Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis

Abstract

Background In the current meta-analysis, we aimed to systematically review and summarize the eligible studies evaluating the association between dietary acid load in terms of potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with anthropometric parameters and serum lipids in adult population. Methods In a systematic search from PubMed, Scopus, Web of Sciences and Cochrane electronic databases up to December 2018, relevant studies were included. Cross-sectional, case control or cohort studies evaluating the association between PRAL and NEAP with the mean values of body mass index (BMI), waist circumference (WC), low and high density lipoprotein cholesterol (LDL, HDL), triglyceride (TG), total cholesterol (TC) and the prevalence of obesity were included. Results According to our results, having higher dietary acid load content in terms of high PRAL scores was associated with higher triglyceride concentrations (weighted mean difference (WMD): 3.468; confidence interval (CI): -0.231, 7.166, P = 0.04) and higher obesity prevalence (30% and 27% in highest versus lowest categories). Accordingly, being in the highest category of NEAP was associated with higher prevalence of obesity (25% and 22% in highest versus lowest category). In subgroup analysis, higher PRAL scores was associated with higher BMI in women (WMD: 0.122; CI: -0.001, 0.245; P = 0.049) and higher NEAP in men (WMD: 0.890; CI: 0.430, 1.350; P < 0.001). There was no association between dietary acid load and other studied parameters. Conclusions In the current meta-analysis, high dietary acid load content was associated with higher serum triglyceride concentrations and higher obesity prevalence. Reducing dietary acid load content might be a useful preventive strategy against obesity and metabolic disorders.

Impact of Social Determinants of Health on the Emerging COVID-19 Pandemic in the United States

“…Diets high in acid induce metabolic acidosis, which can lead to hypertension, CKD, insulin resistance, diabetes, and other complications (20). A high dietary acid load has also been linked to obesity (22).…”

The association between dietary acid load with cardiometabolic risk factors and inflammatory markers amongst elderly men: A cross‐sectional study

“…Bahadoran et al, supported that both PRAL and Pro/k scores were positively associated with TG and inversely associated with HDL‐C 58 . A recently published systematic review and meta‐analysis of 17 observational studies reported that the highest category of PRAL scores was associated with higher TG 59 . In contrast, a cross‐sectional study by Mukarami et al, on 1136 female Japanese dietetic students aged 18‐22 years found that PRAL was directly associated with total cholesterol and LDL, but there was no association between PRAL and TG 60 .…”

Epidemiologic Evidence for Association between a High Dietary Acid Load and the Breast Cancer Risk

“…[15,16] Metabolic acidosis can be calculated through the potential renal acid load (PRAL) [15] and net endogenous acid production (NEAP) [16] formulas, which are validated and straightforward methods to estimate the dietary acid load from diet-composition data. A prolonged diet-induced low-grade metabolic acidosis over the years may predispose to metabolic abnormalities, in particular, insulin resistance, diabetes, high serum triglycerides, and obesity [17,18]. Consequently, the production of insulin-like growth factor-1 (IGF-I) probably increases [19], which, in turn, is associated with an increased BC risk [20].…”