PRAL Timeline: Early Adoption Of New Standard

Early Adoption Of PRAL Standard is second in my series, Potential Renal Acid Load Timeline. So if you missed it, read PRAL Timeline: Proof Of Concept Years first. Then see below, how Remer and Manz’s new idea becomes validated and adopted around the world.

In future timelines, I will show how PRAL is adopted more as a world standard for measuring Alkaline Diets. Then you will see how useful PRAL is for many diseases. Because it can be used as an assessment tool during diagnosis. Also, PRAL can help measure treatment progress where diet is strongly linked to a disease.

Please note that this is not a practical healthy eating help series. Because I want to establish the scientific facts of alkaline diets now. Then I will bring you practical eating plans and nutrition advice for many different diseases. So I can send you a brief summary email when I publish more. If you want to stay informed about healthy eating subscribe:

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PRAL 2003-2007 Early Adoption Of New Standard

Below, I list the diseases shown to be helped by a PRAL-based alkaline diet. In summary, these are Hip Fracture, Kidney Stones, Osteopenia, and Osteoporosis.

2003 March

Citation: Massey, Linda K. “Dietary animal and plant protein and human bone health: a whole foods approach.” The Journal of Nutrition 133, no. 3 (2003): 862S-865S.
Main Disease: Osteoporosis
Other Diseases: Hip Fracture

“Excess” dietary protein from either animal or plant proteins may be detrimental to bone health, but its effect will be modified by other nutrients in the food and total diet.

2003 May

Citation: Remer, Thomas, Triantafillia Dimitriou, and Friedrich Manz. “Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents.” The American journal of clinical nutrition 77, no. 5 (2003): 1255-1260.

The PRAL estimate based on only 4 nutrients may allow relatively simple assessment of the acidity of foods and diets.

Notes: Proof of PRAL concept rather than specific diseases.

2003 October

Citation: Remer, Thomas, and Friedrich Manz. “Paleolithic diet, sweet potato eaters, and potential renal acid load.” The American journal of clinical nutrition 78, no. 4 (2003): 802-803.

we also conclude that the average Paleolithic diet principally led to net base production (yielding a negative PRAL)

Notes: Confirmation that authentic Paleo Diet should be alkaline-forming.

PRAL 2005

2005 July

Citation: Zwart, S. R., J. E. Davis-Street, D. Paddon-Jones, A. A. Ferrando, R. R. Wolfe, and S. M. Smith. “Amino acid supplementation alters bone metabolism during simulated weightlessness.” Journal of Applied Physiology 99, no. 1 (2005): 134-140.
Main Disease: Osteopenia

Potential renal acid load was higher in the amino acid-supplemented group [and]… bone resorption increased

2005 April

Citation: Macdonald, Helen M., Susan A. New, William D. Fraser, Marion K. Campbell, and David M. Reid. “Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women–.” The American journal of clinical nutrition 81, no. 4 (2005): 923-933.
Main Disease: Osteoporosis

Dietary potassium, an indicator of NEAP and fruit and vegetable intake, may exert a modest influence on markers of bone health, which over a lifetime may contribute to a decreased risk of osteoporosis.

2005 November

Citation: Alexy, Ute, Thomas Remer, Friedrich Manz, Christina M. Neu, and Eckhard Schoenau. “Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children–.” The American journal of clinical nutrition 82, no. 5 (2005): 1107-1114.
Main Disease: Osteopenia

Long-term dietary protein intake appears to act anabolically on diaphyseal bone strength during growth, and this may be negated, at least partly, if dietary PRAL is high, ie, if the intake of alkalizing minerals is low.

PRAL 2006

2006 February

Citation: Trinchieri, Alberto, Renata Lizzano, Federica Marchesotti, and Giampaolo Zanetti. “Effect of potential renal acid load of foods on urinary citrate excretion in calcium renal stone formers.” Urological research 34, no. 1 (2006): 1-7.
Main Disease: Kidney Stones.

The computation of the renal acid load is advisable to investigate the role of diet in the pathogenesis of calcium stone disease and it is also a useful tool to evaluate the lithogenic potential of the diet of the individual patient.

2006 May

Citation: Berkemeyer, Shoma, and Thomas Remer. “Anthropometrics provide a better estimate of urinary organic acid anion excretion than a dietary mineral intake-based estimate in children, adolescents, and young adults.” The Journal of Nutrition 136, no. 5 (2006): 1203-1208.

This further confirms that the (principally diet-dependent) NEAP comprises a component, i.e., organic acid anions, that is reasonably predictable by anthropometrics. Consequently, the other component, i.e., the potential renal acid load, appears to be the primary parameter that characterizes the diet-induced acid load.

Notes: Osteoporosis, muscle wasting, and kidney stones are mentioned in this PRAL study. However, the conclusion is a validation of PRAL rather than it’s benefit in any specific disease.

2007 April

Citation: Welch, Ailsa A., Sheila A. Bingham, Jonathan Reeve, and K. T. Khaw. “More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study–.” The American journal of clinical nutrition 85, no. 4 (2007): 1134-1141.
Main Disease: Osteopenia

PRAL was inversely associated with bone ultrasound measures in women, but the magnitude of the association was relatively small compared with other known risk factors. Further longitudinal studies are required to establish whether, in the long term, these small effects are important in overall fracture risk in populations.

PRAL Standard Measure for Alkaline Diet

How do you measure your alkaline diet?

Your PRAL Standard

Do you measure your Alkaline Diet with the PRAL standard? Or do you have a different way of assessing and planning your healthy meals? Please tell me what you think about PRAL as an alkaline diet scoring system in the Feedback Form below.

So far, my first two timelines have shown PRAL develop as an aid to bone health and kidney stones. Next, take heart as PRAL finds its place in the cardiovascular world. If you want an email when I publish, please scroll back to the subscription form.

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