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J Nutr. 2016 May;146(5):1076-83. doi: 10.3945/jn.115.225177. Epub 2016 Apr 6.

High Dietary Acid Load Score Is Associated with Increased Risk of Type 2 Diabetes in Japanese Men: The Japan Public Health Center-based Prospective Study.

Author information

1
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; samimarub@ri.ncgm.go.jp.
2
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan;
3
Department of Public Health, Tokyo Women's University, Tokyo, Japan; Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan; and.
4
Department of Public Health, Tokyo Women's University, Tokyo, Japan;
5
Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.

Abstract

BACKGROUND:

Diet-induced metabolic acidosis has been linked to cardiometabolic abnormalities in Westerners, but the evidence on this issue is scarce in Asians.

OBJECTIVE:

The present study prospectively examined the association between dietary acid load and type 2 diabetes (T2D) in Japanese adults.

METHODS:

Study participants were 27,809 men and 36,851 women, aged 45-75 y, who completed a dietary questionnaire of the second survey of the Japan Public Health Center-based Prospective Study and had no previous history of T2D. Dietary intake was assessed by using a validated 147-item food-frequency questionnaire. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were derived from the nutrient intake. A multilevel logistic regression model was used to estimate ORs and 95% CIs of self-reported, physician-diagnosed T2D over 5 y, with adjustment for potential confounding variables.

RESULTS:

A total of 1191 cases of newly diagnosed T2D were reported. PRAL score was positively associated with T2D in men; the multivariable-adjusted ORs (95% CIs) for the lowest through the highest quartiles of PRAL were 1.00, 1.09 (0.87, 1.36), 1.10 (0.88, 1.37), and 1.25 (1.01, 1.55) (P-trend = 0.047). Further adjustment for dietary intake strengthened the association. NEAP score was not associated with the risk of T2D (P-trend = 0.20). In stratified analyses, the positive association between PRAL and T2D was confined to younger men (age <50 y; P-trend = 0.046). There was no association between dietary acid load score and T2D in women.

CONCLUSION:

A high dietary acid load score is associated with an increased risk of T2D in Japanese men.

KEYWORDS:

Japanese; dietary acid load; net endogenous acid production; potential renal acid load; prospective; type 2 diabetes

PMID:
27052540
DOI:
10.3945/jn.115.225177
[Indexed for MEDLINE]

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