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Kalium voor sterke botten*
Uit twee studies blijken de voordelen van het voedingsupplement kaliumcitraat. Kaliumcitraat zorgt dat de verwerking van voeding minder zuur en meer basisch wordt en dat blijkt goed te zijn voor een betere botopbouw en gezondere botten. Veel rauwe groenten en fruit zijn van nature een goede bron van citraten (zouten van citroenzuur) waaronder ook kaliumcitraat.
Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women.
Moseley K, Weaver C, Appel L, Sebastian A, Sellmeyer DE.
Source
Johns Hopkins University, School of Medicine, Baltimore, MD 21224, USA.
Abstract
The dietary acid load created by the typical Western diet may adversely impact the skeleton by disrupting calcium metabolism. Whether neutralizing dietary acid with alkaline potassium salts results in sustained improvements in calcium balance remains controversial. In this randomized, double blind, placebo controlled study, 52 men and women (mean age 65.2 + 6.2 years) were randomly assigned to potassium citrate 60 mmol, 90 mmol or placebo daily with measurements of bone turnover markers, net acid excretion, and calcium metabolism including intestinal fractional calcium absorption and calcium balance obtained at baseline and six months. At six months, net acid excretion was significantly lower in both treatment groups compared to placebo and negative, meaning subjects' dietary acid was completely neutralized (-11.3 mmol/day, 60 mmol/day; -29.5 mmol/day, 90 mmol/day, P < 0.001 compared to placebo). At 6-months, 24-hour urine calcium was significantly reduced in persons taking potassium citrate 60 mmol (-46 ± 15.9 mg/day) and 90 mmol (-59 ± 31.6 mg/day) daily compared with placebo (p < 0.01). Fractional calcium absorption was not changed by potassium citrate supplementation. Net calcium balance was significantly improved in participants taking potassium citrate 90 mmol/day compared to placebo (142 ± 80 mg/day, 90 mmol vs. -80 ± 54 mg/day, placebo; p = 0.02). Calcium balance was also improved on potassium citrate 60 mmol/day, but this did not reach statistical significance (p = 0.18). Serum C-telopeptide decreased significantly in both potassium citrate groups compared to placebo (-34.6 ± 39.1 ng/L, 90 mmol/d, p = 0.05; -71.6 ± 40.7 ng/L, 60 mmol/day, p = 0.02) while bone specific alkaline phosphatase did not change. Intact parathyroid hormone was significantly decreased in the 90 mmol/day group (p = 0.01). Readily available, safe, and easily administered in an oral form, potassium citrate has the potential to improve skeletal health. Longer term trials with definitive outcomes such as bone density and fracture are needed. © American Society for Bone and Mineral Research.
Effect of Potassium Citrate on Bone Density, Microarchitecture, and Fracture Risk in Healthy Older Adults without Osteoporosis: A Randomized Controlled Trial 
1. Sigrid Jehle, 2. Henry N. Hulter and 3. Reto Krapf - Author Affiliations
1. Department of Medicine (S.J., R.K.), Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel, Switzerland; and Department of Medicine (H.N.H.), University of California, San Francisco, San Francisco, California 94143 
1. Address all correspondence and requests for reprints to: Reto Krapf, M.D., Department of Medicine, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel, Switzerland. E-mail: reto.krapf@ksbh.ch. 
Abstract
Context: The acid load imposed by a modern diet may play an important role in the pathophysiology of osteoporosis. 
Objective: Our objective was to evaluate the skeletal efficacy and safety and the effect on fracture prediction of K-citrate to neutralize diet-induced acid loads. 
Design and Setting: We conducted a randomized, double-blind, placebo-controlled trial at a teaching hospital. 
Subjects: Subjects included 201 elderly (>65 yr old) healthy men and women (t-score of −0.6 at lumbar spine). 
Intervention: Intervention was 60 mEq of K-citrate daily or placebo by mouth. All subjects received calcium and vitamin D. 
Outcome Measures: The primary outcome was change in areal bone mineral density (aBMD) at the lumbar spine by dual-energy x-ray absorptiometry after 24 months. Secondary endpoints included changes in volumetric density and microarchitectural parameters by high-resolution peripheral quantitative computed tomography in both radii and both tibiae and fracture risk assessment by FRAX (Switzerland). 
Results: K-citrate increased aBMD at lumbar spine from baseline by 1.7 ± 1.5% [95% confidence interval (CI) = 1.0–2.3, P < 0.001] net of placebo after 24 months. High-resolution peripheral quantitative computed tomography-measured trabecular densities increased at nondominant tibia (1.3 ± 1.3%, CI = 0.7–1.9, P < 0.001) and nondominant radius (2.0 ± 2.0%, CI = 1.4–2.7, P < 0.001). At nondominant radius, trabecular bone volume/tissue volume 
increased by 0.9 ± 0.8%, (CI = 0.1–1.7), trabecular thickness by 1.5 ± 1.6% (CI = 0.7–2.3), and trabecular number by 1.9 ± 1.8% (CI = 0.7–3.1, for all, P < 0.05). K-citrate diminished fracture prediction score by FRAX significantly in both sexes. 
Conclusions: Among a group of healthy elderly persons without osteoporosis, treatment with K-citrate for 24 months resulted in a significant increase in aBMD and volumetric BMD at several sites tested, while also improving bone microarchitecture. Based on the effect on fracture prediction, an effect on future fractures by K-citrate is possible.  (Januari 2013)



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