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Wieërs MLAJ, Beynon-Cobb B, Visser WJ, Attaye I. Dietary acid load in health and disease. Pflugers Arch 2024; 476:427-443. [PMID: 38282081 PMCID: PMC11006742 DOI: 10.1007/s00424-024-02910-7] [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: 10/27/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
Maintaining an appropriate acid-base equilibrium is crucial for human health. A primary influencer of this equilibrium is diet, as foods are metabolized into non-volatile acids or bases. Dietary acid load (DAL) is a measure of the acid load derived from diet, taking into account both the potential renal acid load (PRAL) from food components like protein, potassium, phosphorus, calcium, and magnesium, and the organic acids from foods, which are metabolized to bicarbonate and thus have an alkalinizing effect. Current Western diets are characterized by a high DAL, due to large amounts of animal protein and processed foods. A chronic low-grade metabolic acidosis can occur following a Western diet and is associated with increased morbidity and mortality. Nutritional advice focusing on DAL, rather than macronutrients, is gaining rapid attention as it provides a more holistic approach to managing health. However, current evidence for the role of DAL is mainly associative, and underlying mechanisms are poorly understood. This review focusses on the role of DAL in multiple conditions such as obesity, cardiovascular health, impaired kidney function, and cancer.
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Affiliation(s)
- Michiel L A J Wieërs
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Beverley Beynon-Cobb
- Department of Nutrition & Dietetics, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Wesley J Visser
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Ilias Attaye
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands.
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Bae S, Kang SI, Ko HC, Park J, Jun W. Anti-Obesity Effect of Jeju Roasted Citrus Peel Extract in High-Fat Diet-Induced Obese Mice and 3T3-L1 Adipocytes Via Lipid Metabolism Regulation. J Med Food 2024; 27:369-378. [PMID: 38489599 DOI: 10.1089/jmf.2023.k.0299] [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] [Indexed: 03/17/2024] Open
Abstract
Lipid accumulation in adipocytes occurs through multifactorial effects such as overnutrition due to unbalanced eating habits, reduced physical activity, and genetic factors. In addition, obesity can be intensified by the dis-regulation of various metabolic systems such as differentiation, lipogenesis, lipolysis, and energy metabolism of adipocytes. In this study, the Jeju roasted peel extract from Citrus unshiu S.Markov. (JRC), which is discarded as opposed to the pulp of C. unshiu S.Markov., is commonly consumed to ameliorate obesity. To investigate the anti-obesity effect of JRC, these studies were conducted on differentiated 3T3-L1 cells and in high-fat diet-induced mice, and related methods were used to confirm whether it decreased lipid accumulation in adipocytes. The mechanism of inhibiting obesity by JRC was confirmed through mRNA expression studies. JRC suppressed lipid accumulation in adipocytes and adipose tissue, and significantly improved enzymes such as alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase and serum lipid profiles. In addition, it effectively modulated the expression of genes related to lipid and energy metabolism in adipose tissue. As a result, these findings suggest that JRC could be a therapeutic regulator of body fat accumulation by significantly alleviating the dis-regulation of intracellular lipid metabolism in adipocytes and by enhancement of energy metabolism (Approval No. CNU IACUC-YB-2023-98).
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Affiliation(s)
- Subin Bae
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
| | - Seong-Il Kang
- Planning Management and Research Development, Jeju Institute of Korean Medicine, Jeju, Korea
| | - Hee Chul Ko
- Planning Management and Research Development, Jeju Institute of Korean Medicine, Jeju, Korea
| | - Jeongjin Park
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
- Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
| | - Woojin Jun
- Division of Food and Nutrition, Chonnam National University, Gwangju, Korea
- Research Institute for Human Ecology, Chonnam National University, Gwangju, Korea
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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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Roberts R, Williams DM, Min T, Barry J, Stephens JW. Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study. J Diabetes Metab Disord 2023; 22:1763-1768. [PMID: 37975098 PMCID: PMC10638127 DOI: 10.1007/s40200-023-01311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/12/2023] [Indexed: 11/19/2023]
Abstract
Background Bariatric surgery is well-established to support long-term metabolic health benefits associated with considerable weight loss. Here, we aim to determine the longer-term impact of bariatric surgery on liver enzymes and associations with other metabolic improvements. Methods One hundred patients who underwent bariatric surgery between 2007 and 2014 were included, and changes in liver enzymes, anthropometric measures and other parameters were observed over a mean 9.8 years. Results At the time of surgery, the mean age was 45.4 ± 9.6 years, weight 141.2 ± 31.6 kg, and body mass index (BMI) 50.2 ± 10.1 kg/m2. Most patients underwent sleeve gastrectomy [n = 71] with a mean follow-up duration 9.8 ± 2.3 years. From baseline, alanine transaminase (ALT) reduced by 41.3% within 12 months post-operatively (36.6 ± 29.2 U/L to 21.5 ± 14.9 U/L, p < 0.001), which was sustained at recent follow-up (20.2 ± 10.7 U/L, p < 0.001). There were associated reductions in body weight, BMI, HbA1c, blood pressure and triglycerides. Patients with greater baseline ALT had the greatest reduction in ALT over follow-up. Conclusions Bariatric surgery is associated with rapid and sustained improvements in routine liver enzymes at 10 years, and sustained improvements in features of the metabolic syndrome. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01311-4.
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Affiliation(s)
- Richard Roberts
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
| | - David M Williams
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
- Diabetes Centre, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Thinzar Min
- Diabetes Centre, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
- Diabetes Centre, Neath Port Talbot Hospital, Baglan Way, Port Talbot, SA12 7BX UK
| | - Jonathan Barry
- Welsh Institute of Metabolic & Obesity Surgery, Morriston Hospital, Swansea Bay UHB, Swansea, SA6 6NL UK
| | - Jeffrey W Stephens
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
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Storz MA. Health Inequities in the USA: a Role for Dietary Acid Load? Results from the National Health and Nutrition Examination Surveys. J Racial Ethn Health Disparities 2023; 10:2851-2860. [PMID: 36422851 PMCID: PMC10645648 DOI: 10.1007/s40615-022-01462-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cardiovascular disease and obesity affect racial and ethnic minorities disproportionally. Public health research suggests that suboptimal diet is an important contributor to health disparities. Limited evidence points at an increased dietary acid load (DAL) in certain ethnic groups. DAL is determined by the balance of acidifying foods and alkaline foods, and elevated DAL scores have been associated with numerous chronic lifestyle-related conditions. The present analysis investigated DAL scores among ethnic groups in the USA. METHODS Using cross-sectional data from the National Health and Nutrition Examination surveys (NHANES, 2007-2016), we contrasted several markers of DAL (potential renal acid load (PRAL) and net endogenous acid production (NEAP)) between Non-Hispanic Whites, Non-Hispanic Blacks, Mexican Americans, Other Hispanics, and Other Race. The comparison included crude scores and adjusted scores following multivariate linear regression. RESULTS The sample for this analysis comprised 19,565 participants, which may be extrapolated to represent 156,116,471 United States Americans. When compared to Non-Hispanic Whites, Non-Hispanic Blacks and Mexican Americans had significantly higher crude DAL scores. PRALR was highest in Mexican Americans (20.42 (0.61) mEq/day), followed by Non-Hispanic Blacks (17.47 (0.42) mEq/day). Crude NEAPF was highest in Non-Hispanic Blacks (64.66 (0.43) mEq/day), and almost 9 mEq/day higher compared to Non-Hispanic Whites (55.78 (0.39) mEq/day). Multivariate linear regression adjusting for confounders revealed comparable interracial DAL differences. CONCLUSIONS We found significant DAL differences across the investigated ethnic groups. Whether these differences potentially play a role in population health inequity in the USA will be subject to additional research.
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Affiliation(s)
- Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Faculty of Medicine, Freiburg University Hospital, University of Freiburg, Freiburg, Germany.
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Emamat H, Farhadnejad H, Poustchi H, Teymoori F, Bahrami A, Hekmatdoost A. The association between dietary acid load and odds of non-alcoholic fatty liver disease: A case-control study. Nutr Health 2023; 29:637-644. [PMID: 35306902 DOI: 10.1177/02601060221088383] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Hadi Emamat
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and pancreatobiliary research group, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Teymoori
- Student Research Committee, Iran University Of Medical Sciences, Tehran, Iran
| | - Alireza Bahrami
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tangestani H, Emamat H, Tavakoli A, Ghalandari H, Keshavarz SA, Yekaninejad MS, Mirzaei K. Association of dietary acid load with metabolic syndrome in overweight and obese women. INT J VITAM NUTR RES 2023; 93:420-426. [PMID: 35045755 DOI: 10.1024/0300-9831/a000748] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
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.
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Affiliation(s)
- Hadith Tangestani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Nutrition, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hadi Emamat
- Department and Faculty of Clinical Nutrition Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Tavakoli
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamid Ghalandari
- Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Keshavarz
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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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: 1] [Impact Index Per Article: 1.0] [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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Detopoulou P, Dedes V, Pylarinou I, Syka D, Tzirogiannis K, Panoutsopoulos GI. Dietary acid load is associated with waist circumference in university students with low adherence to the Mediterranean diet: The potential role of ultra-processed foods. Clin Nutr ESPEN 2023; 56:43-51. [PMID: 37344082 DOI: 10.1016/j.clnesp.2023.05.005] [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: 03/05/2023] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND AIMS Dietary acid load (DAL), as expressed by potential renal acid load (PRAL) and net acid production (NEAP), is connected to cardiometabolic disorders and obesity. Mediterranean diet relates to lower, while western diets to higher DAL values. The present study aimed to assess the association of PRAL and NEAP with adiposity measures in young adults (19.61 ± 3.15 years, mean ± standard deviation) and explore the implication of Mediterranean diet adherence and ultra-processed foods (UPF) intake in this relation. METHODS 346 students (269 women) participated. Anthropometry was performed, and a food frequency questionnaire was administered. The MedDietScore was calculated, UPF consumption was calculated based on the NOVA classification and PRAL/NEAP was estimated from published equations. Waist Circumference (WC) was transformed to WC-1 (1/WC) in order to achieve normality and run linear regression models. RESULTS In subjects with MedDietScore ≤ 28.00, PRAL and NEAP were negatively associated with 1/WC (B = -1.594 × 10-5± 8 × 10-6, p = 0.044 for PRAL and B = -2.84 × 10-5 ± 1 × 10-5, p = 0.048 for NEAP). Moreover, in this subgroup, subjects with medium to high UPF intake i.e., in the 2nd or 3rd tertile of UPF intake representing more than 34.16% of energy, PRAL (2nd tertile B = -0.00007, SE = 0.00003, p = 0.018; 3rd tertile B = -0.00002, SE = 0.00001, p = 0.024) and NEAP (2nd tertile B = -0.00004, SE = 0.00002, p = 0.040; 3rd tertile B = -0.00007, SE = 0.00004, p = 0.055) were connected to central obesity. In similar models, PRAL and NEAP were not significant predictors of BMI. CONCLUSION The DAL may be related to central obesity, especially in individuals with worse dietary quality, as reflected by lower adherence to the Mediterranean diet, and high intake of UPF. Nutrition guidance aiming at the reduction of DAL may be useful in the reduction of central obesity in these subgroups.
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Affiliation(s)
- Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526, Athens, Greece
| | - Vassilios Dedes
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
| | - Ioanna Pylarinou
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
| | - Dimitra Syka
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece
| | | | - Georgios I Panoutsopoulos
- Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece.
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Saeedirad Z, Ariyanfar S, Noormohammadi M, Ghorbani Z, Naser Moghadasi A, Shahemi S, Ghanaatgar M, Rezaeimanesh N, Hekmatdoost A, Ghaemi A, Razeghi Jahromi S. Higher Dietary Acid Load Might Be a Potent Derivative Factor for Multiple Sclerosis: The Results from a Case-Control Study. Nutrients 2023; 15:3311. [PMID: 37571248 PMCID: PMC10420939 DOI: 10.3390/nu15153311] [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: 06/07/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to investigate the association between dietary acid load (DAL) and multiple sclerosis (MS), through the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. In a hospital-based case-control study of 109 patients with MS and 130 healthy individuals, a validated 168-item semi-quantitative food frequency questionnaire and a logistic regression model were used to evaluate the association between the DAL and MS. After adjusting for age (years), gender (male/female), body mass index (Kg/m2), and total calories (Kcal), the MS odds were 92% lower for those in the highest tertile of total plant-based protein (OR: 0.08, 95%CI: 0.03, 0.23; p-value < 0.001) and about four times higher for those in the highest tertile of the PRAL (OR: 4.16, 95%CI: 1.94, 8.91; p-value < 0.001) and NEAP scores (OR: 3.57, 95%CI: 1.69, 7.53; p-value < 0.001), compared to those in the lowest tertile. After further adjusting for sodium, saturated fatty acid, and fiber intake, the results remained significant for total plant-based protein intake (OR: 0.07, 95%CI: 0.01, 0.38; p-value = 0.002). In conclusion, a higher NEAP or PRAL score may be associated with increased odds of MS, while a higher intake of plant-based protein instead of animal-based protein may be protective.
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Affiliation(s)
- Zahra Saeedirad
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
| | - Shadi Ariyanfar
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Science, Virginia Tech, Blacksburg, VA 24060, USA;
| | - Morvarid Noormohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran 14496-14535, Iran
| | - Zeinab Ghorbani
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht 41937-1311, Iran;
- Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht 41937-1311, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 14167-53955, Iran;
| | - Sahar Shahemi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19839-69411, Iran
| | - Milad Ghanaatgar
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
| | - Nasim Rezaeimanesh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 14167-53955, Iran;
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
| | - Amir Ghaemi
- Department of Virology, Pasteur Institute of Iran, Tehran 13169-43551, Iran;
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran; (Z.S.); (S.S.); (M.G.); (N.R.); (A.H.)
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran 14167-53955, Iran;
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12
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Duan D, Perin J, Osman A, Sgambati F, Kim LJ, Pham LV, Polotsky VY, Jun JC. Effects of sex, age, and body mass index on serum bicarbonate. FRONTIERS IN SLEEP 2023; 2:1195823. [PMID: 37736141 PMCID: PMC10512520 DOI: 10.3389/frsle.2023.1195823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Rationale Obesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into risk factors for OHS. We hypothesized that the bicarbonate levels would increase with an increase in body mass index (BMI), since the prevalence of OHS increases with obesity. Methods We used the TriNetX Research Network, an electronic health record database with de-identified clinical data from participating healthcare organizations across the United States, to identify 93,320 adults without pulmonary or advanced renal diseases who had serum bicarbonate and BMI measurements within 6 months of each other between 2017 and 2022. We used linear regression analysis to examine the associations between bicarbonate and BMI, age, and their interactions for the entire cohort and stratified by sex. We also applied a non-linear machine learning algorithm (XGBoost) to examine the relative importance of age, BMI, sex, race/ethnicity, and obstructive sleep apnea (OSA) status on bicarbonate. Results This cohort population was 56% women and 72% white and 80% non-Hispanic individuals, with an average (SD) age of 49.4 (17.9) years and a BMI of 29.1 (6.1) kg/m2. The mean bicarbonate was 24.8 (2.8) mmol/L, with higher levels in men (mean 25.2 mmol/L) than in women (mean 24.4 mmol/L). We found a small negative association between bicarbonate and BMI, with an expected change of -0.03 mmol/L in bicarbonate for each 1 kg/m2 increase in BMI (p < 0.001), in the entire cohort and both sexes. We found sex differences in the bicarbonate trajectory with age, with women exhibiting lower bicarbonate values than men until age 50, after which the bicarbonate levels were modestly higher. The non-linear machine learning algorithm similarly revealed that age and sex played larger roles in determining bicarbonate levels than the BMI or OSA status. Conclusion Contrary to our hypothesis, BMI is not associated with elevated bicarbonate levels, and age modifies the impact of sex on bicarbonate.
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Affiliation(s)
- Daisy Duan
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Adam Osman
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Francis Sgambati
- Center for Interdisciplinary Sleep Research and Education, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lenise J. Kim
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Luu V. Pham
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vsevolod Y. Polotsky
- Departments of Anesthesiology and Critical Care Medicine and Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Jonathan C. Jun
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Ronco AL, Storz MA. Dietary Acid Load and Cancer Risk: A Review of the Uruguayan Experience. Nutrients 2023; 15:3098. [PMID: 37513516 PMCID: PMC10385454 DOI: 10.3390/nu15143098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Dietary acid load (DAL) is recognized as a risk factor for several chronic disorders, including obesity, diabetes, and osteoporosis. Recent evidence suggests that an elevated DAL, as measured by the validated potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores, could also increase the risk for several cancers. This narrative review summarizes the potential role of DAL in Uruguayan cancer patients and outlines the potentially involved pathophysiological pathways that mediate the role of DAL in both cancer development and growth. Although Uruguay is a developing country, its average diet is a heavily meat-based Western one, translating into a supraphysiological acid burden from diet. In recent years, we have published epidemiologic evidence based on ten case-control studies involving 3736 cancer cases and 9534 hospital-based controls. Odds ratios and 95% confidence intervals were estimated for each interest variable to analyze the association between the exposure levels of DAL scores and cancer, calculated by unconditional logistic regression. In a majority of the cases, the highest DAL scores tended to double the cancer risk as compared to the lowest category. We also found high risks for methionine intake, an acidifying amino acid found in higher concentrations in animal-based foods, which may increase cancer risks at least by a joint action based on the pH and the proliferation enhancing properties of the amino acid itself.
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Affiliation(s)
- Alvaro Luis Ronco
- Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Bvard. Artigas 1590, Montevideo 11600, Uruguay
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
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14
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Abaj F, Esmaeily Z, Naeini Z, Alvandi E, Rafiee M, Koohdani F. Dietary acid load and its interaction with CETP TaqB1 polymorphisms on lipid profile among patients with Type 2 diabetes mellitus. BMC Endocr Disord 2023; 23:138. [PMID: 37407953 DOI: 10.1186/s12902-023-01391-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Abstract
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.
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Affiliation(s)
- Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeily
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Naeini
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Alvandi
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Masoumeh Rafiee
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.
| | - Fariba Koohdani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Ekmeiro-Salvador JE, Storz MA. The Impact of Plant-Based Diets on Dietary Acid Load Metrics in Venezuela: A Cross-Sectional Study. Nutrients 2023; 15:2745. [PMID: 37375649 DOI: 10.3390/nu15122745] [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: 05/19/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Dietary acid load (DAL) is an important determinant of the acid-base balance in humans and has been associated with several chronic non-communicable diseases. Plant-based diets, including vegetarian and vegan diets, decrease DAL-although their alkalizing potential varies substantially. Their net effect on common DAL scores, including potential renal acid load and net endogenous acid production, has been insufficiently quantified and is poorly understood-particularly in populations outside of Europe and North America. We assessed the associations between three plant-based dietary patterns (flexitarian vs. lacto-ovo-vegetarian vs. vegan diet) and DAL scores in a healthy Venezuelan population in the metropolitan area of Puerto La Cruz, Venezuela. Substantial differences in DAL scores were observed, whereby the vegan diet yielded the highest alkalizing potential, followed by the lacto-ovo-vegetarian and the flexitarian diet. DAL scores were substantially lower in comparison to European and North American plant-based populations, probably due to the higher potassium intake (exceeding 4000 mg/d in vegans), the higher magnesium intake (390.31 ± 1.79 mg/d in vegans) and the lower intake of protein in vegans and lacto-ovo-vegetarians. Additional studies in other non-industrialized populations are warranted to allow for a better understanding of the (numeric) impact of plant-based dietary patterns on DAL scores, potentially allowing for an establishment of reference ranges in the near future.
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Affiliation(s)
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
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Doustmohammadian A, Amirkalali B, Gholizadeh E, Khoonsari M, Faraji AH, Nikkhah M, Maadi M, Motamed N, Mansourian MR, Hajjar M, Clark CCT, Chaibakhsh S, Tameshkel FS, Afzali A, Zamani F. Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study. Eur J Clin Nutr 2023; 77:370-379. [PMID: 36443393 DOI: 10.1038/s41430-022-01240-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 10/31/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM). METHODS A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols. RESULTS DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P < 0.0001, and of WC to NAFLD: β = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (β = -0.06, P = 0.001, β = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (β = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ2/df = 4.72, GFI = 0.98, AGFI = 0.97, IFI = 0.95, CFI = 0.95, RMSEA = 0.03, and SRMR = 0.02). CONCLUSION Meat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Amirkalali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeel Gholizadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoodreza Khoonsari
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Faraji
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nikkhah
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Reza Mansourian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Melika Hajjar
- Student Research Committee (National Nutrition and Food Technology Research Institute, Department of Community Nutrition, School of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Samira Chaibakhsh
- Eye Reasearch Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Arian Afzali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
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17
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Identification and Association of Single Nucleotide Polymorphisms of the FTO Gene with Indicators of Overweight and Obesity in a Young Mexican Population. Genes (Basel) 2023; 14:genes14010159. [PMID: 36672899 PMCID: PMC9858641 DOI: 10.3390/genes14010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/10/2023] Open
Abstract
(1) Background: obesity is a global public health problem; various factors have been associated with this disease, and genetic factors play a very important role. Previous studies in multiple populations have associated a gene with fat mass and obesity (FTO). Thus, the present work aims to identify and determine associations between genetic variants of FTO with indicators of overweight and obesity in the Mexican population. (2) Methods: a total of 638 subjects were evaluated to compile data on body mass index (BMI), the percentage of body fat (%BF), the waist circumference (WC), the serum levels of triglycerides (TG), and food consumption. A total of 175 genetic variants in the FTO gene were sampled by a microarray in the evaluated population, followed by association statistical analyses and comparisons of means. (3) Results: a total of 34 genetic variants were associated with any of the 6 indicators of overweight and obesity, but only 15 showed mean differences using the recessive model after the Bonferroni correction. The present study shows a wide evaluation of FTO genetic variants associated with a classic indicator of overweight and obesity, which highlights the importance of genetic analyses in the study of obesity.
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Mansordehghan M, Daneshzad E, Basirat V, Gargari BP, Rouzitalab T. The association between dietary acid load and body composition in physical education students aged 18-25 years. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:58. [PMID: 36529754 PMCID: PMC9761980 DOI: 10.1186/s41043-022-00340-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
AIM To find the association between dietary acid load (DAL) and body composition in physical education students. METHODS This study was carried out on 207 students of both genders aged 18-25 years. DAL was calculated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) methods. Anthropometric indices were measured. Bioelectric impedance was used to assess body composition and other related items. RESULTS The mean score of NEAP and PRAL was 80.18 ± 31.30 and 33.94 ± 22.11, respectively. The mean weight and fat mass of subjects were 64.05 ± 9.72 kg and 20.28 ± 0.67 kg, respectively. Participants in the highest tertile of PRAL had a higher weight (64.56 ± 1.14 kg) in comparison with participants in the lowest tertile (61.65 ± 1.19 kg) (P = 0.027). After adjusting for confounders, a significant positive association was found between NEAP score and hip circumference (β = 0.206, P = 0.039), body mass index (β = 0.214, P = 0.031), fat mass (β = 0.218, P = 0.001) and body adiposity index (β = 0.182, P = 0.037). Furthermore, a statistically significant negative association was observed between total body water and NEAP score (β = - 0.217, P = 0.001) and the percentage of fat-free mass and NEAP (β = - 0.229, P = 0.001). CONCLUSION Individuals with a higher DAL score may have a higher weight, fat mass and hip circumference and a lower fat-free mass. In addition, there might be an association between DAL and obesity.
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Affiliation(s)
- Maryam Mansordehghan
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Vahid Basirat
- Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran
| | - Bahram Pourghassem Gargari
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Rouzitalab
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Mobasheri F, Shidfar F, Aminianfar A, Keshteli AH, Esmaillzadeh A, Adibi P. The association between dietary acid load and odds and severity of irritable bowel syndrome in adults. Sci Rep 2022; 12:18943. [PMID: 36347922 PMCID: PMC9643348 DOI: 10.1038/s41598-022-23098-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
No study has been conducted to investigate the association between dietary acid load and irritable bowel syndrome (IBS). So, this cross-sectional study was performed to investigate the association between dietary acid load and odds of IBS, its severity, and IBS subtypes. A sample of 3362 Iranian subjects was selected from health centers in Isfahan province. A validated semi-quantitative food frequency questionnaire (DS-FFQ) was applied to estimate dietary intakes. The dietary acid load was measured using net endogenous acid production (NEAP), dietary acid load (DAL), and potential renal acid load (PRAL) scores. In crude models, the highest compared with the lowest category of the PRAL score was significantly associated with increased odds of IBS severity in participants with BMI ≥ 25 (kg/m2) (OR = 1.54; 95% CI = (1.03-2.32). Also, the results indicated a significant positive association between the PARL and odds of mixed subtype of IBS (OR = 1.74; 95% CI = (1.11-2.74); P trend = 0.02). In propensity score-adjusted model with potential confounders, only a positive association was found between PRAL and odds of mixed subtype of IBS (OR = 1.78; 95% CI = (1.05-3.00); P trend = 0.03). The DAL and NEAP scores tended to show non-significant similar findings. This study indicates that dietary acid load might be associated with odds of mixed type of IBS. However, further research is warranted to infer these findings.
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Affiliation(s)
- Fatemeh Mobasheri
- grid.411746.10000 0004 4911 7066Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- grid.411746.10000 0004 4911 7066Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- grid.444768.d0000 0004 0612 1049Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Ahmad Esmaillzadeh
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- grid.411036.10000 0001 1498 685XIntegrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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In Vitro Mimicking of Obesity-Induced Biochemical Environment to Study Obesity Impacts on Cells and Tissues. Diseases 2022; 10:diseases10040076. [PMID: 36278576 PMCID: PMC9590073 DOI: 10.3390/diseases10040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/29/2022] Open
Abstract
Obesity represents a heavy burden for modern healthcare. The main challenge facing obesity research progress is the unknown underlying pathways, which limits our understanding of the pathogenesis and developing therapies. Obesity induces specific biochemical environments that impact the different cells and tissues. In this piece of writing, we suggest mimicking obesity-induced in vivo biochemical environments including pH, lipids, hormones, cytokines, and glucose within an in vitro environment. The concept is to reproduce such biochemical environments and use them to treat the tissue cultures, explant cultures, and cell cultures of different biological organs. This will allow us to clarify how the obesity-induced biochemistry impacts such biological entities. It would also be important to try different environments, in terms of the compositions and concentrations of the constitutive elements, in order to establish links between the effects (impaired regeneration, cellular inflammation, etc.) and the factors constituting the environment (hormones, cytokines, etc.) as well as to reveal dose-dependent effects. We believe that such approaches will allow us to elucidate obesity mechanisms, optimize animal models, and develop therapies as well as novel tissue engineering applications.
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Sorraya N, Arab A, Talebi S. The association between dietary acid load and adiposity measures among children and adolescents. BMC Pediatr 2022; 22:484. [PMID: 35962430 PMCID: PMC9375392 DOI: 10.1186/s12887-022-03541-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Nasim Sorraya
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shokoofeh Talebi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Hezar Jerib street, Isfahan, 8174673461, Iran.
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Abaj F, Esmaeily Z, Naeini Z, Rafiee M, Koohdani F. 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. BMC Endocr Disord 2022; 22:190. [PMID: 35883173 PMCID: PMC9316730 DOI: 10.1186/s12902-022-01083-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeily
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Naeini
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box: 141556117, Tehran, Iran
| | - Masoumeh Rafiee
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fariba Koohdani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box: 141556117, Tehran, Iran.
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Doustmohammadian A, Nouri Saeidlou S, Esfandyari S, Gholizadeh E, Maadi M, Motamed N, Ajdarkosh H, Khoonsari M, Clark CCT, Zamani F. Dietary Acid Load (DAL), Glycated Hemoglobin A1c (HbA1c), and Metabolic Syndrome (MeS) Mediate the Association of the Adherence to the Dietary Approaches to Stopping Hypertension (DASH) and Mediterranean Diet (MeD) With Nonalcoholic Fatty Liver Disease. Front Nutr 2022; 9:921415. [PMID: 35873411 PMCID: PMC9301207 DOI: 10.3389/fnut.2022.921415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
The study aimed to investigate the association of adults adhering to Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diet (MeD) with nonalcoholic fatty liver disease (NAFLD) using structural equation modeling (SEM) in Iran. In this population-based cross-sectional study, 3,220 adults (44.65% female) aged ≥18 years were selected from the Amol Cohort Study (AmolCS). The dietary intakes were assessed by a validated 168-item semi-quantitative food-frequency questionnaire (FFQ). Residual method energy adjustment of MeD and DASH scores were calculated. Demographic characteristics and anthropometric and laboratory measurements were collected. NAFLD was diagnosed by an expert radiologist via ultrasound sonography. Based on the primary hypothesis, DASH, MeD, and NAFLD were fitted into models. Metabolic syndrome (MeS) as a potential risk factor directly affected NAFLD risk in all these models. In both genders, the higher adherence to DASH negatively affected NAFLD risk indirectly through the two following paths. (1) Dietary acid load (DAL) and metabolic syndrome (2) DAL and hemoglobin A1c (HbA1c). In addition, the higher DAL positively affected NAFLD risk among male participants indirectly via increasing HbA1c level and MeS (from DAL to HbA1c: β = 0.07, P < 0.001; from HbA1c to MeS: β = 0.10, P < 0.001). Similarly, in both genders, the relationship between MeD and NAFLD was mediated through (1) DAL, HbA1c, and MeS and (2) DAL and MeS. Further, among male participants, the MeD and NAFLD risk were also associated via the mediators of HbA1c and MeS. In female participants, the higher MeD score was directly associated with a reduction of NAFLD risk (β = -0.07, P = 0.008). The present study found three important mediators, including DAL, HbA1c, and MeS, in the association of DASH and MeD scores with NAFLD risk. Preventive and therapeutic interventions should target the mediators, including DAL, HbA1c, MeS, and its components, to reduce NAFLD incidence in the general population.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sakineh Nouri Saeidlou
- Food and Beverages Safety Research Center, Urmia University of Medical Science, Urmia, Iran
| | | | - Esmaeel Gholizadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoodreza Khoonsari
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
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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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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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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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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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Association between dietary acid load and clinical features of migraine headaches among Iranian individuals. Sci Rep 2022; 12:2460. [PMID: 35165363 PMCID: PMC8844046 DOI: 10.1038/s41598-022-06515-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
There is limited evidence regarding the possible role of dietary acid load (DAL) in the pathophysiology of migraine headaches. Therefore, we sought to examine DAL in relation to the clinical features of migraine including headache frequency, severity and duration, headache impact test-6 (HIT-6), and serum levels of nitric oxide (NO). In the present cross-sectional study, 262 patients (38 men and 224 women aged 20–50 years) were recruited through a simple random sampling method. Dietary intakes were obtained by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). DAL was then calculated by two different methods; potential renal acid load (PRAL) and net endogenous acid production (NEAP). In total, 262 patients with a mean (SE) age of 36.1 (0.53) and a BMI of 25.55 (0.21) were included in the current study. After controlling for potential confounders, a higher DAL was positively associated with headache frequency in those with the highest DAL score compared to the lowest (PRAL; β = 2.33; 95% CI 0.78, 3.88; NEAP; β = 1.74; 95% CI 0.13, 3.34). Increasing NEAP from 28.96 to 35.89 resulted in a 3.43 and 2.74 increment in HIT-6 scores in the crude (95% CI 1.35, 5.52) and fully-adjusted models (95% CI 0.40, 5.07), respectively. Moreover, a higher dietary PRAL was significantly associated with migraine-related disability, as shown by HIT-6, in subjects of the third tertile compared to those in the first tertile after controlling for confounders (β = 2.42; 95% CI 0.13, 4.70). In conclusion, our study highlighted the importance of the acid–base properties of a diet in the pathophysiology of migraine headaches. However, further well-designed studies are needed to confirm our findings.
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The association of dietary acid load with resting metabolic rate and metabolic components in overweight and obese women: A cross sectional study. Clin Nutr ESPEN 2022; 47:267-276. [DOI: 10.1016/j.clnesp.2021.11.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022]
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Mohammadpour S, Ghorbaninejad P, Shahavandi M, Shab-Bidar S. Interaction of dietary acid load and general and central obesity with muscle strength and skeletal muscle mass. Clin Nutr ESPEN 2022; 48:361-369. [DOI: 10.1016/j.clnesp.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
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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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Jafari A, Ghanbari M, Shahinfar H, Bellissimo N, Azadbakht L. The association between dietary acid load with cardiometabolic risk factors and inflammatory markers amongst elderly men: A cross-sectional study. Int J Clin Pract 2021; 75:e14109. [PMID: 33624383 DOI: 10.1111/ijcp.14109] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Existing epidemiological data on dietary acid load and cardiovascular disease (CVD) are controversial. There is no literature evaluating the association between dietary acid load (DAL) with cardiometabolic risk factors and inflammatory markers in elderly. OBJECTIVE To evaluate the association between DAL and cardiometabolic risk factors amongst Iranian elders. METHOD A cross-sectional study was completed using 357 Iranian elders above >60 years of age. Anthropometric, clinical, and biochemical measurements were performed. Dietary intake was assessed using a validated and reliable food frequency questionnaire. DAL was estimated using the Potential Renal Acid Load (PRAL) score, Net Endogenous Acid Production (NEAP) and the Net Endogenous Acid Excretion (NAE) score. Metabolic syndrome (MetS) was defined according to the ATP-III criteria. Multivariable-adjusted odds ratios (ORs) of CVD risk factors were estimated using logistic regression. RESULTS After adjustment for confounders, a higher PRAL score was associated with higher odds of hypertriglyceridemia (OR: 2.28, 95% CI: 1.15, 4.50). We also observed that the NEAP score was positively associated with MetS (OR: 17.2, 95% CI: 2.34, 127). Finally, there was a positive association between NAE and lipid accumulation product (LAP) (OR: 1.81, 95% CI: 1.04, 3.17) and hypertriglyceridemia (OR: 2.46 95% CI: 1.22, 4.95). CONCLUSION Men with higher DAL scores had a higher risk of MetS, hypertriglyceridemia and LAP. Our findings suggest that further prospective studies are required to appraise DAL-CVD risk factors in populations with varying dietary patterns.
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Affiliation(s)
- Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Nutritional Health Team (NHT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahtab Ghanbari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran
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Ronco AL, Martínez-López W, Calderón JM, Golomar W. Dietary acid load and lung cancer risk: A case-control study in men. Cancer Treat Res Commun 2021; 28:100382. [PMID: 33957561 DOI: 10.1016/j.ctarc.2021.100382] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Dysregulation of the endogenous acid-base balance can contribute to inflammation and cancer development if metabolic acidosis is sustained. The epidemiologic evidence on the association between diet-dependent acid load and cancer risk is scarce and inconsistent. We aim to explore the possible role of dietary acid load in lung cancer (LC) risk. METHODS A case-control study was performed on 843 LC cases and 1466 controls by using a multi-topic questionnaire, including a food frequency questionnaire. Controls were matched to cases by age-frequency, urban/rural residence, and region. Food-derived nutrients were calculated from available databases. The dietary acid load was calculated using validated measures as potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (ORs) were estimated by logistic regression. RESULTS We found direct associations between dietary acid load and LC risk. The highest quartile of the NEAP score was significantly associated (OR=2.22, ptrend<0.001). The PRAL score displayed similar associations in simpler regression models, but there was no association when a more complex one was used (OR=0.99, ptrend =0.94). The NEAP score was associated with a significant risk increase in all cell types, except for small cell cancers, but the PRAL score did not show any association. CONCLUSIONS The NEAP scores, directly associated with meat intake and inversely associated with plant-based foods intake, suggest that a high acid load dietary style may increase LC risk. Studies focused on food groups, and nutritional patterns are in line with our findings. Although the data shown here represent the first one to be published on this issue, further studies are needed to confirm these findings.
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Affiliation(s)
- Alvaro L Ronco
- Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Bvar. Artigas 1590, Montevideo 11600, Uruguay; School of Medicine, CLAEH University, Prado and Salt Lake, Maldonado 20100, Uruguay; Biomedical Sciences Center, University of Montevideo, Puntas de Santiago 1604, Montevideo 11500, Uruguay.
| | - Wilner Martínez-López
- Epigenetics and Genomics Instability Laboratory and Biodosimetry Service, Instituto de Investigaciones Biológicas Clemente Estable, Av. Italia 3318, Montevideo 11600, Uruguay
| | - Juan M Calderón
- Biomedical Sciences Center, University of Montevideo, Puntas de Santiago 1604, Montevideo 11500, Uruguay
| | - Wilson Golomar
- Unit of Thoracic Oncology, National Cancer Institute, Joanicó 3265, Montevideo 11600, Uruguay
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Mousavi M, Jahromi SR, Togha M, Ghorbani Z, Hekmatdoost A, Rafiee P, Torkan B, Shirani P, Ansari H, Karami A, Nourmohammadi M, Khorsha F. The Association Between Dietary Acid Load and Odds of Migraine: A Case-Control Survey. Neurol Ther 2021; 10:335-348. [PMID: 33893990 PMCID: PMC8140036 DOI: 10.1007/s40120-021-00247-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/24/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION It has been shown that a high acid load in the human body can affect inflammatory factors and the nitric oxide pathway. These factors are also thought to play an important role in the initiation of migraine attacks. We have therefore explored the association between dietary acid load and odds of migraine in a case-control study. METHODS The migraine group (n = 514, diagnosed according to the International Classification of Headache Disorders 3rd edition [ICHDIII] criteria) was recruited from a tertiary headache clinic. The controls consisted of 582 sex-matched healthy volunteers who were randomly selected from the general population. A validated 168-item semiquantitative food frequency questionnaire was used for dietary intake assessments. Estimation of the dietary acid load was performed using three different measures: potential renal acid load (PRAL) score, net endogenous acid production (NEAP) score, and protein/potassium ratio. RESULTS Multivariable logistic regression analysis showed that, in comparison with the lowest tertile, the highest tertile of dietary acid load measures, including PRAL (odds ratio [OR] 7.208, 95% confidence intervals [CI] 3.33-15.55), and NEAP (OR 4.108, 95% CI 1.924-8.774) scores and the protein/potassium ratio (OR 4.127, 95% CI 1.933-8.814), significantly increased the odds of migraine (P value for trend ≤ 0.001). CONCLUSION In this study, high dietary acid load was associated with higher odds of migraine. It is therefore possible that restricting dietary acid load could reduce the odds of migraine in susceptible subjects. However, due to the preliminary nature of the current evidence, caution is advised in drawing a definitive conclusion. More well-designed studies are required for a better understanding of this important issue.
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Affiliation(s)
- Maryam Mousavi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Togha
- Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zeinab Ghorbani
- Department of Cardiology, Cardiovascular Diseases Research Centre, School of Medicine, Heshmat Hospital-Guilan University of Medical Sciences, Rasht, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Rafiee
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Boshra Torkan
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Shirani
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ansari
- Department of Neurology, University of California San Diego (UCSD), San Diego, USA
| | - Ahmadreza Karami
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Nourmohammadi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Khorsha
- Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiology, Cardiovascular Diseases Research Centre, School of Medicine, Heshmat Hospital-Guilan University of Medical Sciences, Rasht, Iran
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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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Singu S, Acharya A, Challagundla K, Byrareddy SN. Impact of Social Determinants of Health on the Emerging COVID-19 Pandemic in the United States. Front Public Health 2020; 8:406. [PMID: 32793544 PMCID: PMC7385373 DOI: 10.3389/fpubh.2020.00406] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/09/2020] [Indexed: 01/19/2023] Open
Abstract
A novel coronavirus (2019-nCoV) caused a global pandemic in the months following the first four cases reported in Wuhan, China, on December 29, 2019. The elderly, immunocompromised, and those with preexisting conditions-such as asthma, cardiovascular disease (CVD), hypertension, chronic kidney disease (CKD), or obesity-experience higher risk of becoming severely ill if infected with the virus. Systemic social inequality and discrepancies in socioeconomic status (SES) contribute to higher incidence of asthma, CVD, hypertension, CKD, and obesity in segments of the general population. Such preexisting conditions bring heightened risk of complications for individuals who contract the coronavirus disease (COVID-19) from the virus (2019-nCoV)-also known as "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). In order to help vulnerable groups during times of a health emergency, focus must be placed at the root of the problem. Studying the social determinants of health (SDOH), and how they impact disadvantaged populations during times of crisis, will help governments to better manage health emergencies so that every individual has equal opportunity to staying healthy. This review summarizes the impact of social determinants of health (SDOH) during the COVID-19 pandemic.
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Affiliation(s)
- Sravani Singu
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Centre, Omaha, NE, United States
| | - Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Centre, Omaha, NE, United States
| | - Kishore Challagundla
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Centre, Omaha, NE, United States
| | - Siddappa N. Byrareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Centre, Omaha, NE, United States
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Centre, Omaha, NE, United States
- Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Centre, Omaha, NE, United States
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Arisawa K, Katsuura-Kamano S, Uemura H, Van Tien N, Hishida A, Tamura T, Kubo Y, Tsukamoto M, Tanaka K, Hara M, Takezaki T, Nishimoto D, Koyama T, Ozaki E, Suzuki S, Nishiyama T, Kuriki K, Kadota A, Takashima N, Ikezaki H, Murata M, Oze I, Matsuo K, Mikami H, Nakamura Y, Takeuchi K, Wakai K. Association of Dietary Acid Load with the Prevalence of Metabolic Syndrome among Participants in Baseline Survey of the Japan Multi-Institutional Collaborative Cohort Study. Nutrients 2020; 12:nu12061605. [PMID: 32486113 PMCID: PMC7352218 DOI: 10.3390/nu12061605] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022] Open
Abstract
The association between dietary acid load and metabolic syndrome (MetS) has not been fully investigated. A cross-sectional study was performed on 14,042 men and 14,105 women (aged 35-69 years) who participated in a baseline survey of the Japan Multi-Institutional Collaborative Cohort study. Dietary acid load was assessed using the net-endogenous-acid-production (NEAP) score that is closely correlated with the rate of renal net acid excretion. MetS was diagnosed according to the Joint Interim Statement Criteria of 2009 using body-mass index instead of waist circumference. After adjusting for potential confounders, higher NEAP scores were associated with a significantly increased odds ratio (OR) of MetS, obesity, high blood pressure, and high fasting blood glucose. These associations remained significant after further adjustment for carbohydrate intake or two nutrient-pattern scores significantly associated with MetS. After adjustment for fiber, iron, potassium, and vitamin pattern scores, the OR of MetS for the highest quartile of NEAP scores, relative to the lowest quartile, was 1.25 (95% confidence interval 1.12-1.39). There was no significant interaction between sex, age, or body-mass index and NEAP. Higher dietary acid load was associated with a higher prevalence of MetS and several of its components, independently of carbohydrate intake or nutrient patterns.
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Affiliation(s)
- Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; (S.K.-K.); (H.U.); (N.V.T.)
- Correspondence: ; Tel.: +81-88-633-7071
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; (S.K.-K.); (H.U.); (N.V.T.)
| | - Hirokazu Uemura
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; (S.K.-K.); (H.U.); (N.V.T.)
| | - Nguyen Van Tien
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan; (S.K.-K.); (H.U.); (N.V.T.)
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (K.T.); (M.H.)
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (K.T.); (M.H.)
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan;
| | - Daisaku Nishimoto
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan;
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (T.K.); (E.O.)
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (T.K.); (E.O.)
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan; (S.S.); (T.N.)
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan; (S.S.); (T.N.)
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan;
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan; (A.K.); (N.T.)
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan; (A.K.); (N.T.)
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka 589-8511, Japan
| | - Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University Graduate School of Medicine, Fukuoka 812-8582, Japan;
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan;
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan;
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan; (I.O.); (K.M.)
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan; (I.O.); (K.M.)
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba 260-8717, Japan; (H.M.); (Y.N.)
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba 260-8717, Japan; (H.M.); (Y.N.)
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan; (A.H.); (T.T.); (Y.K.); (M.T.); (K.T.); (K.W.)
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Dehghan P, Abbasalizad Farhangi M. Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: Findings from an updated systematic review and meta-analysis. Int J Clin Pract 2020; 74:e13471. [PMID: 31884719 DOI: 10.1111/ijcp.13471] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/07/2019] [Accepted: 12/24/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES There is no clear summarised report of the association between dietary acid load components including potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with cardiometabolic risk factors. In the current meta-analysis, we aimed to systematically review and summarise the eligible observational studies evaluating the association between PRAL and NEAP with blood pressure and hypertension and markers of glucose haemostasis among adults. DESIGN AND SETTING In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases up to May 2019, relevant studies were included in the literature review. Observational studies evaluating the association between PRAL and NEAP with the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), haemoglobin A1 C (HbA1 C), HOMA-β and quantitative insulin check index (QUICKI) and also prevalence or odds of hypertension, hyperglycaemia and diabetes were included. RESULTS Total number of studies included in the 14 separate meta-analyses were as follows: Mean (SD) of SBP (PRAL, n = 12; NEAP, n = 6), mean (SD) of DBP (PRAL, n = 8; NEAP, n = 3), mean (SD) of FBS (PRAL, n = 12; NEAP, n = 5), mean (SD) of HbA1 C (PRAL, n = 6; NEAP, n = 4), mean (SD) of HOMA-IR (PRAL, n = 7), mean (SD) of insulin (PRAL, n = 7; NEAP, n = 2); OR of type 2 diabetes mellitus (T2 DM) (PRAL, n = 8; NEAP; n = 6), HTN prevalence (PRAL, n = 9; NEAP, n = 9), T2 DM prevalence (PRAL, n = 7; NEAP, n = 6). According to our results, being in the highest PRAL categories was associated with higher SBP (WMD = 0.98; CI: 0.51, 1.45; P < .001), DBP (WMD = 0.61; CI: 0.089, 1.135; P = .022), insulin (WMD = -0.235, CI: 0.070, 0.400; P = .005), higher odds of diabetes (OR = 1.19; CI: 1.092, 1.311; P < .001), higher prevalence of T2 DM (13% and 11% in highest vs lowest category). While, being in the highest category of NEAP was only associated with higher odds of diabetes (OR = 1.22; CI: 1.14, 1.31, P < .001). In subgroup analysis for finding the possible source of heterogeneity, the continent, dietary assessment tool, sample size and gender were the potent sources of heterogeneity. No association between PRAL and NEAP with HbA1 C, HOMA-IR was reported. CONCLUSIONS In the current meta-analysis, we found potent negative effects of high dietary acid load particularly higher PRAL scores cardiometabolic risk factors. Therefore, lower acidogenic food ingredients in the diets are suggested for the prevention of cardiovascular risk factors and diabetes.
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Affiliation(s)
- Parvin Dehghan
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Association between Fatty Liver Index and Periodontitis: the Korea National Health and Nutrition Examination Survey. Sci Rep 2020; 10:3805. [PMID: 32123238 PMCID: PMC7051950 DOI: 10.1038/s41598-020-60797-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/14/2020] [Indexed: 11/25/2022] Open
Abstract
It has been suggested that periodontitis is associated with metabolic abnormalities including non-alcoholic fatty liver disease (NAFLD). The fatty liver index (FLI) is a non-invasive surrogate marker and predictor of NAFLD. We aimed to determine whether FLI itself would be associated with periodontitis through a secondary analysis of previously reported nationally representative probability sample data of the Korean population. FLI was calculated from a previously developed algorithm which combines measures of body mass index (BMI), waist circumference, triglyceride, and gamma-glutamyl transferase (GGT). Periodontitis was diagnosed based on the Community Periodontal Index (CPI) developed by the World Health Organization. Of 4,272 participants, 26.1% were diagnosed with periodontitis. Higher FLI was associated with a higher prevalence of periodontitis (Odds ratio (OR) highest vs. lowest quartile of FLI,1.63; 95% confidence interval (CI), 1.23–2.16; P = 0.001 for trend) adjusting for confounding factors. In the highest FLI quartile, prevalence of periodontitis was higher in individuals with diabetes (OR highest vs. lowest quartile of FLI, 2.89; 95% CI, 1.01–8.27 for diabetic subgroup; OR highest vs. lowest quartile of FLI, 1.45; 95% CI, 1.07–1.96 for non-diabetic subgroup). In summary, FLI was associated with prevalent periodontitis.
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Hajianfar H, Mollaghasemi N, Jahan Mihan A, Arab A. Association between maternal dietary acid load during the early pregnancy and pregnancy-related complications. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2020. [DOI: 10.1080/10942912.2020.1820518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Hossein Hajianfar
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negar Mollaghasemi
- Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Alireza Jahan Mihan
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, USA
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Chong L, Tian R, Shi R, Ouyang Z, Xia Y. Coupling the Paternò-Büchi (PB) Reaction With Mass Spectrometry to Study Unsaturated Fatty Acids in Mouse Model of Multiple Sclerosis. Front Chem 2019; 7:807. [PMID: 31850304 PMCID: PMC6901994 DOI: 10.3389/fchem.2019.00807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
Lipid dysregulation has been implicated in multiple sclerosis due to its involvement during and after inflammation. In this study, we have profiled fatty acids (FAs) in the mouse model of multiple sclerosis with new capabilities of assigning carbon-carbon double bond (C=C) location(s) and quantifying C=C location isomers. These new capabilities are enabled by pairing the solution phase Paternò-Büchi (PB) reaction that modifies C=C bonds in FAs, with tandem mass spectrometry (MS/MS), termed as PB-MS/MS. A series of unsaturated FAs and C=C location isomers have been identified, including FA17:1 (Δ10), FA18:1 (Δ9 and Δ11), FA18:2 (Δ9 and Δ12), and FA 20:4 (Δ5, Δ8, Δ11, Δ14). Notable differences in saturated and unsaturated FAs between normal and experimental autoimmune encephalomyelitis (EAE) mice spinal cords have been detected. Furthermore, the effects of hydralazine, a scavenger of acrolein, on profile changes of FAs in mice were studied. Increased Δ11-to-Δ9 isomer ratios for FA 18:1 were noted in the diseased samples as compared to the control. The present work provides a facile and robust analytical method for the quantitation of unsaturated FAs as well as identification of FA C=C location isomers, which will facilitate discovering prospective lipid markers in multiple sclerosis.
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Affiliation(s)
- Leelyn Chong
- State Key Laboratory of Crop Stress Adaptation and Improvement, State Key Laboratory of Cotton Biology, School of Life Sciences, Henan University, Kaifeng, China
- Department of Chemistry, Purdue University, West Lafayette, IN, United States
| | - Ran Tian
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Riyi Shi
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Zheng Ouyang
- Department of Chemistry, Purdue University, West Lafayette, IN, United States
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
- State Key Laboratory of Precision Measurement Technology and Instruments, Department of Precision Instrument, Tsinghua University, Beijing, China
| | - Yu Xia
- Department of Chemistry, Purdue University, West Lafayette, IN, United States
- Department of Chemistry, Tsinghua University, Beijing, China
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Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma? Nutrients 2019; 11:nu11092255. [PMID: 31546888 PMCID: PMC6770083 DOI: 10.3390/nu11092255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 01/16/2023] Open
Abstract
Obesity has been repeatedly linked to asthma, and several potential mechanisms have been proposed in the etiologies of the obese-asthma phenotype. Considering that lungs play an important role in systemic pH and acid–base regulation, are a key organ in asthma development, and that nutritional inadequacy of several nutrients and high dietary acid load can affect airway inflammation and reactivity, we aimed to test the hypothesis that dietary acid load may be associated with asthma in children. Data on 699 children (52% females), aged 7–12 years, were analyzed. Anthropometric measurements were performed to assess body mass index. Dietary acid load was calculated using potential renal acid load (PRAL) equations from a 24 h dietary recall administrated to children. Adjusted PRAL for total energy intake was applied with the use of the residual method. Lung function and airway reversibility were assessed with spirometry. Asthma was defined by a positive bronchodilation or self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) in the past 12 months. After adjustment for energy intake, sex, age, parent’s education level, and physical activity, positive and significant associations were found between asthma and PRAL [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730) in overweight/obese children. Our findings suggest that dietary acid load might be a possible mechanism in overweight/obese-asthma phenotype development.
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