Dietary acid load and risk of diminished ovarian reserve: a case-control study.

BACKGROUND: The epidemiologic evidence on the association between acid load potential of diet and the risk of diminished ovarian reserve (DOR) is scarce. We aim to explore the possible relationship between dietary acid load (DAL), markers of ovarian reserve and DOR risk in a case-control study. METHODS: 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and BMI, were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The DAL scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Antral follicle count (AFC), serum antimullerian hormone (AMH) and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of NEAP and PRAL scores. RESULTS: Following increase in PRAL and NEAP scores, serum AMH significantly decreased in women with DOR. Also, AFC count had a significant decrease following increase in PRAL score (P = 0.045). After adjustment for multiple confounding variables, participants in the top quartile of PRAL had increased OR for DOR (OR: 1.26; 95%CI: 1.08-1.42, P = 0.254). CONCLUSION: Diets with high acid-forming potential may negatively affect ovarian reserve in women with DOR. Also, high DAL may increase the risk of DOR. The association between DAL and markers of ovarian reserve should be explored in prospective studies and clinical trials.

Association Between Dietary Acid Load and Grip Strength in Adults 50 Years and Older: A Cross-Sectional Study.

Minimal data exist on whether the acid-base balance of the diet is linked to muscle strength. The aim of this study was to determine if dietary acid load is associated with grip strength in a nationally representative sample of middle- to older-age adults. We examined the cross-sectional association of grip strength with dietary acid load quantified through potential renal acid load (PRAL) and net endogenous acid production (NEAP) in 4,059 adults aged 50 years and older in the 2011-2014 NHANES survey cycles. PRAL and NEAP were estimated from two 24-h recalls and categorized into sex-specific quartiles. Grip strength was measured on a dynamometer. Multiple linear regression models were used to determine the associations of PRAL and NEAP (as quartiles) with grip strength for men and women separately, adjusting for total energy, age, race/ethnicity, weight, physical activity, smoking, serum 25-hydroxyvitamin D, and estimated glomerular filtration rate. Mean grip strength was 26.8 ± 0.2 kg in women and 43.0 ± 0.4 kg in men. Adjusted grip strength was inversely associated with quartiles of PRAL (ptrend = 0.049) and NEAP (ptrend = 0.034) in women with quartile 4 vs 1 differences of - 1.21 and - 1.08 kg (both p < 0.05), respectively. Adjusted grip strength was not associated with PRAL or NEAP in men. Overall, we found inverse associations between dietary acid load and grip strength in middle- and older-age women, suggesting that an alkaline diet may be important in maintaining muscle strength in this population. There was no association between dietary acid load and grip strength in men.

Effects of dietary interventions for metabolic acidosis in chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND AND HYPOTHESIS: Metabolic acidosis is a common complication of kidney disease and can result in further disease progression. Alkali therapy has been used to treat metabolic acidosis for decades. However, some concerns have been raised regarding its safety and long-term tolerability. Existing data suggest that dietary interventions can be beneficial in the management of chronic kidney disease (CKD). This systematic review and meta-analysis aims to summarize findings from studies comparing dietary interventions with placebo/usual care/no treatment in the management of metabolic acidosis in outpatient adults with CKD. METHODS: Medline, Embase, Cochrane Central, CINAHL, and Web of Science Core Collection were searched from inception to June 2022. Our primary outcome measure was change in serum bicarbonate. Any dietary intervention looking to manipulate dietary acid load was considered as an intervention. Data screening and extraction were performed by two independent reviewers. Random effects meta-analysis was performed to pool data. RESULTS: Dietary interventions resulted in clinically significant improvement in serum bicarbonate (mean difference (MD):2.98, 95% CI: [0.77, 5.19]; I2: 91%) and higher eGFR levels (MD: 3.16, 95%CI: [0.24, 6.08], I2: 67%) compared to controls. Serum potassium, albumin and body mass index remained unchanged. Dietary interventions were reported to be safe. Subgroup analyses indicated a superiority of plant-based over non-plant-based interventions in the improvement of acid-base balance and eGFR, however, these findings are from low quality and heterogenous studies. CONCLUSION: Our findings support the beneficial effects of dietary interventions aimed at reducing acid or adding base in the management of metabolic acidosis and kidney function in adults with CKD, with no adverse effects on serum potassium and nutritional status. Well-designed clinical trials looking at the treatment of metabolic acidosis with dietary interventions with a focus on adding base through fruit and vegetables are required.

Effects of higher dietary acid load: a narrative review with special emphasis in children.

Metabolic effects of high diet acid load (DAL) have been studied for years in adults, although only recently in children. Contemporary diets, especially those of Western societies, owe their acidogenic effect to high animal-origin protein content and low contribution of base-forming elements, such as fruits and vegetables. This imbalance, where dietary acid precursors exceed the body's buffering capacity, results in an acid-retaining state known by terms such as "eubicarbonatemic metabolic acidosis," "low-grade metabolic acidosis," "subclinical acidosis," or "acid stress". Its consequences have been linked to chronic systemic inflammation, contributing to various noncommunicable diseases traditionally considered more common in adulthood, but now have been recognized to originate at much earlier ages. In children, effects of high DAL are not limited to growth impairment caused by alterations of bone and muscle metabolism, but also represent a risk factor for conditions such as obesity, insulin resistance, diabetes, hypertension, urolithiasis, and chronic kidney disease (CKD). The possibility that high DAL may be a cause of chronic acid-retaining states in children with growth impairment should alert pediatricians and pediatric nephrologists, since its causes have been attributed traditionally to inborn errors of metabolism and renal pathologies such as CKD and renal tubular acidosis. The interplay between DAL, overall diet quality, and its cascading effects on children's health necessitates comprehensive nutritional assessments and interventions. This narrative review explores the clinical relevance of diet-induced acid retention in children and highlights the potential for prevention through dietary modifications, particularly by increasing fruit and vegetable intake alongside appropriate protein consumption.

A high dietary acid load can potentially exacerbate cardiometabolic risk factors: An updated systematic review and meta-analysis of observational studies.

AIMS: Chronic metabolic acidosis has been shown to be associated with cardiometabolic risk factors. The aim of the currently updated meta-analysis was to explore the association between Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) with these risk factors. DATA SYNTHESIS: Databases were searched up to May 2023. The mean of waist circumference (WC), body mass index (BMI), high- and low-density lipoprotein-cholesterol (HDL-C and LDL-C), triglyceride (TG), total cholesterol (TC), fasting blood sugar (FBS), and systolic- and diastolic blood pressure (SBP and DBP) in highest category vs lowest categories of NEAP and PRAL were recorded. Effect sizes were generated as weighted mean difference (WMD). Results showed that SBP, DBP, and WC had a significant difference in the upper and lower categories of PRAL (WMDSBP: 1.466 mmHg; 95% CI: 2.121, -0.811; P<0.001, WMDDBP: 0.710 mmHg; 95 % CI: 1.170, -0.249; P=0.003, and WMDWC: 0.819 cm; 95% CI: 1.446, -0.192; P=0.010) or NEAP (WMDSBP: 1.690 mmHg; 95% CI: 2.789, -0.591; P=0.003, WMDDBP: 1.076 mmHg, and WMDWC: 1.325 cm; 95% CI: 1.901, -0.749; P<0.001; 95% CI: 1.938, -0.214; P =0.014). The lowest versus highest categories of dietary PRAL were associated with lower BMI (WMDPRAL: 0.297 kg/m2; 95 % CI: 0.440, -0.154; P<0.001) and TG (WMD: 2.280 mg/dl; 95%CI: 3.828, -0.732; P=0.004; I2=99.4 %; P<0.001). CONCLUSIONS: High DAL can be considered as an independent risk factor for increasing anthropometric indices, blood pressure, and TG. This study registered in the PROSPERO database (Registration No. CRD42023402985).

The Role of Dietary Acid Load on Progression of Estimated Glomerular Filtration Rate Among Individuals Diagnosed With Chronic Kidney Disease.

OBJECTIVE: Individuals with chronic kidney disease (CKD) are at an increased risk for developing metabolic acidosis. Metabolic acidosis has been shown to worsen kidney function and exacerbate systemic inflammation. Diets high in protein foods can exacerbate metabolic acidosis as protein foods tend to be more acidic, while fruits and vegetables are more alkalotic. The main objective of this systematic review was to determine if higher consumption of fruits and vegetables in adults with CKD stages 1-5 reduces the rate of decline of estimated glomerular filtration rate. METHODS: Searches of Cumulated Index to Nursing and Allied Health Literature (CINAHL -Elton B. Stephens Company [EBSCO]), Cochrane Library (Wiley), Dissertation & Thesis Global (ProQuest), Embase (Elsevier), Medline (OVID), PubMed (National Library of Medicine), Scopus (Elsevier), and Web of Sciences (Clarivate) identified 1,451 articles published between January 2015 and June 2023. RESULTS: After independent review, 7 total studies were included. Six of the studies found an association between dietary acid load and progression of CKD. CONCLUSIONS: Dietary counseling focusing on decreasing dietary acid load may be beneficial for individuals with CKD.

Combined Effect of Dietary Acid Load and Cardiometabolic Syndrome on Bone Resorption Marker among Post-Menopausal Women in Malaysia.

Background: This study aimed to investigate factors associated with bone resorption status and determine the independent and interactive effects of dietary acid load (DAL) and cardiometabolic syndrome (CMS) on bone resorption in post-menopausal women. Methods: Overall, 211 community-dwelling post-menopausal women were recruited from the National Council of Senior Citizens Organization, Malaysia. DAL was estimated using the potential renal acid load from the food frequency questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and smoking behaviour was assessed using the Global Adult Tobacco Survey 2011. Serum 25(OH) vitamin D levels were determined using the ADVIA Centaur vitamin D assay and serum C-terminal telopeptides of type I collagen (CTX1) were used as surrogate markers to assess bone resorption. CMS was determined based on the harmonised criteria. Results: Age (ß = -0.145, t = -2.002, P < 0.05) was negatively associated while DAL (ß = 0.142, t = 2.096, P < 0.05) and sleep quality (ß = 0.147, t = 2.162, P < 0.05) were positively associated with CTX1. Height was positively correlated with CTX1 (r = 0.136, P <0.05). Conversely, other variables (CMS traits, CMS, serum 25(OH) vitamin D level, years of menopause, years of education and physical activity) were not significantly associated with CTX1 levels. There was no significant interaction between DAL and CMS on bone resorption. Conclusion: Our findings propose that high DAL, but not CMS, is a potential risk factor for bone resorption. The analysis did not demonstrate the combined effects of DAL and CMS on bone resorption.

Dietary acid load and cardiovascular diseases.

Diet affects the body's acid-base balance by providing acid or alkali precursors in the metabolism. The importance of the acid-base balance of the diet for cardiovascular diseases, which have become the most important cause of morbidity on the global scale, has started to take its place in the literature. The prediction of endogenous acid production in dietary acid-base balance is expressed as dietary acid load. Although the available information about the effect of dietary acid load on cardiovascular diseases is limited, possible mechanisms are indicated as excessive calcium and magnesium excretion from the kidneys, reduced urinary citrate excretion, and excessive cortisol production. Metabolic acidosis has an important role in the development of cardiometabolic abnormalities, especially insulin resistance. Studies examining the relationship between dietary acid load and cardiovascular disease are limited and there is an inconsistency between studies. Practices for determining risk factors for cardiovascular diseases and preventing their effects are very important for the protection and improvement of health. Considering dietary acid load when planning a diet for individuals with cardiovascular diseases can help increase the effectiveness of the diet. The purpose of this review is to examine the effect of dietary acid load on cardiovascular diseases.

Dietary acid load and its interaction with CETP TaqB1 polymorphisms on lipid profile among patients with Type 2 diabetes mellitus.

OBJECTIVE: Gene-diet interaction plays a key role in the inter-individual differences in lipid abnormalities as a major risk factor for cardiovascular diseases (CVDs). Thus, we explored the interaction between CETP TaqB1 polymorphism with dietary acid load (DAL) on lipid profile among type 2 diabetes mellitus (T2DM). METHOD: This cross-sectional study conducted on 220 Iranian patients with T2DM. Dietary acid load (PRAL and NEAP) was calculated via a validated food-frequency questionnaire (FFQ). The polymerase chain reaction (PCR) used for genotyping Taq1B polymorphism. Biochemical markers were measured by standard protocol. The interaction between CETP Taq1B polymorphism and DAL (PRAL and NEAP) on lipid profile was performed by a generalized linear regression model (GLM). RESULTS: The overall prevalence of rs708272 genotypes was 8.6%, 72.7% and 18.6% for B1B1, B1B2 and B2B2 genotype respectively. This study showed that people with the B1B1 genotype had greater LDL, TC, LDL/HDL, and TG when they consumed diets that scored higher on the NEAP and PRAL indexes than those with the B1B2 and B2B2 genotypes. Besides, carriers of the B1B1 allele who were in the highest tertile of NEAP, had lower HDL (P Interaction < 0.05). CONCLUSIONS: In summary, the lipid profile might be improved in B1B1 homozygotes by less adherence to DAL indexes, however, the findings should be validated in high-quality interventional studies.

Dietary acid load in children with chronic kidney disease: its association with nutritional status and health-related quality of life.

BACKGROUND: This study aimed to determine the dietary acid load of children with chronic kidney disease (CKD) and to evaluate the relationship between dietary acid load, nutritional status, and health-related quality of life (HRQOL). METHOD: A total of 67 children aged 3-18 years with a diagnosis of CKD stages II-V were included in the study. Anthropometric measurements (body weight, height, mid-upper arm circumference, waist, and neck circumference) and 3-day food consumption records were taken to evaluate the nutritional status. The net endogenous acid production (NEAP) score was calculated to determine the dietary acid load. "Pediatric Inventory of Quality of Life (PedsQL)" was used to assess the participants' HRQOL. RESULTS: The mean NEAP was 59.2 ± 18.96 mEq/day. Stunted and malnourished children had significantly higher NEAP than those who were not (p < 0.05). There were no significant differences in terms of HRQOL scores according to NEAP groups. The multivariate logistic regression analysis showed that waist circumference (OR: 0.890, 95% CI: 0.794-0.997), serum albumin (OR: 0.252, 95% CI: 0.068-0.929), and glomerular filtration rate (GFR) (OR: 0.985, 95% CI: 0.970-1.000) were negatively associated with high NEAP. CONCLUSION: This study shows that a diet shifted in an acidic direction in children with CKD and a higher dietary acid load are associated with lower serum albumin, GFR, and waist circumference, but not HRQOL. These results suggest that dietary acid load might affect nutritional status and CKD progression in children with CKD. Future studies with larger samples are needed to confirm these results and to understand underlying mechanisms. A higher resolution version of the Graphical abstract is available as Supplementary information.

Dietary acid load, depression, and anxiety: results of a population-based study.

BACKGROUND: Dietary acid load seems to be associated with psychological disorders through several mechanisms, and may barricade their treatment and recovery. The aim of current study was to evaluate the relationship between dietary acid load, using potential renal acid load (PRAL) and dietary acid load (DAL) scores, with the severity of depression and anxiety among Iranian adults. METHODS: A total of 6531 participants aged 35-65 years were recruited in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using PRAL and DAL scores. Depression and anxiety were screened using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: In the fully adjusted model, women with the highest DAL or PRAL had higher odds of more severe depression compared to those in the lowest category (OR = 1.20; 95% CI = 1.03-1.42 and OR = 1.20; 95% CI = 1.03-1.39, respectively). No significant association was observed between DAL and PRAL and depression severity in men and in the population as a whole. Regarding the association between PRAL and anxiety severity, there was no significant association when separated by sex. However, in the fully adjusted model for the whole population, participants in the highest tertile of PRAL had 13% greater odds of more severe anxiety than the lowest tertile (OR: 1.13, 95% CI: 1.01-1.13). No significant association was observed between DAL and anxiety severity in women, men or in the whole population. CONCLUSION: Women, but not men, with higher dietary acid load had significantly higher odds of having more severe depression. A significant positive association was also observed between dietary acid load and anxiety in the whole population.

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

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.

Dietary Acid Load and Predialysis Serum Bicarbonate Levels in Patients With End-Stage Renal Disease.

OBJECTIVES: Maintaining the predialysis serum bicarbonate at a recommended level is critical in patients undergoing hemodialysis. Therefore, the present study investigated the association between dietary acid load (DAL) and serum predialysis bicarbonate levels in patients with end-stage renal disease. METHODS: Adult patients undergoing hemodialysis were enrolled in this cross-sectional study. Diet was assessed using a semiquantitative food frequency questionnaire. DAL was calculated with 2 validated indices: potential renal acid load (PRAL) and net endogenous acid production (NEAP). Values regarding predialysis serum bicarbonate level and serum electrolytes were obtained from the participant's medical records. The multiple linear regression analysis was used to determine the association between DAL indices and predialysis serum bicarbonate level. RESULTS: The number of hemodialysis patients eligible for this study was 122. The participants' mean age and body mass index was 57.14 ± 3.8 years and 25.2 ± 4.9 kg/m2, respectively. About 65.6% of participants were male. The mean serum levels of predialysis bicarbonate were 21.59 ± 3.1 mEq/L. Also, 47.5% of patients had predialysis serum bicarbonate levels below the recommended value. The mean values of PRAL and NEAP were -2.8 ± 7.48 and 42.7 ± 10.1 mEq/day, respectively. PRAL significantly and inversely predicted predialysis serum bicarbonate level independent of covariates (standardized ß = -0.38; P < .001). Also, NEAP was independently and inversely associated with predialysis bicarbonate level (standardized ß = -0.40; P < .001). Consuming vegetables such as lettuce, tomato, cucumber, spinach, and dried fruits as well as low-fat milk, plain yogurt, and cream cheese were positively correlated to predialysis serum bicarbonate level. However, the canned tuna had a negative correlation with the predialysis serum bicarbonate. CONCLUSIONS: The study's findings showed that the lower DAL was associated with higher predialysis serum bicarbonate levels in patients with end-stage renal disease. Due to the cross-sectional nature of the present study, prospective cohorts or well-controlled clinical trials are needed to confirm our result.

Association of dietary acid load with metabolic syndrome in overweight and obese women.

Background: There is increasing evidence supporting the association between dietary acid load and metabolic syndrome (MetS) components. However, to the best of our knowledge, there are rare and inconsistent studies to examine the association of dietary acid load and MetS score. The aim of this research was to assess dietary acid loads as measured by potential renal acid load (PRAL) in relation to MetS. Methods: The current study involved 246 overweight or obese women. Dietary assessment was performed using a validated 147-item food frequency questionnaire (FFQ). Remer's equation was used to calculate PRAL score. MetS was defined as the National Cholesterol Education Program (NCEP)/Adult Treatment Panel ΙΙΙ (ATP). Multivariable logistic regression models were used to find the association between PRAL score and MetS. Results: The mean age and BMI of participants were 36.49±8.38 years old and 31.04±4.31 kg/m2, respectively. Overall, 32 percent of participants had MetS. According to the final model, although not statistically significant, there was a trend which suggested that being in the highest quartile of adherence to dietary acid load, evaluated by PRAL score, compared to the lowest quartile was associated with higher odds of MetS [(OR: 2.80; 95% CI: 0.95-8.26), (P=0.06)]. Conclusions: Our study shows a borderline non-significant association between PRAL and odds of MetS in overweight or obese women. However, definitive clarification of this relationship requires future intervention studies.

The association between dietary acid load and odds of non-alcoholic fatty liver disease: A case-control study.

Background: Data on the association between dietary acid load and non-alcoholic fatty liver disease (NAFLD) are scarce and controversial. Aim: This study aimed to assess the association between dietary acid-base loads and odds of NAFLD. Methods: In the current study, 196 cases of NAFLD (proven by a gastroenterologist using Fibroscan) and 803 age-matched controls were enrolled from the same clinic. Dietary intakes of patients with NAFLD and controls without hepatic steatosis were evaluated using a validated food frequency questionnaire. Dietary acid load was estimated using the validated potential renal acid load (PRAL) algorithm. Multivariable logistic regression model was used to estimate the odds of NAFLD across quintiles of PRAL. Results: The mean ± SD age of the study population (43% male) was 43.28 ± 14.02 years. The mean ± SD of PRAL was -1.90 ± 7.12 for all participants. After adjustment for all known confounders, subjects in the third quintile of PRAL (nearly with neutral PRAL) had a 54% lower odds of NAFLD compared with those in the lowest quintiles of the PRAL [(OR: 0.46; 95%CI: 0.24-0.89), (P = 0.021)]. However, the odds of NAFLD in the highest quintiles of PRAL was not different in comparison to the lowest quintiles (OR: 0.90; 95%CI: 0.41-1.57). Conclusion: In conclusion, our results have shown a modest U shaped relationship between PRAL and NAFLD. Further studies with acid-base biomarkers are needed to confirm the role of dietary acid load in the development of NAFLD and its potential mechanisms.

The dietary acid load is associated with disease severity in psoriatic arthritis (PsA).

OBJECTIVES: An acidogenic diet, by disrupting the blood pH equilibrium, can contribute to metabolic acidosis and lead to inflammation. Therefore, we hypothesized that dietary acid load (DAL) increases disease activity and inflammation in PsA patients. METHODS: This study was conducted with 58 obese/overweight patients, aged 20-65 years. Dietary intake was assessed using a 3-consecutive-day 24-hour recall. The DAL was evaluated through the PRAL (potential renal acid load) and NEAP (net endogenous acid production) and divided into the low and high groups by their median values. The disease activity assessments, anthropometric measurements, dietary data and blood parameters of patients were recorded and compared at the low and high DAL groups. RESULTS: We observed that patients in the high NEAP and PRAL groups had worse PsA pattern scores (p<0.05). Also, PRAL and NEAP scores were positively associated with DAPSA, HAQ, and PSAID-12 scores. After adjusting age, sex, smoking, and BMI, 1 mEq increase in PRAL and NEAP was associated with an elevation of DAPSA (0.506 and 0.486 points, respectively). CONCLUSIONS: These results showed a close relationship between DAL and PsA symptoms. An acidogenic diet may negatively affect PsA prognosis. Healthy eating recommendations should be part of the management of the disease.

Dietary acid load, alternative healthy eating index score, and bacterial vaginosis: is there any association? A case-control study.

BACKGROUND: Changing the dietary pattern may be an alternative treatment for bacterial vaginosis, the prevalent vaginal infection in women. METHODS: One hundred and forty-three bacterial vaginosis-affected women diagnosed by Amsel criteria and 151 healthy controls aged 18 to 45 entered the current case-control research. To calculate the alternative healthy eating index and dietary acid load score, food consumption was recorded with an accurate and precise food frequency questionnaire. The dietary acid load was measured by potential renal acid load (PRAL) and net endogenous acid production (NEAP) indices. Using logistic regression models, the association between the alternative healthy eating index and dietary acid load score with bacterial vaginosis was investigated. RESULTS: The last tertile of the alternative healthy eating index had a 75% decreased odds of experiencing bacterial vaginosis in the adjusted model (adjusted odds ratio (aOR) = 0.25, 95% confidence interval (CI) = 0.12-0.53, P for trend = 0.001). Besides, vegetables (aOR = 0.34, 95% CI = 0.17-0.69, P for trend = 0.003), nuts and legumes (aOR = 0.44, 95% CI = 0.23-0.87, P for trend = 0.028), and meats (aOR = 0.31, 95% CI = 0.16-0.60, P for trend = 0.001) intake was linked to a decreased bacterial vaginosis odds. However, sugar-sweetened beverages and fruit juice (aOR = 3.47, 95% CI = 1.68-7.17, P for trend < 0.001), trans fatty acids (aOR = 2.29, 95% CI = 1.18-4.43, P for trend = 0.005), and sodium (aOR = 3.44, 95% CI = 1.67-7.06, P for trend = 0.002) intake were directly associated with bacterial vaginosis odds. There was no evidence of a link between dietary acid load and bacterial vaginosis. CONCLUSION: According to the present study's findings, there is no correlation between dietary acid load and the likelihood of developing bacterial vaginosis. However, following a plant-based dietary pattern based on the healthy eating index may lead to a lower odds of bacterial vaginosis.

Higher dietary acid load is associated with hyperuricemia in Chinese adults: a case-control study.

BACKGROUND: This study aims to explore the association between dietary acid load and hyperuricemia in Chinese adults. METHODS: A case-control study was conducted. Adult participants with hyperuricemia were recruited as the cases and those without hyperuricemia were as the controls. Food consumption was evaluated by food frequency questionnaire (FFQ). Dietary acid load was assessed by potential renal acid load (PRAL) and net endogenous acid production (NEAP). Dietary acid load was divided into four levels: the first quartile (Q1), the second quartile (Q2), the third quartile (Q3) and the fourth quartile (Q4). Logistic regression model was applied for exploring the association between dietary acid load (PRAL and NEAP) and hyperuricemia. Odds ratio (OR) and its correspondence confidence interval (CI) were computed. RESULTS: A total of 290 participants were eligible in this study, in which there were 143 individuals in case group and 147 in control group. A higher level of PRAL was found to be associated with odds of hyperuricemia. ORs of hyperuricemia for Q2, Q3 and Q4 of PRAL were 2.74 (95%CI: 1.94 ~ 3.88, p-value: 0.004), 2.90 (95%CI: 2.05 ~ 4.10, p-value: 0.002) and 3.14 (95%CI: 2.22 ~ 4.45, p-value: 0.001), respectively. There was a positive association between elevated NEAP and hyperuricemia. OR of hyperuricemia for Q2 was not material significance (OR:1.54, 95%CI: 0.93 ~ 2.53, p-value: 0.210), however, ORs of hyperuricemia for Q3 (OR: 2.40, 95%CI: 1.70 ~ 3.38, p-value: 0.011) and Q4 (OR: 3.27, 95%CI: 2.31 ~ 4.62, p-value: 0.001) were statistically significant. CONCLUSION: Higher level of dietary acid load was found to be associated with hyperuricemia in Chinese adults, indicative of advocation of a well-balanced diet in this population.

Dietary acid load modifies the effects of ApoA2-265 T > C polymorphism on lipid profile and serum leptin and ghrelin levels among type 2 diabetic patients.

This investigation with aimed the effect of APOA2-265 T > C polymorphism and dietary acid load (DAL) as either potential renal acid load (PRAL) and net endogenous acid production (NEAP) intake interaction on metabolic markers in type 2 diabetes mellitus (T2DM). In present cross-sectional study, 737 patients with T2DM (290 men and 447 women) were enlisted from diabetes centers in Tehran. The dietary intakes of all participants during the last year was acquired by a validated semi-quantitative food frequency (FFQ) questionnaire. Polymerase chain reaction (PCR) was used for genotyping the APOA2-265 T > C. Biochemical indises containing leptin, ghrelin, total cholesterol (Bailey et al., J Clin Invest 97:1147-1453, 1996), low-density lipoprotein cholestrol (LDL-C), high-density lipoprotein cholestrol (HDL-C), triglyceride (TG), superoxide dismutase (SOD), high sensitivy C-reactive protein (hs-CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), prostaglandin F2α (PGF2α) and interleukin 18 (IL18) were measured by standard method. Atherogenic indices (AIP, AC, CR-I, CR-II) were calculated. The gene-diet interactions were evaluated using an GLM. The frequency overall prevalence of rs5082 genotypes was 63.82 and 36.17% for T-allele and C-allele respectively. TG, Ghrelin, and hs-CRP concentrations were significantly higher among carriers with C allele than TT homozygotes. However, TC/CC genotypes have lower PTX3 than TT homozygotes (P < 0.05). C-allele carriers had highest mean of BMI (PNEAP=0.04, PPRAL = 0.006), WC (PNEAP=0.04, PPRAL = 0.04), TC (PNEAP=0.03, PPRAL = 0.01), ghrelin (PNEAP=0.01, PPRAL = 0.04), and leptin (PNEAP=0.04, PPRAL = 0.03) when placed in top tertiles of NEAP and PRAL.BMI, WC, TC, ghrelin, and leptin levels may be modified in C carriers by decreasing DAL, though, further investigations are required to confirm these findings.

The association between dietary acid load and adiposity measures among children and adolescents.

BACKGROUND: Childhood obesity is one of the most important health problems in the present century. It is imperative to plan preventive programs through risk factor identification. The present study was conducted to examine the association between the dietary acid load (DAL) and anthropometric indices in a sample of Iranian children and adolescents. METHODS: In the current survey, students aged 11-18 years were recruited. To assess usual dietary intake, a validated self-administered 168-item food frequency questionnaire was used. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) was used to estimate DAL. The association between DAL and anthropometric indices was evaluated using logistic regression and reported as an odds ratio (OR) with a 95% confidence interval (CI). RESULTS: In total, 456 students (267 girls), with a mean age of 14.44 years participated in the current study. After controlling for potential confounders, the PRAL was positively associated with the risk of obesity (OR = 4.56, 95% CI: 2.26, 9.17), abdominal obesity (OR = 12.64, 95% CI: 3.05, 52.27), and adiposity based on the percent of body fat (PBF) (OR = 3.58, 95% CI: 1.83, 6.99). The NEAP was also significantly associated with the risk of obesity (OR = 5.17, 95% CI: 2.56, 10.43), abdominal obesity (OR = 15.08, 95% CI: 3.35, 67.81), and adiposity based on PBF (OR = 4.53, 95% CI: 2.30, 8.92). CONCLUSION: Our findings suggest that higher adherence to the acidogenic diet, expressed as DAL, was associated with a higher risk of general and central obesity among children and adolescents.