Abstract
Objective
Epidemiologic evidence on the potential effects of dietary acid load on frailty is lacking. This cross-sectional study examined the association between dietary acid load and frailty.
Methods
This study was based on self-reported data obtained from 2176 Japanese women aged 65–94 years. Dietary acid load was characterized as potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on information on nutrient intake, obtained from a validated brief diet history questionnaire. Frailty score (0–5) was defined as the sum of slowness/weakness (two points), exhaustion (one point), low physical activity (one point), and unintentional weight loss (one point). A score of ≥3 was classified as indicating frailty.
Results
The prevalence of frailty was 17.9%. After adjustment for potential confounding factors, higher PRAL and NEAP were associated with a higher prevalence of frailty. Adjusted OR (95% CI) for frailty in the highest compared to the lowest quintiles was 1.59 (1.08, 2.34) for PRAL (P for trend = 0.048) and 1.42 (0.98, 2.06) for NEAP (P for trend = 0.03). PRAL and NEAP also showed positive associations with the prevalence of slowness/weakness and low physical activity (all P for trend ≤0.03). PRAL (but not NEAP) was positively associated with the prevalence of exhaustion (P for trend = 0.04). There was no association for unintentional weight loss.
Conclusions
Dietary acid load was positively associated with the prevalence of frailty, particularly slowness/weakness and low physical activity, in elderly Japanese women.
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Acknowledgements
The authors thank Hiroka Sakai and Naoko Minobe (Department of Nutrition, School of Human Cultures, University of Shiga Prefecture, Japan) for manuscript preparation. The authors also thank the member of the Three-generation Study of Women on Diets and Health Study Group listed elsewhere [30].
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YK contributed to the conceptualization of the study question, conducted the statistical analysis, and prepared the first draft of the manuscript; KM contributed to the concept and design of the survey, conceptualized the study question, interpreted the data, provided input into the final draft of the manuscript, and had primary responsibility for the final content of the manuscript; SK, HS, and SS contributed to the concept and design of the survey, coordination of the fieldwork, data collection, and management, and provided input into the final draft of the manuscript. All authors read and approved the final manuscript.
Ethical approval
This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Ethics Committee of the University of Tokyo’s Faculty of Medicine. Written informed consent was obtained from each participant and also from a parent/guardian for participants aged <20 years.
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All authors declare that there was no conflict of interest.
Funding
This work was supported in part by the Grants-in Aid for Young Scientists (B) (to KM, Grant Number 15K16213) from the Ministry of Education, Culture, Sports, Science and Technology of Japan and the Grants-in-Aid for Scientific Research (A) (to SS, Grant number 22240077) from the Japan Society for the Promotion of Science. The Ministry of Education, Culture, Sports, Science and Technology of Japan and the Japan Society for the Promotion of Science had no role in the design, analysis, or writing of this article.
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Kataya, Y., Murakami, K., Kobayashi, S. et al. Higher dietary acid load is associated with a higher prevalence of frailty, particularly slowness/weakness and low physical activity, in elderly Japanese women. Eur J Nutr 57, 1639–1650 (2018). https://doi.org/10.1007/s00394-017-1449-4
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DOI: https://doi.org/10.1007/s00394-017-1449-4