Vol 21. N°1. 2020  |  Enero-Marzo de 2020


REVISIÓN - NUTRICIÓN


DIETA ALCALINA Y SU RELACIÓN CON LA SALUD Y LA ENFERMEDAD: UNA REVISIÓN SISTEMÁTICA

Autores: ALCIDES JUAN DIEGO CABALLERO, CAROLONA CLERICI


RESUMEN

Introducción: el balance ácido-base del ser humano se encuentra en constante equilibrio, pero ciertos alimentos, según su naturaleza química, pueden influir sobre este mecanismo y desequilibrarlo. Actualmente estas dietas basadas en la alcalinidad del medio interno están en auge, por lo que se han convertido en un tema de relevancia social.
Objetivos: conocer el estado actual de la cuestión en lo referente a la incorporación de una dieta alcalina y alimentos alcalinizantes, y su relación con la salud y la enfermedad.
Materiales y métodos: para abordar esta problemática se llevó a cabo una revisión sistemática que permitió dar una actualización y generalización acerca del tema. Se realizó siguiendo las directrices Strobe y se utilizaron nueve temas de los 22 de la lista de control. La búsqueda se realizó en PubMed utilizando la palabra clave alkaline diet, en inglés. Se obtuvieron 30 artículos, de los cuales 15 cumplieron los criterios de selección.
Resultados: según los artículos analizados, lo que diferencia a un alimento ácido de uno alcalino es la variación entre los iones o moléculas ionizadas presentes en cada uno. En general se define a la dieta alcalina como aquella compuesta mayoritariamente por frutas y verduras, con bajo contenido de alimentos de origen animal altos en proteínas, como las carnes, los huevos y los quesos, asociados a una dieta más ácida. El contenido elevado de K junto con los bajos niveles de Cl y Na caracterizaron a las dietas alcalinas, mientras que aquellas en las que el Cl y Na fueron predominantes representaron a las dietas ácidas.
Conclusiones: a partir de los artículos analizados no es posible concluir sobre las consecuencias de una dieta alcalina sobre la salud y la enfermedad, coincidiendo con otras revisiones en la necesidad de más estudios que permitan probar los beneficios de la dieta alcalina.

Palabras clave: dieta alcalina; salud y enfermedad; revisión sistemática.

Referencias:
1. Vasey C. La importancia del equilibrio ácido-básico. Editorial Edaf, S.L. 1º Ed., 1º imp (2010). ISBN: 8441408998.
2. Adeva MM, Souto G. Diet induced metabolic acidosis. Clinical Nutrition 2011; 30:416-421.
3. Bolet-Astoviza M, Socarrás-Suárez MM. Alimentación adecuada para mejorar la salud y evitar enfermedades crónicas. Revista Cubana de Medicina General Integral 2010; 26.
4. Ríos-Enríquez O, Guerra-Hernández E, Feriche FernándezCastanys B. Effects of the metabolic alkalosis induced by the diet in the high intensity anaerobic performance. Nutrición Hospitalaria 2010; 25:768-773.
5. Osuna-Padilla IA, Leal-Escobar G, Garza-García CA, Rodrí- guez-Castellas FE. Carga ácida de la dieta: mecanismos y evidencia de sus repercusiones en la salud. Sociedad Española de Nefrología 2019; 39:343-354.
6. Urra-Medina E. La revisión sistemática y su relación con la práctica basada en la evidencia en salud. Revista Latinoamericana de Enfermagem 2010; 18:1-8. p.2
7. von Elm EL, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. The Lancet 2007; 370:1453-1457.
8. Faure AM, Fischer K, Dawson-Hughes B, et al. Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporosis International 2017; 28:3451-3462.
9. Hamaguchi R, Okamoto T, Sato M, et al. Effects of an alkaline diet on GFR-TKI therapy in EGFR mutation-positive NSCLC. Anticancer Research 2015; 37:5141-5145.
10. Kozan P, Blythe JC, Greenfield JR, et al. The effect of buffering high acid load meal with sodium bicarbonate on postprandial glucose metabolism in humans. A randomized placebo controlled study. Nutrients 2017; 9:861. Doi:10.3390/ nu9080861.
11. Magnoni LJ, Salas-Leiton E, Peixoto MJ, et al. Dietary electrolyte balance affects growth performance, amylase activity and metabolic response in the meagre (Argyrosomus regius). Comparative Biochemistry And Physiology 2017; 211:8-15.
12. Caciano S, Inman C, Gockel-Blessing E, Weiss E. Effects of dietary acid load on exercise metabolism and anaerobic exercise performance. Journal of Sports Science & Medicine 2015;14:364-371.
13. Wen D, Cornelius R, Rivero-Hernández D, et al. Relation between BK-?/?4-mediated potassium secretion and ENaCmediated sodium reabsorption. Kidney International: Official Journal of the International Society of Nephrology 2014; 86:139-145.
14. Wen D, Cornelius R, Yuan Y, Samson S. Regulation of BK-? expression in the distal nephron by aldosterone and urine pH. American Journal of Physiology 2013; 305:463-473.
15. Welch A, MacGregor A, Skinner J, Spector T, Moayyedi A, Cassidy A. A higher alkaline dietary load is associated with greater indexes of skeletal muscle mass in women. Osteoporosis International 2013; 24:1899-1908.
16. Cornelius R, Wen D, Hatcher L, Samson S. Bicarbonate promotes BK-?/?4 mediated K excretion in the renal distal nephron. American Journal of Physiology 2012; 303:1563-1571.
17. Kanbara A, Miura Y, Hyogo H, Chayama K, Seyama I. Effect of urine pH changed by dietary intervention on uric acid clearance mechanism of pH-dependent excretion of urinary uric acid. Nutrition Journal 2012; 11.
18. Kanbara A, Seyama I. Effect of urine pH on uric acid excretion by manipulating food materials. Nucleosides Nucleotides Nucleic Acids. 2011;12:1066-71. Doi: 10.1080/15257770.2011.596498.
19. Fenton T, Eliasziw M, Tough S, Lyon A, Brown J, Hanley DA. Low urine pH and acid excretion do not predict bone fractures or the loss of bone mineral density: a prospective cohort study. BMC Musculoskelet Disord. 2010; 10;11:88. Doi: 10.1186/1471-2474-11-88.
20. Welch AA, Mulligan A, Bingham SA, Khaw KT. 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. British Journal of Nutrition 2008; 99:1335-1343.
21. Ballina JC, Di Masso R, Puche RC. Calcium metabolism of intact and thyroparathyroidectomized rats fed a bicarbonate enriched diet. Journal of Endocrinological Investigation 1985; 8:171-174.
22. Riley WW Jr, Austic RE. Influence of dietary electrolytes on digestive tract pH and acid-base status of chicks. Poultry Science 1984; 63:2247-2251.
23. Passey C. Reducing the dietary acid load: how a more alkaline diet benefits patients with chronic kidney disease. Journal of Renal Nutrition 2017; 27:151-160.
24. Schwalfenberg GK. The alkaline diet: is there evidence that an alkaline pH diet benefits health? J Environ Public Health. 2012;2012:727630. Doi:10.1155/2012/727630.
25. Hanley DA, Whiting SJ. Does a high dietary acid content cause bone loss, and can bone loss be prevented with an alkaline diet? Journal of Clinical Densitometry 2013; 16:420-425.
26. Applegate C, Mueller M, Zuniga KE. Influence of dietary acid load on exercise performance. International Journal of Sport Nutrition and Exercise 2017; 27:213-219.
27. Fenton TR, Huang T. Systematic review of the association between dietary acid load, alkaline water and cancer. BMJ Open 2016; 6.
28. Huebner J, Marienfeld S, Abbenhardt C, et al. Counseling patients on cancer diets. A review of the literature and recommendations for clinical practice. Anticancer Research 2014; 34:39-48.

---

ALKALINE DIET AND ITS RELATION WITH HEALTH AND DESEASE: A SYSTEMATIC REVIEW

SUMMARY

Introduction: the acid-base balance of the human being is in constant equilibrium, but certain foods, depending on their chemical nature, can influence this mechanism by unbalancing it. Currently these diets based on the alkalinity of the internal environment are booming, so they have become a topic of social relevance.
Objectives: to describe the current state of the art on the incorporation of an alkaline diet and alkalizing foods, and its relation to health and disease.
Materials and methods: to address this problem, a systematic review was carried out that allowed an update and generalization on the subject. It was carried out following the Strobe guidelines, 9 items of the 22 of the checklist were used. The search was conducted in PubMed using the keyword: alkaline diet, in English. Thirty articles were obtained, fifteen of which met the selection criteria.
Results: according to the articles analyzed, what differentiates an acidic food from an alkaline one is the variation between the ions or ionized molecules present in each. In general, the alkaline diet is defined as composed mainly of fruits and vegetables, with a low content of animal foods high in protein, such as meats, eggs and cheeses, associated with a more acidic diet. The high K content together with the low levels of Cl and Na characterized the alkaline diets under study; while those in which Cl and Na were predominant represented acid diets.
Conclusions: the articles analyzed are inconclusive as to the consequences of an alkaline diet on health and disease, in line with other reviews on the need for more studies to prove the benefits of the alkaline diet.

Key words: alkaline diet; health and disease; systematic review.


DESCARGAR TEXTO COMPLETO EN PDF