By Anne Harding
NEW YORK (Reuters Health) Nov 27 – Elderly, osteoporosis-free men and women who take potassium citrate daily have significant increases in areal and volumetric bone mineral density (BMD) after two years, new findings show.
“By neutralizing the acid we generate by our diet it is possible to slow or possibly reverse the age related decline in bone density and bone mass,” Dr. Reto Krapf of the University of Basel in Switzerland, one of the study’s authors, told Reuters Health.
Eating a diet heavy in proteins from meat and grains can increase the acid load in the body, leaching calcium from the bone and resulting in other bone-weakening effects, Dr. Krapf and his team noted in a paper online November 15th in the Journal of Clinical Endocrinology and Metabolism.
The researchers note that a study in osteopenic women found those who took potassium citrate for a year to neutralize diet-induced acidosis showed an increase in areal BMD.
To investigate whether this approach could also prevent the decline in bone mass and quality that occurs with aging, Dr. Krapf and his colleagues enrolled 201 men and women over 65, none of whom had osteoporosis at baseline. Subjects took 60 mEq of potassium citrate daily or placebo, along with calcium and vitamin D. The primary outcome was areal BMD at the lumbar spine as measured by dual-energy x-ray absorptiometry (DEXA) at 24 months.
Twenty-four-hour urinary acid excretion showed complete neutralization of endogenous acid production in the patients taking potassium citrate, while these patients also showed lower calcium excretion at six and 12 months.
After two years, lumbar spine density had increased by 1.7%, on average, in patients taking potassium citrate. All parameters measured showed increases, with no signs of a plateau.
High-resolution peripheral quantitative computed tomography, used to measure volumetric bone density, showed trabecular density increases in the non-dominant tibia and radius of 1.3% and 2.0%, respectively. Both men and women taking potassium citrate had significant decreases in fracture risk as measured by FRAX.
The participants in the current study were at very low risk of fracture, Dr. Krapf noted, and conducting a study that would yield fracture data would require enrolling thousands of patients and following them for several years. However, he noted, the current findings probably provide enough evidence to make claims for the bone-strengthening benefits of potassium citrate as a nutritional supplement
He and his colleagues conclude: “K-citrate administered in a background of vitamin D and calcium supplements is well-tolerated and constitutes an inexpensive intervention to increase bone aBMD and trabecular vBMD and to improve bone micro architecture in healthy elderly people with normal bone mass.”
J Clin Endocrinol Metab 2012.
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