Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19816-19573, Iran.
Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Science, Virginia Tech, Blacksburg, VA 24060, USA.
Nutrients. 2023 Jul 26;15(15):3311. doi: 10.3390/nu15153311.
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/m), 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; -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; -value < 0.001) and NEAP scores (OR: 3.57, 95%CI: 1.69, 7.53; -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; -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.
本研究旨在通过潜在肾酸负荷(PRAL)和净内源性酸产生(NEAP)评分,探讨饮食酸负荷(DAL)与多发性硬化症(MS)之间的关联。在一项基于医院的 109 例 MS 患者和 130 名健康个体的病例对照研究中,采用经过验证的 168 项半定量食物频率问卷和逻辑回归模型,评估 DAL 与 MS 之间的关联。在校正年龄(岁)、性别(男/女)、体重指数(Kg/m)和总热量(Kcal)后,总植物性蛋白摄入量最高三分位的 MS 患病比值比(OR)为 0.08(95%CI:0.03,0.23;-值<0.001),PRAL 和 NEAP 评分最高三分位的 MS 患病比值比(OR)分别为 4.16(95%CI:1.94,8.91;-值<0.001)和 3.57(95%CI:1.69,7.53;-值<0.001),与最低三分位相比,MS 患病风险分别降低 92%和增加 4 倍。在校正钠、饱和脂肪酸和纤维摄入后,总植物性蛋白摄入与 MS 患病风险的相关性仍然显著(OR:0.07,95%CI:0.01,0.38;-值=0.002)。综上所述,较高的 NEAP 或 PRAL 评分可能与 MS 患病风险增加相关,而较高的植物性蛋白摄入而非动物性蛋白摄入可能具有保护作用。