TY - JOUR
T1 - Dietary acid load and risk of type 2 diabetes
T2 - The E3N-EPIC cohort study
AU - Fagherazzi, Guy
AU - Vilier, Alice
AU - Bonnet, Fabrice
AU - Lajous, Martin
AU - Balkau, Beverley
AU - Boutron-Ruault, Marie Christine
AU - Clavel-Chapelon, Françoise
N1 - Funding Information:
Funding The study is supported by the Mutuelle Générale de l’Education Nationale, the Institut de Cancérologie Gustave Roussy, and the Institut National de la Santé et de la Recherche Médicale. The validation of potential diabetes cases was supported by the European Union (Integrated Project LSHM-CT-2006-037197 in the Framework Programme 6 of the European Community) InterAct project. Study sponsors had no role in the design of the study, the analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication.
PY - 2014/2
Y1 - 2014/2
N2 - Aims/hypothesis: The objective of this study was to evaluate the prospective relationship between dietary acid load, assessed with both the potential renal acid load (PRAL) and the net endogenous acid production (NEAP) scores, and type 2 diabetes risk. Methods: A total of 66,485 women from the E3N-EPIC cohort were followed for incident diabetes over 14 years. PRAL and NEAP scores were derived from nutrient intakes. HRs for type 2 diabetes risk across quartiles of the baseline PRAL and NEAP scores were estimated with multivariate Cox regression models. Results: During follow-up, 1,372 cases of incident type 2 diabetes were validated. In the overall population, the highest PRAL quartile, reflecting a greater acid-forming potential, was associated with a significant increase in type 2 diabetes risk, compared with the first quartile (HR 1.56, 95% CI 1.29, 1.90). The association was stronger among women with BMI <25 kg/m2 (HR 1.96, 95% CI 1.43, 2.69) than in overweight women (HR 1.28, 95% CI 1.00, 1.64); statistically significant trends in risk across quartiles were observed in both groups (p trend < 0.0001 and p trend = 0.03, respectively). The NEAP score provided similar findings. Conclusions/interpretation: 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. Further research is required on the underlying mechanisms.
AB - Aims/hypothesis: The objective of this study was to evaluate the prospective relationship between dietary acid load, assessed with both the potential renal acid load (PRAL) and the net endogenous acid production (NEAP) scores, and type 2 diabetes risk. Methods: A total of 66,485 women from the E3N-EPIC cohort were followed for incident diabetes over 14 years. PRAL and NEAP scores were derived from nutrient intakes. HRs for type 2 diabetes risk across quartiles of the baseline PRAL and NEAP scores were estimated with multivariate Cox regression models. Results: During follow-up, 1,372 cases of incident type 2 diabetes were validated. In the overall population, the highest PRAL quartile, reflecting a greater acid-forming potential, was associated with a significant increase in type 2 diabetes risk, compared with the first quartile (HR 1.56, 95% CI 1.29, 1.90). The association was stronger among women with BMI <25 kg/m2 (HR 1.96, 95% CI 1.43, 2.69) than in overweight women (HR 1.28, 95% CI 1.00, 1.64); statistically significant trends in risk across quartiles were observed in both groups (p trend < 0.0001 and p trend = 0.03, respectively). The NEAP score provided similar findings. Conclusions/interpretation: 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. Further research is required on the underlying mechanisms.
KW - Acidity
KW - Cohort
KW - Diabetes
KW - Diet
KW - Risk factor
UR - http://www.scopus.com/inward/record.url?scp=84893646969&partnerID=8YFLogxK
U2 - 10.1007/s00125-013-3100-0
DO - 10.1007/s00125-013-3100-0
M3 - Article
C2 - 24232975
AN - SCOPUS:84893646969
SN - 0012-186X
VL - 57
SP - 313
EP - 320
JO - Diabetologia
JF - Diabetologia
IS - 2
ER -