High dietary acid load is associated with increased prevalence of hypertension: The Furukawa Nutrition and Health Study

Akter, Shamima; Eguchi, M.; Kurotani, Kayo; Kochi, Takeshi; Pham, Ngoc Minh; Ito, Rie; Kuwahara, Keisuke; Tsuruoka, Hiroko; Mizoue, Tetsuya; Kabe, Isamu; Nanri, Akiko

doi:10.1016/j.nut.2014.07.007

Cited by 63 publications

(72 citation statements)

References 43 publications

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“…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%

“…Acid‐base balance is tightly regulated in human and even its minor changes would lead to deleterious effects including chronic kidney disease and its progression, impaired bone homoeostasis and insulin resistance . Recently, the role of diet‐related low‐level metabolic acidosis in the pathogenesis of metabolic disorders including metabolic syndrome, diabetes and CVDs has been suggested by numerous researches highlighting the triggering effects of Western dietary pattern . Several potential underlying mechanisms for the association between dietary acid load and metabolic disorders have also been suggested; it has been mentioned that the association of the higher dietary acid load with hypertension and insulin resistance is a result of excessive urinary execration of calcium and magnesium, increased cortisol and reduced urinary citrate excretions .…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] Several potential underlying mechanisms for the association between dietary acid load and metabolic disorders have also been suggested; it has been mentioned that the association of the higher dietary acid load with hypertension and insulin resistance is a result of excessive urinary execration of calcium and magnesium, increased cortisol and reduced urinary citrate excretions. 5,6 Reduced insulin sensitivity, 8 insulin secretion 9 and reduced insulin binding to its receptors because of impaired acid-base balance 10 are also several other possible suggested mechanisms. A diet rich in acidogenic foods including meat, fish, cheese and low in alkaline foods including fruits and vegetables are the potential cause of endogenous acid production and elevated dietary acid load.…”

Section: Introductionmentioning

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: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…Second, the measurement of biomarkers representing dietary acid load was not provided. Although the estimation equation used in this study has been widely adopted in many studies including those performed on populations other than Western countries, it has been validated in Western population, not in Asians [38]. Third, the causal relationship between the dietary acid load and RHF could not be tested due to the observational nature of this study.…”

Section: Discussionmentioning

confidence: 99%

The Association between Renal Hyperfiltration and the Sources of Habitual Protein Intake and Dietary Acid Load in a General Population with Preserved Renal Function: The KoGES Study

Song

Lee

et al. 2016

PLoS ONE

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Although the differential response of the kidney to the acute load of various sources of dietary protein in subjects with normal renal function is well known, the influence of habitual dietary protein intake and dietary acid load on renal function has not been tested well. The association between renal hyperfiltration (RHF), the earlier and possibly reversible stage of chronic kidney disease, and the sources of habitual dietary protein and dietary acid load was analyzed with the baseline data of 123,169 middle-aged healthy Koreans of a large prospective cohort study, who had a baseline estimated glomerular filtration rate (eGFR) >60 mL/min/m2 and no known history of diabetes and/or hypertension. eGFR was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation using serum creatinine and RHF was defined as eGFR >95th percentile after adjustment for age, sex, height, and body weight. Dietary acid load was calculated with estimated net endogenous acid production (eNEAP). Although the level of habitual intake of animal protein was positively and vegetable protein was negatively associated with RHF, this association was significant only in women and younger participants (younger than sex-specific median age). The odds for RHF increased as the percentile rank of eNEAP increased until about the 50th percentile and then leveled off. The positive association between eNEAP and RHF was significant in both sexes and age groups. Dietary acid load was associated with RHF regardless of sex and age and rather than the amount of the total or the individual sources of habitual dietary protein, may be a better target for the dietary intervention of chronic kidney disease.

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“…When compared to the participants who were in the first decile of NEAP, those who were in the last decile had an increased risk of hypertension of 23% [54]. In another study, which included 2028 participants from the Japan Epidemiology Collaboration on Occupational Health Study, PRAL and NEAP were positively associated with the increased chance of hypertension; however, when there was adjustment for renal function, this association did not remain significant [55]. …”

Section: Dietary Acid Load and Clinical Outcomesmentioning

confidence: 99%

Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review

Carnauba¹,

Baptistella²,

Paschoal³

et al. 2017

Nutrients

106

115

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Low-grade metabolic acidosis is a condition characterized by a slight decrease in blood pH, within the range considered normal, and feeding is one of the main factors that may influence the occurrence of such a condition. The excessive consumption of acid precursor foods (sources of phosphorus and proteins), to the detriment of those precursors of bases (sources of potassium, calcium, and magnesium), leads to acid-base balance volubility. If this condition occurs in a prolonged, chronic way, low-grade metabolic acidosis can become significant and predispose to metabolic imbalances such as kidney stone formation, increased bone resorption, reduced bone mineral density, and the loss of muscle mass, as well as the increased risk of chronic diseases such as type 2 diabetes mellitus, hypertension, and non-alcoholic hepatic steatosis. Considering the increase in the number of studies investigating the influence of diet-induced metabolic acidosis on clinical outcomes, this review gathers the available evidence evaluating the association of this disturbance and metabolic imbalances, as well as related mechanisms. It is necessary to look at the western dietary pattern of most countries and the increasing incidence of non-comunicable diseases for the balance between fruit and vegetable intake and the appropriate supply of protein, mainly from animal sources, so that it does not exceed the daily recommendations.

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High dietary acid load is associated with increased prevalence of hypertension: The Furukawa Nutrition and Health Study

Cited by 63 publications

References 43 publications

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

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

The Association between Renal Hyperfiltration and the Sources of Habitual Protein Intake and Dietary Acid Load in a General Population with Preserved Renal Function: The KoGES Study

Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review

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