Potential Renal Acid Load Scores Research Articles

Association between Potential Renal Acid Load and 10-Year Mortality in Patients on Hemodialysis.

Higher dietary acid load (DAL) has been linked to elevated incidence and progression of chronic kidney disease. However, the association between DAL and mortality in patients on maintenance hemodialysis (MHD) has not been evaluated. We retrospectively analyzed baseline laboratory data, self-administered diet history questionnaire results, and 10-year mortality rates in 44 patients (26 men, 67.9±10.4 years) on MHD who participated in a randomized, double-blind, crossover pilot trial of rice endosperm protein supplementation which was conducted in 2013. DAL was estimated from nutrition intake using potential renal acid load (PRAL), and patients were divided into tertiles using this score. During the 10-year observation period, 19 patients (43%) died. A higher PRAL score was significantly associated with higher all-cause mortality. The multivariable-adjusted hazard ratio for all-cause mortality in the highest tertile of PRAL versus the lowest tertile was 3.88 (95% confidence interval [CI], 1.10-13.61). Multiple logistic regression analysis showed a significant association between higher PRAL and lower intake of green and yellow vegetables (odds ratio, 5.40; 95% CI, 1.37-21.26) and fruits (odds ratio, 4.76; 95% CI, 1.30-16.76). Higher PRAL is positively associated with all-cause mortality, and these associations might be affected by a lower intake of fruits and vegetables in Japanese patients on MHD.

Assessing the role of dietary acid load in the development of hypertensive disorders during pregnancy: uncovering the association through prospective cohort analysis

BackgroundHypertensive disorders of pregnancy (HDPs) are common complications encountered in pregnancy that affect between 5% and 15% of pregnancies worldwide. Some studies have associated adherence to a diet with a high acid load with an increased risk of HDPs. This study investigates the association between Dietary Acid Load (DAL) and the incidence of preeclampsia, chronic hypertension (HTN), and gestational hypertension (GHTN).MethodsPregnant women aged 18 to 45 in the first trimester of pregnancy were selected and followed up until delivery. Diet was evaluated using a 168-question semi-quantitative food frequency questionnaire (FFQ). After calculating the DAL score, the inverse probability weight of the propensity scores, estimated from augmented generalized models, was used to obtain a causal risk ratio (RR) adjusted for potential confounders.ResultsOut of 1,856 women, 92 (4.95%) developed preeclampsia. The potential renal acid load (PRAL) score ranged from − 16.14 to 0.58, while the net endogenous acid production (NEAP) score ranged from 34.61 to 50.15. Multivariable analysis revealed a significant association between PRAL and preeclampsia in the first (aRR: 1.87, 95% CI: 1.01, 3.49, p = 0.048) and third (aRR: 2.01, 95% CI: 1.07, 3.81, p = 0.030) quartiles compared to the reference group (Q2). No significant linear association was found in continuous analyses. For chronic HTN, significant associations were observed in the first (aRR: 2.56, 95% CI: 1.21, 5.42, p = 0.014) and fourth (aRR: 4.79, 95% CI: 2.37, 9.71, p < 0.001) PRAL quartiles, with similar findings for NEAP. Continuous analysis showed a significant linear association between both PRAL and NEAP scores and chronic HTN. Regarding GHTN, significant associations were found in the first (aRR: 1.48, 95% CI: 1.02, 2.16, p = 0.041) and fourth (aRR: 1.88, 95% CI: 1.31, 2.70, p = 0.001) PRAL quartiles, and in Q4 for NEAP (aRR: 1.56, 95% CI: 1.10, 2.21, p = 0.012), with no significant linear association in continuous analysis.ConclusionExtremes in DAL, as indicated by PRAL and NEAP, are associated with an increased risk of preeclampsia, chronic HTN, and GHTN, particularly in the highest and lowest quartiles. These findings highlight the potential impact of DAL on HDPs.

Evaluation of the relationship between dietary acid load and cardiovascular risk factors in patients with type 2 diabetes: a case-control study.

Diets high in dietary acid load are thought to be associated with metabolic diseases. However, the number of studies examining the relationship between dietary acid load and metabolic diseases in Turkey is insufficient. The aim of this study was to investigate the relationship between cardiovascular disease risk factors and dietary acid load in individuals with type 2 diabetes. In this case-control study, 51 participants aged 30-65 years with type 2 diabetes and 59 participants in the control group were included. Blood pressure and biochemical findings were measured. Anthropometric measurements and body composition measurements were made. Dietary intake was assessed using a 3-day (1 day on weekends, 2 days on weekdays) food consumption record. Dietary acid load scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), were calculated based on dietary intake. NEAP and PRAL scores were categorized as low and high according to the median value. Smoking status, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), trigylceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL), waist-hip ratio (WHR), waist-to- height ratio (WtHR), hemoglobin and fat mass (%) were evaluated as cardiovascular risk factors. The cut-off values of PRAL and NEAP were 3.61 and 44.78 mEq/d, respectively. After adjustment for various covariates, a significant positive association between PRAL and TG levels was observed in the diabetic group [odds ratio (OR), 5.98; 95% CI, 1.45-24.67; p = 0.013]. In contrast, a negative association was found between PRAL and SBP in the control group [odds ratio (OR), 0.21; 95% CI, 0.05-0.83; p = 0.026]. However, these associations were not observed for NEAP values in either group. A higher PRAL value was consistently associated with higher TG level, but other cardiovascular risk factors were not. More longitudinal and interventional studies are needed to better establish a causal effect between dietary acid load and cardiovascular risk factors in individuals with diabetes.

Dietary acid load as well as dietary phytochemical index, and association with multiple sclerosis: results from a case–control study

IntroductionMultiple sclerosis (MS) is a chronic inflammatory disease characterized by central nervous system (CNS) lesions. Although the etiology and pathogenesis of MS remains unclear, nutrition is among the environmental factors that may be involved in developing MS. Currently, no specific diet has been associated with MS. This study aimed to investigate the relationship between the dietary phytochemical index (DPI), dietary acid load (DAL), and the risk of developing MS.MethodsThis case‒control study was conducted on 174 patients with MS and 171 healthy individuals in Mashhad, Iran. Data were collected using a 160-item semiquantitative food frequency questionnaire (FFQ). The study investigated the association between DPI, DAL, and MS, considering anthropometric measures, dietary intake, smoking habits, and sex. DPI, potential renal acid load (PRAL), and net endogenous acid production (NEAP), as indicators of DAL, were calculated based on the FFQ.ResultsThe study analyzed 345 participants, comprising 174 (50.4%) MS patients and 171 (49.6%) healthy individuals. The mean age of the participants was 32.45 ± 8.66 years. The DPI score was significantly lower among MS patients, while the NEAP and PRAL scores were significantly higher among MS patients compared to the healthy group. There was no relationship between NEAP (OR 1.001; 95% CI 0.959–1.044; P = 0.974) and PRAL (OR 1.019; 95% CI 0.979–1.061; P = 0.356) and MS incidence.ConclusionsThe study found higher smoking and obesity rates in MS patients, with a reduced DPI score and increased DAL. Further studies are needed before recommending plant-based foods and dietary acid–base balance evaluation as therapeutic approach.Graphical

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

BackgroundThe epidemiologic evidence on the association between acid load potential of diet and the risk of diminished ovarian reserve (DOR) is scarce. We aim to explore the possible relationship between dietary acid load (DAL), markers of ovarian reserve and DOR risk in a case-control study.Methods370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and BMI, were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The DAL scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Antral follicle count (AFC), serum antimullerian hormone (AMH) and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of NEAP and PRAL scores.ResultsFollowing increase in PRAL and NEAP scores, serum AMH significantly decreased in women with DOR. Also, AFC count had a significant decrease following increase in PRAL score (P = 0.045). After adjustment for multiple confounding variables, participants in the top quartile of PRAL had increased OR for DOR (OR: 1.26; 95%CI: 1.08–1.42, P = 0.254).ConclusionDiets with high acid-forming potential may negatively affect ovarian reserve in women with DOR. Also, high DAL may increase the risk of DOR. The association between DAL and markers of ovarian reserve should be explored in prospective studies and clinical trials.

The impact of dietary acid load on super-agers with exceptional cognitive abilities: a propensity score analysis of national health and nutrition examination survey (NHANES) 2011–2014

Objectives'Super-agers,' individuals over 80 with memory abilities comparable to those 20–30 years younger. The relationship between super-agers and dietary acid load (DAL) is an area that warrants further investigation. We aim to examine the link between DAL and super-agers and assess DAL's effects on cognitive functions across different age groups and cognitive domains. DesignEmploying a cross-sectional analysis of the 2011–2014 National Health and Nutrition Examination Survey (NHANES) data, we utilized propensity score analysis and multivariate-adjusted regression to mitigate confounding factors. SettingOlder adults aged 60 and above in the United States. ParticipantsOur primary analysis encompassed 985 older adults, supplemented by a sensitivity analysis with 2,522 participants. MeasurementsDAL was assessed through potential renal acid load (PRAL), estimated net acid excretion (NAEes), and net endogenous acid production (NEAP) indices. ResultsSuper-agers demonstrate a preference for alkaline diets, shown by their lower DAL indices. After inverse probability of treatment weighting (IPTW), multivariate-adjusted logistic regression reveals that each unit reduction in NAEes and PRAL increases the chances of being a super-ager by 3.9% and 3.0%, respectively. The DAL's impact on cognitive function becomes more pronounced with age. Lower PRAL and NAEes scores are significantly linked to higher situational memory and overall cognitive performance scores in those over 70, with these effects being even more pronounced in participants over 80. ConclusionThis research pioneers in demonstrating that super-agers prefer an alkaline diet, highlighting the potential role of alkaline diet in countering cognitive decline associated with aging.

Dietary acid load and markers of malnutrition, inflammation, and oxidative stress in hemodialysis patients.

The present study was conducted to examine the association between dietary acid load (DAL) and markers of inflammation, oxidative stress, and malnutrition in a group of Iranian hemodialysis (HD) patients. This cross-sectional study was performed on individuals aged ≥18 years who were on HD at least 6 months before their enrollment in the study. A 4-day dietary recall was used for the evaluation of dietary intake. DAL was calculated using two methods including potential renal acid load (PRAL) and net endogenous acid production (NEAP). For assessing the malnutrition status, we used the subjective global assessment (SGA), dialysis malnutrition score (DMS), and malnutrition inflammation score (MIS). Fasting blood samples were collected from each participant to assess serum levels of high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), sE-selectin, malondialdehyde (MDA), nitric oxide (NO), and endothelin-1. In total, 291 patients with a mean age of 57.73 ± 0.88 years and HD vintage of 4.27 ± 0.25 months were enrolled in the current study. Significant positive associations were observed between PRAL and hs-CRP (β = 1.77, 95% CI: 0.88, 2.65), sICAM-1 (β = 83.21, 95% CI: 10.39, 156.04), sVCAM-1 (β = 194.63, 95% CI: 74.68, 314.58), and sE-selectin (β = 6.66, 95% CI: 1.81, 11.50) among participants with the highest PRAL scores, compared to those with the lowest PRAL scores. NEAP was positively correlated with hs-CRP (β = 1.34, 95% CI: 0.46, 2.22), sICAM-1 (β = 88.83, 95% CI: 16.99, 160.67), and MDA (β = 0.35, 95% CI: 0.005, 0.71). Additionally, marginally significant higher odds of SGA (OR = 1.98, 95% CI: 0.95, 4.11) and DMS (OR = 1.94, 95% CI: 0.92, 4.05) were observed in individuals in the third tertile of PRAL vs. the first tertile of PRAL. NEAP had also a marginally significant positive correlation with DMS (OR = 2.01, 95% CI: 0.93, 4.31). This study illustrates that higher consumption of acidic foods is correlated with markers of inflammation, oxidative stress, and malnutrition in HD patients.

Dietary acid load and cirrhosis-related mortality: a prospective cohort study

As a global health concern, cirrhosis contributes significantly to morbidity and mortality. This prospective cohort study aimed to investigate the association between dietary acid load (DAL) and cirrhosis-related mortality. Present study was conducted on 121 patients with newly diagnosed cirrhosis who were followed up for 48 months. Anthropometric measures, nutritional status and dietary intakes were assessed and DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Participants in the high PRAL and NEAP scores had significantly higher intakes of grains and lower intakes of fruits and vegetables. Also, the intake of dairy products and legumes, nuts and seeds decreased significantly with increasing NEAP score. After adjustment of all the confounders, the risk of mortality in the second and third tertiles of PRAL was 5.9 times and 10.97 higher than those in the first tertile, respectively (P trend: 0.006). Similarly, comparing the risk of mortality in the second and third tertiles with the first tertile of NEAP showed a 4.46-fold and 12.3-fold increased risk, respectively (P trend: 0.010). Our findings suggested that DAL was significantly associated with cirrhosis-related mortality and highlight the need for further research to understand the underlying mechanisms and establish optimal DAL levels in cirrhotic patients.

Association between Dietary Acid Load and Hypertension in Chinese Adults: Analysis of the China Health and Nutrition Survey (2009).

(1) Background: Current studies show conflicting results regarding the relationship between dietary acid load (DAL) and blood pressure. (2) Methods: The study used data from the Chinese Health and Nutrition Survey (CHNS) 2009. DAL was assessed on the basis of potential renal acid load (PRAL) and net endogenous acid production (NEAP). To examine the link between DAL and the risk of hypertension, a multivariate logistic regression model was utilized. (3) Results: A total of 7912 subjects were enrolled in the study, of whom 2133 participants had hypertension, a prevalence of 27.0%. After accounting for potential covariates, higher PRAL and NEAP scores were associated with a greater likelihood of developing hypertension, with ORs of 1.34 (95% CI, 1.10-1.62) and 1.29 (95% CI, 1.09-1.53) for PRAL and NEAP scores in Q4, respectively, compared with Q1. In the male group, PRAL and NEAP scores were positively linked to hypertension risk, with ORs of 1.33 (95% CI, 1.06-1.67) and 1.46 (95% CI, 1.14-1.85) for PRAL and NEAP scores in Q4, respectively, compared with Q1, while no significant associations were observed in the female group. Correlations between PRAL scores and hypertension risk lacked significance in the subgroup analyses for participants aged <60 years. There was a significant nonlinear connection observed in the dose-response relationship between DAL (based on PRAL) and hypertension; (4) Conclusions: In Chinese adults, higher PRAL and NEAP scores were positively linked to hypertension risk. This implies that a diet with a low DAL may be a favorable dietary pattern for lowering blood pressure.

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

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

Association between dietary acid load and the odds of ulcerative colitis: a case–control study

Ulcerative colitis (UC) is one of the two types of inflammatory bowel disease (IBDs), which have a pivotal role in weakening the quality of lives of suffering patients. According to some recent studies, significant changes in dietary patterns may have contributed to the increased prevalence of UC. Potential renal acid load (PRAL) is an index used to estimate dietary acid load of the diet. The aim of the current study is to investigate the association between PRAL and odds of UC. The current case–control study included 62 newly diagnosed cases of UC and 124 healthy controls. Dietary habits of participants in the last year were collected with a valid food frequency questionnaire (FFQ). Thereafter, PRAL score was calculated based on a formula containing the dietary intake of protein, phosphorus, potassium, calcium, and magnesium. Participants were categorized according to quartiles of PRAL. Multivariable logistic regression models were used to estimate the odds' ratio (OR) with 95% confidence intervals (CIs) of UC across quartiles of PRAL. The results of the current study indicated that in the crude model, participants in the fourth quartile of PRAL had 2.51 time higher odds of UC compared with those in the first quartile of the PRAL [(OR 2.51; 95% CI 1.03–6.14), (P = 0.043)]. After adjustment for age and biological gender, this positive association remained significant [(OR 2.99; 95% CI 1.16–7.72), (P = 0.023)]. In the final model, after further adjustment for BMI, current smoking, education, Helicobacter pylori infection, and dietary intakes of total energy, omega-3 fatty acids, trans-fatty acids, and total dietary fiber, the odds of UC in the highest quartile of PRAL was significantly higher compared to the lowest quartile [(OR 3.08; 95% CI 1.01–9.39), (P = 0.048)]. So, we observed that higher dietary acid load assessed by PRAL score is associated with greater odds of UC.

Potential renal acid load of non-dairy plant-based milk alternatives

ABSTRACT The market for plant-based milk alternatives has been growing continuously within the last years, and numerous new food items including almond, oat, and soy milk are nowadays commercially available. The impact of said foods on the acid-base balance in humans has been rarely assessed but is of great importance for individuals who adopt an alkaline diet for health reasons. Using the Potential Renal Acid Load (PRAL) score as a measurement of the amount of acid or base a certain food produces in the human body, we analyzed n = 39 plant-based milk items available on the German market. For this cross-sectional study, we used manufacturer-derived data and aimed to compare the PRAL values of different plant-based milks. The median PRAL score for all plant-based milk alternatives was −0.23 (2.14) mEq/100 ml, and indicated a slightly alkalizing potential. Soy milks yielded, on average, the lowest PRAL score (−1.11 ± 1.14 mEq/100 ml), whereas mixed milks were slightly acidifying (mean PRAL score: 0.19 ± 0.39 mEq/100 ml). When compared to the PRAL value of cow’s milk, plant-based milk alternatives were slightly more alkaline. Our results allow for a better characterization of plant-based milk alternatives and are useful for individuals and researchers that aim to estimate the potential renal acid load from a growing group of food items.

Higher Dietary Acid Load Might Be a Potent Derivative Factor for Multiple Sclerosis: The Results from a Case-Control Study.

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.

Potential Renal Acid Load, Salivary Buffer Capacity and Healthy Eating Index as Predictors of Children's Dental Caries: A Cross-Sectional Study.

Dental caries is one of the most common childhood diseases. This study purposed to investigate the prediction capability of potential renal acid load(PRAL), salivary buffer capacity (SBC), and Healthy Eating Index (HEI) on children's dental caries. The decay, missing, filing, and teeth for primary teeth (dmft)/Decay, Missing, Filling, and Teethfor permanent teeth (DMFT) indexes of the children aged 7-12 years who applied to our faculty were recorded. Approximately 1 mL of unstimulated saliva samples were collected, and SBC was evaluated. PRAL and HEI scores were calculated by entering the data in the form of a daily nutrition record of the children into the BeBiS software (Ebispro for Windows, Stuttgart, Germany). The association of dental caries indices with PRAL, SBC, and HEI was analyzed using an independent samplet-test. A binomial logistic regression analysis was performed to predict the dental caries burden. The statistical significance level was adjusted to a=0.05. A total of 150 children, 88 (58.6%) females and 62 (41.4%) males, were included in the study. Significant differences were found between the low and high dental caries groups for dmft regarding PRAL and SBC (p<0.001). A significant difference was found between the low and high dental caries groups for DMFT in terms of SBC (p<0.05). In our study, established regression models significantly predicted dental caries in primary teeth. SBC was the most influential factor in predicting dental caries compared to PRAL and HEI. There was a significant relationship between SBC, PRAL, and caries in primary teeth. In the model we created, the strongest predictor was SBC.

Association between Dietary Acid Load and Hyperuricemia in Chinese Adults: Analysis of the China Health and Nutrition Survey (2009).

This study evaluates the association between dietary acid load (DAL) and hyperuricemia in Chinese adults. The China Health and Nutrition Survey (CHNS) in 2009 was used in this cross-sectional study. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) were applied to estimate DAL. A multiple logistic regression model was used to test the relationship between DAL and hyperuricemia risk. A total of 7947 participants were included in this study, of whom 1172 had hyperuricemia. The PRAL score was positively related to the prevalence of hyperuricemia, even when potential covariates were taken into account. In comparison with Q1, the ORs were 1.12 (95% CI, 0.92-1.38), 1.20 (95% CI, 0.97-1.47) and 1.42 (95% CI, 1.16-1.75) in Q2, Q3 and Q4. However, there was no significant relationship between NEAP scores and hyperuricemia. Every 10 g increase in energy-adjusted fat, protein and animal protein intakes caused a 10%, 17% and 18% increase in hyperuricemia risk, respectively (OR: 1.10, 95% CI: 1.04-1.16; OR: 1.17, 95% CI: 1.11-1.25; OR: 1.18, 95% CI: 1.12-1.24, respectively). An obvious linear correlation was also suggested by the restricted cubic spline. Hyperuricemia risk was associated with higher PRAL among Chinese adults. This means that a diet low in PRAL scores could be a very valuable uric acid-lowering dietary pattern.

Diet-dependent acid load and the risk of breast cancer: A case–control study

Dietary acid load causes metabolic acidosis, which leads to inflammation and cell change, both of which are related to cancer development. Even though a high acid load has been associated with an increased risk of breast cancer (BC), epidemiologic evidence correlating diet-dependent acid load and cancer risk, particularly for BC, is still lacking. As a result, we intend to investigate its potential role. The potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated in this case-control study using the dietary intake of individuals as determined by a verified FFQ. Logistic regression was used to calculate odds ratios (ORs), which were adjusted for probable confounders. Using multivariate logistic regression models, the odds ratios (OR) of BC according to quartiles of PRAL and NEAP scores revealed that neither PRAL (P-trend=0.53) nor NEAP (P-trend=0.19) scores were significantly associated with BC risk. Multiple logistic regressions remained non-significant after controlling for covariates, indicating no significant relationships between PRAL (P-trend=0.96) and NEAP (trend=0.45) scores and the odds of BC. According to the findings of our study, there is no relation between DAL and the risk of BC in Iranian women.

Purine Content and Renal Acid Load Evaluation in Healthy Japanese Diets.

During the treatment of hyperuricemia, attention should be paid to purine intake as part of the diet. Additionally, many patients with obese hyperuricemic expect early weight loss through glucose restriction. However, the amounts of purine in the diet are unknown. This study aimed to compare the purine content and potential renal acid load (PRAL) of a hospital diet and a low carbohydrate (LC). We calculated the nutritional values in the menus of the normal hospital (NH), energy-control (EC) diets served at several Shizuoka general hospitals, and the menus of LC diets. The amount of purine and PRAL was determined based on the nutritional values. The average daily purine content and energy were NH 349.0 mg, 1,808 kcal, EC 340.4 mg, 1,681 kcal, and LC 697.6 mg, 1,454 kcal, respectively. LC consumed more purine than the recommended daily intake of 400 mg. The PRAL score for NH was 4.5 mEq/d, EC 3.8 mEq/d, and LC 19.0 mEq/d, with LC representing diets with a higher acid load. In terms of both purine intake and uric acid excretion, the hospital diet is preferred over the low-carbohydrate diet for patients. Dietitians should exercise caution when recommending a low-carbohydrate diet for patients with hyperuricemia.

Long-term dietary acid load is associated with depression in multiple sclerosis, but less evidence was found with fatigue and anxiety

BackgroundDiet-dependent acid-base load has been associated with worsening in mental health, but to date no study has examined this in people with multiple sclerosis (PwMS). We examined the association between potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores and depression, anxiety, and fatigue in PwMS. MethodsParticipants with a first clinical diagnosis of CNS demyelination were followed prospectively as part of the AusLong Study (aged 18-59 years at cohort entry). At baseline, 5- and 10-year reviews, PRAL and NEAP scores were calculated using dietary intake in the preceding 12 months calculated from a food frequency questionnaire. At 5- and 10-year reviews, the Hospital Anxiety and Depression Scale was used to assess depression and anxiety, and the Fatigue Severity Scale assessed fatigue. ResultsHigher PRAL and NEAP scores were associated with increased subsequent absolute value and change in HADS depression scores over five years’ follow-up (e.g., highest vs lowest PRAL quartile, 5-year change in HADS-D score: β=+3.01, 95%CI= 1.54, 4.48, p<0.001). The level of depression at the 10-year review was determined by both the baseline dietary acid scores and baseline-5-year changes in dietary acid scores (e.g., PRAL change from baseline to 5-year review, 10-year review HADS-D score: β=+0.09, 95%CI= 0.03, 0.15, p<0.001, NEAP change from baseline to 5-year review, 10-year review HADS-D score: β=+0.07, 95%CI= 0.01, 0.14, p=0.03). Some associations were observed with anxiety and fatigue but were much weaker and less consistent. ConclusionOur findings indicate that a higher dietary acid load potentially has a long-term influence on the level of depression in PwMS. The evidence is less convincing for anxiety and fatigue.

The association between dietary acid load and odds and severity of irritable bowel syndrome in adults

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.

Dietary acid load is associated with primary osteoporosis in postmenopausal women aged 50-65 years: A cross-sectional study.

This study aimed to investigate the association between dietary acid load (DAL) and primary osteoporosis. This was a cross-sectional study. Among 850 randomly selected postmenopausal women aged 50-65 years, 232 women consisted of 124 women with normal bone mineral density (BMD) and 108 with primary osteoporosis were selected after examining the eligibility criteria. Demographic characteristics, anthropometric indices, and physical activity were collected through questionnaires. Osteoporosis was diagnosed using the dual-energy X-ray absorptiometry method. DAL was assessed by a valid and reliable semiquantitative food frequency questionnaire during the last year. Independent t-test, Mann-Whitney, Chi-square, and adjusted binary logistic regression were used for data analysis through SPSS/24. There were significant differences between the two groups in terms of age, body mass index (BMI), number of deliveries, and years after menopause (p< .05). The mean (standard deviation (SD)) potential renal acid load (PRAL) and net endogenous acid production (NEAP) were higher in postmenopausal women with osteoporosis than those with normal BMD (PRAL: -13.1± 11.1mEq/day vs. -10.8± 12.7mEq/day; NEAP: 29.5± 8.5mEq/day vs. 31.2± 9.2mEq/day). The mean consumption of potassium, magnesium, and calcium in the osteoporosis group was significantly lower than in the other group (p< .05). There were significant associations between osteoporosis with PRAL (odds ratio (OR)=1.030; 95% confidence interval (CI): 1.001 to 1.060, p= .027) and NEAP scores (OR=1.041; 95% CI: 1.003 to 1.081, p= .037). The odds of osteoporosis increased by 3% following one unit increase in PRAL score. Similarly, it increased by 4% with increasing NEAP score up to one unit. Therefore, dietary patterns that produce high DAL can have a detrimental effect on bone health.