Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands.
Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, The Netherlands.
Osteoporos Int. 2017 Aug;28(8):2357-2365. doi: 10.1007/s00198-017-4037-9. Epub 2017 Apr 12.
We studied the relation between a diet that is high in acid-forming nutrients (e.g. proteins) and low in base-forming nutrients (e.g. potassium) and bone structure. We showed a negative relation, which was more prominent if proteins were of animal rather than of vegetable origin and if intake of dietary fibre was high.
Studies on dietary acid load (DAL) and fractures have shown inconsistent results. Associations between DAL, bone mineral density (BMD) and trabecular bone integrity might play a role in these inconsistencies and might be influenced by renal function and dietary fibre intake. Therefore, our aim was to study (1) associations of DAL with BMD and with the trabecular bone score (TBS) and (2) the potential influence of renal function and dietary fibre in these associations.
Dutch individuals aged 45 years and over (n = 4672) participating in the prospective cohort of the Rotterdam study were included. Based on food frequency questionnaires, three indices of DAL were calculated: the net endogenous acid production (NEAP) and the ratios of vegetable or animal protein and potassium (VegPro/K and AnPro/K). Data on lumbar spinal TBS and BMD were derived from dual-energy X-ray absorptiometry measurements.
Independent of confounders, NEAP and AnPro/K, but not VegPro/K, were associated with low TBS (standardized β (95%) = -0.04 (-0.07, -0.01) and -0.08 (-0.11, -0.04)) but not with BMD. Associations of AnPro/K and VegPro/K with TBS were non-linear and differently shaped. Unfavourable associations between NEAP, BMD and TBS were mainly present in subgroups with high fibre intake.
High NEAP was associated with low TBS. Associations of AnPro/K and VegPro/K and TBS were non-linear and differently shaped. No significant associations of DAL with BMD were observed, nor was there any significant interaction between DAL and renal function. Mainly in participants with high intake of dietary fibre, DAL might be detrimental to bone.
研究高酸形成营养素（如蛋白质）和低碱形成营养素（如钾）饮食与骨结构之间的关系。方法：我们进行了一项前瞻性队列研究，纳入了 45 岁及以上的荷兰人（n=4672）。基于食物频率问卷，计算了三个酸负荷指标：净内源性酸产生（NEAP）以及植物蛋白与钾（VegPro/K）和动物蛋白与钾（AnPro/K）的比值。通过双能 X 射线吸收法测量腰椎骨小梁骨评分（TBS）和骨密度（BMD）。结果：独立于混杂因素，NEAP 和 AnPro/K 与低 TBS 相关（标准化β（95%）=-0.04（-0.07，-0.01）和-0.08（-0.11，-0.04）），但与 BMD 无关。AnPro/K 和 VegPro/K 与 TBS 的相关性是非线性的，且形状不同。NEAP、BMD 和 TBS 之间的不利关联主要存在于高纤维摄入量的亚组中。结论：高 NEAP 与低 TBS 相关。AnPro/K 和 VegPro/K 与 TBS 的相关性是非线性的，且形状不同。未观察到 DAL 与 BMD 之间存在显著关联，DAL 与肾功能之间也没有显著的相互作用。主要在膳食纤维摄入量较高的参与者中，DAL 可能对骨骼有害。
