PRAL Diet Research

PRAL Diet Research Introduction

PRAL (Potential Renal Acid Load) is one of two accepted methods for estimating acid load on the kidneys. The other being NEAP (Net Endogenous Acid Production). For Foodary, I use PRAL. As it is easy to calculate from food databases and nutrition labels.

PRAL Diet Research Topics

I found 147 studies on PubMed for PRAL diet. With over half of these in the last 4 years. Showing an increasing interest in this area of research. Below, I present brief summaries of a selection of these studies. However, there are more diseases being studied with respect to PRAL diet. So please let me know if you want me to summarize other diseases.

PRAL Diet, Mortality, & Heart Disease

My first study involves more than 90,000 adults over many years. Comparing death rates and causes of death between 4 PRAL diet groups. Where the average PRAL totals were -7.98, 3.30, 10.22, and 18.10. Resulting in links between high PRAL diets and mortality rates. Especially from heart disease. But no links were found with death caused by cancer.

Akter, S., Nanri, A., Mizoue, T., Noda, M., Sawada, N., Sasazuki, S., Tsugane, S. and Japan Public Health Center–based Prospective Study Group, 2017. Dietary acid load and mortality among Japanese men and women: the Japan Public Health Center–based Prospective Study. The American journal of clinical nutrition, 106(1), pp.146-154.

a high dietary acid load score is associated with an increased risk of death from all causes and CVD [Cardiovascular Disease], particularly IHD [Ischemic Heart Disease] mortality. The findings of our study suggest that maintaining an adequate acid-base balance can contribute to longevity by decreasing the risk of death, predominantly from CVD.

PRAL Diet Prevents Acidosis

My second study is a review of 39 PRAL diet studies. It explains the history of PRAL and its mechanisms. Followed by summaries of the benefits of PRAL diets for several diseases.

Osuna-Padilla, I.A., Leal-Escobar, G., Garza-García, C.A. and Rodríguez-Castellanos, F.E., 2019. Dietary acid load: mechanisms and evidence of its health repercussions. Nefrología (English Edition), 39(4), pp.343-354.

The consumption of a diet high in protein and phosphorus, low in potassium, calcium and magnesium, has an impact on long-term health, since these are considered acidogenic diets, that cause low-grade MA [Metabolic Acidosis].

One of the complications of low-grade MA is the increase in cortisol secretion and the decrease in its inactivation leading to hypercortisolism which increases the risk various metabolic disorders such as sarcopenia, insulin resistance, Type 2 diabetes mellitus and cardiovascular diseases, among others

PRAL Diet & Kidney Disease

My third study compares dietary approaches to treating Chronic Kidney Disease (CKD). Comparing them favorably to chemical interventions. However, it mistakenly includes reference to the “acid-ash” hypothesis. Which is widely disputed and best ignored. But I decided to retain this study, as that bad sentence doesn’t negate its findings on PRAL diet.

Noce, A., Marrone, G., Wilson Jones, G., Di Lauro, M., Pietroboni Zaitseva, A., Ramadori, L., Celotto, R., Mitterhofer, A.P. and Di Daniele, N., 2021. Nutritional approaches for the management of metabolic acidosis in chronic kidney disease. Nutrients, 13(8), p.2534.

Another innovative dietetic approach for CKD early stage is the alkaline diet (AD), which is constructed based on PRAL and potassium content present in different food types. This dietetic treatment, rich in fruit and vegetables, can represent a valid therapeutic alternative to traditional pharmacological therapy based on bicarbonate assumption. Other positive characteristics of the AD are represented by its low cost and the variety of foods

PRAL Diet & Weight Loss

In my fourth study, over 200 overweight adults were divided into an intervention group and a control group. With the intervention being a low fat vegan diet for 16 weeks. Being the researcher’s chosen method for creating a low PRAL diet group.

Kahleova, H., McCann, J., Alwarith, J., Rembert, E., Tura, A., Holubkov, R. and Barnard, N.D., 2021. A plant-based diet in overweight adults in a 16-week randomized clinical trial: The role of dietary acid load. Clinical Nutrition ESPEN, 44, pp.150-158.

Alterations in PRAL and NEAP were positively associated with body weight, fat mass, visceral fat, and hepatic insulin resistance, and negatively correlated with peripheral insulin sensitivity. The results remained significant even after adjustment for energy intake. These improvements appear to be partly attributable to the alkalizing nutrient content of a vegan diet and the metabolism of these substances. Our findings support preexisting evidence of the favorable effects of low-PRAL diets on weight, adiposity, and insulin resistance.

PRAL Diet & Cancer

My final study examines links between PRAL diet and colorectal cancer (CRC). Also, with colorectal adenoma (CRA) which is described as a precursor to colorectal cancer.

Nasab, S.J., Rafiee, P., Bahrami, A., Rezaeimanesh, N., Rashidkhani, B., Sohrab, G., Naja, F., Hejazi, E. and Sadeghi, A., 2021. Diet-dependent acid load and the risk of colorectal cancer and adenoma: a case–control study. Public Health Nutrition, 24(14), pp.4474-4481.

higher diet-dependent acid load is associated with higher risk of CRC and CRA. Further intervention studies are needed to determine whether diets with lower acid load could reduce the risk of CRC and CRA as a precursor of colorectal malignancies.

High PRAL Diet = High Risk of Death

Your PRAL Diet Research

Which aspects of PRAL diet are you interested in? How do you think PRAL diet might affect your health or wellbeing?

Please tell me your PRAL diet story below.

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