ReviewNutrients2018
Acid Balance, Dietary Acid Load, and Bone Effects-A Controversial Subject.
Review in Nutrients, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Effects of Potassium Citrate Supplementation on Bone Turnover Markers in Postmenopausal Women: A GRADE-Assessed Systematic Review, Meta-analysis and Trial Sequential Analysis.Calcified tissue international · 2026Pooled it
- Association between dietary acid load and risk of osteoporotic fractures in adults: a systematic review and meta-analysis of observational studies.BMC musculoskeletal disorders · 2025Pooled it
- Dietary Acid Load and Bone Health: A Systematic Review and Meta-Analysis of Observational Studies.Frontiers in nutrition · 2022Pooled it
- Trial
- Personalization and Fortification of In-Space Manufactured Emulsified Beverages for Long-Term Space Travel.Comprehensive reviews in food science and food safety · 2026Review
- Bone Health in Children and Adolescents with Type 1 Diabetes: Optimizing Bone Accrual and Preventing Fractures.Nutrients · 2025Review
- Hydration Meets Regulation: Insights into Bicarbonate Mineral Water and Acid-Base Balance.Nutrients · 2025Review
- Associations between adherence to plant-based diets and osteoporosis and visceral fat area in middle-aged adults: evidence of a large population-based study.Journal of diabetes and metabolic disorders · 2025Article
- Effects of higher dietary acid load: a narrative review with special emphasis in children.Pediatric nephrology (Berlin, Germany) · 2025Review
- Article
- Risk Factors for a Higher Dietary Acid Load (Potential Renal Acid Load) in Free-Living Elderly in Poland.Nutrients · 2024Article
- Summatory Effects of Anaerobic Exercise and a 'Westernized Athletic Diet' on Gut Dysbiosis and Chronic Low-Grade Metabolic Acidosis.Microorganisms · 2024Review
- Review
- Nutritional Quality and Safety Assessment of Pork Meat Cuts from Romania: Fatty Acids and Elemental Profile.Foods (Basel, Switzerland) · 2024Article
- Effect of high in comparison to low dairy intake intervention on markers of bone and cartilage remodeling and phosphate metabolism in healthy adults with overweight.European journal of nutrition · 2024Article
- The Role of the Endocrine System in the Regulation of Acid-Base Balance by the Kidney and the Progression of Chronic Kidney Disease.International journal of molecular sciences · 2024Review
- Pathophysiology of Diet-Induced Acid Stress.International journal of molecular sciences · 2024Review
- Bone mineral density parameters and related nutritional factors in vegans, lacto-ovo-vegetarians, and omnivores: a cross-sectional study.Frontiers in nutrition · 2024Article
- Review
- Association of body mass index with the development of metabolic acidosis in patients with chronic kidney disease.Obesity science & practice · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Modern Western diets, with higher contents of animal compared to fruits and vegetable products, have a greater content of acid precursors vs. base precursors, which results in a net acid load to the body. To prevent inexorable accumulation of acid in the body and progressively increasing degrees of metabolic acidosis, the body has multiple systems to buffer and titrate acid, including bone which contains large quantities of alkaline salts of calcium. Both in vitro and in vivo studies in animals and humans suggest that bone base helps neutralize part of the dietary net acid load. This raises the question of whether decades of eating a high acid diet might contribute to the loss of bone mass in osteoporosis. If this idea is true, then additional alkali ingestion in the form of net base-producing foods or alkalinizing salts could potentially prevent this acid-related loss of bone. Presently, data exists that support both the proponents as well as the opponents of this hypothesis. Recent literature reviews have tended to support either one side or the other. Assuming that the data cited by both sides is correct, we suggest a way to reconcile the discordant findings. This overview will first discuss dietary acids and bases and the idea of changes in acid balance with increasing age, then review the evidence for and against the usefulness of alkali therapy as a treatment for osteoporosis, and finally suggest a way of reconciling these two opposing points of view.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.