A western diet that is rich in animal products and other acidogenic foods can induce acid load which can cause chronic metabolic acidosis and metabolic complications. An increase in acidosis can reduce insulin sensitivity because the insulin loses its’ ability to bind with the receptors in the body. It has been shown that type 2 diabetes incidence and glucose intolerance are found in people with lower urinary pH.
In this study, 66,485 female were followed for new diabetes cases over 14 years. The patients dietary acid load was calculated using the potential renal acid load (PRAL) and net endogenous acid production (NEAP). Researchers assessed dietary information with questions about the kind of food or drink the patients consumed from breakfast to after-dinner snacks.
Results revealed women with a higher dietary acid load (higher PRAL score) were younger than women who had a lower dietary acid load. These patients had less physical activity, fewer were treated for hypercholestrolemia, more often had a family history of diabetes, and had a better adherence to a Western diet. A high-PRAL diet consisted of lower percentage of carbohydrates, higher percentage of fat and protein.
During the 14 years of follow-up, 1,372 new cases of type 2 diabetes were found. There was a statistically significant correlation of increasing type 2 diabetes risk with increasing PRAL and NEAP scores. Women who had a higher acid load were at a higher risk of type 2 diabetes. There was a 56% increased risk of developing type 2 diabetes in the top 25% quartile for PRAL. Women with a normal weight had a higher increased risk of developing the disease than women who were overweight.
The study had some limitations where the diet information was not updated during the follow-up. Dietary habits may have changed over time. The study only consisted of women. However, there have been prior studies that has not shown a major difference in risk factors for diabetes between men and women.
- Increasing acidosis can reduce ability of insulin to bind to receptors.
- High dietary acid load can lead to increase risk of type 2 diabetes.
- Normal weight women had a higher increase risk of developing type 2 diabetes compared to overweight women.
Diabetologia Nov, 2013