title: High Dietary Acid Load Score Is Associated with Increased Risk of Type 2 Diabetes in Japanese Men: The Japan Public Health Center-based Prospective Study.
abstract: Diet-induced metabolic acidosis has been linked to cardiometabolic abnormalities in Westerners, but the evidence on this issue is scarce in Asians.
  
  
  
  The present study prospectively examined the association between dietary acid load and type 2 diabetes (T2D) in Japanese adults.
  
  
  
  Study participants were 27,809 men and 36,851 women, aged 45-75 y, who completed a dietary questionnaire of the second survey of the Japan Public Health Center-based Prospective Study and had no previous history of T2D. Dietary intake was assessed by using a validated 147-item food-frequency questionnaire. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were derived from the nutrient intake. A multilevel logistic regression model was used to estimate ORs and 95% CIs of self-reported, physician-diagnosed T2D over 5 y, with adjustment for potential confounding variables.
  
  
  
  A total of 1191 cases of newly diagnosed T2D were reported. PRAL score was positively associated with T2D in men; the multivariable-adjusted ORs (95% CIs) for the lowest through the highest quartiles of PRAL were 1.00, 1.09 (0.87, 1.36), 1.10 (0.88, 1.37), and 1.25 (1.01, 1.55) (P-trend = 0.047). Further adjustment for dietary intake strengthened the association. NEAP score was not associated with the risk of T2D (P-trend = 0.20). In stratified analyses, the positive association between PRAL and T2D was confined to younger men (age <50 y; P-trend = 0.046). There was no association between dietary acid load score and T2D in women.
  
  
  
  A high dietary acid load score is associated with an increased risk of T2D in Japanese men.
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; samimarub@ri.ncgm.go.jp.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan;
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan;
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kashino
authors.affiliation: Department of Public Health, Tokyo Women's University, Tokyo, Japan; Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan; and.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan;
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: Department of Public Health, Tokyo Women's University, Tokyo, Japan;
authors.forename: Mitsushiko
authors.initials: M
authors.lastname: Noda
authors.affiliation: Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000138:Acidosis / Q000150:complications*; D000143:Acids / Q000378:metabolism*; D000328:Adult; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000378:metabolism; D004032:Diet / Q000009:adverse effects*; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007564:Japan; D007668:Kidney / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011634:Public Health; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000143:Acids
keywords: Japanese; dietary acid load; net endogenous acid production; potential renal acid load; prospective; type 2 diabetes