Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526, Athens, Greece.
Department of Nutritional Science and Dietetics, Faculty of Health Sciences, University of Peloponnese, New Building, Antikalamos, 24100 Kalamata, Greece.
Clin Nutr ESPEN. 2023 Aug;56:43-51. doi: 10.1016/j.clnesp.2023.05.005. Epub 2023 May 9.
Dietary acid load (DAL), as expressed by potential renal acid load (PRAL) and net acid production (NEAP), is connected to cardiometabolic disorders and obesity. Mediterranean diet relates to lower, while western diets to higher DAL values. The present study aimed to assess the association of PRAL and NEAP with adiposity measures in young adults (19.61 ± 3.15 years, mean ± standard deviation) and explore the implication of Mediterranean diet adherence and ultra-processed foods (UPF) intake in this relation.
346 students (269 women) participated. Anthropometry was performed, and a food frequency questionnaire was administered. The MedDietScore was calculated, UPF consumption was calculated based on the NOVA classification and PRAL/NEAP was estimated from published equations. Waist Circumference (WC) was transformed to WC (1/WC) in order to achieve normality and run linear regression models.
In subjects with MedDietScore ≤ 28.00, PRAL and NEAP were negatively associated with 1/WC (B = -1.594 × 10-5± 8 × 10-6, p = 0.044 for PRAL and B = -2.84 × 10-5 ± 1 × 10-5, p = 0.048 for NEAP). Moreover, in this subgroup, subjects with medium to high UPF intake i.e., in the 2nd or 3rd tertile of UPF intake representing more than 34.16% of energy, PRAL (2nd tertile B = -0.00007, SE = 0.00003, p = 0.018; 3rd tertile B = -0.00002, SE = 0.00001, p = 0.024) and NEAP (2nd tertile B = -0.00004, SE = 0.00002, p = 0.040; 3rd tertile B = -0.00007, SE = 0.00004, p = 0.055) were connected to central obesity. In similar models, PRAL and NEAP were not significant predictors of BMI.
The DAL may be related to central obesity, especially in individuals with worse dietary quality, as reflected by lower adherence to the Mediterranean diet, and high intake of UPF. Nutrition guidance aiming at the reduction of DAL may be useful in the reduction of central obesity in these subgroups.
膳食酸负荷（DAL），通过潜在肾酸负荷（PRAL）和净酸生成（NEAP）来表示，与心脏代谢疾病和肥胖有关。地中海饮食与较低的 DAL 值有关，而西方饮食与较高的 DAL 值有关。本研究旨在评估 PRAL 和 NEAP 与年轻成年人（19.61±3.15 岁，均值±标准差）肥胖指标的相关性，并探讨地中海饮食依从性和超加工食品（UPF）摄入对这种关系的影响。
346 名学生（269 名女性）参加了研究。进行了人体测量学检查，并进行了食物频率问卷。计算了 MedDietScore，根据 NOVA 分类计算了 UPF 的摄入量，并根据已发表的公式计算了 PRAL/NEAP。为了使腰围（WC）达到正态分布，对 WC 进行了转换（WC（1/WC）），并运行了线性回归模型。
在 MedDietScore≤28.00 的受试者中，PRAL 和 NEAP 与 1/WC 呈负相关（PRAL：B=-1.594×10-5±8×10-6，p=0.044；NEAP：B=-2.84×10-5±1×10-5，p=0.048）。此外，在这个亚组中，中高 UPF 摄入量的受试者，即 UPF 摄入量处于第 2 或第 3 tertile（代表超过 34.16%的能量），PRAL（第 2 tertile B=-0.00007，SE=0.00003，p=0.018；第 3 tertile B=-0.00002，SE=0.00001，p=0.024）和 NEAP（第 2 tertile B=-0.00004，SE=0.00002，p=0.040；第 3 tertile B=-0.00007，SE=0.00004，p=0.055）与中心性肥胖有关。在类似的模型中，PRAL 和 NEAP 与 BMI 没有显著相关性。
DAL 可能与中心性肥胖有关，尤其是在饮食质量较差的个体中，反映为地中海饮食依从性较低和 UPF 摄入量较高。旨在降低 DAL 的营养指导可能有助于减少这些亚组的中心性肥胖。
