Endocrine Abstracts

Introduction: Bone metabolism and osteoporotic fractures have been related to inflammatory status and associated to metabolic disorders such as obesity, cardiovascular disease or metabolic syndrome (MS). Evidence suggests that a more acidic diet could be considered detrimental in terms of bone health. Thus, dietary acid load could be associated to the metabolic syndrome evolution.

Methods: A longitudinal study was conducted with 282 elderly subjects at high risk of cardiovascular disease randomly assigned to three interventional groups, a recommended low-fat diet (control diet group), a Mediterranean diet (Med-diet) supplemented with virgin olive oil or a Med-diet supplemented with mixed nuts. Main outcome was the evolution and reversion rate of MS defined by the updated National Cholesterol and Education Program Adult Treatment Panel III criteria after 1 year of nutritional intervention.

Results: From the 282 subjects, 168 were diagnosed of MS at the beginning of the study. The dietary potential renal acid load (PRAL) and the daily net endogenous acid production (NEAP) at baseline did not differ between the interventional groups. PRAL and NEAP were not related to MS at the beginning of the study. After nutritional intervention, subjects allocated to the Med-diet supplemented with mixed nuts but not with olive oil had a significant increase in PRAL and NEAP in relation to control group. The decrease of PRAL and NEAP during the intervention were good indicators of a lower incidence of the metabolic syndrome (OR (95%IC)) 0.96(0.93–0.99) and 0.93(0.87–0.99); P<0.024, respectively after adjusting by sex, age, intervention group and differences in total energy intake. However reversion rate of MS did not differ in relation to dietary acid load changes during the intervention.

Conclusion: The present data suggest that a more acidic diet has a negative effect on metabolic syndrome evolution but not effect on the reversion of metabolic syndrome.