Food groups associated with measured net acid excretion in community-dwelling older adults

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Abstract
Background/Objectives: Acid-producing diets have been associated with adverse health conditions. Dietary acid load can be estimated from dietary intake data, but the available methods require a full dietary assessment. We sought to identify a simpler means to estimate 24-h urinary net acid excretion (NAE), a robust measure of net endogenous acid production, using self-reported intakes of fruits, vegetables (acid-neutralizing foods), grain and/or protein (acid-producing foods) acquired by two different methods in community-dwelling older adults. Identifying food groups associated with NAE by using a method not requiring a full diet assessment could have a broad clinical application. Subjects/Methods: Fruit, vegetable, protein and grain servings/day were estimated with a widely used food frequency questionnaire (study A, n=162, 63±8 years). Differences in their intakes across NAE categories (n=232, 67±6 years). Results: Fruit intake was significantly associated with NAE in both studies. In study A, fruit intake was 9% lower with each categorical NAE increase (unstandardized beta=−0.21, P=0.01) and 7% lower with each categorical NAE increase in study B (unstandardized beta=−0.18; P=0.02). Grain intake was positively associated with NAE in study B only (unstandardized beta=+0.14; P=0.01). Vegetable and protein intake were not associated with NAE in either study. Conclusions: The inverse association between fruit intake and NAE suggests low self-reported fruit intake may be an indicator of acid-producing diets in older adults.

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