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Marinescu SC(N, Apetroaei MM, Nedea MI(I, Arsene AL, Velescu BȘ, Hîncu S, Stancu E, Pop AL, Drăgănescu D, Udeanu DI. Dietary Influence on Drug Efficacy: A Comprehensive Review of Ketogenic Diet-Pharmacotherapy Interactions. Nutrients 2024; 16:1213. [PMID: 38674903 PMCID: PMC11054576 DOI: 10.3390/nu16081213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
It is widely acknowledged that the ketogenic diet (KD) has positive physiological effects as well as therapeutic benefits, particularly in the treatment of chronic diseases. Maintaining nutritional ketosis is of utmost importance in the KD, as it provides numerous health advantages such as an enhanced lipid profile, heightened insulin sensitivity, decreased blood glucose levels, and the modulation of diverse neurotransmitters. Nevertheless, the integration of the KD with pharmacotherapeutic regimens necessitates careful consideration. Due to changes in their absorption, distribution, metabolism, or elimination, the KD can impact the pharmacokinetics of various medications, including anti-diabetic, anti-epileptic, and cardiovascular drugs. Furthermore, the KD, which is characterised by the intake of meals rich in fats, has the potential to impact the pharmacokinetics of specific medications with high lipophilicity, hence enhancing their absorption and bioavailability. However, the pharmacodynamic aspects of the KD, in conjunction with various pharmaceutical interventions, can provide either advantageous or detrimental synergistic outcomes. Therefore, it is important to consider the pharmacokinetic and pharmacodynamic interactions that may arise between the KD and various drugs. This assessment is essential not only for ensuring patients' compliance with treatment but also for optimising the overall therapeutic outcome, particularly by mitigating adverse reactions. This highlights the significance and necessity of tailoring pharmacological and dietetic therapies in order to enhance the effectiveness and safety of this comprehensive approach to managing chronic diseases.
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Affiliation(s)
- Simona Cristina (Nicolescu) Marinescu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
- Amethyst Radiotherapy Center, 42, Drumul Odăi, 075100 Otopeni, Romania
| | - Miruna-Maria Apetroaei
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Marina Ionela (Ilie) Nedea
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Andreea Letiția Arsene
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
- Marius Nasta Institute of Pneumophthiology, 90, Viilor Street, 050159 Bucharest, Romania
| | - Bruno Ștefan Velescu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Sorina Hîncu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
- Fundeni Clinical Institute, 258, Fundeni Street, 022328 Bucharest, Romania
| | - Emilia Stancu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Anca Lucia Pop
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Doina Drăgănescu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
| | - Denisa Ioana Udeanu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania (A.L.A.); (B.Ș.V.); (S.H.); (E.S.); (A.L.P.); (D.D.); (D.I.U.)
- Marius Nasta Institute of Pneumophthiology, 90, Viilor Street, 050159 Bucharest, Romania
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Attaye I, Beynon-Cobb B, Louca P, Nogal A, Visconti A, Tettamanzi F, Wong K, Michellotti G, Spector TD, Falchi M, Bell JT, Menni C. Cross-sectional analyses of metabolites across biological samples mediating dietary acid load and chronic kidney disease. iScience 2024; 27:109132. [PMID: 38433906 PMCID: PMC10907771 DOI: 10.1016/j.isci.2024.109132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/14/2023] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Chronic kidney disease (CKD) is a major public health burden, with dietary acid load (DAL) and gut microbiota playing crucial roles. As DAL can affect the host metabolome, potentially via the gut microbiota, we cross-sectionally investigated the interplay between DAL, host metabolome, gut microbiota, and early-stage CKD (TwinsUK, n = 1,453). DAL was positively associated with CKD stage G1-G2 (Beta (95% confidence interval) = 0.34 (0.007; 0.7), p = 0.046). After adjusting for covariates and multiple testing, we identified 15 serum, 14 urine, 8 stool, and 7 saliva metabolites, primarily lipids and amino acids, associated with both DAL and CKD progression. Of these, 8 serum, 2 urine, and one stool metabolites were found to mediate the DAL-CKD association. Furthermore, the stool metabolite 5-methylhexanoate (i7:0) correlated with 26 gut microbial species. Our findings emphasize the gut microbiota's therapeutic potential in countering DAL's impact on CKD through the host metabolome. Interventional and longitudinal studies are needed to establish causality.
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Affiliation(s)
- Ilias Attaye
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, the Netherlands
| | - Beverley Beynon-Cobb
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
- Department of Nutrition & Dietetics, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Panayiotis Louca
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Ana Nogal
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Alessia Visconti
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Francesca Tettamanzi
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Kari Wong
- Metabolon, Research Triangle Park, Morrisville, NC 27560, USA
| | | | - Tim D. Spector
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Mario Falchi
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Jordana T. Bell
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
| | - Cristina Menni
- Department of Twin Research, King’s College London, St Thomas' Hospital Campus, London SE1 7EH, UK
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Dolati S, Razmjouei S, Alizadeh M, Faghfouri AH, Moridpour AH. A high dietary acid load can potentially exacerbate cardiometabolic risk factors: An updated systematic review and meta-analysis of observational studies. Nutr Metab Cardiovasc Dis 2024; 34:569-580. [PMID: 38316575 DOI: 10.1016/j.numecd.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/07/2024]
Abstract
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).
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Affiliation(s)
- Shamim Dolati
- Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soha Razmjouei
- School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Alizadeh
- Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
| | - Amir Hossein Moridpour
- Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Aljuraiban GS, Gibson R, Chan DS, Van Horn L, Chan Q. The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies. Adv Nutr 2024; 15:100123. [PMID: 37783307 PMCID: PMC10831905 DOI: 10.1016/j.advnut.2023.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.
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Affiliation(s)
- Ghadeer S Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | - Rachel Gibson
- Department of Nutritional Sciences, King's College London, London, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Doris Sm Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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Yurtdaş Depboylu G, Kaner G, Özdemir Şimşek Ö, Turan KN, Kasap Demir B. Dietary acid load in children with chronic kidney disease: its association with nutritional status and health-related quality of life. Pediatr Nephrol 2023; 38:3417-3426. [PMID: 37145186 DOI: 10.1007/s00467-023-05991-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
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.
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Affiliation(s)
- Gamze Yurtdaş Depboylu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İzmir Katip Çelebi University, Çiğli Ana Yerleşkesi, Merkezi Ofisler 35620 Çiğli, İzmir, Turkey.
| | - Gülşah Kaner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İzmir Katip Çelebi University, Çiğli Ana Yerleşkesi, Merkezi Ofisler 35620 Çiğli, İzmir, Turkey
| | - Özgür Özdemir Şimşek
- Department of Pediatrics, Division of Nephrology, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Kübra Nur Turan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İzmir Katip Çelebi University, Çiğli Ana Yerleşkesi, Merkezi Ofisler 35620 Çiğli, İzmir, Turkey
| | - Belde Kasap Demir
- Department of Pediatrics, Division of Nephrology, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Department of Pediatrics, Division of Nephrology and Rheumatology, İzmir Katip Çelebi University, İzmir, Turkey
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Park J, Ha MR, Song J, Kim OY. The Synergistic Effect of Dietary Acid Load Levels and Cigarette Smoking Status on the Risk of Chronic Obstructive Pulmonary Disease (COPD) in Healthy, Middle-Aged Korean Men. Nutrients 2023; 15:4063. [PMID: 37764846 PMCID: PMC10536353 DOI: 10.3390/nu15184063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
We investigated whether cigarette smoking and dietary acid load (DAL) are associated with a risk of chronic obstructive pulmonary disease (COPD) in healthy, middle-aged Korean men. Healthy men without diagnosed chronic disease (aged 40-64 years) from the KNHANES-VI (2013-2015) were included in the analysis (n = 774) and were subdivided by smoking status and DAL levels, as estimated using the quartile of net endogenous acid production (NEAP). The current smokers tended to have a higher risk of COPD than the never-smokers before and after adjustment. When divided by the DAL quartile, the Q4 group tended to have a higher risk of COPD than the Q1 group. Additionally, the current smokers with lower (Q2), modest (Q3), and the highest NEAP scores (Q4) showed risks of COPD that were more than fourfold higher than those of the never-smokers with the lowest NEAP scores (Q1). The ex-smokers with higher NEAP scores (Q3 and Q4) showed risks of COPD that were more than fourfold higher than those of the Q1 group. Interestingly, the risk of COPD was also more than sixfold higher in the never-smokers with the highest NEAP scores compared to that in the Q1 group. The NEAP scores and smoking status synergistically increased the risk of COPD in healthy, middle-aged Korean men. This suggests that DAL levels are an important factor in the prevention and management of COPD.
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Affiliation(s)
- Jihyun Park
- Clinical Nutrition, Department of Health Sciences, Graduate School of Dong-A University, Sahagu, Nakdongdaero 550 beon-gil, Busan 49315, Republic of Korea; (J.P.); (M.R.H.)
| | - Mi Ri Ha
- Clinical Nutrition, Department of Health Sciences, Graduate School of Dong-A University, Sahagu, Nakdongdaero 550 beon-gil, Busan 49315, Republic of Korea; (J.P.); (M.R.H.)
| | - Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Jeollanam-do, Republic of Korea
| | - Oh Yoen Kim
- Clinical Nutrition, Department of Health Sciences, Graduate School of Dong-A University, Sahagu, Nakdongdaero 550 beon-gil, Busan 49315, Republic of Korea; (J.P.); (M.R.H.)
- Department of Food Science and Nutrition, Dong-A University, Sahagu, Nakdongdaero 550 beon-gil, Busan 49315, Republic of Korea
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Al-Hawary SIS, Mushabab F, Abullais SS, Althomali RH, Saleh EAM, Alnajjar SN, Oudaha KH, Romero-Parra RM, Hussien BM, Garousi N. Metabolic syndrome in relation to dietary acid load: a dose-response meta-analysis of observational studies. Front Nutr 2023; 10:1233746. [PMID: 37637946 PMCID: PMC10450920 DOI: 10.3389/fnut.2023.1233746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background and aim Several studies have identified that dietary acid load (DAL) may be associated with the odds of metabolic syndrome (MetS); however, the evidence is inconclusive. This dose-response meta-analysis aimed to examine the relation of DAL to MetS. Methods A systematic literature search was carried out in PubMed and Scopus up to April 2023 for pertinent studies evaluating the relation of DAL scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), to the odds of MetS. The odds ratios (OR) with 95% confidence intervals (CI) were pooled using a random-effects meta-analysis to test the association. Results Eight studies, with an overall sample size of 31,351 participants, were included in this meta-analysis. Higher DAL scores were significantly related to the elevated odds of MetS (NEAP: OR = 1.42, 95%CI = 1.12-1.79; PRAL: OR = 1.76, 95%CI = 1.11-2.78), with significant evidence of heterogeneity across studies. The linear dose-response analysis proposed that a 10 mEq/day elevation in NEAP and PRAL was linked to a 2% (OR = 1.02, 95%CI = 1.001-1.05) and 28% (OR = 1.28, 95%CI = 1.11-1.47) increased odds of MetS, respectively. No non-linear association was observed between MetS and NEAP (P-non-linearity = 0.75) and PRAL (P-non-linearity = 0.92). Conclusion This study revealed a significant direct relationship between DAL and MetS. Therefore, lower acidogenic diets are suggested for the prevention of MetS.
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Affiliation(s)
| | - Faris Mushabab
- Department of Periodontics, Albaha University, Al Bahah, Saudi Arabia
| | - Shahabe Saquib Abullais
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Raed H. Althomali
- Department of Chemistry, College of Arts and Science, Prince Sattam Bin Abdulaziz University, Wadi Al-Dawasir, Saudi Arabia
| | - Ebraheem Abdu Musad Saleh
- Department of Chemistry, College of Arts and Science, Prince Sattam Bin Abdulaziz University, Wadi Al-Dawasir, Saudi Arabia
| | | | - Khulood H. Oudaha
- Pharmaceutical Chemistry Department, College of Pharmacy, Al-Ayen University, Nasiriyah, Iraq
| | | | - Beneen M. Hussien
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Nazila Garousi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Fang Q, Yu L, Tian F, Zhang H, Chen W, Zhai Q. Effects of dietary irritants on intestinal homeostasis and the intervention strategies. Food Chem 2023; 409:135280. [PMID: 36587512 DOI: 10.1016/j.foodchem.2022.135280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 12/11/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Abundant diet components are unexplored as vital factors in intestinal homeostasis. Dietary irritants stimulate the nervous system and provoke somatosensory responses, further inducing diarrhea, gut microbiota disorder, intestinal barrier damage or even severe gastrointestinal disease. We depicted the effects of food with piquancy, high fat, low pH, high-refined carbohydrates, and indigestible texture. The mechanism of dietary irritants on intestinal homeostasis were comprehensively summarized. Somatosensory responses to dietary irritants are palpable and have specific chemical and neural mechanisms. In contrast, even low-dose exposure to dietary irritants can involve multiple intestinal barriers. Their mechanisms in intestinal homeostasis are often overlapping and dose-dependent. Therefore, treating symptoms caused by dietary irritants requires personalized nutritional advice. The reprocessing of stimulant foods, additional supplementation with probiotics or prebiotics, and enhancement of the intestinal barrier are effective intervention strategies. This review provides promising preliminary guidelines for the treatment of symptoms and gastrointestinal injury caused by dietary irritants.
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Affiliation(s)
- Qingying Fang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China
| | - Leilei Yu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China
| | - Fengwei Tian
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, PR China
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu 214122, PR China; Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research Institute, Wuxi Branch, PR China; Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, PR China
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu 214122, PR China
| | - Qixiao Zhai
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu 214122, PR China; Institute of Food Biotechnology, Jiangnan University, Yangzhou 225004, PR China.
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Storz MA, Ronco AL. Carbohydrate Intake and Its Association With Dietary Acid Load in U.S. Adults: Results From a Cross-Sectional Study. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221133297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The safety profile of low-carbohydrate diets is controversial and poorly understood. We investigated the effects of low-moderate carbohydrate intake on dietary acid load (DAL), an emerging health risk factor and novel clinical marker associated with numerous adverse clinical outcomes. Methods: We used data from the National Health and Nutrition Examination Surveys to investigate how low-moderate carbohydrate intake quantitatively affects DAL (as assessed by PRAL and NEAP scores) and to contrast the results to DAL scores in individuals that meet carbohydrate intake recommendations. Results: We analyzed data from 23 825 individuals, of which 4891 consumed a low-moderate carbohydrate diet. Said individuals derived 37.84% of energy from carbohydrates, tended to be male, had a mean BMI of 28.47 kg/m2, and consumed significantly more energy from fat and protein ( P≤.01 for both) than individuals that met carbohydrate recommendations Low-moderate carbohydrate intake was associated with a significantly higher DAL. Mean PRALR, NEAPR, and NEAPF values were 26.12, 71.02, and 68.98 mEq/d, respectively. Multivariate regression revealed the highest DAL scores in individuals on a low-carbohydrate diet, obtaining <26% of energy from carbohydrates. Conclusions: Low-moderate carbohydrate intake is associated with increased DAL scores, which has been repeatedly associated with various health repercussions.
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Affiliation(s)
- Maximilian A. Storz
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, Freiburg, Germany (MAS); Unit of Oncology and Radiotherapy, Pereira Rossell Women’s Hospital, Montevideo, Uruguay (ALR); School of Medicine, CLAEH University, Maldonado, Uruguay (ALR); and Biomedical Sciences Center, University of Montevideo, Montevideo, Uruguay (ALR)
| | - Alvaro L. Ronco
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, Freiburg, Germany (MAS); Unit of Oncology and Radiotherapy, Pereira Rossell Women’s Hospital, Montevideo, Uruguay (ALR); School of Medicine, CLAEH University, Maldonado, Uruguay (ALR); and Biomedical Sciences Center, University of Montevideo, Montevideo, Uruguay (ALR)
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10
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Household Income Is Related to Dietary Fiber Intake and Dietary Acid Load in People with Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2022; 14:nu14153229. [PMID: 35956405 PMCID: PMC9370737 DOI: 10.3390/nu14153229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
Abstract
Household income was related to habitual dietary intake in general Japanese people. This cross-sectional study investigated the relationship between household income and habitual dietary intake in people with type 2 diabetes mellitus (T2DM). Household income was evaluated using a self-reported questionnaire and categorized into high and low household income. Nutritional status was assessed using a brief-type self-administered diet history questionnaire. Among 128 men and 73 women, the proportions of participants with low household income were 67.2% (n = 86/128) in men and 83.6% (n = 61/73) in women. Dietary fiber intake (11.3 ± 4.2 vs. 13.8 ± 6.0 g/day, p = 0.006) was lower, and dietary acid load, net endogenous aid production score (NEAP) (51.7 ± 10.5 vs. 46.8 ± 10.4 mEq/day, p = 0.014) and potential renal acid load score (PRAL) (9.5 ± 10.7 vs. 3.7 ± 14.1 mEq/day, p = 0.011) were higher in men with low household income than in those without. Multivariable linear regression analyses demonstrated that log (dietary fiber intake) in men with low household income was lower than that in those with high household income after adjusting for covariates (2.35 [2.26−2.44] vs. 2.52 [2.41−2.62], p = 0.010). Furthermore, NEAP (54.6 [51.7−57.4] vs. 45.8 [42.5−49.2], p <0.001) in men with low household income were higher than in those with high household income after adjusting for covariates. Contrastingly, household income was not related to diet quality in women. This study showed that household income was related to dietary fiber intake and dietary acid load in men but not in women.
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11
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Association between dietary acid load and metabolic health status in overweight and obese adolescents. Sci Rep 2022; 12:10799. [PMID: 35750714 PMCID: PMC9232519 DOI: 10.1038/s41598-022-15018-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/16/2022] [Indexed: 02/03/2023] Open
Abstract
The relationship between dietary acid load (DAL) and metabolic health status in adolescents has not been studied yet. We aimed to examine the association between DAL and metabolic health status in Iranian overweight/obese adolescents. This cross-sectional study included 203 overweight/obese adolescents selected by a multistage cluster random sampling method. Dietary intakes were assessed using a validated 147-item food frequency questionnaire (FFQ). Anthropometric indices and blood pressure values were measured. Fasting blood samples were obtained to determine glucose, insulin, and lipid profiles. Based on two methods (International Diabetes Federation (IDF) criteria and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)), participants were classified into metabolically healthy obese (MHO) or unhealthy obese (MUO). Adolescents in the highest tertile of potential renal acid load (PRAL) and net endogenous acid production (NEAP), compared with those in the lowest tertile, had 172% (95% CI 1.32–5.59) and 161% (95% CI 1.26–5.41) higher odds of MUO status, based on IDF criteria. This association was significant after adjustment for age, sex, and energy intake (PRAL: OR 2.42; 95% CI CI 1.13–5.15; NEAP: OR 2.52; 95% CI 1.17–5.41); but it disappeared after adjustment for other confounders. Based on IDF/HOMA-IR definition, there was a significant positive association between PRAL and being MUO only in the crude model (OR 2.37; 95% CI 1.13–4.96). The stratified analysis revealed that these associations for NEAP scores were stronger among overweight subjects than obese individuals, based on both metabolic status definitions. However, after adjustment for all potential confounders these relations were insignificant. Having higher DAL might be associated with higher odds of MUO phenotype in Iranian overweight/obese adolescents. More prospective studies are warranted to confirm this finding.
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12
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Zhao R, Zhou L, Lei G, Wang S, Li Y, Yang X, Xiong G, Hao L. Dietary Acid Load Is Positively Associated With Risk of Gestational Diabetes Mellitus in a Prospective Cohort of Chinese Pregnant Women. Front Nutr 2022; 9:892698. [PMID: 35694169 PMCID: PMC9184257 DOI: 10.3389/fnut.2022.892698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Growing evidence suggests that dietary acid load plays an important role in the development of type 2 diabetes. However, prospective studies on the relationship between dietary acid load and gestational diabetes mellitus (GDM) are limited in the pregnant population. This study aimed to investigate the effect of dietary acid load during early pregnancy on the risk of GDM in Chinese pregnant women. Methods A total of 1,327 pregnant women were enrolled from an ongoing prospective study of the Tongji Birth cohort (TJBC) in Wuhan, China. Dietary intake was assessed before 20 weeks using a 74-item semiquantitative food frequency questionnaire (FFQ). The dietary acid load was estimated using potential renal acid load (PRAL), net endogenous acid production (NEAP), and animal protein to potassium ratio (A:P ratio). A 75g 2-h oral glucose tolerance test (OGTT) was performed at 24-28 gestational weeks to diagnose GDM. Results The mean (standard deviation) values for PRAL score, NEAP score, and A:P ratio were 0.8 ± 11.3 mEq/day, 45.3 ± 16.5 mEq/day, and 9.8 ± 6.0, respectively. There was a significant positive correlation of dietary acid load with the intake of red meat, poultry, fish, and eggs, and a negative correlation with the intake of vegetables, fruits, nuts, and legumes (all P < 0.05). Compared to the lowest tertile, the highest tertile of dietary acid load, including PRAL score (odds ratio [OR]: 2.26, 95% confidence interval [CI] = 1.38–3.71, P-trend = 0.002), NEAP score (OR: 2.02, 95% CI = 1.25–3.27, P-trend = 0.009), and A:P ratio (2.08, 95% CI = 1.30–3.31, P-trend = 0.005), significantly increased the risk of GDM. In addition, the dietary acid load was also significantly associated with an increase in 1-h and 2-h post-load blood glucose concentrations (all P-trend < 0.05). Conclusion We found a significant positive association between dietary acid load during early pregnancy and the risk of GDM in a Chinese population, suggesting that the reduction of food sources of dietary acid load may be an effective strategy for preventing the risk of GDM.
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Affiliation(s)
- Rui Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Leilei Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Lei
- The Central Hospital of Wuhan, Wuhan, China
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, China
- *Correspondence: Guoping Xiong,
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Liping Hao,
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13
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Sanz JM, Sergi D, Colombari S, Capatti E, Situlin R, Biolo G, Di Girolamo FG, Lazzer S, Šimunič B, Pišot R, Passaro A. Dietary Acid Load but Not Mediterranean Diet Adherence Score Is Associated With Metabolic and Cardiovascular Health State: A Population Observational Study From Northern Italy. Front Nutr 2022; 9:828587. [PMID: 35558749 PMCID: PMC9087734 DOI: 10.3389/fnut.2022.828587] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/14/2022] [Indexed: 12/28/2022] Open
Abstract
Diet plays a pivotal role in shaping the trajectory of chronic diseases. In this regard, the Mediterranean diet has been widely shown to exert beneficial effects on cardiometabolic health. On the contrary, the Western diet, which has also been reported to be an acidogenic dietary pattern, elicits detrimental effects on both metabolic and cardiovascular (CV) health. However, the role of dietary acid load (DAL) as a predictor of cardiometabolic prognosis remains to be elucidated. Thus, this study aims to compare Mediterranean diet adherence (MDA) and DAL focusing on their relationship with metabolic and CV prognosis. A total of 448 individuals aged 55–80 years were grouped depending on their MDA, assessed using food frequency questionnaires, or DAL, evaluated using potential renal load acid (PRAL) and net-endogenous acid production (NEAP). Study participants underwent anthropometric and biochemical measurements. The metabolic syndrome (MetS) prevalence was evaluated according to the National Cholesterol Education Program-Adult Treatment Panel III. Finally, the CV risk was evaluated using three independent algorithms: atherosclerotic cardiovascular disease (ASCVD), European Systematic COronary Risk Evaluation (SCORE), and Cuore risk scores. Mediterranean diet adherence was negatively associated with PRAL and NEAP. Individuals in the higher MDA tertile group had higher HDL cholesterol as well as lower homeostasis model assessment index (HOMA-IR) and fat mass relative to the lowest MDA tertile. However, in the high-MDA tertile group, there was neither a significantly lower MetS prevalence nor CV risk. Instead, both the MetS prevalence and CV risk were higher in individuals in the higher acid PRAL quartile relative to the lower alkaline PRAL quartile. Dietary acid load, especially assessed using PRAL but not MDA, was associated with indices of metabolic and CV prognosis. Thus, DAL assessed by 24-h dietary recalls may represent a better predictor of cardiometabolic health if compared to MDA evaluated using food frequency questionnaires.
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Affiliation(s)
- Juana Maria Sanz
- Department of Chemical and Pharmaceutical and Agricultural Sciences, University of Ferrara, Ferrara, Italy
| | - Domenico Sergi
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Simona Colombari
- University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Eleonora Capatti
- University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Roberta Situlin
- Department of Medical Surgical and Health Sciences, Clinica Medica ASUGI, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Department of Medical Surgical and Health Sciences, Clinica Medica ASUGI, University of Trieste, Trieste, Italy
| | - Filippo Giorgio Di Girolamo
- Department of Medical Surgical and Health Sciences, Clinica Medica ASUGI, University of Trieste, Trieste, Italy.,Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Italy
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14
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Abstract
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.
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Affiliation(s)
- Nursel Sahın
- Department of Nutrition and Dietetic, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Ugur Gunsen
- Department of Nutrition and Dietetic, Bandirma Onyedi Eylul University, Balikesir, Turkey
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15
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Smeha L, Fassula AS, Moreno YMF, Gonzalez-Chica DA, Nunes EA. Dietary acid load is positively associated with insulin resistance a population-based study. Clin Nutr ESPEN 2022; 49:341-347. [DOI: 10.1016/j.clnesp.2022.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/05/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
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16
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Omma T, Gulcelik NE, Zengin FH, Karahan I, Culha C. Dietary Acid Load is Associated with Hypertension and Diabetes in the Elderly. Curr Aging Sci 2022; 15:242-251. [PMID: 35346013 DOI: 10.2174/1874609815666220328123744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/15/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diet can affect the body's acid-base balance due to its content of acid or base precursors. There is conflicting evidence for the role of metabolic acidosis in the development of cardiometabolic disorders, hypertension (HT), and insulin resistance (IR). OBJECTIVE We hypothesize that dietary acid load (DAL) is associated with adverse metabolic risk factors and we aimed to investigate this in the elderly. METHODS A total of 114 elderly participants were included in the study. The participants were divided into four groups such as HT, diabetes (DM), both HT and DM, and healthy controls. Anthropometric, biochemical, and clinical findings were recorded. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) results were obtained from three-day, 24-hour dietary records via a nutrient database program. (BeBiS software program). RESULTS The groups were matched for age, gender, and BMI. There was a statistically significant difference between the groups in terms of NEAP (p=0.01) and no significant difference for PRAL (p=0.086). The lowest NEAP and PRAL levels were seen in the control group while the highest in the HT group. Both NEAP and PRAL were correlated with waist circumference (r=0,325, p=0.001; r=0,231, p=0,016, respectively). CONCLUSION Our data confirmed that subjects with HT and DM had diets with greater acid-forming potential. High NEAP may be a risk factor for chronic metabolic diseases, particularly HT. PRAL couldn't be shown as a significantly different marker in all participants. Dietary content has a significant contribution to the reduction of cardiovascular risk factors such as HT, DM, and obesity.
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Affiliation(s)
- Tulay Omma
- Department of Endocrinology and Metabolism, University of Health Sciences, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Nese Ersoz Gulcelik
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, 06010, Ankara, Turkey
| | - Fatmanur Humeyra Zengin
- Department of Nutrition and Dietetics, University of Health Sciences, Ankara Training and Research Hospital, 06230, Ankara, Turkey
| | - Irfan Karahan
- Department of Internal Medicine, University of Kırıkkale, Faculty of Medicine, 71450, Kırıkkale, Turkey
| | - Cavit Culha
- Department of Endocrinology and Metabolism, University of Health Sciences, Ankara Training and Research Hospital, 06230, Ankara, Turkey
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17
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Nikniaz Z, Mahdavi R, Akhavan Sabbagh M, Nikniaz L, Shirmohammadi M. Comparison of dietary acid load score between celiac patients and healthy population. BMC Nutr 2022; 8:18. [PMID: 35232484 PMCID: PMC8889752 DOI: 10.1186/s40795-022-00512-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 02/23/2022] [Indexed: 12/11/2022] Open
Abstract
Background and aims In the present study, we assessed the dietary acid load in adult celiac patients and compared it with that of the healthy population to provide more specific dietary recommendations for celiac patients. Methods This study was a cross-sectional study that included 130 celiac patients and 462 Non-celiac participants. The 80-item semi-quantitative food frequency questionnaire was used to obtain dietary data. Based on the dietary data, the dietary acid load (DAL), Potential renal net acid load (PRAL), and net endogenous acid production (NEAP) were calculated. Results The mean PRAL value is negative in the celiac group but positive in the general population. There was a significant difference in the PRAL score between celiac patients and the general population (p < 0.001). The mean NEAP and DAL score were significantly lower in the celiac group compared with the healthy population (P < 0.001). There were no significant differences between gluten-free diet adherents and non-adherents regarding the PRAL, NEAP, and DAL values (P > 0.05). Conclusion We showed that the patients with celiac disease had a significantly less acidogenic diet compared with that of the general population. So, following dies low in gluten may be associated with less acid production spacially in populations at risk of acid/base imbalance.
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Affiliation(s)
- Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Reza Mahdavi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masood Shirmohammadi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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18
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Müller A, Zimmermann-Klemd AM, Lederer AK, Hannibal L, Kowarschik S, Huber R, Storz MA. A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199998. [PMID: 34639299 PMCID: PMC8507786 DOI: 10.3390/ijerph18199998] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022]
Abstract
The composition of diet strongly affects acid–base homeostasis. Western diets abundant in acidogenic foods (meat and cheese) and deficient in alkalizing foods (fruits and vegetables) increase dietary acid load (DAL). A high DAL has been associated with numerous health repercussions, including cardiovascular disease and type-2-diabetes. Plant-based diets have been associated with a lower DAL; however, the number of trials exploring this association is limited. This randomized-controlled trial sought to examine whether an isocaloric vegan diet lowers DAL as compared to a meat-rich diet. Forty-five omnivorous individuals were randomly assigned to a vegan diet (n = 23) or a meat-rich diet (n = 22) for 4 weeks. DAL was determined using potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores at baseline and after 3 and 4 weeks, respectively. After 3 weeks, median PRAL (−23.57 (23.87)) and mean NEAPR (12.85 ± 19.71) scores were significantly lower in the vegan group than in the meat-rich group (PRAL: 18.78 (21.04) and NEAPR: 60.93 ± 15.51, respectively). Effects were mediated by a lower phosphorus and protein intake in the vegan group. Our study suggests that a vegan diet is a potential means to reduce DAL, whereas a meat-rich diet substantially increases the DAL burden.
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Affiliation(s)
- Alexander Müller
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
| | - Amy Marisa Zimmermann-Klemd
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
| | - Ann-Kathrin Lederer
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
| | - Luciana Hannibal
- Medical Center, Laboratory of Clinical Biochemistry and Metabolism, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany;
| | - Stefanie Kowarschik
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
| | - Roman Huber
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
| | - Maximilian Andreas Storz
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.M.Z.-K.); (A.-K.L.); (S.K.); (R.H.)
- Correspondence:
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19
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Mirmiran P, Houshialsadat Z, Bahadoran Z, Khalili-Moghadam S, Shahrzad MK, Azizi F. Dietary acid load and risk of cardiovascular disease: a prospective population-based study. BMC Cardiovasc Disord 2021; 21:432. [PMID: 34511069 PMCID: PMC8436514 DOI: 10.1186/s12872-021-02243-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 09/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM Considering the inconsistencies in the cardiovascular effects of dietary acid load and the impact of dietary acidity on the acid-base homeostasis within the body, we aimed to assess the association of dietary acid load and the risk of cardiovascular disease (CVD) in a prospective community-based study. MATERIALS AND METHODS Participants (n = 2369) free of CVD at baseline (2006-2008) were included from the Tehran Lipid and Glucose Study (TLGS) and followed up for a mean of 6.7 ± 1.4 years. Dietary intakes of the participants were assessed using a semi-quantitative food frequency questionnaire (FFQ). The dietary acid load was evaluated by Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) scores. Both scores have used the macronutrient and micronutrient data of the Food Frequency Questionnaires. Multivariate Cox proportional hazard regression models were used to estimate the 6-years incident risk of CVDs across tertiles of PRAL and NEAP scores. RESULTS Mean age and body mass index of participants were 38.5 ± 13.3 years and 26.6 ± 4.8 kg/m2 at baseline. Within 6.7 ± 1.4 years of follow-up, 79 cases of cardiovascular events were reported. NEAP was significantly associated with the incidence of CVDs (HRs = 0.50, CI 0.32-0.96; P for trend = 0.032); however, after adjusting for potential confounders, no significant associations were observed between PRAL and NEAP scores and the risk of CVDs. CONCLUSIONS This study failed to obtain independent associations between dietary acid load and the incidence of CVDs among an Asian population.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Zeinab Houshialsadat
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran.
| | - Sajjad Khalili-Moghadam
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran
| | - Mohammad Karim Shahrzad
- Shohada Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, No. 24, Sahid-Erabi St, Yemen St, Chamran Exp, P.O.Box: 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lim SY, Chan YM, Ramachandran V, Shariff ZM, Chin YS, Arumugam M. Dietary Acid Load and Its Interaction with IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) Polymorphisms on Metabolic Traits among Postmenopausal Women. Nutrients 2021; 13:nu13072161. [PMID: 34201855 PMCID: PMC8308464 DOI: 10.3390/nu13072161] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to explore the effects of dietary acid load (DAL) and IGF1 and IL6 gene polymorphisms and their potential diet–gene interactions on metabolic traits. A total of 211 community-dwelling postmenopausal women were recruited. DAL was estimated using potential renal acid load (PRAL). Blood was drawn for biochemical parameters and DNA was extracted and Agena® MassARRAY was used for genotyping analysis to identify the signalling of IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) polymorphisms. Interactions between diet and genetic polymorphisms were assessed using regression analysis. The result showed that DAL was positively associated with fasting blood glucose (FBG) (β = 0.147, p < 0.05) and there was significant interaction effect between DAL and IL6 with systolic blood pressure (SBP) (β = 0.19, p = 0.041). In conclusion, these findings did not support the interaction effects between DAL and IGF1 and IL6 single nucleotide polymorphisms (rs35767, rs7136446, and rs1800796) on metabolic traits, except for SBP. Besides, higher DAL was associated with higher FBG, allowing us to postulate that high DAL is a potential risk factor for diabetes.
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Affiliation(s)
- Sook Yee Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
| | - Yoke Mun Chan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
- Research Center of Excellence Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
- Correspondence: (Y.M.C.); (V.R.)
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
- Centre for Research, Bharath Institute of Higher Education and Research, 173, Agaram Main Rd, Selaiyur, Chennai, Tamil Nadu 600073, India
- Correspondence: (Y.M.C.); (V.R.)
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
| | - Yit Siew Chin
- Research Center of Excellence Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
| | - Manohar Arumugam
- Department of Orthopedics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia;
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Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutr Diabetes 2020; 10:38. [PMID: 33257645 PMCID: PMC7705738 DOI: 10.1038/s41387-020-00142-z] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/19/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background At present, the beneficial effect of the ketogenic diet (KD) on weight loss in obese patients is generally recognized. However, a systematic research on the role of KD in the improvement of glycemic and lipid metabolism of patients with diabetes is still found scarce. Methods This meta-study employed the meta-analysis model of random effects or of fixed effects to analyze the average difference before and after KD and the corresponding 95% CI, thereby evaluating the effect of KD on T2DM. Results After KD intervention, in terms of glycemic control, the level of fasting blood glucose decreased by 1.29 mmol/L (95% CI: −1.78 to −0.79) on average, and glycated hemoglobin A1c by 1.07 (95% CI: −1.37 to −0.78). As for lipid metabolism, triglyceride was decreased by 0.72 (95% CI: −1.01 to −0.43) on average, total cholesterol by 0.33 (95% CI: −0.66 to −0.01), and low-density lipoprotein by 0.05 (95% CI: −0.25 to −0.15); yet, high-density lipoprotein increased by 0.14 (95% CI: 0.03−0.25). In addition, patients’ weight decreased by 8.66 (95% CI: −11.40 to −5.92), waist circumference by 9.17 (95% CI: −10.67 to −7.66), and BMI by 3.13 (95% CI: −3.31 to −2.95). Conclusion KD not only has a therapeutic effect on glycemic and lipid control among patients with T2DM but also significantly contributes to their weight loss.
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Dietary Acid Load and Cardiometabolic Risk Factors-A Narrative Review. Nutrients 2020; 12:nu12113419. [PMID: 33171835 PMCID: PMC7695144 DOI: 10.3390/nu12113419] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
The Western, diet rich in acidogenic foods (e.g., meat, fish and cheese) and low in alkaline foods (e.g., vegetables, fruits and legumes), is deemed to be a cause of endogenous acid production and elevated dietary acid load (DAL), which is a potential cause of metabolic acidosis. Multiple authors have suggested that such a dietary pattern increases the excretion of calcium and magnesium, as well as cortisol secretion. In addition, it is associated with decreased citrate excretion. All of these seem to increase blood pressure and insulin resistance and may contribute to the development of cardiometabolic disorders. However, there are inconsistencies in the results of the studies conducted. Therefore, this narrative literature review aims to present the outcomes of studies performed in recent years that investigated the association between DAL and the following cardiometabolic risk factors: blood pressure, hypertension, carbohydrate metabolism and lipid profile. Study outcomes are divided into (i) statistically significant positive association, (ii) statistically significant inverse association, and (iii) no statistically significant association.
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Farhangi MA, Nikniaz L, Khodarahmi M. Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose-response meta-analysis. J Transl Med 2020; 18:344. [PMID: 32891165 PMCID: PMC7487688 DOI: 10.1186/s12967-020-02511-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the current systematic review and meta-analysis, we summarized the studies that evaluated the effects of sugar-sweetened beverages (SSBs) intake on blood pressure among children and adolescents. METHODS In a systematic search from PubMed, Scopus, Embase and Cochrane electronic databases up to 20 April 2020, the observational studies that evaluated the association between sugar-sweetened beverages intake and hypertension, systolic or diastolic blood pressure (SBP, DBP) were retrieved. RESULTS A total of 14 studies with 93873 participants were included in the current meta-analysis. High SSB consumption was associated with 1.67 mmHg increase in SBP in children and adolescents (WMD: 1.67; CI 1.021-2.321; P < 0.001). The difference in DBP was not significant (WMD: 0.313; CI -0.131- 0.757; P = 0.108). High SSB consumers were 1.36 times more likely to develop hypertension compared with low SSB consumers (OR: 1.365; CI 1.145-1.626; P = 0.001). In dose-response meta-analysis, no departure from linearity was observed between SSB intake and change in SBP (P-nonlinearity = 0.707) or DBP (P-nonlinearity = 0.180). CONCLUSIONS According to our finding, high SSB consumption increases SBP and hypertension in children and adolescents.
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Affiliation(s)
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Khodarahmi
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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