Abstract：
Metabolic effects of high diet acid load (DAL) have been studied for years in adults, although only recently in children. Contemporary diets, especially those of Western societies, owe their acidogenic effect to high animal-origin protein content and low contribution of base-forming elements, such as fruits and vegetables. This imbalance, where dietary acid precursors exceed the body\'s buffering capacity, results in an acid-retaining state known by terms such as \"eubicarbonatemic metabolic acidosis,\" \"low-grade metabolic acidosis,\" \"subclinical acidosis,\" or \"acid stress\". Its consequences have been linked to chronic systemic inflammation, contributing to various noncommunicable diseases traditionally considered more common in adulthood, but now have been recognized to originate at much earlier ages. In children, effects of high DAL are not limited to growth impairment caused by alterations of bone and muscle metabolism, but also represent a risk factor for conditions such as obesity, insulin resistance, diabetes, hypertension, urolithiasis, and chronic kidney disease (CKD). The possibility that high DAL may be a cause of chronic acid-retaining states in children with growth impairment should alert pediatricians and pediatric nephrologists, since its causes have been attributed traditionally to inborn errors of metabolism and renal pathologies such as CKD and renal tubular acidosis. The interplay between DAL, overall diet quality, and its cascading effects on children\'s health necessitates comprehensive nutritional assessments and interventions. This narrative review explores the clinical relevance of diet-induced acid retention in children and highlights the potential for prevention through dietary modifications, particularly by increasing fruit and vegetable intake alongside appropriate protein consumption.
摘要：
高饮食酸负荷（DAL）的代谢作用已经在成人中研究了多年，虽然只是最近在儿童中。当代饮食，尤其是西方社会，它们的产酸作用归因于高动物源性蛋白质含量和低碱基形成元素的贡献，如水果和蔬菜。这种不平衡,其中膳食酸前体超过身体的缓冲能力，导致酸保持状态，如“Eubiccarbonatemic代谢性酸中毒，低度代谢性酸中毒，亚临床酸中毒,\"或\"酸压力\"。它的后果与慢性全身性炎症有关，导致传统上被认为在成年期更常见的各种非传染性疾病，但现在已经被认为起源于更早的年龄。在儿童中，高DAL的影响不仅限于骨骼和肌肉代谢改变引起的生长障碍，但也代表了肥胖等疾病的风险因素，胰岛素抵抗，糖尿病,高血压,尿石症,慢性肾病（CKD）。高DAL可能是生长障碍儿童慢性酸保持状态的原因，应该提醒儿科医生和儿科肾病学家，因为其原因传统上归因于先天性代谢错误和肾脏病变，例如CKD和肾小管酸中毒。DAL之间的相互作用，整体饮食质量，其对儿童健康的连锁影响需要全面的营养评估和干预措施。这篇叙述性综述探讨了儿童饮食引起的酸潴留的临床相关性，并强调了通过饮食调整预防的潜力。特别是通过增加水果和蔬菜的摄入量和适当的蛋白质消费。
