Interesting study published last year:
http://www.ncbi.nlm....IC cohort studyDiabetologia. 2013 Nov 14. [Epub ahead of print]
Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study.
Fagherazzi G, Vilier A, Bonnet F, Lajous M, Balkau B, Boutron-Ruault MC, Clavel-Chapelon F.
Abstract
AIMS/HYPOTHESIS: The objective of this study was to evaluate the prospective relationship between dietary acid load, assessed with both the potential renal acid load (PRAL) and the net endogenous acid production (NEAP) scores, and type 2 diabetes risk.
METHODS: A total of 66,485 women from the E3N-EPIC cohort were followed for incident diabetes over 14 years. PRAL and NEAP scores were derived from nutrient intakes. HRs for type 2 diabetes risk across quartiles of the baseline PRAL and NEAP scores were estimated with multivariate Cox regression models.
RESULTS: During follow-up, 1,372 cases of incident type 2 diabetes were validated. In the overall population, the highest PRAL quartile, reflecting a greater acid-forming potential, was associated with a significant increase in type 2 diabetes risk, compared with the first quartile (HR 1.56, 95% CI 1.29, 1.90). The association was stronger among women with BMI <25 kg/m2 (HR 1.96, 95% CI 1.43, 2.69) than in overweight women (HR 1.28, 95% CI 1.00, 1.64); statistically significant trends in risk across quartiles were observed in both groups (p trend < 0.0001 and p trend = 0.03, respectively). The NEAP score provided similar findings.
CONCLUSIONS/INTERPRETATION: We have demonstrated for the first time in a large prospective study that dietary acid load was positively associated with type 2 diabetes risk, independently of other known risk factors for diabetes. Our results need to be validated in other populations, and may lead to promotion of diets with a low acid load for the prevention of diabetes. Further research is required on the underlying mechanisms.
PMID:24232975
Commentary from Food Navigator:
Link: http://www.foodnavig...etes-risk-Study
A diet with high acidity may be associated with up to a 56% increased risk of type 2 diabetes, says the study.
Published in Diabetologia, the research team analysed data from more than 60,000 women over 14 years in order to assess whether dietary acid load impacted later risk of type 2 diabetes.
Led by Dr Guy Fagherazzi from the Gustave Roussy Institute, France, the researchers reported that a higher overall acidity of diet was linked to increases in the incidence of type 2 diabetes - regardless of the individual foods making up that diet.
"We have demonstrated for the first time in a large prospective study that dietary acid load was positively associated with type 2 diabetes risk, independently of other known risk factors for diabetes," said Fagherazzi and his colleagues.
"Our results need to be validated in other populations, and may lead to promotion of diets with a low acid load for the prevention of diabetes," they said - noting that further research that focuses on the underlying mechanism is needed.
Study details
The team investigated data from a total of 66,485 women from the E3N study (the French Centre of the European Prospective Investigation into Cancer and Nutrition, a well-known ongoing epidemiological study). The women were followed for new diabetes cases over 14 years, and dietary acid load was calculated from their potential renal acid load (PRAL) and their net endogenous acid production (NEAP) scores - both of which are standard techniques for assessing dietary acid consumption from nutrient intake.
During the 14 year follow-up, Fagherazzi and his colleagues observed 1,372 new cases of type 2 diabetes.
In the overall population, those in the top 25% (quartile) for PRAL had a 56% increased risk of developing type 2 diabetes compared with the bottom quartile.
Women of normal weight (BMI of 25 and under) had the highest increased risk (96% for top quartile versus bottom) while overweight women (BMI 25 and over) had only a 28% increased risk (top quartile versus bottom). NEAP scores showed a similar increased risk for higher acid load.
"In our study, the fact that the association between both PRAL and NEAP scores and the risk of incident type 2 diabetes persisted after adjustment for dietary patterns, meat consumption and intake of fruit, vegetables, coffee and sweetened beverages suggests that dietary acids may play a specific role in promoting the development of type 2 diabetes, irrespective of the foods or drinks that provide the acidic or alkaline components," said Fagherazzi and his colleagues.
"A diet rich in animal protein may favour net acid intake, while most fruits and vegetables form alkaline precursors that neutralise the acidity," they explained. "Contrary to what is generally believed, most fruits such as peaches, apples, pears, bananas and even lemons and oranges actually reduce dietary acid load once the body has processed them."
The take away message would seem to be: eat plenty of vegetables & fruits, and limit (within reason) the amount of animal protein you consume.
Also:
- No link between high dietary acid-load and hypertension:
http://www.ncbi.nlm....pubmed/22552032- No (or equivocal) link between high dietary acid load & osteoporosis:
http://www.ncbi.nlm....pubmed/24094472Interesting papers:
http://www.ncbi.nlm....pubmed/18042305
Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28.
Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study.
Welch AA, Mulligan A, Bingham SA, Khaw KT.
Author information
Department of Public Health and Primary Care, University of Cambridge, Strangeways Site, Wort's Causeway, Cambridge CB1 8RN, UK. ailsa.welch@phpc.cam.ac.uk
Abstract
Evidence exists that a more acidic diet is detrimental to bone health. Although more precise methods exist for measurement of acid-base balance, urine pH reflects acid-base balance and is readily measurable but has not been related to habitual dietary intake in general populations. The present study investigated the relationship between urine pH and dietary acid-base load (potential renal acid load; PRAL) and its contributory food groups (fruit and vegetables, meats, cereal and dairy foods). There were 22,034 men and women aged 39-78 years living in Norfolk (UK) with casual urine samples and dietary intakes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk FFQ. A sub-study (n 363) compared pH in casual samples and 24 h urine and intakes from a 7 d diary and the FFQ. A more alkaline diet (low PRAL), high fruit and vegetable intake and lower consumption of meat was significantly associated with a more alkaline urine pH before and after adjustment for age, BMI, physical activity and smoking habit and also after excluding for urinary protein, glucose, ketones, diagnosed high blood pressure and diuretic medication. In the sub-study the strongest relationship was found between the 24 h urine and the 7 d diary. In conclusion, a more alkaline diet, higher fruit and vegetable and lower meat intake were related to more alkaline urine with a magnitude similar to intervention studies. As urine pH relates to dietary acid-base load its use to monitor change in consumption of fruit and vegetables, in individuals, warrants further investigation.
PMID: 18042305
http://www.ncbi.nlm....pubmed/24094472
J Clin Densitom. 2013 Oct-Dec;16(4):420-5. doi: 10.1016/j.jocd.2013.08.014. Epub 2013 Oct 2.
Does a high dietary acid content cause bone loss, and can bone loss be prevented with an alkaline diet?
Hanley DA, Whiting SJ.
Abstract
A popular concept in nutrition and lay literature is that of the role of a diet high in acid or protein in the pathogenesis of osteoporosis. A diet rich in fruit and vegetable intake is thought to enhance bone health as the result of its greater potassium and lower "acidic" content than a diet rich in animal protein and sodium. Consequently, there have been a number of studies of diet manipulation to enhance potassium and "alkaline" content of the diet to improve bone density or other parameters of bone health. Although acid loading or an acidic diet featuring a high protein intake may be associated with an increase in calciuria, the evidence supporting a role of these variables in the development of osteoporosis is not consistent. Similarly, intervention studies with a more alkaline diet or use of supplements of potassium citrate or bicarbonate have not consistently shown a bone health benefit. In the elderly, inadequate protein intake is a greater problem for bone health than protein excess.
Edited by blood, 03 February 2014 - 03:41 AM.