Association between Dietary Acid Load and the Incidence of Metabolic Syndrome and Its Components: A Population-Based Study

Najmeh  Seifi; Niloufar  Abdollahpour; Gelare  Koochakpoor; Nioosha  Samadi; Habibollah  Esmaily; Majid  Ghayour-Mobarhan

doi:10.18502/ijdl.v26i2.21921

Najmeh Seifi Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Niloufar Abdollahpour Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Gelare Koochakpoor School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
Nioosha Samadi Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Habibollah Esmaily Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
Majid Ghayour-Mobarhan Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/ijdl.v26i2.21921

Keywords: Dietary acid load, Metabolic syndrome, Diabetes mellitus, Hypertension, Dyslipidemia

Abstract

Background: Dietary acid load is thought to contribute to the development of metabolic syndrome through effects on acid–base balance with evidence being inconsistent. This study aimed to examine the associations between dietary acid load indices, Dietary Acid Load (DAL), Potential Renal Acid Load (PRAL), and Net Endogenous Acid Production (NEAP) and risk of metabolic syndrome and its components in an Iranian adult cohort.
Methods: 6,482 adults aged 35-65 years were enrolled from the Mashhad Stroke and Atherosclerosis Study. Dietary intake was assessed using a validated food frequency questionnaire, and dietary acid load indices were calculated. Participants were followed for nearly 10 years. Logistic regression models were used to evaluate associations of DAL, PRAL, and NEAP with the incidence of metabolic syndrome, diabetes, hypertension, and dyslipidemia, adjusting for major confounders.
Results: Following adjustment, no significant associations were found between DAL indices and the incidence of metabolic syndrome or its components. DAL odds ratio (OR) for the highest versus lowest tertile was 0.984 [95% confidence interval (CI): 0.815–1.188; p= 0.868]. For PRAL, the OR was 1.024 (95% CI: 0.865–1.212; p= 0.782), and for NEAP, the OR was 0.902 (95% CI: 0.763–1.066; p= 0.227). None of the indices were significantly related to new cases of diabetes, hypertension, or dyslipidemia (all p> 0.05).
Conclusion: In this Iranian adult cohort, DAL indices were not associated with the risk of metabolic syndrome or its components. Further studies in populations with different dietary habits are needed to clarify potential threshold effects or effect modifiers.