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How metabolic acidosis and kidney disease may accelerate the aging process

European Journal of Clinical Nutrition volume 74, pages 27–32 (2020)Cite this article

Abstract

Consuming a lower acid (and particularly lower phosphate) diet and/or supplementing the diet with base precursors, such as bicarbonate, might have a number of mitigating effects on the aging process. These include: (1) slowing progression of fibrosis by reduction of high endogenous acid production to preserve net acid excretion and minimize the degree of systemic acidosis; (2) avoiding the downregulation of klotho, a membrane and soluble factor associated with aging. Klotho declines when constant high dietary phosphate intake leads to an increase in FGF23 production; and (3) increasing activity of the enzyme telomerase, an important factor in maintaining telomere length, another factor associated with longer lifespan. Current evidence is based on studies in invertebrate and small animal models. These results, and extrapolations of associated human studies, suggest that low acid-producing diets, or neutralization of the low grade metabolic acidosis seen in humans with age-related renal dysfunction could potentially lead to a longer, healthier lifespan.

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Fig. 1: Potential acid and base content in common dietary sources.

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Acknowledgements

One of the authors, AS, died shortly after the original draft of this manuscript was completed. AS was one of the early pioneers in research on dietary acid loads and their potential pathophysiologic effects.

Funding

This article is published as part of a supplement sponsored by NuOmix-Research k.s. The conference was financially supported by Protina Pharmazeutische GmbH, Germany, and Sirius Pharma, Germany, and organized by NuOmix-Research k.s. Neither company had any role in writing of the manuscript.

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  1. University of California San Francisco, San Francisco, CA, USA

    Lynda Ann Frassetto & Anthony Sebastian

  2. Wake Forest School of Medicine, Winston-Salem, NC, USA

    Thomas Durward DuBose Jr

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Correspondence to Lynda Ann Frassetto.

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Frassetto, L.A., Sebastian, A. & DuBose Jr, T.D. How metabolic acidosis and kidney disease may accelerate the aging process. Eur J Clin Nutr 74 (Suppl 1), 27–32 (2020). https://doi.org/10.1038/s41430-020-0693-5

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