title: A neglected requirement for optimizing treatment of age-related osteoporosis: Replenishing the skeleton's base reservoir with net base-producing diets.
abstract: Osteoporosis is a disorder of bone in which the mass of the bone is reduced and the bone's architecture at the microscopic level is disordered. Together those abnormalities predispose affected individuals to experience fractures despite only minimal trauma (i.e., fragility fractures). Age related osteoporosis is a common type of osteoporosis that occurs with aging in both men and women usually beginning after the age of peak bone mass. Research has found that the disorder can be partially reversed by reducing the net amount of acid that is produced when consuming typical Western diets. However, the amelioration that results has not been so dramatic or so consistent that physicians have adopted the procedure as part of the standard treatment for age-related osteoporosis. We propose that reducing the net acid load from the diet is not sufficient to reverse age related osteoporosis because it fails to supply base needed to restore the large amount of base in bone that had been lost by reacting with the net acid load of the diet that had been consumed for years or decades. Reducing the net acid load from the diet might be expected to have little ameliorative effect or merely slow the progression of the disorder. We hypothesize that both to restore osteoporotic bone to, or nearly to, its pre-disease state, as well as to eliminate the risk of fragility fractures, requires consuming diets that produce net amounts of base to restore the base lost from years to decades of consuming diets that produce net amounts of acid. We hypothesize also that the excess base and attendant subclinical metabolic alkalosis will both stimulate the cellular process of bone formation and suppress the cellular process of bone resorption, and thereby implement the restorative process.
authors.affiliation: Department of Medicine, Division of Nephrology, University of California, San Francisco 94143, United States. Electronic address: anthony_sebastian@msn.com.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sebastian
authors.affiliation: Department of Medicine, Division of Nephrology, University of California, San Francisco 94143, United States.
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Frassetto
mesh_terms: D000368:Aged; D000375:Aging; D000471:Alkalosis; D015519:Bone Density; D016723:Bone Remodeling; D001862:Bone Resorption; D001842:Bone and Bones / Q000378:metabolism*; D004032:Diet; D005260:Female; D006706:Homeostasis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010006:Osteoblasts / Q000378:metabolism; D010012:Osteogenesis; D010024:Osteoporosis / Q000188:drug therapy*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control; D011188:Potassium / Q000378:metabolism
chemical_list: D011188:Potassium