Dietary acid load decreases with age and is associated with sagittal abdominal diameter: a nationally representative quantification study in US adults

Abstract

Background Dietary acid load (DAL) has been associated with frailty and hip fractures in older adults, who often have a reduced kidney function and thus compromised buffering capacities. Studies to quantify DAL in older adults are scarce and controversies persist as to whether DAL in- or decreases with age. Aim To enhance the understanding of DAL in older individuals, we examined its relationship with increasing age and selected anthropometric data in a well-characterized sample of US adults. Methods Secondary data analysis of nationally representative data from the National Health and Nutrition Examination Surveys data (NHANES 2011–2016). The sample included n = 3018 adults aged 60+, which may be extrapolated to represent n = 45,113,471 Americans. DAL was estimated using 4 formulas, including Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP). Results All employed DAL scores tended to decline with increasing age. Participants aged 80 years or older yielded the lowest DAL scores. The average US citizen aged 60+ consumed an acidifying diet, yet there were sex-specific differences in the adjusted means for some scores. NEAP was positively correlated with both body mass index (r = 0.26, p < 0.001) and the sagittal abdominal diameter (r = 0.31, p < 0.001) in this nationally representative sample. Conclusion The previously reported phenomenon of increasing DAL values in older people in non-Western countries may not apply to the US. Our findings may constitute an important step towards a better understanding of DAL in older US adults, and highlight the need for additional population-specific research in the field.

Macroalgae as Alkalizing Marine Drugs with a Low Potential Renal Acid Load

“…Te human kidneys, in contrast, can only excrete 40-70 mEq of acid within 24 h [50]. Once that limit is reached, acid is retained in the human body, with potentially harmful efects for human health [51][52][53][54][55][56]. As summarized in a previous review, dietary acid load has been linked to several cardiovascular disease risk factors, unfavorable metabolic alterations, diabetes, and chronic kidney disease [20].…”

Association of Dietary Acid Load with Nonalcoholic Fatty Liver Disease and Advanced Liver Fibrosis in US Adults: Evidence from NHANES 1999–2018

“…We use four well-established formulas as proxies for DAL based on a recent study. 16 First, we used the PRAL formula proposed by Remer et al which is based on daily intake of total protein and multiple minerals: 9 Subsequently, Frassetto et al 10 proposed a simplified formula for calculating DAL, ie, . Another NEAP formula is from Remer et al 17 where OA est is the anthropometrically estimated organic acid secretion, which is obtained from the body surface area× 41/1.73 (the body surface area was calculated by the formula of Dubois et al 18 ).…”

“…We use four well-established formulas as proxies for DAL based on a recent study. 16 First, we used the PRAL formula proposed by Remer et al which is based on daily intake of total protein and multiple minerals: PRAL R mEq=day ð Þ¼ 0:49…”

Dietary acid load in health and disease

“…In addition to BMI, several studies report a positive association between high DAL and various other anthropometric measurements. These include an increased waist-to-height ratio, larger hip and neck circumference, a higher fat mass, and lower fat-free mass [ 11 , 96 , 141 , 142 ]. Moreover, a study involving 3018 individuals aged 60 years and older from the USA identified that a high DAL is not only positively correlated with BMI but also with sagittal abdominal diameter [ 142 ].…”

“…These include an increased waist-to-height ratio, larger hip and neck circumference, a higher fat mass, and lower fat-free mass [ 11 , 96 , 141 , 142 ]. Moreover, a study involving 3018 individuals aged 60 years and older from the USA identified that a high DAL is not only positively correlated with BMI but also with sagittal abdominal diameter [ 142 ]. This association was also found in a study in 456 children from Iran, which identified a positive association between a high DAL and a greater risk of childhood obesity, as defined by BMI and higher body fat percentage [ 141 ].…”