Association of dietary acid load with abdominal adiposity based on traditional and novel anthropometric indices.

Abstract

Background: Central or visceral adiposity is associated with metabolic syndrome and related health problems. The association of dietary acid load (DAL) with body mass index (BMI) and waist circumference (WC) has been studied in a few previous studies. We aimed to investigate the association of dietary acidity with abdominal obesity which was assessed using traditional and more novel indices.

Methods: In this cross-sectional study, a total of 6482 participants aged 35-65 years were recruited as part of the MASHAD cohort study. Dietary intakes were assessed using a validated food frequency questionnaire. Dietary acid load was assessed as the potential renal acid load (PRAL), net endogenous acid production (NEAP), and DAL. Central obesity was defined as a WC ≥ 94 cm in men and 80 cm in women, waist-hip ratio (WHR) ≥ 0.9 in men, and 0.85 in women, and body shape index (ABSI) and abdominal volume index (AVI) above the median. Multivariable logistic regression models were applied to determine the association between diet-based acid load scores and abdominal obesity.

Results: In the crude and age-adjusted models for women, higher levels of NEAP were related to an increased risk of central obesity, as measured by WC and WHR. For women, NEAP was associated with an increased odds of central obesity based on ABSI in the full-adjusted model (odds ratios (ORs) and 95% confidence intervals (CIs): 1.234 (1.045-1.456)). In both gender groups, higher levels of DAL were related to increased chances of central obesity based on WC, WHR and AVI across all models. However, the multiple logistic regression ORs and 95% CIs for abdominal adiposity indices across levels of PRAL showed no significant association in the fully adjusted model.

Conclusion: Our findings suggest that a higher dietary acid measured by NEAP and DAL load may contribute to an increased risk of abdominal obesity. Notably, this effect appears to be more pronounced in women.