HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Macdonald, H. M Articles by Reid, D. M Search for Related Content PubMed PubMed Citation Articles by Macdonald, H. M Articles by Reid, D. M Agricola Articles by Macdonald, H. M Articles by Reid, D. M

Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women^1,2,3,4,5

¹ From the Department of Medicine and Therapeutics, University of Aberdeen, Medical School Buildings, Aberdeen, United Kingdom (HMM and DMR); the Centre for Nutrition and Food Safety, School of Biomedical and Molecular Sciences, University of Surrey, Guildford, United Kingdom (SAN); the Department of Clinical Chemistry, Royal Liverpool University Hospital, Liverpool, United Kingdom (WDF); and the Health Services Research Unit, University of Aberdeen Medical School, Aberdeen, United Kingdom (MKC).

Background: The Western diet may be a risk factor for osteoporosis. Excess acid generated from high protein intakes increases calcium excretion and bone resorption. Fruit and vegetable intake could balance this excess acidity by providing alkaline salts of potassium. Algorithms based on dietary intakes of key nutrients can be used to approximate net endogenous acid production (NEAP) and to explore the association between dietary acidity and bone health.

Objective: We investigated the relation between dietary potassium and protein, NEAP (with an algorithm including the ratio of protein to potassium intake), and potential renal acid load (with an algorithm including dietary protein, phosphorous, potassium, magnesium, and calcium) and markers of bone health.

Design: Measurements of bone mineral density (BMD) (n = 3226) and urinary bone resorption markers (n = 2929) at the lumbar spine and femoral neck were performed in perimenopausal and early postmenopausal women aged 54.9 ± 2.2 y ( ± SD) in 1997–1999. BMD (g/cm²), free pyridinoline (fPYD), and free deoxypyridinoline (fDPD) were expressed relative to creatinine. Dietary intake was assessed with a food-frequency questionnaire.

Results: Comparison of the highest with the lowest quartile of potassium intake or the lowest with the highest NEAP showed a 6–8% increase in fPYD/creatinine and fDPD/creatinine. A difference of 8% in BMD was observed between the highest and lowest quartiles of potassium intake in the premenopausal group (n = 337).

Conclusions: Dietary potassium, an indicator of NEAP and fruit and vegetable intake, may exert a modest influence on markers of bone health, which over a lifetime may contribute to a decreased risk of osteoporosis.

Key Words: Fruit • vegetables • net endogenous (noncarbonic) acid production • NEAP • potential renal acid load • PRAL • acid base balance • dietary potassium • bone resorption markers • bone mineral density • menopause

This article has been cited by other articles:

				H. M Macdonald, A. J Black, L. Aucott, G. Duthie, S. Duthie, R. Sandison, A. C Hardcastle, S. A Lanham New, W. D Fraser, and D. M Reid Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial Am. J. Clinical Nutrition, August 1, 2008; 88(2): 465 - 474. [Abstract] [Full Text] [PDF]

				L. D. Carbone, J. D. Cross, S. H. Raza, A. J. Bush, R. J. Sepanski, S. Dhawan, B. Q. Khan, M. Gupta, K. Ahmad, R. N. Khouzam, et al. Fracture Risk in Men With Congestive Heart Failure: Risk Reduction With Spironolactone J. Am. Coll. Cardiol., July 8, 2008; 52(2): 135 - 138. [Abstract] [Full Text] [PDF]

				H. M Macdonald, F. E McGuigan, S. A Lanham-New, W. D Fraser, S. H Ralston, and D. M Reid Vitamin K1 intake is associated with higher bone mineral density and reduced bone resorption in early postmenopausal Scottish women: no evidence of gene-nutrient interaction with apolipoprotein E polymorphisms Am. J. Clinical Nutrition, May 1, 2008; 87(5): 1513 - 1520. [Abstract] [Full Text] [PDF]

				J. Mardon, V. Habauzit, A. Trzeciakiewicz, M.-J. Davicco, P. Lebecque, S. Mercier, J.-C. Tressol, M.-N. Horcajada, C. Demigne, and V. Coxam Long-Term Intake of a High-Protein Diet with or without Potassium Citrate Modulates Acid-Base Metabolism, but Not Bone Status, in Male Rats J. Nutr., April 1, 2008; 138(4): 718 - 724. [Abstract] [Full Text] [PDF]

				J. Vormann and T. Remer Dietary, Metabolic, Physiologic, and Disease-Related Aspects of Acid-Base Balance: Foreword to the Contributions of the Second International Acid-Base Symposium J. Nutr., February 1, 2008; 138(2): 413S - 414S. [Abstract] [Full Text] [PDF]

				M. Thorpe, M. C. Mojtahedi, K. Chapman-Novakofski, E. McAuley, and E. M. Evans A Positive Association of Lumbar Spine Bone Mineral Density with Dietary Protein Is Suppressed by a Negative Association with Protein Sulfur J. Nutr., January 1, 2008; 138(1): 80 - 85. [Abstract] [Full Text] [PDF]

				F. A. Tylavsky, L. A. Spence, and L. Harkness The Importance of Calcium, Potassium, and Acid-Base Homeostasis in Bone Health and Osteoporosis Prevention J. Nutr., January 1, 2008; 138(1): 164S - 165S. [Full Text] [PDF]

				S. A. Lanham-New The Balance of Bone Health: Tipping the Scales in Favor of Potassium-Rich, Bicarbonate-Rich Foods J. Nutr., January 1, 2008; 138(1): 172S - 177S. [Abstract] [Full Text] [PDF]

				L. A. Frassetto, S. A. Lanham-New, H. M. Macdonald, T. Remer, A. Sebastian, K. L. Tucker, and F. A. Tylavsky Standardizing Terminology for Estimating the Diet-Dependent Net Acid Load to the Metabolic System J. Nutr., June 1, 2007; 137(6): 1491 - 1492. [Full Text] [PDF]

				A. A Welch, S. A Bingham, J. Reeve, and K. Khaw More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study Am. J. Clinical Nutrition, April 1, 2007; 85(4): 1134 - 1141. [Abstract] [Full Text] [PDF]

				S. Jehle, A. Zanetti, J. Muser, H. N. Hulter, and R. Krapf Partial Neutralization of the Acidogenic Western Diet with Potassium Citrate Increases Bone Mass in Postmenopausal Women with Osteopenia J. Am. Soc. Nephrol., November 1, 2006; 17(11): 3213 - 3222. [Abstract] [Full Text] [PDF]

				C. J Prynne, G. D Mishra, M. A O'Connell, G. Muniz, M A. Laskey, L. Yan, A. Prentice, and F. Ginty Fruit and vegetable intakes and bone mineral status: a cross sectional study in 5 age and sex cohorts. Am. J. Clinical Nutrition, June 1, 2006; 83(6): 1420 - 1428. [Abstract] [Full Text] [PDF]

				S. Berkemeyer and T. Remer Anthropometrics Provide a Better Estimate of Urinary Organic Acid Anion Excretion than a Dietary Mineral Intake-Based Estimate in Children, Adolescents, and Young Adults J. Nutr., May 1, 2006; 136(5): 1203 - 1208. [Abstract] [Full Text] [PDF]

				J.-P. Bonjour Dietary Protein: An Essential Nutrient For Bone Health J. Am. Coll. Nutr., December 1, 2005; 24(suppl_6): 526S - 536S. [Abstract] [Full Text] [PDF]