Dietary acid load is associated with primary osteoporosis in postmenopausal women aged 50-65 years: A cross-sectional study

Azizeh Farshbaf-Khalili; Alireza Ostadrahimi; Javad Ahmadian Heris; Somayyeh Sarrafi; Neda Mohammadisima

doi:10.1002/fsn3.3102

Dietary acid load is associated with primary osteoporosis in postmenopausal women aged 50-65 years: A cross-sectional study

Food Sci Nutr. 2022 Oct 13;11(2):668-676. doi: 10.1002/fsn3.3102. eCollection 2023 Feb.

Authors

Azizeh Farshbaf-Khalili¹, Alireza Ostadrahimi², Javad Ahmadian Heris³, Somayyeh Sarrafi⁴, Neda Mohammadisima⁵

Affiliations

¹ Physical Medicine and Rehabilitation Research Centre Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran.
² Nutrition Research Center Tabriz University of Medical Science Tabriz Iran.
³ Department of Allergy and Clinical Immunology Pediatric Hospital Tabriz University of Medical Sciences Tabriz Iran.
⁴ Midwifery Department Bonab Branch Islamic Azad University Bonab Iran.
⁵ Department of Biochemistry and Dietetics Faculty of Nutrition and Food Sciences Tabriz University of Medical Sciences Tabriz Iran.

Abstract

This study aimed to investigate the association between dietary acid load (DAL) and primary osteoporosis. This was a cross-sectional study. Among 850 randomly selected postmenopausal women aged 50-65 years, 232 women consisted of 124 women with normal bone mineral density (BMD) and 108 with primary osteoporosis were selected after examining the eligibility criteria. Demographic characteristics, anthropometric indices, and physical activity were collected through questionnaires. Osteoporosis was diagnosed using the dual-energy X-ray absorptiometry method. DAL was assessed by a valid and reliable semiquantitative food frequency questionnaire during the last year. Independent t-test, Mann-Whitney, Chi-square, and adjusted binary logistic regression were used for data analysis through SPSS/24. There were significant differences between the two groups in terms of age, body mass index (BMI), number of deliveries, and years after menopause (p < .05). The mean (standard deviation (SD)) potential renal acid load (PRAL) and net endogenous acid production (NEAP) were higher in postmenopausal women with osteoporosis than those with normal BMD (PRAL: -13.1 ± 11.1 mEq/day vs. -10.8 ± 12.7 mEq/day; NEAP: 29.5 ± 8.5 mEq/day vs. 31.2 ± 9.2 mEq/day). The mean consumption of potassium, magnesium, and calcium in the osteoporosis group was significantly lower than in the other group (p < .05). There were significant associations between osteoporosis with PRAL (odds ratio (OR) = 1.030; 95% confidence interval (CI): 1.001 to 1.060, p = .027) and NEAP scores (OR = 1.041; 95% CI: 1.003 to 1.081, p = .037). The odds of osteoporosis increased by 3% following one unit increase in PRAL score. Similarly, it increased by 4% with increasing NEAP score up to one unit. Therefore, dietary patterns that produce high DAL can have a detrimental effect on bone health.

Keywords: NEAP; PRAL; dietary acid load; osteoporosis; postmenopausal women.