The 1995 potential renal acid load (PRAL) values may no longer adequately reflect the actual acid–base impact of certain foods: A hypothesis

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Abstract

Background: In 1995, Remer and Manz reported potential renal acid load (PRAL) values of various foods, quantifying their estimated impact on acid–base balance. Their estimation considered ionic dissociation, sulphur metabolism and intestinal absorption rates for several micronutrients and proteins. Notably, PRAL values are based on food content data from the early 1990s and may nowadays no longer adequately reflect accurate estimates. Some foods’ macronutrient and mineral content has declined over the past three decades due to changes in soil mineral health. Aim: We hypothesize that the 1995 PRAL values no longer adequately reflect reliable estimates of the current acid–base impact of some foods. Methods: Based on specific examples, we argue that these values overestimate the alkalizing effects of various fruits and vegetables. Conclusion: Discussing evidence in favour of (and against) our hypothesis, we conclude that the 1995 PRAL estimates should nowadays rather be used as a relative guidance and reviewed carefully.

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Most cited references 34

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Soil and the intensification of agriculture for global food security

Peter M. Kopittke, Neal W. Menzies, Peng Wang … (2019)

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Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein.

F Manz, T Remer (1994)

The object of this study was to determine whether it is possible to reliably estimate the renal net acid excretion (NAE) produced by adults consuming different amounts of dietary protein. A physiologically based calculation model that corrects for intestinal absorption of minerals and sulfur-containing protein and assumes a rate of urinary excretion of organic acids proportional to body surface area was used to estimate NAE. Urinary excretion of different minerals and NAE was measured during the last 48 h of each of four separate 5-d diet periods in six healthy adults. On the basis of food tables, the four nearly isoenergetic diets (one lacto-vegetarian and one high- and two moderate-protein diets) were estimated to yield the following NAE values: 3.7, 117.5, 62.2, and 102.2 mEq/d, respectively. The analytically determined urinary NAE (24.1 +/- 10.7, 135.5 +/- 16.4, 69.7 +/- 21.4, and 112.6 +/- 10.9 mEq/d) corresponded reasonably well to these estimates, suggesting that the calculation model is appropriate to predict the renal NAE from nutrient intake and anthropometric data.

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Potential renal acid load of foods and its influence on urine pH.

THOMAS REMER, FRIEDRICH MANZ (1995)

The purpose of this study was to calculate the potential renal acid load (PRAL) of selected, frequently consumed foods. A physiologically based calculation model was recently validated to yield an appropriate estimate of renal net acid excretion (NAE); the model depends primarily on nutrient intake data. When nutrient data from actual food composition tables were used, the calculation model yielded PRAL values that ranged from an average maximum of 23.6 mEq/100 g for certain hard cheeses over 0 mEq/100 g for fats and oils to an average minimum of approximately -3 mEq/100 g for fruits and fruit juices and vegetables. By means of these PRAL data (summed according to the amounts of foods and beverages consumed daily and by an estimate of excretion of organic acids [based on body size]), the daily NAE can be calculated. This calculation methodology, primarily based on PRAL, allows an appropriate prediction of the effects of diet on the acidity of urine. For practical applicability in dietetic prevention of recurrent urolithiasis or in other fields of dietetics, the additionally determined correlation (r = .83; P < .001) between NAE and urine pH can be used to ascertain NAE target values for a desired urine pH modification.

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Author and article information

Contributors

Maximilian Andreas Storz: (View ORCID Profile)

Journal

Title: Nutrition and Health

Abbreviated Title: Nutr Health

Publisher: SAGE Publications

ISSN (Print): 0260-1060

ISSN (Electronic): 2047-945X

Publication date Created: September 2023

Publication date (Electronic): March 15 2023

Publication date (Print): September 2023

Volume: 29

Issue: 3

Pages: 363-368

Affiliations

[1 ]Department of Internal Medicine II, Center for Complementary Medicine, Freiburg Medical Center – Faculty of Medicine, University of Freiburg, Freiburg, Germany

[2 ]Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Montevideo, Uruguay

[3 ]School of Medicine, CLAEH University, Maldonado, Uruguay

Article

DOI: 10.1177/02601060231164667

SO-VID: b29b6f61-471b-445e-9805-3edd7e2650ec

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http://journals.sagepub.com/page/policies/text-and-data-mining-license

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