Alkaline diets favor lean tissue mass in older adults

Background: Maintaining muscle mass while aging is important to prevent falls and fractures. Metabolic acidosis promotes muscle wasting, and the net acid load from diets that are rich in net acid-producing protein and cereal grains relative to their content of net alkali-producing fruit and vegetables may therefore contribute to a reduction in lean tissue mass in older adults. Objective: We aimed to determine whether there was an association of 24-h urinary potassium and an index of fruit and vegetable content of the diet with the percentage lean body mass (%LBM) or change in %LBM in older subjects. Design: Subjects were 384 men and women >= 65 y old who participated in a 3-y trial comparing calcium and vitamin D with placebo. Potassium was measured in 24-h urine collections at baseline. The %LBM, defined as total body nonfat, nonbone tissue weight divided by weight X 100, was measured by using dual-energy X-ray absorptiometry at baseline and at 3 y. Physical activity, height, and weight were assessed at baseline and at 3 y. Results: At baseline, the mean urinary potassium excretion was 67.0 +/- 21.1 mmol/d. Urinary potassium (mmol/d) was significantly positively associated with %LBM at baseline (beta = 0.033, P = 0.006; adjusted for sex, weight, and nitrogen excretion) but not with 3-y change in %LBM. Over the 3-y study, %LBM increased by 2.6 +/- 3.6%. Conclusion: Higher intake of foods rich in potassium, such as fruit and vegetables, may favor the preservation of muscle mass in older men and women.