Guest Blog: Joel Fuhrman, M.D. on Sodium, Acid-Base Balance, and Bone Health

I am honored to introduce my readers to Dr. Joel Fuhrman, M.D. in his first Guest Appearance on my blog:

Joel Fuhrman M.D. is a board-certified family physician, nutrition researcher, best-selling author, and one of the country’s leading nutritional medicine experts.

Dr. Fuhrman is a graduate of the University of Pennsylvania School of Medicine and he is presently involved in research trials of his high micronutrient, plant-based diet with physicians and scientists at the University of Pennsylvania health system as well as other researchers.

Dr. Fuhrman created the Aggregate Nutrient Density Index (ANDI) scoring system that evaluates the levels of micronutrients and antioxidants in food to aid people in making healthier food choices. Dr. Fuhrman is on the medical advisory board of Whole Foods Market.

Dr. Fuhrman is the author of six books, including Disease-Proof Your Child and his best-selling book, Eat To Live which has gone through 18 printings and several foreign language translations. His most recent book, Eat For Health was published in April 2008.

Dr. Fuhrman teaches nutritional excellence which is not only preventative, but is also the safest and most effective therapeutic intervention for most chronic medical conditions. Dr. Fuhrman is on the board of directors of the American Academy of Lifestyle Medicine and active in educating physicians and health professionals on nutritional medicine. His lectures have been approved for CME credit by the American Academy of Family Physicians.


To learn more about Dr. Fuhrman please visit his website at DrFuhrman.com and his blog at DiseaseProof.com.





Sodium, Acid-Base Balance, and Bone Health

We’ve known for years that excessive sodium intake contributes to hypertension, and a new meta-analysis of 13 studies has confirmed that high sodium intake is associated with increased risk of stroke and overall cardiovascular disease.1 Salt consumption is also associated with kidney disease, and a new study suggests that reduced sodium intake could benefit bone health.

Women 45-75 years old with prehypertension or stage 1 hypertension were assigned to either a low-sodium diet or a higher sodium, high-carbohydrate, low-fat diet. Both diets supplied the same amount (800 mg) of calcium, but the low-sodium diet was designed to have a lesser acid load than the high-carbohydrate diet.2

Western diets, generally high in animal protein, produce acid in the body, forcing the body to buffer this acid in part by the release of alkalizing salts from bone (e.g. calcium citrate and calcium carbonate) – this is associated with urinary calcium loss and is thought to contribute to osteoporosis. Fruits, vegetables, and legumes have favorable effects on acid-base balance, since the acid-forming effect of their protein content, which is lower than that of animal products anyway, are balanced by their mineral content.3-4

After 14 weeks, the women on both diets increased markers of bone formation and reduced their calcium excretion – those on the low sodium diet had a greater reduction in calcium loss. The authors concluded that this diet was protecting the mineral reserves in bone, and that this could have long-term implications for bone health. Future studies will likely measure bone mineral density and fracture incidence in response to these diets.2

The average daily consumption of sodium for Americans is around 4000mg, almost double the U.S. recommended maximum of 2300mg. The low sodium diet in this study provided a maximum of 1500mg of sodium per day, but included up to six servings of red meat per week, limited the consumption of nutrient-rich legumes to 4-5 per week, and was based on high-calorie, nutrient-poor grain products - 7-8 servings per day.5 The high-carbohydrate low-fat diet was likely based on grain products as well.

Although both of these diets had favorable effects when implemented in place of a standard western diet, they both have room for improvement. By minimizing the high-protein, high-saturated fat animal products, and replacing grain products with mineral- and phytochemical-rich vegetables, fruits, and legumes as the base of the diet, both acid load and sodium would be further reduced, presumably leading to further benefits on bone health.

To learn more about this topic and more, please visit his website at DrFuhrman.com and his blog at DiseaseProof.com.

References:
1. Strazzullo P et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009;339:b4567
2. Nowson CA et al. The effects of a low-sodium base-producing diet including red meat compared with a high-carbohydrate, low-fat diet on bone turnover markers in women aged 45-75 years. Br J Nutr. 2009 Oct;102(8):1161-70. Epub 2009 May 18.
3. Welch AA et al. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and
Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28.
4. Massey LK. J Nutr. Dietary animal and plant protein and human bone health: a whole foods approach. 2003 Mar;133(3):862S-865S.
5. http://dashdiet.org/
http://www.bakeryandsnacks.com/Publications/Food-Beverage-Nutrition/FoodNavigator.com/Science-Nutrition/Salt-reduction-may-also-benefit-bone-health/?c=9EU3KtLmkBBxmwtf4jYClA%3D%3D&utm_source=newsletter_daily&utm_medium=email&utm_campaign=Newsletter%2BDaily
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf