Association of Dietary Acid Load with the Prevalence of Metabolic Syndrome among Participants in Baseline Survey of the Japan Multi-Institutional Collaborative Cohort Study

Kokichi Arisawa,Keitaro Tanaka,Daisaku Nishimoto,Naoyuki Takashima,Yoko Kubo,Kenji Wakai,Teruhide Koyama,Hirokazu Uemura,Nguyen Van Tien,Sadao Suzuki,Yohko Nakamura,Keitaro Matsuo,Toshiro Takezaki,Kenji Takeuchi,Hiroaki Ikezaki,Takashi Tamura,Kiyonori Kuriki,Etsuko Ozaki,Megumi Hara,Masayuki Murata,Mineko Tsukamoto,Takeshi Nishiyama,Aya Kadota,Isao Oze,Asahi Hishida,Haruo Mikami,Sakurako Katsuura‐Kamano

doi:10.3390/nu12061605

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.

Highlights

Metabolic syndrome (MetS) is characterized by a cluster of high blood pressure, central obesity, high serum triglyceride levels, low serum high-density lipoprotein (HDL) cholesterol levels, and high fasting blood glucose, with insulin resistance as an underlying condition [1]
We examined the associations of Net Endogenous Acid Production (NEAP) with MetS and its components among approximately
Written informed consent was obtained from each participant after the outline and purposes

Summary

Introduction

Metabolic syndrome (MetS) is characterized by a cluster of high blood pressure, central obesity, high serum triglyceride levels, low serum high-density lipoprotein (HDL) cholesterol levels, and high fasting blood glucose, with insulin resistance as an underlying condition [1]. People who have MetS are at increased risk of the future development of Type 2 diabetes and cardiovascular diseases [2,3]. A prudent/healthy diet pattern, characterized by high intake of vegetables, fruits, whole grains, and legumes, was inversely associated with MetS, while a Western/unhealthy pattern, characterized by a high intake of meat, processed meat, refined grains, and sweets, was positively associated with. The dietary-approaches-to-stop-hypertension (DASH) [5] and Mediterranean diets [6] were associated with reduced risk of MetS. Positive associations of low-grade metabolic acidosis, assessed by a high dietary acid load [7,8,9] or high animal-protein intake [10], with increased risk of Type 2 diabetes, were reported from

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Conclusion