Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial
BackgroundEvidence suggests that changes in dietary acid load may influence body weight, and the purpose of this secondary analysis was to assess its role in the context of the Mediterranean and a vegan diet in overweight adults.MethodsIn this randomized cross-over trial, 62 overweight adults were r...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1634215/full |
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| author | Hana Kahleova Cristina Maracine Joseph Himmelfarb Arathi Jayaraman Tatiana Znayenko-Miller Richard Holubkov Neal D. Barnard Neal D. Barnard |
| author_facet | Hana Kahleova Cristina Maracine Joseph Himmelfarb Arathi Jayaraman Tatiana Znayenko-Miller Richard Holubkov Neal D. Barnard Neal D. Barnard |
| author_sort | Hana Kahleova |
| collection | DOAJ |
| description | BackgroundEvidence suggests that changes in dietary acid load may influence body weight, and the purpose of this secondary analysis was to assess its role in the context of the Mediterranean and a vegan diet in overweight adults.MethodsIn this randomized cross-over trial, 62 overweight adults were randomized to a Mediterranean or a low-fat vegan diet for 16-weeks, separated by a 4-week washout. Change in body weight was the primary outcome. Three-day dietary records were analyzed, and Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) were calculated as markers of dietary acid load, and their relationship was tested with changes in body weight.ResultsCompared with no change on the Mediterranean diet, PRAL and NEAP significantly decreased on the vegan diet; effect sizes: −25.8 (95% CI −34.1 to −17.5); p < 0.001; and −27.1 (95% CI −35.4 to −18.7); p < 0.001, respectively. Across both diets, changes in PRAL and NEAP were positively associated with changes in body weight in the first 16 weeks of the study: r = +0.34; p = 0.009; and r = +0.39; p = 0.002, respectively, as well as in the second 16 weeks: r = +0.59; p < 0.001, and r = +0.61; p < 0.001, respectively.ConclusionThese findings suggest that, compared with the Mediterranean diet, dietary acid load decreased significantly on the low-fat vegan diet and was associated with weight loss. The alkalizing effect of a vegan diet may be an independent mechanism by which a vegan diet promotes weight loss.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT03698955. |
| format | Article |
| id | doaj-art-e04c60c93a1047c1aed92f386f6c8813 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-e04c60c93a1047c1aed92f386f6c88132025-08-20T03:32:12ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-06-011210.3389/fnut.2025.16342151634215Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trialHana Kahleova0Cristina Maracine1Joseph Himmelfarb2Arathi Jayaraman3Tatiana Znayenko-Miller4Richard Holubkov5Neal D. Barnard6Neal D. Barnard7Physicians Committee for Responsible Medicine, Washington, DC, United StatesPhysicians Committee for Responsible Medicine, Washington, DC, United StatesPhysicians Committee for Responsible Medicine, Washington, DC, United StatesPhysicians Committee for Responsible Medicine, Washington, DC, United StatesPhysicians Committee for Responsible Medicine, Washington, DC, United StatesSchool of Medicine, University of Utah, Salt Lake City, UT, United StatesPhysicians Committee for Responsible Medicine, Washington, DC, United StatesGeorge Washington University School of Medicine and Health Sciences, Washington, DC, United StatesBackgroundEvidence suggests that changes in dietary acid load may influence body weight, and the purpose of this secondary analysis was to assess its role in the context of the Mediterranean and a vegan diet in overweight adults.MethodsIn this randomized cross-over trial, 62 overweight adults were randomized to a Mediterranean or a low-fat vegan diet for 16-weeks, separated by a 4-week washout. Change in body weight was the primary outcome. Three-day dietary records were analyzed, and Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) were calculated as markers of dietary acid load, and their relationship was tested with changes in body weight.ResultsCompared with no change on the Mediterranean diet, PRAL and NEAP significantly decreased on the vegan diet; effect sizes: −25.8 (95% CI −34.1 to −17.5); p < 0.001; and −27.1 (95% CI −35.4 to −18.7); p < 0.001, respectively. Across both diets, changes in PRAL and NEAP were positively associated with changes in body weight in the first 16 weeks of the study: r = +0.34; p = 0.009; and r = +0.39; p = 0.002, respectively, as well as in the second 16 weeks: r = +0.59; p < 0.001, and r = +0.61; p < 0.001, respectively.ConclusionThese findings suggest that, compared with the Mediterranean diet, dietary acid load decreased significantly on the low-fat vegan diet and was associated with weight loss. The alkalizing effect of a vegan diet may be an independent mechanism by which a vegan diet promotes weight loss.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT03698955.https://www.frontiersin.org/articles/10.3389/fnut.2025.1634215/fulldietary acid loadMediterraneannutritionplant-basedvegan |
| spellingShingle | Hana Kahleova Cristina Maracine Joseph Himmelfarb Arathi Jayaraman Tatiana Znayenko-Miller Richard Holubkov Neal D. Barnard Neal D. Barnard Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial Frontiers in Nutrition dietary acid load Mediterranean nutrition plant-based vegan |
| title | Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial |
| title_full | Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial |
| title_fullStr | Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial |
| title_full_unstemmed | Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial |
| title_short | Dietary acid load on the Mediterranean and a vegan diet: a secondary analysis of a randomized, cross-over trial |
| title_sort | dietary acid load on the mediterranean and a vegan diet a secondary analysis of a randomized cross over trial |
| topic | dietary acid load Mediterranean nutrition plant-based vegan |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1634215/full |
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