Higher Dietary Acid Load Contributed to the Increased Risk of Metabolic Syndrome among the Early Middle Aged Men based on National Wide Population Study

Abstract

Abstract Background: Previous studies have reported a positive association between dietary acid load (DAL) and chronic degenerative diseases, such as diabetes, cardiovascular disease, and chronic kidney disease. Metabolic syndrome (MetS) is an early risk factor for chronic disease. However, few studies have shown the relationship between DAL and MetS. Therefore, this study investigatedwhether DAL is associated with MetS and can provide the basis for optimal dietary guidelines to manage the risk of MetS, thereby preventing MetS related chronic diseases. Methods: Among the Korean men (20-64 years) participating in the nationwide population study (Korean National Health And Nutrition Examination Survey, KNHANES 2012-2016), we finally included 3,816 men who were not diagnosed with disease and had anthropometric and biochemical parameters and diet information. DAL scores expressed as net endogenous acid production (NEAP) were calculated using the nutrient information provided by the KNHANES. Results: Among the age groups (20s–60s), men in their 30s and 40s, particularly those in their 40s, had an unfavorable lifestyle. Significant relationships between MetS risk parameters and NEAP scores were observed only among men in their 40s. Specifically, men in their 40s with the highest NEAP scores (4th quartile, Q4) showed a 1.65 fold higher risk of MetS than those with the lowest NEAP scores (1st quartile, Q1) (odds ratio [OR]:1.650; confidence intervals[CIs:1.045-20.605; p=0.032). In addition, the ORs (CIs) for having higher fasting triglycerides and higher fasting glucose in the Q4 group than in the Q1 group were 1.632 (1.082-2.461, p=0.019) and 1.514 (1.033-2.218, p=0.034), respectively. These results were maintained even after adjusting for confounding factors. Conclusion: DAL scores were positively associated with MetS risk among Korean men in their 40s, the early middle age. This may confirm that dietary intake among men in their 40s who are susceptible to exposure to various stressful conditions sensitively reflects metabolic status and suggests that proper dietary habits are most important in the early middle age period. It is expected that DAL can be applied to the establishment of optimal dietary guidelines for the prevention and management of MetS.