title: Dietary acid load, insulin sensitivity and risk of type 2 diabetes in community-dwelling older men.
abstract: OBJECTIVE
  We tested the hypothesis that dietary acid load may increase the risk of type 2 diabetes, and studied the association between acid load and insulin sensitivity as a possible mechanism involved.
  
  
  METHODS
  An observational survey with prospective follow-up including 911 non-diabetic Swedish men aged 70-71 years was carried out. The gold standard euglycaemic-hyperinsulinaemic clamp technique and the OGTT were used to determine insulin sensitivity and beta cell function, respectively. Diabetes incidence was assessed during 18 years of follow-up. Renal function was estimated from serum cystatin C concentrations. Dietary acid load was calculated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) algorithms from 7 day food records. Adequate dietary reporters were identified by Goldberg cut-offs.
  
  
  RESULTS
  PRAL and NEAP were not associated with insulin sensitivity or beta cell function. Underlying kidney function or consideration of dietary adequate reporters did not modify these null findings. During follow-up, 115 new cases of diabetes were validated. Neither PRAL nor NEAP was associated with diabetes incidence.
  
  
  CONCLUSIONS
  Our results do not support the hypothesis that dietary acid load influences insulin sensitivity, beta cell function or diabetes risk. Interventional studies modifying acid-base dietary intake are needed to further elucidate a possible role of acid load in the development of type 2 diabetes.
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital K56, Karolinska Institutet, 14186, Stockholm, Sweden.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.forename: Ting
authors.initials: T
authors.lastname: Jia
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Huang
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.forename: Johan
authors.initials: J
authors.lastname: Arnlöv
authors.forename: Per
authors.initials: P
authors.lastname: Sjögren
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Juan-Jesús
authors.initials: JJ
authors.lastname: Carrero
mesh_terms: D000143:Acids; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D004032:Diet; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D012111:Residence Characteristics; D012306:Risk
chemical_list: D000143:Acids