] G.K.Schwalfenberg,S.J.Genuis,andM.N.Hiltz,“Addressing bolism,vol.22,no.1–3,pp.58–61,1996. vitamin D deficiency in Canada: a public health innovation [41] G.CasoandP.J.Garlick,“Controlofmuscleproteinkinetics whosetimehascome,”PublicHealth,vol.124,no.6,pp.350– by acid-base balance,” Current Opinion in Clinical Nutrition 359,2010. andMetabolicCare,vol.8,no.1,pp.73–76,2005. [26] K.C.Lu,S.H.Lin,F.C.Yu,S.H.Chyr,andS.D.Shieh,“Influ- [42] M.J.Webster,M.N.Webster,R.E.Crawford,andL.B.Glad- ence of metabolic acidosis on serum 1,25(OH)2D3 levels in den,“Effectofsodiumbicarbonateingestiononexhaustivere- chronicrenalfailure,”MineralandElectrolyteMetabolism,vol. sistanceexerciseperformance,”MedicineandScienceinSports 21,no.6,pp.398–402,1995. andExercise,vol.25,no.8,pp.960–965,1993. JournalofEnvironmentalandPublicHealth 7 [43] E. McSherry and R. C. Morris Jr., “Attainment and mainte- nance of normal stature with alkali therapy in infants and childrenwithclassicrenaltubularacidosis,”JournalofClinical Investigation,vol.61,no.2,pp.509–527,1978. [44] L. Frassetto, R. C. Morris Jr., and A. Sebastian, “Potassium bicarbonate reduces urinary nitrogen excretion in post- menopausal women,” Journal of Clinical Endocrinology and Metabolism,vol.82,no.1,pp.254–259,1997. [45] J.A.H.WassandR.Reddy,“Growthhormoneandmemory,” JournalofEndocrinology,vol.207,no.2,pp.125–126,2010. [46] L. Frassetto, R. C. Morris Jr., and A. Sebastian, “Long-term persistenceoftheurinecalcium-loweringeffectofpotassium bicarbonate in postmenopausal women,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 2, pp. 831–834, 2005. [47] J.Vormann,M.Worlitschek,T.Goedecke,andB.Silver,“Sup- plementation with alkaline minerals reduces symptoms in patientswithchroniclowbackpain,”JournalofTraceElements inMedicineandBiology,vol.15,no.2-3,pp.179–183,2001. [48] I. Zofkova´ and R. L. Kancheva, “The relationship between magnesiumandcalciotropichormones,”MagnesiumResearch, vol.8,no.1,pp.77–84,1995. [49] G. Schwalfenberg, “Improvement of chronic back pain or failed back surgery with vitamin D repletion: a case series,” JournaloftheAmericanBoardofFamilyMedicine,vol.22,no. 1,pp.69–74,2009. [50] E. Groos, L. Walker, and J. R. Masters, “Intravesical chemo- therapy.StudiesontherelationshipbetweenpHandcytotox- icity,”Cancer,vol.58,no.6,pp.1199–1203,1986. [51] S.R.Smith,P.A.Martin,andR.H.T.Edwards,“TumourpH andresponsetochemotherapy:aninvivo31Pmagneticreson- ancespectroscopystudyinnon-Hodgkin’slymphoma,”British JournalofRadiology,vol.64,no.766,pp.923–928,1991. [52] N. Raghunand and R. J. Gillies, “pH and chemotherapy,” NovartisFoundationSymposium,vol.240,pp.199–211,2001. [53] N. Raghunand, X. He, R. Van Sluis et al., “Enhancement of chemotherapybymanipulationoftumourpH,”BritishJour- nalofCancer,vol.80,no.7,pp.1005–1011,1999. 8/30/2017 Biological significance of essential fatty acids. - PubMed - NCBI PubMed Format: Abstract J Assoc Physicians India. 2006 Apr;54:30919. Biological significance of essential fatty acids. 1 Das UN . Author information Abstract Essential fatty acids (EFAs)linoleic acid (LA) and alphalinolenic acid (ALA) are critical for human survival. EFAs are readily available in the diet. But, to derive their full benefit, EFAs need to be metabolized to their respective longchain metabolites. EFAs not only form precursors to respective prostaglandins (PGs), thromboxanes (TXs), and leukotrienes (LTs), but also give rise to lipoxins (LXs), resolvins, isoprostanes, and hydroxy and hydroperoxyeicosatetraenoates. Certain PGs, TXs, and LTs have proinflammatory actions whereas LXs and resolvins are antiinflammatory in nature. Furthermore, EFAs and their longchain metabolites modulate the activities of angiotensin converting and HMGCoA reductase enzymes, enhance acetylcholine levels in the brain, increase the synthesis of endothelial nitric oxide, augment diuresis, and enhance insulin action. Thus, EFAs and their metabolites may function as endogenous ACE and HMGCoA reductase inhibitors, nitric oxide enhancers, betablockers, diuretics, antihypertensive, and antiatherosclerotic molecules. In addition, EFAs and their longchain metabolites react with nitric oxide (NO) to yield respective nitroalkene derivatives that exert cellsignaling actions via ligation and activation of peroxisome proliferatoractivated receptors (PPARs). Thus, EFAs and their derivatives have varied biological actions that may have relevance to their involvement in several physiological and pathological processes. PMID: 16944615 [Indexed for MEDLINE] Publication type, MeSH terms, Substances LinkOut more resources https://www.ncbi.nlm.nih.gov/pubmed/16944615 1/2 8/30/2017 Biological significance of essential fatty acids. - PubMed - NCBI PubMed Commons PubMed Commons home 0 comments How to join PubMed Commons https://www.ncbi.nlm.nih.gov/pubmed/16944615 2/2 (cid:204) (cid:29) Linus Pauling Institute » Micronutrient Information Center Other Nutrients » Essential Fatty Acids Read the updated articles on indole-3-carbinol and co�ee. If you value this website, please consider donating to its maintenance. Essential Fatty Acids Summary Contents Linoleic acid (LA), an omega-6 fatty acid, and α- Summary linolenic acid (ALA), an omega-3 fatty acid, are Introduction considered essential fatty acids (EFA) because they cannot be synthesized by humans. (More Metabolism and Bioavailability information) Biological Activities The long-chain omega-3 fatty acids, Membrane structure and function eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can be synthesized Vision from ALA, but due to low conversion e�ciency, it Nervous system is recommended to obtain EPA and DHA from Synthesis of lipid mediators additional sources. (More information) Regulation of gene expression LA, arachidonic acid (AA), and DHA are the most common polyunsaturated fatty acids (PUFA) De�ciency accumulating in tissues. (More information) Essential fatty acids Both omega-6 and omega-3 fatty acids are Omega-3 de�ciency important structural components of cell membranes, serve as precursors to bioactive Omega-3 index lipid mediators, and provide a source of energy. Disease Prevention Long-chain omega-3 PUFA in particular exert Visual and neurological development anti-in�ammatory e�ects and it is recommended to increase their presence in the Gestation and pregnancy diet. (More information) Cardiovascular disease Both dietary intake and endogenous metabolism Alzheimer's disease in�uence whole-body status of EFA. Genetic
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