What Foods Should You Avoid If You Have Lactic Acidosis?

Lactic acidosis is a serious condition characterized by a buildup of lactic acid in the blood, and in clinical settings, higher blood lactate levels correlate with higher mortality rates. Understanding what foods you should avoid if you have lactic acidosis is a critical component of its management, alongside medical treatment for the underlying cause. Making informed dietary choices can help support your body’s ability to maintain a proper acid-base balance.

Quick Summary

Managing lactic acidosis often requires dietary adjustments to help the body regulate its acid-base balance. Limiting high-protein meats, certain processed foods, and high-phosphorus drinks can reduce the body's acid load. Additionally, those with D-lactic acidosis must avoid fermented foods like yogurt and sauerkraut. Hydration and a focus on alkalizing fruits and vegetables are key dietary strategies.

Key Points

• Restrict High-Protein Animal Foods: Limit intake of red meat, poultry, fish, and hard cheeses, as they can contribute to the body’s acid load.

• Avoid Alcohol and Carbonated Beverages: These drinks stress the organs responsible for clearing lactate and add to the body's total acid burden.

• Skip Fermented Foods for D-Lactic Acidosis: Patients with D-lactic acidosis must avoid foods like yogurt, sauerkraut, and pickled vegetables due to their D-lactate content.

• Choose Alkalizing Foods: Incorporate plenty of fruits, vegetables, and plant-based proteins, which help reduce the body's acid levels.

• Stay Well-Hydrated: Drinking plenty of water is crucial for helping the kidneys and liver flush excess lactic acid from the body.

• Prioritize Medical Advice: Diet is a supportive measure. Always work with a healthcare provider to treat the underlying cause of your lactic acidosis.

Understanding Lactic Acidosis and Its Causes

Lactic acidosis occurs when there is an imbalance between the production and clearance of lactic acid in the body, which is normally managed by the liver and kidneys. The condition can arise from various medical issues that lead to tissue hypoxia (low oxygen), such as severe illness, or from impaired lactate metabolism caused by liver or kidney disease, certain medications, and other systemic issues. Dietary interventions are a supportive measure, but they are not a replacement for treating the root cause. Consulting a healthcare provider or a registered dietitian is essential for a personalized treatment plan.

There are primarily two types of lactic acidosis: Type A, caused by tissue hypoxia, and Type B, which occurs without evident poor oxygenation and includes subtypes linked to systemic diseases, toxins, and medications. A rare but important form is D-lactic acidosis, resulting from an overgrowth of D-lactate-producing bacteria, typically in individuals with short bowel syndrome. Each type has specific dietary considerations, though some general principles apply to all.

Foods to Limit or Avoid with Metabolic Lactic Acidosis

For metabolic lactic acidosis, the goal is often to reduce the dietary acid load, which is influenced by the potential renal acid load (PRAL) of foods. Foods with a high PRAL can contribute to the body's acid burden.

High-Protein and High-Phosphorus Foods

Chronic, excessive intake of high-protein foods, particularly animal-based proteins, can contribute significantly to a dietary acid load. These include:

• Meat and Poultry: Beef, chicken, and processed meats like corned beef or deli slices have a high PRAL.
• Fish and Seafood: These are also known to increase the acid-producing potential of the diet.
• Eggs: While nutritious, eggs are another high-protein, acid-producing food to be mindful of.
• Hard and Processed Cheeses: Certain types, such as mozzarella, parmesan, and brie, have a very high PRAL and should be limited.

Alcohol and Carbonated Beverages

Both alcohol and carbonated drinks can negatively impact an individual with lactic acidosis. Excessive alcohol consumption, particularly chronic abuse, places significant stress on the liver and kidneys, impairing their ability to process lactate. Carbonated beverages contain carbonic acid, which adds to the body's total acid load. It's recommended to limit or avoid intake of:

• Soda and Seltzers: All carbonated beverages should be avoided due to their carbonic acid content.
• Beer: This beverage is often high in phosphorus and should be limited.
• Excessive Alcohol: Binge drinking or chronic heavy alcohol consumption is particularly detrimental.

Highly Processed and High-Sodium Foods

Many processed foods are high in sodium and other additives that can worsen the body's acid-base balance. Examples include:

• High-Sodium Condiments: Soy sauce, barbecue sauce, and some salad dressings can have high sodium levels.
• Processed Meats: Cured or pre-packaged deli meats often contain high levels of sodium and preservatives.
• Salty Snacks: Foods like pretzels and chips are often packed with salt and offer little nutritional value towards a balanced diet.

Dietary Considerations for D-Lactic Acidosis

D-lactic acidosis, a specific and rare type, requires avoiding foods that contain high amounts of D-lactate or are produced by bacterial fermentation. These bacteria break down carbohydrates, creating D-lactate as a byproduct. This is a distinct and crucial consideration for affected individuals.

Fermented and Pickled Foods

Since lactic acid bacteria are central to fermentation, many fermented foods should be strictly avoided.

• Yogurt and Kefir: Cultured dairy products are produced via lactic acid fermentation.
• Sauerkraut and Pickled Vegetables: The pickling process relies on lactic acid fermentation.
• Certain Breads: Sourdough bread, for instance, uses lactic acid bacteria in its leavening process.
• Miso and Soy Sauce: These are fermented soy products that contain lactic acid.
• Kombucha: This fermented tea is rich in lactic acid and other organic acids.

Comparison of Food Choices for Managing Acid Load

Food Category	Avoid/Limit with Lactic Acidosis	Encourage with Lactic Acidosis
Protein	Red meat, cured meats, hard cheeses, eggs	Lean meats in moderation, plant-based proteins like soy and lentils
Beverages	Alcohol, soda, beer, hot chocolate packets	Water, herbal teas, most fruit juices (if tolerated)
Dairy	Yogurt, kefir, hard/processed cheeses	Milk, unsweetened yogurt (discuss with doctor)
Processed	High-sodium condiments, processed meats, salty snacks	Fresh vegetables, fruits, whole grains
Fermented (D-Lactic Acidosis)	Sauerkraut, pickled vegetables, kimchi, miso	Non-fermented versions of these foods

Lifestyle and Hydration are Also Key

Besides dietary restrictions, other lifestyle factors are important for managing lactic acidosis. Staying adequately hydrated is crucial, as drinking plenty of water helps the body flush out excess acid. A balanced diet focusing on whole, unprocessed foods can help prevent the overconsumption of acid-producing items. Regular, moderate exercise can also help the body process lactic acid more effectively, but intense, anaerobic exercise should be approached with caution to avoid further buildup. Patients should always follow their healthcare provider’s specific instructions, especially regarding exercise levels and the management of any underlying disease.

Conclusion

For those with lactic acidosis, adjusting your diet is a key supportive measure. This involves limiting high-protein, high-phosphorus, and high-sodium foods, as well as avoiding alcohol and carbonated beverages. In the case of D-lactic acidosis, a strict avoidance of all fermented foods is necessary. A balanced diet rich in alkalizing fruits and vegetables, along with sufficient hydration, can help mitigate the body's acid load. Since dietary needs can be complex and dependent on the underlying cause, all patients should work closely with their doctor or a renal dietitian to create a safe and effective dietary plan tailored to their specific health needs. A good resource for understanding causes and treatment options can be found on the Cleveland Clinic website.

What foods should you avoid if you have lactic acidosis?

Fermented Foods: Those with D-lactic acidosis, a specific and rare type, must avoid foods with high levels of D-lactate, such as yogurt, sauerkraut, pickled vegetables, and certain sourdough breads. High-Protein Animal Products: Excessive intake of high-protein foods like red meat, poultry, and hard cheeses can increase the body's acid load in cases of metabolic lactic acidosis. Alcohol and Carbonated Drinks: Both place stress on the liver and kidneys, and carbonated beverages add carbonic acid to the system, hindering the body’s ability to process excess lactate. Processed Foods: High-sodium condiments, processed meats, and salty snacks should be limited to help balance the dietary acid load. High-Phosphorus Beverages: Drinks like beer and hot chocolate from packets are often high in phosphorus, which can be problematic for some individuals with acidosis.

FAQs

Question: Why should people with lactic acidosis avoid certain high-protein foods? Answer: High intake of animal-based protein can increase the body's dietary acid load, which can exacerbate the imbalance already caused by lactic acidosis.

Question: Are all types of lactic acidosis affected by the same foods? Answer: No. While most types benefit from reducing overall dietary acid load, D-lactic acidosis specifically requires avoiding fermented foods because the D-lactate is produced by gut bacteria.

Question: Is it safe to drink alcohol with lactic acidosis? Answer: No, excessive alcohol consumption puts enormous stress on the liver and kidneys, which are responsible for clearing lactic acid. This can worsen the condition.

Question: What should I drink instead of soda or alcohol? Answer: Plain water is best for hydration and helping the body flush out excess acid. Herbal teas are also a good option.

Question: Do fresh fruits increase lactic acid in the body? Answer: While some fruits have a low pH, most have an alkalizing effect on the body's acid-base balance upon digestion and metabolism. They are generally encouraged.

Question: Can lactic acidosis be managed with diet alone? Answer: Diet is a supportive measure, but it is not a cure. Lactic acidosis requires medical treatment to address the underlying cause, whether it's an illness or medication.

Question: Why are fermented foods like yogurt bad for D-lactic acidosis? Answer: Fermented foods contain lactic acid bacteria and D-lactate. In patients with D-lactic acidosis, who often have short bowel syndrome, these bacteria can produce excessive D-lactate that the body cannot clear.

Question: Is exercise still okay with lactic acidosis? Answer: Moderate, aerobic exercise can be beneficial. However, strenuous, high-intensity exercise should be done with caution, as it can cause a temporary buildup of lactic acid. Always follow your doctor's advice.

Frequently Asked Questions

Why should people with lactic acidosis avoid certain high-protein foods?

High intake of animal-based protein can increase the body's dietary acid load, which can exacerbate the imbalance already caused by lactic acidosis.

Are all types of lactic acidosis affected by the same foods?

No. While most types benefit from reducing overall dietary acid load, D-lactic acidosis specifically requires avoiding fermented foods because the D-lactate is produced by gut bacteria.

Is it safe to drink alcohol with lactic acidosis?

No, excessive alcohol consumption places stress on the liver and kidneys, which are responsible for clearing lactic acid, and can therefore worsen the condition.

What should I drink instead of soda or alcohol?

Plain water is the best choice for hydration and helping the body flush out excess acid. Herbal teas are also a good option.

Do fresh fruits increase lactic acid in the body?

Although some fruits are initially acidic, most have an alkalizing effect on the body's acid-base balance once digested and metabolized. They are generally encouraged.

Can lactic acidosis be managed with diet alone?

Diet is a supportive measure, but it is not a cure. Lactic acidosis requires medical treatment to address the underlying cause, whether it's an illness or medication.

Why are fermented foods like yogurt bad for D-lactic acidosis?

Fermented foods contain lactic acid bacteria and D-lactate. In patients with D-lactic acidosis, who often have short bowel syndrome, these bacteria can produce excessive D-lactate that the body cannot clear.

Is exercise still okay with lactic acidosis?

Moderate, aerobic exercise can be beneficial, but strenuous, high-intensity exercise should be approached with caution as it can cause a temporary buildup of lactic acid. Always follow your doctor's advice.