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Meta-Analysis
. 2019 May 9;14(5):e0216547.
doi: 10.1371/journal.pone.0216547. eCollection 2019.

Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis

Mahdieh Abbasalizad Farhangi  1   2 , Leila Nikniaz  3 , Zeinab Nikniaz  4
Affiliations
Meta-Analysis

Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis

Mahdieh Abbasalizad Farhangi et al. PLoS One. .

Abstract

Background: In the current meta-analysis, we aimed to systematically review and summarize the eligible studies evaluating the association between dietary acid load in terms of potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with anthropometric parameters and serum lipids in adult population.

Methods: In a systematic search from PubMed, Scopus, Web of Sciences and Cochrane electronic databases up to December 2018, relevant studies were included. Cross-sectional, case control or cohort studies evaluating the association between PRAL and NEAP with the mean values of body mass index (BMI), waist circumference (WC), low and high density lipoprotein cholesterol (LDL, HDL), triglyceride (TG), total cholesterol (TC) and the prevalence of obesity were included.

Results: According to our results, having higher dietary acid load content in terms of high PRAL scores was associated with higher triglyceride concentrations (weighted mean difference (WMD): 3.468; confidence interval (CI): -0.231, 7.166, P = 0.04) and higher obesity prevalence (30% and 27% in highest versus lowest categories). Accordingly, being in the highest category of NEAP was associated with higher prevalence of obesity (25% and 22% in highest versus lowest category). In subgroup analysis, higher PRAL scores was associated with higher BMI in women (WMD: 0.122; CI: -0.001, 0.245; P = 0.049) and higher NEAP in men (WMD: 0.890; CI: 0.430, 1.350; P < 0.001). There was no association between dietary acid load and other studied parameters.

Conclusions: In the current meta-analysis, high dietary acid load content was associated with higher serum triglyceride concentrations and higher obesity prevalence. Reducing dietary acid load content might be a useful preventive strategy against obesity and metabolic disorders.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of study screening and selection process.
Fig 2
Fig 2. Forest plot illustrating obesity proportions in highest versus lowest PRAL categories.
Fig 3
Fig 3. Forest plot illustrating obesity proportion in highest versus lowest NEAP categories.
Fig 4
Fig 4. Forest plot illustrating weighted mean difference in BMI in highest versus lowest PRAL and NEAP.
Fig 5
Fig 5. Forest plot illustrating weighted mean difference in WC in highest versus lowest PRAL.
Fig 6
Fig 6. Forest plot illustrating weighted mean difference in TC in highest versus lowest PRAL and NEAP.
Fig 7
Fig 7. Forest plot illustrating weighted mean difference in TG in highest versus lowest PRAL and NEAP.
Fig 8
Fig 8. Forest plot illustrating weighted mean difference in HDL in highest versus lowest PRAL and NEAP.
Fig 9
Fig 9. Forest plot illustrating weighted mean difference in LDL in highest versus lowest PRAL and NEAP.
Fig 10
Fig 10. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the association between BMI, PRAL and NEAP.
Fig 11
Fig 11. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the association between WC, PRAL and NEAP.
Fig 12
Fig 12. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the the association between TC, PRAL and NEAP.
Fig 13
Fig 13. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the association between TG, PRAL and NEAP.
Fig 14
Fig 14. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the association between HDL, PRAL and NEAP.
Fig 15
Fig 15. Begg's funnel plots (with pseudo 95% CIs) of the WMD versus the se (WMD) of the association between LDL, PRAL and NEAP.
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