Pathophysiology of Diet-Induced Acid Stress

Area of Science:

• Nutrition Science
• Nephrology
• Metabolic Physiology

Background:

• Diet composition significantly impacts the body's acid-base balance.
• Modern diets, rich in animal products, are typically net acid-producing, posing an ongoing "acid challenge."
• This acid challenge can lead to "acid stress," ranging from "covert acidosis" to overt chronic metabolic acidosis.

Purpose of the Study:

• To review the continuum of "acid stress" from modern diets.
• To elucidate the mechanisms by which dietary acid impacts health, particularly kidney health.
• To highlight the potential health threats of progressive acid accumulation, even without diagnosed metabolic acidosis.

Main Methods:

• Literature review of studies on diet, acid-base metabolism, and health outcomes.
• Analysis of the physiological responses to dietary acid load.
• Examination of the link between acid retention and kidney injury progression.

Main Results:

• Acid accumulation can lead to chronic metabolic acidosis, harming bones and muscles and accelerating chronic kidney disease (CKD).
• Subclinical "covert acidosis" (acid retention without reduced serum bicarbonate) also appears to injure kidneys and worsen CKD.
• The body's chronic efforts to counteract dietary acid load may also negatively impact health, including kidney function.

Conclusions:

• Modern diets present a spectrum of "acid stress" that challenges overall health and kidney function.
• Identifying and mitigating "acid stress" may be crucial for preventing or slowing CKD progression.
• Further research is needed to develop tools for early "acid stress" detection and to confirm the benefits of dietary acid reduction.