Abstract
Background and aimConsidering 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 methodsParticipants (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.ResultsMean 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.ConclusionsThis study failed to obtain independent associations between dietary acid load and the incidence of CVDs among an Asian population.
Highlights
The acid–base balance within the body can be influenced by eating patterns and the acid load of the diet [1]
The Poten‐ tial Renal Acid Load (PRAL) score is comprised of dietary magnesium, potassium, phosphorus, calcium, and protein [7], and Net Endogenous Acid Production (NEAP) formula is based on dietary intake of protein and potassium [8]
PRAL alone is linked to the incidence of insulin resistance [15, 16], metabolic syndrome [17], and progression of chronic kidney disease [18, 19]
Summary
The acid–base balance within the body can be influenced by eating patterns and the acid load of the diet [1]. Potential Renal Acid Load (PRAL) [6] and Net Endogenous Acid Production (NEAP) [7] are common and valid indicators of dietary acid load and overall nutritional quality of a diet [6, 7]. The PRAL score is comprised of dietary magnesium, potassium, phosphorus, calcium, and protein [7], and NEAP formula is based on dietary intake of protein and potassium [8]. Both scores are associated with the prevalence of type 2 diabetes [9, 10] and hypertension [11,12,13,14]. 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
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