Dietary acid load and risk of type 2 diabetes: A systematic review and dose-response meta-analysis of prospective observational studies

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#acid-base-equilibrium #acids #databases-factual #diabetes-mellitus-type-2 #diet

Dietary acid load and risk of type 2 diabetes: A systematic review and dose-response meta-analysis of prospective observational studies

Jayedi et al., 2018 | Clin Nutr ESPEN | Meta Analysis

Citation

Jayedi Ahmad, Shab-Bidar Sakineh. Dietary acid load and risk of type 2 diabetes: A systematic review and dose-response meta-analysis of prospective observational studies. Clin Nutr ESPEN. 2018-Feb;23:10-18. doi:10.1016/j.clnesp.2017.12.005

Abstract

BACKGROUND & AIMS: Existing evidence suggests a link between acid-forming potential of diet and type 2 diabetes. But the degree of the associations and shape of the dose-response relations across different indices of diet-dependent acid load and risk of type 2 diabetes and potential confounding by sex have not been established. We aimed to test the dose-response association of different measures of dietary acid load and risk of incident type 2 diabetes, with considering the sex as a potential confounder. METHODS: Systematic search was done using PubMed and Scopus, from inception up to September 2017. Prospective observational studies reporting the risk estimates of type 2 diabetes for three or more quantitative categories of potential renal acid load (PRAL), net endogenous acid production (NEAP) and animal protein-to-potassium ratio (A:P) scores were included. Pooled relative risks (RRs) were calculated using random effects models. RESULTS: Seven prospective cohort studies with 319,542 participants and 17,986 incident cases of type 2 diabetes were included. Pooled RRs for a 5 unit increment in dietary PRAL, NEAP and A:P was 1.04 (95% CI: 1.01, 1.06; I2 = 79%, n = 7), 1.03 (95% CI: 1.01, 1.04; I2 = 54%, n = 7), and 1.11 (95% CI: 1.07, 1.15; I2 = 41%, n = 3), respectively. Subgroup analysis resulted in significant positive relationship only among women, compared with men. There was a linear association between NEAP and A:P scores and risk of type 2 diabetes, whereas the association appeared to be U-shaped in analysis of PRAL. CONCLUSIONS: Adherence to a diet with high acid-forming potential might increase the risk of type 2 diabetes. Shape of the dose-response relations across different indices of dietary acid load and potential sex differences in the associations need to be further explored. The interpretation of the results is limited by low number of studies.

Key Findings

Seven prospective cohort studies with 319,542 participants and 17,986 incident cases of type 2 diabetes were included. Pooled RRs for a 5 unit increment in dietary PRAL, NEAP and A:P was 1.04 (95% CI: 1.01, 1.06; I2 = 79%, n = 7), 1.03 (95% CI: 1.01, 1.04; I2 = 54%, n = 7), and 1.11 (95% CI: 1.07, 1.15; I2 = 41%, n = 3), respectively. Subgroup analysis resulted in significant positive relationship only among women, compared with men. There was a linear association between NEAP and A:P scores and

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 7
Age Range See abstract
Condition diabetes

MeSH Terms

  • Acid-Base Equilibrium
  • Acids
  • Databases, Factual
  • Diabetes Mellitus, Type 2
  • Diet
  • Dietary Proteins
  • Humans
  • Observational Studies as Topic
  • Potassium, Dietary
  • Risk Factors

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09