Dietary acid load and cardiometabolic risk
in the Polish adult population

Kucharska, Alicja; Szostak-Węgierek, Dorota; Waśkiewicz, Anna; Piotrowski, Walerian; Stepaniak, Urszula; Pająk, Andrzej; Kozakiewicz, Krystyna; Tykarski, Andrzej; Rutkowski, Marcin; Bielecki, Wojciech; Drygas, Wojciech

doi:10.17219/acem/69733

Cited by 27 publications

(59 citation statements)

References 18 publications

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“…In the study by Akter, no association between PRAL, NEAP and FBS or HbA 1 C was reported. Similar findings were also observed in several other studies . Akter et al reported that men in the highest quartiles of PRAL had 61% higher odds of developing diabetes compared with the lowest quartile; while no association was observed among women.…”

Section: Resultssupporting

confidence: 88%

“…While no association among men was reported. Similar findings of the higher prevalence of diabetes or higher odds of diabetes were reported in two other studies . In the study by Kiefte‐de Jong, the odds of T 2 DM in highest quintile of NEAP and PRAL were higher compared with the lowest in NHS and NHS II cohorts while in the HPFS study these associations were not significant.…”

Section: Resultssupporting

confidence: 85%

“…Several other studies also reported similar results of higher prevalence of HTN or higher SBP and DBP values in highest vs lowest PRAL or NEAP groupings . Only one study reported inverse association between HTN prevalence among NEAP quartiles and several other studies found no difference . In the data analysis of Rotterdam study by Engberink et al, SBP in the highest tertile of PRAL was significantly higher than the lowest.…”

Section: Resultsmentioning

confidence: 69%

“…We did not observe any association between PRAL, NEAP and markers of glucose homoeostasis including FBS, HbA 1 C and HOMA‐IR values. Higher FBS concentrations in higher PRAL categories were reported in the Haghighatdoost et al study although this association did not achieve significant threshold, while other studies reported no significant difference . The current meta‐analysis has several limitations and strengths; the current meta‐analysis included the results of observational studies with the cross‐sectional or cohort design which makes the causal inference impossible; although, the studies were large population‐based studies with acceptable quality.…”

Section: Discussionmentioning

confidence: 89%

“…Table presents the summary of systematically reviewed studies evaluated the association between dietary acid load (eg PRAL or NEAP), blood pressure and hypertension prevalence. Totally, 20 studies reported the association between HTN, blood pressure and PRAL or NEAP among the systematically reviewed literature . In the study by Akter et al evaluating the association between dietary acid load and prevalence of HTN in the Furukawa Nutrition and Health Study the odds of HTN in subjects in the highest tertile of PRAL and NEAP was 31% and 40% more than individuals in lowest tertile (PRAL; OR: 1.31; CI: 1.01‐1.70; NEAP OR: 1.40; CI: 1.08‐1.82) among 2028 working Japanese population.…”

Section: Resultsmentioning

confidence: 99%

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Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Dehghan

Farhangi

2020

Int J Clin Pract

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Objectives There is no clear summarised report of the association between dietary acid load components including potential renal acid load (PRAL) and net‐endogenous acid production (NEAP) with cardiometabolic risk factors. In the current meta‐analysis, we aimed to systematically review and summarise the eligible observational studies evaluating the association between PRAL and NEAP with blood pressure and hypertension and markers of glucose haemostasis among adults. Design and Setting In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases up to May 2019, relevant studies were included in the literature review. Observational studies evaluating the association between PRAL and NEAP with the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, homeostatic model assessment of insulin resistance (HOMA‐IR), haemoglobin A1C (HbA1C), HOMA‐β and quantitative insulin check index (QUICKI) and also prevalence or odds of hypertension, hyperglycaemia and diabetes were included. Results Total number of studies included in the 14 separate meta‐analyses were as follows: Mean (SD) of SBP (PRAL, n = 12; NEAP, n = 6), mean (SD) of DBP (PRAL, n = 8; NEAP, n = 3), mean (SD) of FBS (PRAL, n = 12; NEAP, n = 5), mean (SD) of HbA1C (PRAL, n = 6; NEAP, n = 4), mean (SD) of HOMA‐IR (PRAL, n = 7), mean (SD) of insulin (PRAL, n = 7; NEAP, n = 2); OR of type 2 diabetes mellitus (T2DM) (PRAL, n = 8; NEAP; n = 6), HTN prevalence (PRAL, n = 9; NEAP, n = 9), T2DM prevalence (PRAL, n = 7; NEAP, n = 6). According to our results, being in the highest PRAL categories was associated with higher SBP (WMD = 0.98; CI: 0.51, 1.45; P < .001), DBP (WMD = 0.61; CI: 0.089, 1.135; P = .022), insulin (WMD = −0.235, CI: 0.070, 0.400; P = .005), higher odds of diabetes (OR = 1.19; CI: 1.092, 1.311; P < .001), higher prevalence of T2DM (13% and 11% in highest vs lowest category). While, being in the highest category of NEAP was only associated with higher odds of diabetes (OR = 1.22; CI: 1.14, 1.31, P < .001). In subgroup analysis for finding the possible source of heterogeneity, the continent, dietary assessment tool, sample size and gender were the potent sources of heterogeneity. No association between PRAL and NEAP with HbA1C, HOMA‐IR was reported. Conclusions In the current meta‐analysis, we found potent negative effects of high dietary acid load particularly higher PRAL scores cardiometabolic risk factors. Therefore, lower acidogenic food ingredients in the diets are suggested for the prevention of cardiovascular risk factors and diabetes.

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Section: Resultssupporting

confidence: 88%

Section: Resultssupporting

confidence: 85%

Section: Resultsmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta‐analysis

Dehghan

Farhangi

2020

Int J Clin Pract

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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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