Kahleova Hana, Maracine Cristina, Himmelfarb Joseph, Jayaraman Arathi, Znayenko-Miller Tatiana, Holubkov Richard, Barnard Neal D
Physicians Committee for Responsible Medicine, Washington, DC, United States.
School of Medicine, University of Utah, Salt Lake City, UT, United States.
Front Nutr. 2025 Jun 25;12:1634215. doi: 10.3389/fnut.2025.1634215. eCollection 2025.
Evidence 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.
In 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.
Compared 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); < 0.001; and -27.1 (95% CI -35.4 to -18.7); < 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: = +0.34; = 0.009; and r = +0.39; = 0.002, respectively, as well as in the second 16 weeks: = +0.59; < 0.001, and = +0.61; < 0.001, respectively.
These 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.
https://clinicaltrials.gov/, identifier NCT03698955.
有证据表明，饮食酸负荷的变化可能会影响体重，本二次分析的目的是评估其在超重成年人的地中海饮食和纯素饮食背景下的作用。
在这项随机交叉试验中，62名超重成年人被随机分配到地中海饮食或低脂纯素饮食组，为期16周，中间有4周的洗脱期。体重变化是主要结局。分析了三天的饮食记录，并计算了潜在肾酸负荷（PRAL）和净内源性酸产生量（NEAP）作为饮食酸负荷的指标，并测试了它们与体重变化的关系。
与地中海饮食无变化相比，纯素饮食时PRAL和NEAP显著降低；效应量分别为：-25.8（95%置信区间-34.1至-17.5）；P<0.001；以及-27.1（95%置信区间-35.4至-18.7）；P<0.001。在两种饮食中，在研究的前16周，PRAL和NEAP的变化与体重变化呈正相关：r分别为+0.34；P=0.009；以及r=+0.39；P=0.002，在第二个16周也是如此：r分别为+0.59；P<0.001，以及r=+0.61；P<0.001。
这些发现表明，与地中海饮食相比，低脂纯素饮食的饮食酸负荷显著降低，且与体重减轻有关。纯素饮食的碱化作用可能是纯素饮食促进体重减轻的一种独立机制。
