Estimated net acid excretion inversely correlates with urine pH in vegans, lacto-ovo vegetarians, and omnivores

Objective: Diet affects urine pH and acid-base balance. Both excess acid/alkaline ash (EAA) and estimated net acid excretion (NAE) calculations have been used to estimate the effects of diet on urine pH. This study's goal was to determine if free-living vegans, lacto-ova vegetarians, and omnivores have increasingly acidic urine, and to assess the ability of EAA and estimated NAE calculations to predict urine pH. Design: This study used a cross-sectional design. Setting and Participants: This study assessed urine samples of 10 vegan, 16 lacto-ova vegetarian, and 16 healthy omnivorous women in the Boston metropolitan area. Six 3-day food records from each dietary group were analyzed for EAA content and estimated NAE, and correlations with measured urine pH were calculated. Results: The mean (+/- SD) urine pH was 6.15 +/- 0.40 for vegans, 5.90 +/- 0.36 for lacto-ova vegetarians, and 5.74 +/- 0.21 for omnivores (analysis of variance, P =.013). Calculated EAA values were not significantly different among the three groups, whereas mean estimated NAE values were significantly different: 17.3 +/- 14.5 mEq/day for vegans, 31.3 +/- 8.5 mEq/day for lacto-ova vegetarians, and 42.6 +/- 13.2 mEq/day for omnivores (analysis of variance, P =.01). The average deattenuated correlation between urine pH and EAA was 0.333; this value was -0.768 for estimated NAE and urine pH, with a regression equation of pH = 6.33 - 0.014 NAE (P =.02, r = -0.54). Conclusions: Habitual diet and estimated NAE calculations indicate the probable ranking of urine pH by dietary groups, and may be used to determine the likely acid-base status of an individual; EAA calculations were not predictive of urine pH. (C) 2008 by the National Kidney Foundation, Inc. All rights reserved.