Department of Internal Medicine II, Center for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Bvard. Artigas 1590, Montevideo 11600, Uruguay.
Nutrients. 2022 Jul 26;14(15):3067. doi: 10.3390/nu14153067.
The gluten-free diet (GFD) ensures improvement of clinical symptoms in the vast majority of celiac disease (CD) patients. Despite stable CD rates in many countries, an increasing number of healthy individuals are adopting gluten-free diets, believing that this diet is an inherently healthier choice. The health effects of gluten-free diets are controversial, and a recent study added to the debate by reporting a lower acidogenic potential of this diet. The effects of the GFD on potential renal acid load (PRAL) and net endogenous acid production (NEAP)-two important markers of dietary acid load (DAL)-are poorly understood, and have never been examined in a Western population. Using cross-sectional data from the National Health and Nutrition Examination Surveys, we estimated DAL in U.S. individuals reporting a GFD and contrasted the results to the general U.S. population consuming gluten and denying special diets. The GFD was associated with significantly lower crude DAL scores, and after adjustments for confounders in multivariate regression, the results remain significant. Yet, our study could not confirm the reported alkalizing properties of the GFD. Although overall DAL scores were significantly lower in the GFD group, they were comparable to Western diets producing 50-75 mEq of acid per day.
无麸质饮食（GFD）可确保绝大多数乳糜泻（CD）患者的临床症状得到改善。尽管许多国家的 CD 发病率保持稳定，但越来越多的健康人开始采用无麸质饮食，他们认为这种饮食本身更健康。无麸质饮食对健康的影响存在争议，最近的一项研究通过报告这种饮食的产酸潜力较低，进一步引发了争议。无麸质饮食对潜在肾酸负荷（PRAL）和净内源性酸产生（NEAP）的影响——这两个是饮食酸负荷（DAL）的重要标志物——尚未被充分了解，而且从未在西方人群中进行过研究。本研究利用美国国家健康和营养调查的横断面数据，估计了报告采用无麸质饮食人群的 DAL，并将结果与食用麸质和拒绝特殊饮食的一般美国人群进行了对比。无麸质饮食与明显较低的粗 DAL 评分相关，且在多元回归中对混杂因素进行调整后，结果仍然具有统计学意义。然而，我们的研究无法证实无麸质饮食的报告中提到的碱化特性。尽管无麸质饮食组的总体 DAL 评分明显较低，但与每天产生 50-75 mEq 酸的西方饮食相当。
