Association of dietary acid load with anthropometric indices in children and adolescents

Aslani, Zahra; Bahreynian, Maryam; Namazi, Nazli; Shivappa, Nitin; Hébert, James R.; Asayesh, Hamid; Motlagh, Mohammad Esmaeil; Pourmirzaei, Mohammad Ali; Kasaeian, Amir; Mahdavi-Gorabi, Armita; Qorbani, Mostafa; Kelishadi, Roya

doi:10.1007/s40519-020-00883-x

Cited by 9 publications

(9 citation statements)

References 45 publications

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“…A population-based cross-sectional study among 5326 Iranian children and adolescents (6–18 years) demonstrated a direct association between the neck circumference, an index of upper subcutaneous adipose tissue distribution, and NEAP. However, this study failed to show any association between the NEAP and PRAL with other anthropometric measures [ 15 ]. Similarly, another cross-sectional study among 1136 young Japanese women (18–22 years) revealed a positive association between DAL, estimated as the ratio of dietary protein to K (Pro: K), with BMI and waist circumference [ 23 ].…”

Section: Discussionmentioning

confidence: 95%

“…For example, a large cross-sectional study showed that NEAP was positively associated with neck circumference in students aged 6–18 years. Also, higher PRAL and NEAP were associated with lower body mass index (BMI) in parents [ 15 ]. In addition, findings from another study revealed that there was no association between PRAL and anthropometric measures in 6-year-old girls [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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The association between dietary acid load and adiposity measures among children and adolescents

2022

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Background Childhood obesity is one of the most important health problems in the present century. It is imperative to plan preventive programs through risk factor identification. The present study was conducted to examine the association between the dietary acid load (DAL) and anthropometric indices in a sample of Iranian children and adolescents. Methods In the current survey, students aged 11–18 years were recruited. To assess usual dietary intake, a validated self-administered 168-item food frequency questionnaire was used. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) was used to estimate DAL. The association between DAL and anthropometric indices was evaluated using logistic regression and reported as an odds ratio (OR) with a 95% confidence interval (CI). Results In total, 456 students (267 girls), with a mean age of 14.44 years participated in the current study. After controlling for potential confounders, the PRAL was positively associated with the risk of obesity (OR = 4.56, 95% CI: 2.26, 9.17), abdominal obesity (OR = 12.64, 95% CI: 3.05, 52.27), and adiposity based on the percent of body fat (PBF) (OR = 3.58, 95% CI: 1.83, 6.99). The NEAP was also significantly associated with the risk of obesity (OR = 5.17, 95% CI: 2.56, 10.43), abdominal obesity (OR = 15.08, 95% CI: 3.35, 67.81), and adiposity based on PBF (OR = 4.53, 95% CI: 2.30, 8.92). Conclusion Our findings suggest that higher adherence to the acidogenic diet, expressed as DAL, was associated with a higher risk of general and central obesity among children and adolescents.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The association between dietary acid load and adiposity measures among children and adolescents

2022

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“…Also, another study found the same finding in adults, but higher scores of NEAP were associated with increased risk of impaired fasting blood glucose 37 . A national multi-center cross-sectional survey on 5326 Iranian students aged 6–18 years after evaluating anthropometric indices, showed a direct association between diet-induced acid load with neck circumference 23 . Furthermore, an inverse relationship was found between DAL indices and parental BMI 23 .…”

Section: Discussionmentioning

confidence: 99%

“…A national multi-center cross-sectional survey on 5326 Iranian students aged 6–18 years after evaluating anthropometric indices, showed a direct association between diet-induced acid load with neck circumference 23 . Furthermore, an inverse relationship was found between DAL indices and parental BMI 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Another investigation conducted among young Japanese women demonstrated a link between a more acidic dietary load and the adverse profile of several cardiometabolic risk factors 22 . In case of children and adolescents, Aslani et al illustrated a direct association between diet-induced acid load and neck circumference (NC) as well as an inverse association between DAL indices and parental BMI 23 . However, a recent study could not find a significant association between DAL and metabolic syndrome among children and adolescents 24 .…”

Section: Introductionmentioning

confidence: 99%

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Association between dietary acid load and metabolic health status in overweight and obese adolescents

Rezazadegan

Mirzaei

Asadi

et al. 2022

Sci Rep

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The relationship between dietary acid load (DAL) and metabolic health status in adolescents has not been studied yet. We aimed to examine the association between DAL and metabolic health status in Iranian overweight/obese adolescents. This cross-sectional study included 203 overweight/obese adolescents selected by a multistage cluster random sampling method. Dietary intakes were assessed using a validated 147-item food frequency questionnaire (FFQ). Anthropometric indices and blood pressure values were measured. Fasting blood samples were obtained to determine glucose, insulin, and lipid profiles. Based on two methods (International Diabetes Federation (IDF) criteria and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)), participants were classified into metabolically healthy obese (MHO) or unhealthy obese (MUO). Adolescents in the highest tertile of potential renal acid load (PRAL) and net endogenous acid production (NEAP), compared with those in the lowest tertile, had 172% (95% CI 1.32–5.59) and 161% (95% CI 1.26–5.41) higher odds of MUO status, based on IDF criteria. This association was significant after adjustment for age, sex, and energy intake (PRAL: OR 2.42; 95% CI CI 1.13–5.15; NEAP: OR 2.52; 95% CI 1.17–5.41); but it disappeared after adjustment for other confounders. Based on IDF/HOMA-IR definition, there was a significant positive association between PRAL and being MUO only in the crude model (OR 2.37; 95% CI 1.13–4.96). The stratified analysis revealed that these associations for NEAP scores were stronger among overweight subjects than obese individuals, based on both metabolic status definitions. However, after adjustment for all potential confounders these relations were insignificant. Having higher DAL might be associated with higher odds of MUO phenotype in Iranian overweight/obese adolescents. More prospective studies are warranted to confirm this finding.

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Dietary acid load in health and disease

Wieërs,

Beynon-Cobb,

Visser

et al. 2024

Pflugers Arch - Eur J Physiol

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Maintaining an appropriate acid–base equilibrium is crucial for human health. A primary influencer of this equilibrium is diet, as foods are metabolized into non-volatile acids or bases. Dietary acid load (DAL) is a measure of the acid load derived from diet, taking into account both the potential renal acid load (PRAL) from food components like protein, potassium, phosphorus, calcium, and magnesium, and the organic acids from foods, which are metabolized to bicarbonate and thus have an alkalinizing effect. Current Western diets are characterized by a high DAL, due to large amounts of animal protein and processed foods. A chronic low-grade metabolic acidosis can occur following a Western diet and is associated with increased morbidity and mortality. Nutritional advice focusing on DAL, rather than macronutrients, is gaining rapid attention as it provides a more holistic approach to managing health. However, current evidence for the role of DAL is mainly associative, and underlying mechanisms are poorly understood. This review focusses on the role of DAL in multiple conditions such as obesity, cardiovascular health, impaired kidney function, and cancer.

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Association of dietary acid load with anthropometric indices in children and adolescents

Cited by 9 publications

References 45 publications

The association between dietary acid load and adiposity measures among children and adolescents

The association between dietary acid load and adiposity measures among children and adolescents

Association between dietary acid load and metabolic health status in overweight and obese adolescents

Dietary acid load in health and disease

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