Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 11:10:1233746.
doi: 10.3389/fnut.2023.1233746. eCollection 2023.

Metabolic syndrome in relation to dietary acid load: a dose-response meta-analysis of observational studies

Sulieman Ibraheem Shelash Al-Hawary  1 , Faris Mushabab  2 , Shahabe Saquib Abullais  3 , Raed H Althomali  4 , Ebraheem Abdu Musad Saleh  4 , Serar Nassir Alnajjar  5 , Khulood H Oudaha  6 , Rosario Mireya Romero-Parra  7 , Beneen M Hussien  8 , Nazila Garousi  9
Affiliations

Metabolic syndrome in relation to dietary acid load: a dose-response meta-analysis of observational studies

Sulieman Ibraheem Shelash Al-Hawary et al. Front Nutr. .

Abstract

Background and aim: Several studies have identified that dietary acid load (DAL) may be associated with the odds of metabolic syndrome (MetS); however, the evidence is inconclusive. This dose-response meta-analysis aimed to examine the relation of DAL to MetS.

Methods: A systematic literature search was carried out in PubMed and Scopus up to April 2023 for pertinent studies evaluating the relation of DAL scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), to the odds of MetS. The odds ratios (OR) with 95% confidence intervals (CI) were pooled using a random-effects meta-analysis to test the association.

Results: Eight studies, with an overall sample size of 31,351 participants, were included in this meta-analysis. Higher DAL scores were significantly related to the elevated odds of MetS (NEAP: OR = 1.42, 95%CI = 1.12-1.79; PRAL: OR = 1.76, 95%CI = 1.11-2.78), with significant evidence of heterogeneity across studies. The linear dose-response analysis proposed that a 10 mEq/day elevation in NEAP and PRAL was linked to a 2% (OR = 1.02, 95%CI = 1.001-1.05) and 28% (OR = 1.28, 95%CI = 1.11-1.47) increased odds of MetS, respectively. No non-linear association was observed between MetS and NEAP (P-non-linearity = 0.75) and PRAL (P-non-linearity = 0.92).

Conclusion: This study revealed a significant direct relationship between DAL and MetS. Therefore, lower acidogenic diets are suggested for the prevention of MetS.

Keywords: NEAP; PRAL; dietary acid load; meta-analysis; metabolic syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for studies selection.
Figure 2
Figure 2
Forest plot of the pooled data for the association between high dietary acid load (based on NEAP) and odds of metabolic syndrome.
Figure 3
Figure 3
Forest plot of the pooled data for the association between high dietary acid load (based on PRAL) and odds of metabolic syndrome.
Figure 4
Figure 4
Meta-analysis of the linear association of dietary acid load for a 10-unit increment in NEAP (A) and PRAL (B) with odds of metabolic syndrome.
Figure 5
Figure 5
Meta-analysis of the non-linear association between dietary acid load [(A) NEAP, (B) PRAL] and odds of metabolic syndrome.
Figure 6
Figure 6
Funnel plot for publication bias in studies on NEAP (A) and PRAL (B).
See this image and copyright information in PMC

References

    1. Askari M, Dehghani A, Abshirini M, Raeisi T, Alizadeh S. Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies, vol. 75. Hoboken, NJ: Wiley Online Library; (2021). e14295 p. - PubMed
    1. Alizadeh S, Ahmadi M, Ghorbani Nejad B, Djazayeri A, Shab-Bidar S. Metabolic syndrome and its components are associated with increased chronic kidney disease risk: evidence from a meta-analysis on 11 109 003 participants from 66 studies. Int J Clin Pract. (2018) 72:e13201. doi: 10.1111/ijcp.13201, PMID: - DOI - PubMed
    1. Rashidbeygi E, Safabakhsh M, Mohammed SH, Alizadeh S. Metabolic syndrome and its components are related to a higher risk for albuminuria and proteinuria: evidence from a meta-analysis on 10, 603, 067 subjects from 57 studies. Diabetes Metab Syndr Clin Res Rev. (2019) 13:830–43. doi: 10.1016/j.dsx.2018.12.006, PMID: - DOI - PubMed
    1. Razi B, Alizadeh S, Omidkhoda A, Imani D, Rezaei R. Association of chronic hepatitis B infection with metabolic syndrome and its components: meta-analysis of observational studies. Diabetes Metab Syndr Clin Res Rev. (2017) 11:S939–47. doi: 10.1016/j.dsx.2017.07.020, PMID: - DOI - PubMed
    1. Mohseni R, Abbasi S, Mohseni F, Rahimi F, Alizadeh S. Association between dietary inflammatory index and the risk of prostate cancer: a meta-analysis. Nutr Cancer. (2019) 71:359–66. doi: 10.1080/01635581.2018.1516787, PMID: - DOI - PubMed

Publication types