Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia.

Randomized, single-center trial in postmenopausal women with osteopenia/low bone mass who were nonvegetarian and lived near Basel, Switzerland. Participants were instructed to keep their self-selected diet and exercise regimen constant during the 12-month study.

Potassium citrate (Kcitrate, wax matrix tablets) was given orally at 10 mmol of trivalent potassium citrate per day in three divided daytime doses for 12 months, providing 30 mmol potassium and 30 mmol bicarbonate daily. The active comparator was potassium chloride.

Potassium citrate increased bone mineral density compared with potassium chloride, with the clearest benefit at the lumbar spine and hip. The intergroup difference in percentage change in areal BMD at L2-L4 at month 12 was 1.87 0.50% (SEM, P < 0.001; n = 161). Month 12 lumbar spine BMD increased 0.89 0.30% with potassium citrate versus decreased 0.98 0.38% with potassium chloride (P < 0.05). Intergroup differences were also significant for total hip (1.98 0.51%, P < 0.001) and femoral neck (1.39 0.48%, P < 0.001), while distal radius and total body differences were not significant. The potassium citrate regimen was associated with favorable safety and blood pressure effects, and gastrointestinal events were reported in the potassium chloride group.

Single-center trial in a relatively narrow population of postmenopausal women with osteopenia, which limits generalizability. The intervention period was 12 months, fracture outcomes were not reported, and distal radius and total body outcomes were not significant. Diet and physical activity were self-selected rather than tightly controlled.