Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma?

Abstract

Obesity has been repeatedly linked to asthma, and several potential mechanisms have been proposed in the etiologies of the obese-asthma phenotype. Considering that lungs play an important role in systemic pH and acid–base regulation, are a key organ in asthma development, and that nutritional inadequacy of several nutrients and high dietary acid load can affect airway inflammation and reactivity, we aimed to test the hypothesis that dietary acid load may be associated with asthma in children. Data on 699 children (52% females), aged 7–12 years, were analyzed. Anthropometric measurements were performed to assess body mass index. Dietary acid load was calculated using potential renal acid load (PRAL) equations from a 24 h dietary recall administrated to children. Adjusted PRAL for total energy intake was applied with the use of the residual method. Lung function and airway reversibility were assessed with spirometry. Asthma was defined by a positive bronchodilation or self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) in the past 12 months. After adjustment for energy intake, sex, age, parent’s education level, and physical activity, positive and significant associations were found between asthma and PRAL [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730) in overweight/obese children. Our findings suggest that dietary acid load might be a possible mechanism in overweight/obese-asthma phenotype development.

Dietary diversity and childhood asthma—Dietary acid load, an additional nutritional variable to consider

“…After adjustment for energy intake, sex, age, parent's education level, and physical activity, diet PRAL had a positive and significant association with asthma [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730] in overweight/obese children. 10 The precise mechanistic pathways explaining these findings in overweight/obese children are still not known, but our work suggests that dietary acid load might be an additional nutritional variable to consider when measuring diet diversity in the context of allergy, particularly where food intake is changing to a more western type diet, high on acid load. 11 Nevertheless, it is of note that some studies failed to show a clear relation between a western type diet and asthma.…”

“…In a recent cross‐sectional study of 699 children (7‐12 years), and applying an interviewer‐administered 24 hours dietary recall method (food and drinks consumption, reporting brands and consuming time and place), we found that dietary acid load might be an additional link in the asthma development risk for overweight/obese children. After adjustment for energy intake, sex, age, parent's education level, and physical activity, diet PRAL had a positive and significant association with asthma [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730] in overweight/obese children 10 . The precise mechanistic pathways explaining these findings in overweight/obese children are still not known, but our work suggests that dietary acid load might be an additional nutritional variable to consider when measuring diet diversity in the context of allergy, particularly where food intake is changing to a more western type diet, high on acid load 11 .…”

Dietary Acid Load Modulation of Asthma-Related miRNAs in the Exhaled Breath Condensate of Children

“…Diet composition influences acid–base balance by providing acid or base precursors, whereas lungs play an important role in systemic pH and acid–base regulation [ 5 ]. Moreover, our group previously demonstrated that higher dietary acid loads, obtained through a higher intake of animal and lower fruits and vegetables, increased the odds of having asthma in overweight children [ 15 ].…”

The Influence of Eating at Home on Dietary Diversity and Airway Inflammation in Portuguese School-Aged Children

“…Considering the negative impact of the lack of dietary diversity on child nutritional status [ 7 ], indicators of diet variety are attractive as a measure of nutritional adequacy [ 8 , 9 ]. Furthermore, diet diversity may be relatively simple to measure, and could expand the limitation of assessing the effects of diets from single dietary components [ 8 , 9 ], while considering the interactions of the matrixes from a variety of foods on health [ 10 , 11 ]. Several observational studies have evaluated the dietary quality through the assessment of the Mediterranean diet, which is characterized not only by a higher consumption of fruits, vegetables, and wholegrain cereals, but also by a greater variety of these foods [ 12 ].…”