Muscle strength is a key determinant of functional capacity and quality of life, influenced by various modifiable factors including nutrition. Emerging evidence suggests a potential link between dietary acid load and musculoskeletal health, but its relationship with muscle strength and performance, especially in young healthy individuals, has not been fully clarified.
Aim
This cross-sectional study aimed to evaluate the relationship between dietary acid load, muscle strength, and physical performance in healthy young women.
Methods
A total of 151 women aged 18–35 years were recruited through convenience sampling from a university campus, excluding those with chronic diseases, physical disabilities, regular exercise habits, or special diets. Handgrip strength was measured using a dynamometer, and functional performance was assessed with a 10-step stair test. A 24-h dietary record was used to calculate the potential renal acid load (PRAL).
Results
Participants had a mean age of 22.5 ± 1.6 years. The average handgrip strength was 25.3 ± 4.8 kg, and the 10-step test times were 5.6 ± 0.9 s. The mean PRAL was 5.0 ± 14.1 mEq/day. There were no significant differences in handgrip strength or 10-step test results across PRAL tertiles (p > 0.05). While no significant correlation was found between PRAL and handgrip strength in the crude model (p = 0.115), a positive association appeared after adjusting for energy intake (p = 0.043). No significant correlation was found between PRAL and 10-step test results (p > 0.05).
Conclusion
A more acidic diet was positively associated with muscle strength, highlighting the potential impact of diet on muscle function.
AlexanderSEPollockACLamonS (2022) The effect of sex hormones on skeletal muscle adaptation in females. European Journal of Sport Science22(7): 1035–1045.
2.
ApplegateCMuellerMZunigaKE (2017) Influence of dietary acid load on exercise performance. International Journal of Sport Nutrition and Exercise Metabolism27(3): 213–219.
3.
BattazzaRAKalytczakMMLeiteCDFC, et al. (2023) Effect of sodium bicarbonate supplementation on muscle performance and muscle damage: A double blind, randomized crossover study. Journal of Dietary Supplements20(5): 689–705.
4.
Bowden DaviesKAPicklesSSprungVS, et al. (2019) Reduced physical activity in young and older adults: Metabolic and musculoskeletal implications. Therapeutic Advances in Endocrinology and Metabolism10: 2042018819888824.
5.
CacianoSLInmanCLGockel-BlessingEE, et al. (2015) Effects of dietary acid load on exercise metabolism and anaerobic exercise performance. Journal of Sports Science & Medicine14(2): 364–371.
6.
CaoJJ (2017) High dietary protein intake and protein-related acid load on bone health. Current Osteoporosis Reports15(6): 571–576.
7.
de CarvalhoDHTScholesSSantosJLF, et al. (2019) Does abdominal obesity accelerate muscle strength decline in older adults? Evidence from the English longitudinal study of ageing. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences74: 1105–1111.
8.
DeschenesMRFlanneryRHawbakerA, et al. (2022) Adaptive remodeling of the neuromuscular junction with aging. Cells11(7): 1150.
9.
DominguezLJVeroneseNSmithL, et al. (2025) Nutrition and physical activity in musculoskeletal health. Endocrines6(1), 10.
10.
FaureAMFischerKDawson-HughesB, et al. (2017) Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporosis International28(12): 3451–3462.
11.
FrassettoLBanerjeeTPoweN, et al. (2018) Acid balance, dietary acid load, and bone effects-A controversial subject. Nutrients10(4): 517.
12.
GholamiFBahrampourNSamadiM, et al. (2023) The association of dietary acid load (DAL) with estimated skeletal muscle mass and bone mineral content: A cross-sectional study. Bmc Nutrition9(1): 31.
13.
HayhoeRPGAbdelhamidALubenRN, et al. (2020) Dietary acid-base load and its association with risk of osteoporotic fractures and low estimated skeletal muscle mass. European Journal of Clinical Nutrition74(Suppl 1): 33–42.
14.
HoJOAbramowitzMK (2022) Clinical consequences of metabolic acidosis-muscle. Advances in Chronic Kidney Disease29(4): 395–405.
15.
KonieczynskiEMCegliaLReitshamerE, et al. (2024) Association between dietary acid load and grip strength in adults 50 years and older: A cross-sectional study. Calcified Tissue International115(4): 373–381.
16.
LarssonLDegensHLiM, et al. (2019) Sarcopenia: Aging-related loss of muscle mass and function. Physiological Reviews99(1): 427–511.
17.
LimmerMEiblADPlatenP (2018) Enhanced 400-m sprint performance in moderately trained participants by a 4-day alkalizing diet: A counterbalanced, randomized controlled trial. Journal of The International Society of Sports Nutrition15(1): 25.
18.
LindemanELeffersPReulenJ, et al. (1998) Quadriceps strength and timed motor performances in myotonic dystrophy, Charcot-Marie-Tooth disease, and healthy subjects. Clinical Rehabilitation12(2): 127–135.
19.
MohammadpourSDjafariFDavarzaniS, et al. (2020) The association between dietary acid load and muscle strength among Iranian adults. Bmc Research Notes13(1): 476.
20.
NightingaleEJFereshtehPClaireEH (2014) Systematic review of timed stair tests. Journal of Rehabilitation Research and Development51(3): 335–350.
21.
NuzzoJL (2023) Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. Journal of Strength and Conditioning Research37(2): 494–536.
22.
QuattrocchiAGarufiGGugliandoloG, et al. (2024) Handgrip strength in health applications: A review of the measurement methodologies and influencing factors. Sensors (Basel, Switzerland)24(16): 5100.
23.
RakıcıoğluNTekNAyazA, et al. (eds) (2012) Yemek ve Besin Fotoğraf Kataloğu: Ölçü ve Miktarlar, 4th ed. Ata Ofset Publications.
24.
ReinMElkanMGodnevaA, et al. (2024) Sex-specific dietary habits and their association with weight change in healthy adults. BMC Medicine22(1): 512.
25.
RemerTManzF (1995) Potential renal acid load of foods and its influence on urine pH. Journal of the American Dietetic Association95: 791–797.
26.
RiviatiNIndraB (2023) Relationship between muscle mass and muscle strength with physical performance in older adults: A systematic review. Sage Open Medicine11: 20503121231214650.
ShimokataHAndoFYukiA, et al. (2014) Age-related changes in skeletal muscle mass among community-dwelling Japanese: A 12-year longitudinal study. Geriatrics & Gerontology International14(Suppl 1): 85–92.
29.
StorzMARoncoALHannibalL (2022) Observational and clinical evidence that plant-based nutrition reduces dietary acid load. Journal of Nutritional Science11: e93.
30.
TemurHB (2017) Alt ve Üst ekstremite Çevre Ölçüm değerleri ile el kavrama kuvveti ve sıçrama mesafesi arasındaki İlişkinin İncelenmesi. Spor ve Performans Araştırmaları Dergisi8(1): 1–9.
31.
WangKWangXWangY (2024) Factors, mechanisms and improvement methods of muscle strength loss. Frontiers in Cell and Developmental Biology12: 1509519.
32.
WelchAAMacGregorAJSkinnerJ, et al. (2013) A higher alkaline dietary load is associated with greater indexes of skeletal muscle mass in women. Osteoporosis International24(6): 1899–1908.
33.
WolfeRR (2006) The underappreciated role of muscle in health and disease. American Journal of Clinical Nutrition84(3): 475–482.
WuFWillsKLaslettLL, et al. (2017) Associations of dietary patterns with bone mass, muscle strength and balance in a cohort of Australian middle-aged women. British Journal of Nutrition118: 598–606.
