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Mediterranean diet and high dietary acid load associated with mixed nuts : effect on bone metabolism in elderly subjects . OBJECTIVES To analyze the effect of differing diet on the acid load content on bone metabolism . DESIGN Multicentric , randomized , single-blind , parallel-group clinical trial . SETTING Outpatient clinics . PARTICIPANTS Two hundred thirty-eight elderly men and women aged 60 to 80 at high risk for cardiovascular disease were randomly assigned to three interventional groups : a recommended low-fat diet ( control diet group ) , a Mediterranean diet supplemented with virgin olive oil , or a Mediterranean diet supplemented with mixed nuts . MEASUREMENTS Main outcomes were 12-month changes from baseline in bone formation and resorption markers and bone mass measured according to quantitative ultrasound scanning . RESULTS The baseline data on the anthropometric , bone densitometry , and biochemical variables did not differ between the three groups . Dietary potential renal acid load ( PRAL ) and daily net endogenous acid production ( NEAP ) at baseline did not differ between groups . After intervention , subjects allocated to the Mediterranean diet with mixed nuts had a significant increase of PRAL and NEAP . In comparison , subjects in the Mediterranean diet with nuts group had higher parathyroid hormone ( PTH ) levels ( 2.63 , 95 % confidence interval ( CI ) =-1.01-6.35 , P=.02 ) and a nonsignificantly higher ( 0.31 , 95 % CI=-0.13-0.74 , P=.14 ) urine free deoxypyridoxine : creatinine ratio , a marker of bone resorption , than the control group and the Mediterranean diet with virgin olive oil group . CONCLUSION A Mediterranean dietary pattern associated with a high dietary acid load derived from consumption of mixed nuts does not seem to have a much greater effect on bone metabolism biomarkers , with the exception of PTH levels , than a Mediterranean diet without mixed nuts or a control diet in elderly subjects .
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Intervention_Other
Mediterranean diet
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Intervention_Other
high dietary acid load
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Intervention_Other
mixed nuts
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Intervention_Control
recommended low-fat diet ( control diet group )
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Intervention_Other
Mediterranean diet supplemented with virgin olive oil
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Intervention_Other
Mediterranean diet with mixed nuts
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Intervention_Other
Mediterranean diet with nuts
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Intervention_Educational
Mediterranean dietary pattern
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Intervention_Other
Mediterranean diet without mixed nuts
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Intervention_Control
control diet
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Outcome_Physical
effect
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Outcome_Physical
bone metabolism
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Outcome_Physical
bone metabolism
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Outcome_Physical
bone formation and resorption markers and bone mass measured
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Outcome_Physical
anthropometric , bone densitometry , and biochemical variables
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Outcome_Physical
Dietary potential renal acid load ( PRAL )
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Outcome_Physical
daily net endogenous acid production ( NEAP )
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Outcome_Physical
PRAL
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Outcome_Physical
NEAP
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Outcome_Physical
parathyroid hormone ( PTH ) levels
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Outcome_Physical
urine free deoxypyridoxine : creatinine ratio
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Outcome_Physical
bone metabolism biomarkers
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Outcome_Physical
PTH levels
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Participant_Age
elderly
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Participant_Sample-size
Two hundred thirty-eight
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Participant_Age
elderly
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Participant_Sex
men
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Participant_Sex
women
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Participant_Age
60 to 80
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Participant_Condition
cardiovascular disease
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Participant_Age
elderly