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

Abstract

Background Existing epidemiological data on dietary acid load and cardiovascular disease (CVD) are controversial. There is no literature evaluating the association between dietary acid load (DAL) with cardiometabolic risk factors and inflammatory markers in elderly. Objective To evaluate the association between DAL and cardiometabolic risk factors amongst Iranian elders. Method A cross‐sectional study was completed using 357 Iranian elders above >60 years of age. Anthropometric, clinical, and biochemical measurements were performed. Dietary intake was assessed using a validated and reliable food frequency questionnaire. DAL was estimated using the Potential Renal Acid Load (PRAL) score, Net Endogenous Acid Production (NEAP) and the Net Endogenous Acid Excretion (NAE) score. Metabolic syndrome (MetS) was defined according to the ATP‐III criteria. Multivariable‐adjusted odds ratios (ORs) of CVD risk factors were estimated using logistic regression. Results After adjustment for confounders, a higher PRAL score was associated with higher odds of hypertriglyceridemia (OR: 2.28, 95% CI: 1.15, 4.50). We also observed that the NEAP score was positively associated with MetS (OR: 17.2, 95% CI: 2.34, 127). Finally, there was a positive association between NAE and lipid accumulation product (LAP) (OR: 1.81, 95% CI: 1.04, 3.17) and hypertriglyceridemia (OR: 2.46 95% CI: 1.22, 4.95). Conclusion Men with higher DAL scores had a higher risk of MetS, hypertriglyceridemia and LAP. Our findings suggest that further prospective studies are required to appraise DAL‐CVD risk factors in populations with varying dietary patterns.

Dietary Acid Load but Not Mediterranean Diet Adherence Score Is Associated With Metabolic and Cardiovascular Health State: A Population Observational Study From Northern Italy

“…These results are in agreement with previous reports indicating similar associations between PRAL as well as NEAP and the prevalence of MetS in Iranian patients with type 2 diabetes ( 40 ) and a cross-sectional Japanese study, in which higher NEAP values (PRAL was not calculated) were associated with an increased prevalence of MetS independently of sex, age, and BMI ( 17 ). Contradictory results were described by Jafari et al ( 41 ) who observed an association between MetS prevalence and NEAP but not PRAL in a cohort of Iranian men. Instead, the other two Iranian studies reported no association between PRAL or NEAP and the MetS ( 42 , 43 ).…”

A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals

“…Median PRAL, NEAP F and NEAP R scores decreased significantly in the vegan intervention group ( Table 3 and Figure 1 ). These findings are of paramount importance, as a high DAL has been associated with a series of health repercussions [ 8 ], including an increased risk for cardiovascular disease [ 30 ], type-2-diabetes [ 31 ], metabolic syndrome [ 32 ], chronic kidney disease [ 33 ] and an elevated lipid accumulation product [ 34 ].…”

Observational and clinical evidence that plant-based nutrition reduces dietary acid load

“…Cancer. Elevated DAL scores have been linked to low-grade inflammation (as indicated by elevated lipid accumulation product levels) (84) . It is now widely accepted that low-grade metabolic acidosis may induce peroxidation of biological structures (1) .…”

“…The authors reported positive associations of a high DAL with higher systolic and diastolic blood pressure as well as with total and LDL-cholesterol. Associations with hypertriglyceridaemia have been reported in a cross-sectional study including 357 Iranian elderly men (84) . Increasing cortisol production caused by mild metabolic acidosis could be the underlying mechanism (85) , but additional research is warranted in this poorly understood field (83) .…”