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Alkaline salts to counteract bone resorption and protein wasting induced by high salt intake: results of a randomized controlled trial.

The Journal of clinical endocrinology and metabolism (2012-10-03)
Judith Buehlmeier, Petra Frings-Meuthen, Thomas Remer, Christiane Maser-Gluth, Peter Stehle, Gianni Biolo, Martina Heer
ABSTRACT

High sodium chloride (NaCl) intake can induce low-grade metabolic acidosis (LGMA) and may thus influence bone and protein metabolism. We hypothesized that oral potassium bicarbonate (KHCO(3)) supplementation may compensate for NaCl-induced, LGMA-associated bone resorption and protein losses. Eight healthy male subjects participated in a randomized trial with a crossover design. Each of two study campaigns consisted of 5 d of dietary and environmental adaptation followed by 10 d of intervention and 1.5 d of recovery. In one study campaign, 90 mmol KHCO(3)/d were supplemented to counteract NaCl-induced LGMA, whereas the other campaign served as a control with only high NaCl intake. When KHCO(3) was ingested during high NaCl intake, postprandial buffer capacity ([HCO(3)(-)]) increased (P = 0.002). Concomitantly, urinary excretion of free potentially bioactive glucocorticoids [urinary free cortisol (UFF) and urinary free cortisone (UFE)] was reduced by 14% [∑(UFF,UFE); P = 0.024]. Urinary excretion of calcium and bone resorption marker N-terminal telopeptide of type I collagen was reduced by 12 and 8%, respectively (calcium, P = 0.047; N-terminal bone collagen telopeptide, P = 0.044). There was a trend of declining net protein catabolism when high NaCl was combined with KHCO(3) (P = 0.052). We conclude that during high salt intake, the KHCO(3)-induced postprandial shift to a more alkaline state reduces metabolic stress. This leads to decreased bone resorption and protein degradation, which in turn might initiate an anticatabolic state for the musculoskeletal system in the long run.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Potassium bicarbonate, BioUltra, ≥99.5% (T)
Sigma-Aldrich
Potassium bicarbonate, puriss., meets analytical specification of Ph. Eur., BP, USP, E501, 99.5-101.0% (acidimetric)
Sigma-Aldrich
Potassium bicarbonate, ≥99.95% trace metals basis, 99.7-100.5% dry basis
Sigma-Aldrich
Potassium bicarbonate, ACS reagent, 99.7%, powder, crystals or granules
Sigma-Aldrich
Potassium bicarbonate, Vetec, reagent grade, 99%