When SID increases, [H+ decreases according to the rule of electroneutrality. SID is usually slightly positive, but fluids of the body cannot be electrically charged. The necessary negative charge comes from pCO2 and Atot. When the production of CO2 exceeds the removal of CO2 in the metabolism of cells, pCO2 increases and causes a rise in [H+. Atot is mainly proteins (mainly albumin) Necrostatin-1 and phosphates and through

them the rule of electroneutrality is fulfilled. If there is a change in one or more independent variable, [H+ changes as a consequence [3]. It is known that nutrition has an effect on acid–base balance, that is, acid load of the human body can be changed via nutrition [6]. It can be evaluated via PRAL (potential renal acid load) whether a certain foodstuff

increases the production of acids or alkali in the body [6, 7]. PRAL can be calculated for 100 g of foodstuff as: PRAL (mEq/100 g) = 0.49 × protein (g/100 g) + 0.037 × check details phosphorous (mg/100 g) – 0.021 x potassium (mg/100 g) – 0.026 × magnesium (mg/100 g) – Osimertinib order 0.013 × calcium (mg/100 g) [7]. A foodstuff with negative PRAL is more alkali than acid forming. For example, fruits and vegetables contain lots of potassium that is a base-forming cation along with magnesium and calcium. Conversely, meat, cheese and cereal products have a positive PRAL and they enhance the production of acids. All protein-rich foodstuffs contain amino acids methionine and cysteine that are acid forming, so nutrition rich in protein and poor in alkali-forming foodstuff increases the acid load of the body [6]. The acid–base balance has an effect on physical performance [8]. Even physical activity of moderate intensity causes metabolic changes, which affect the acid–base balance both in skeletal muscles and other tissues [3]. Maintenance of high alkalinity in extracellular fluids enables faster

H+ removal from the muscle cell and muscle fatigue caused by increased acidosis is delayed [8]. Enhanced Exoribonuclease acid buffering capacity seems to improve both high-intensity anaerobic [9, 10] and aerobic [11] capacity. NaHCO3 is a useful ergogenic aid to increase the [HCO3 - and buffering capacity of the blood [12], but performance can be improved by dietary means as well [13, 14]. It has been observed that protein-rich nutrition combined with a low intake of carbohydrate may cause acidosis and have a negative influence on performance [13]. In one study, for example, low-protein (9.4 ± 1.8%) and high-carbohydrate (65.5 ± 9.8%) diet obeyed for 4 days resulted in higher plasma pH and [HCO3 - prior to the exercise test compared to high-protein (25.3 ± 4.1%) and low-carbohydrate (10.1 ± 6.8%) diet and resulted in a longer time to exhaustion during cycling at 100% of VO2max (345 ± 187 s vs. 221 ± 58 s) [14]. In another study, the use of a plant-based nutrient supplement for 14 days increased the pH of urine, which indicates that the acid load of the body was decreased [15].