From the Department of Urology, UT Southwestern Medical Center, Dallas, TX.
Department of Nutrition, Private Practice, Knoxville, TN.
Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):e352-e359. doi: 10.1097/SPV.0000000000000931.
Acidic urine pH may be protective against recurrent urinary tract infections (RUTIs). After reviewing the literature, we primarily analyzed urine pH fluctuations and secondarily compared them with diet in older women with RUTIs.
After IRB approval, postmenopausal women with documented RUTIs were enrolled. Participants were given preformatted charts to record urinalysis reagent strips (Medimpex) findings 4 times per day and concomitant food/beverage intake (food diary). Urine cultures at baseline ensured no infection during measurement period. Nutrient content reported in food diaries was analyzed by an experienced registered dietitian and compared with parallel fluctuations in urine pH.
Of 26 women with median age of 72 years (55-86 years), the first 3 days of diet and urine pH recordings found that 17 (65%) of 26 exhibited urine pH variation greater than 1 unit, with an overall median of 6 (5-9). Comparing dietary analysis and urine pH changes, beta-carotene (P = 0.017) and total dietary sugar intake (P = 0.036) were associated with a decrease in urine pH, whereas monounsaturated fatty acids (MFA, 22:1, P = 0.023) and protein (P = 0.028) were associated with an increase in urine pH.
In this real-life, observational study, 65% of older women with RUTIs exhibited notable changes in urine pH, with decreased urine pH associated with nutrients found in orange and yellow vegetables and several major food groups. A longitudinal study is needed to determine if changing an individual's diet and/or adding supplements could decrease the urine pH, thus affecting the rate of RUTIs.
酸性尿液 pH 值可能对复发性尿路感染（RUTI）有保护作用。在回顾文献后，我们主要分析了尿液 pH 值波动，并次要地将其与患有 RUTI 的老年女性的饮食进行了比较。
在 IRB 批准后，招募了有记录的 RUTI 的绝经后妇女。参与者被给予格式化的图表，以每天 4 次记录尿液分析试剂条（Medimpex）的结果和同时的食物/饮料摄入（饮食日记）。基线时的尿液培养确保了测量期间没有感染。饮食日记中报告的营养成分由一位经验丰富的注册营养师进行分析，并与尿液 pH 值的平行波动进行比较。
在中位年龄为 72 岁（55-86 岁）的 26 位女性中，前 3 天的饮食和尿液 pH 值记录发现，26 位中的 17 位（65%）表现出尿液 pH 值变化大于 1 个单位，总体中位数为 6（5-9）。比较饮食分析和尿液 pH 值变化，β-胡萝卜素（P=0.017）和总膳食糖摄入量（P=0.036）与尿液 pH 值降低相关，而单不饱和脂肪酸（MFA，22:1，P=0.023）和蛋白质（P=0.028）与尿液 pH 值升高相关。
在这项真实世界的观察性研究中，65%的患有 RUTI 的老年女性表现出显著的尿液 pH 值变化，尿液 pH 值降低与橙色和黄色蔬菜以及几个主要食物组中发现的营养物质有关。需要进行一项纵向研究，以确定改变个体的饮食和/或添加补充剂是否可以降低尿液 pH 值，从而影响 RUTI 的发生率。
