Higher dietary acid load tied to higher insulin resistance: Study
Brazil: A higher dietary acid load (DAL) is associated with higher insulin levels and insulin resistance (IR) but not with other glycemic parameters, reveals a recent study in Clinical Nutrition ESPEN. Apparently, in this population, β-pancreatic cell function does not seem to be affected by DAL.
Cardiovascular disease (CVD) and diabetes mellitus (DM) are the major reasons for death and health expenses worldwide. A higher DAL is shown to be associated with chronic low-grade metabolic acidosis and may increase the risk of DM, hypertension, IR, and CVD mortality. However, there is a lack of population-based studies determining the association between DAL and IR to confirm laboratory findings.
Against the above background, Everson A. Nunes, Federal University of Santa Catarina, Florianópolis, SC, Brazil, and colleagues conducted a population-based observational study including a sample of 545 individuals aged 25–64 years from Florianópolis (Southern Brazil) who were participants of the EpiFloripa cohort study.
Two 24-h Food Recalls were used to obtain all diet variables for getting an estimate of habitual food consumption. Potential Renal Acid Load (PRAL) and Net Endogenous Acid production (NEAP) was used to measure DAL. Fasting blood samples were obtained from all participants.
IR, estimated by HOMA-IR was the primary outcome. Secondary outcomes included glycosylated hemoglobin, HOMA-β, and fasting blood glucose and insulin. Multiple linear regression models adjusted for lifestyle, sociodemographic, and clinical variables were used for analysis, with the outcome and exposure variables standardized as Z-scores to allow comparability of the results.
The findings of the study were as follows:
- The mean PRAL and NEAP in the sample were 16.9 ± 4.8 and 66.1 ± 7.1 mEq/day, respectively.
- The average HOMA-IR score was 2.4 ± 1.6. In adjusted analyses, PRAL was positively associated with HOMA-IR, fasting insulin, and fasting blood glucose, but not with HOMA-β or glycated hemoglobin. NEAP also showed a direct-trend relationship with HOMA-IR and fasting insulin, but not with fasting blood glucose or the other outcomes.
- The strongest association was between PRAL and HOMA-IR (β, 0.20).
"This is the first study that describes the DAL in a population-based sample of adults in Latin America and in a middle-income country population," wrote the authors. "Further longitudinal and interventional studies are needed to establish a better causal effect between DAL and IR."
Reference:
The study titled, "Dietary acid load is positively associated with insulin resistance: a population-based study," was published in Clinical Nutrition ESPEN.
