A study of more than 60,000 women revealed that higher overall acidity of the diet, regardless of the individual foods making up that diet, increased the risk of type 2 diabetes. The study, the first large prospective study to demonstrate these finding was conducted by researchers at the Center for Research in Epidemiology and Population Health, INSERM in Paris, France.
A western diet rich in animal products and other acid-promoting foods can induce an acid load that is not compensated for by fruit and vegetables. This can cause chronic metabolic acidosis and lead to metabolic complications. From a blood-sugar control perspective, increasing acidosis can reduce the ability of insulin to bind at appropriate receptors in the body and reduce insulin sensitivity.
With this in mind, the authors decided to see whether increased acidosis caused by dietary acid loads increased the risk of type 2 diabetes.
A total of 66,485 women were followed for new diabetes cases over 14 years. Their dietary acid load was calculated from their potential renal acid load (PRAL) and their net body acid production (NEAP) scores, both standard techniques for assessing dietary acid consumption from nutrient intake.
Women in the top 25 percent for PRAL had a 56 percent 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.
The researchers said a diet rich in animal protein may favour net acid intake, while most fruits and vegetables form alkaline compounds that neutralize acidity. Contrary to popular opinion, most fruits such as peaches, apples, pears, bananas and even lemons and oranges reduce dietary acid load once the body has processed them.
In the study, the fact that the link between both PRAL and NEAP scores and the risk of type 2 diabetes persisted after controlling for different dietary patterns (meat consumption and intake of fruit, vegetables, coffee and sweetened beverages) suggests that dietary acids play a specific role in promoting the development of type 2 diabetes, regardless of the foods or drinks that provide the acidic or alkaline components.
The researchers conclude: "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."
Source: Diabetologia, November 2013
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