Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 25;9(6):538.
doi: 10.3390/nu9060538.

Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review

Free PMC article

Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review

Renata Alves Carnauba et al. Nutrients. .
Free PMC article


Low-grade metabolic acidosis is a condition characterized by a slight decrease in blood pH, within the range considered normal, and feeding is one of the main factors that may influence the occurrence of such a condition. The excessive consumption of acid precursor foods (sources of phosphorus and proteins), to the detriment of those precursors of bases (sources of potassium, calcium, and magnesium), leads to acid-base balance volubility. If this condition occurs in a prolonged, chronic way, low-grade metabolic acidosis can become significant and predispose to metabolic imbalances such as kidney stone formation, increased bone resorption, reduced bone mineral density, and the loss of muscle mass, as well as the increased risk of chronic diseases such as type 2 diabetes mellitus, hypertension, and non-alcoholic hepatic steatosis. Considering the increase in the number of studies investigating the influence of diet-induced metabolic acidosis on clinical outcomes, this review gathers the available evidence evaluating the association of this disturbance and metabolic imbalances, as well as related mechanisms. It is necessary to look at the western dietary pattern of most countries and the increasing incidence of non-comunicable diseases for the balance between fruit and vegetable intake and the appropriate supply of protein, mainly from animal sources, so that it does not exceed the daily recommendations.

Keywords: acid-base equilibrium; acidosis; fruits; proteins; vegetables.

Conflict of interest statement

The authors declare no conflict of interest.


Figure 1
Figure 1
Consequences to health from low-grade metabolic acidosis induced by diet. Dietary-induced low-grade metabolic acidosis may predispose to various disorders including bone metabolism impairment, kidney stone formation, loss of lean mass, increased systemic blood pressure, and risk of type 2 diabetes mellitus. BMD: bone mineral density; IR: insulin resistance; T2DM: type 2 diabetes mellitus; HBP: high blood pressure.
Figure 2
Figure 2
Schematic representation of the excessive release of acids into the bloodstream on bone tissue. The excess of acid release into the bloodstream, in detriment of the release of bases, may predispose to impaired bone metabolism, which involves the increased release of PTH with a consequent increase in osteoclasts activity and bone resorption, reducing the bone tissue mineralization. As a consequence, there may be an increased risk of bone fractures and bone mass reduction.

Similar articles

See all similar articles

Cited by 9 articles

See all "Cited by" articles


    1. Guyton A.C., Hall J.E. Regulação acidobásica. In: Guyton A.C., Hall J.E., editors. Tratado de Fisiologia Médica. 12th ed. Elsevier; Rio de Janeiro, Brasil: 2011.
    1. Adeva M.M., Souto G. Diet-induced metabolic acidosis. Clin. Nutr. 2011;30:416–421. doi: 10.1016/j.clnu.2011.03.008. - DOI - PubMed
    1. Pizzorno J., Frassetto L.A., Katzinger J. Diet-induced acidosis: Is it real and clinically relevant? Br. J. Nutr. 2010;103:1185–1194. doi: 10.1017/S0007114509993047. - DOI - PubMed
    1. Kurtz I., Maher T., Hulter H.N., Schambelan M., Sebastian A. Effect of diet on plasma acid-base composition in normal humans. Kidney Int. 1983;24:670–680. doi: 10.1038/ki.1983.210. - DOI - PubMed
    1. Lutz J. Calcium balance and acid-base status of women as affected by increased protein intake and by sodium bicarbonate ingestion. Am. J. Clin. Nutr. 1984;39:281–288. - PubMed