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With the growing increase in life expectancy, hip fractures are predicted to rise dramatically in the next decade, and hence there is an urgent need for the implementation of public health strategies to target prevention of poor skeletal health on a population-wide basis. The role that the skeleton plays in acid-base homeostasis has been gaining increasing prominence in the literature; with theoretical considerations of the role alkaline bone mineral may play in the defence against acidosis dating as far back as the late 19th century. Natural, pathological and experimental states of acid loading and\/or acidosis have been associated with hypercalciuria and negative Ca balance and, more recently, the detrimental effects of \u2018acid\u2019 from the diet on bone mineral have been demonstrated. At the cellular level, a reduction in extracellular pH has been shown to have a direct enhancement on osteoclastic activity, with the result of increased resorption pit formation in bone. A number of observational, experimental, clinical and intervention studies over the last decade have suggested a positive link between fruit and vegetable consumption and the skeleton. Further research is required, particularly with regard to the influence of dietary manipulation using alkali-forming foods on fracture prevention. Should the findings prove conclusive, a \u201cfruit and vegetable\u201d approach to bone health maintenance may provide a very sensible (and natural) alternative therapy for osteoporosis treatment, which is likely to have numerous additional health-related benefits.<\/jats:p>","DOI":"10.1079\/pns2002159","type":"journal-article","created":{"date-parts":[[2003,2,26]],"date-time":"2003-02-26T17:47:22Z","timestamp":1046281642000},"page":"151-164","source":"Crossref","is-referenced-by-count":87,"title":["Nutrition Society Medal Lecture: The role of the skeleton in acid\u2014base homeostasis"],"prefix":"10.1017","volume":"61","author":[{"given":"Susan A.","family":"New","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2009,3,27]]},"reference":[{"key":"S0029665102000630_ref078","first-page":"E112","article-title":"PH dependence of bone resorption: mouse calvarial osteoclasts are activated by acidosis","volume":"280","author":"Meghji","year":"2001","journal-title":"American Journal of Physiology"},{"key":"S0029665102000630_ref051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302510"},{"key":"S0029665102000630_ref101","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302502"},{"key":"S0029665102000630_ref068","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/ajcn\/28.6.566-a","article-title":"Bone mineral content of North Alaskan Eskimos (letter)","volume":"28","author":"Mann","year":"1975","journal-title":"American Journal of Clinical Nutrition"},{"key":"S0029665102000630_ref061","first-page":"S511","article-title":"Impact of sodium intake and dietary patterns on biochemical markers of bone and calcium metabolism","volume":"16","author":"Lin","year":"2001","journal-title":"Journal of Bone and Mineral Research"},{"key":"S0029665102000630_ref065","article-title":"Higher intakes of fruit and vegetables are associated with higher bone mass in perimenopausal Scottish women","volume":"61","author":"Macdonald","year":"2002","journal-title":"Proceedings of the Nutrition Society"},{"key":"S0029665102000630_ref003","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090312"},{"key":"S0029665102000630_ref023","first-page":"S386","article-title":"Fruit intake is associated with better bone mass among Hong Kong Chinese early postmenopausal women","volume":"16","author":"Chen","year":"2001","journal-title":"Journal of Bone and Mineral Research"},{"key":"S0029665102000630_ref027","volume-title":"Nutrition and Bone Health: With Particular References to Calcium and Vitamin D. 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