The Effect of Dietary Acid Load on Cardiometabolic Risk, Psychological Resilience and Sleep Quality in Adolescents with Obesity

INTRODUCTION: Mild metabolic acidosis may adversely affect cardiovascular risk factors, and diet-dependent acid-base load may impair mental health and sleep quality. The aim of this study was to investigate the effects of dietary acid load on cardiometabolic risk factors, psychological resilience, and sleep quality in adolescents with obesity.
METHODS: 205 adolescents with obesity (105 males, 100 females) aged 13-18 years participated in the study. Participants' biochemical parameters, anthropometric measurements and blood pressures were measured. Three-day retrospective food intake records were collected from the adolescents, and potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) were derived from food intake records. Psychological resilience levels of adolescents were assessed by the Child and Youth Resilience Measure (CYRM-12) and sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI).
RESULTS: It was found that BMI, fat mass, fat percentage, fasting insulin, triglyceride, systolic blood pressure, HOMA-IR and PSQI scores were significantly higher and psychological resilience levels were significantly lower in high tertiles of dietary acid load (p<0.05). Adolescents in the lowest tertile of dietary acid load scores had higher consumption of whole grains, vegetables, dairies, legumes, and higher intakes of potassium and calcium than adolescents in the highest tertile of the dietary acid load scores (p<0.05). Red meat, white meat consumption and sodium intake were higher in adolescents in the high tertiles (p<0.05). Energy intakes were found to be significantly lower in the first tertile of PRAL and DAL scores compared to the other tertiles (p<0.05). According to the linear regression model, an increase in NEAP, PRAL and DAL scores leads to a decrease in psychological resilience score and an increase in PSQI and HOMA-IR scores (p<0.05).
DISCUSSION AND CONCLUSION: High dietary acid load is associated with high cardiometabolic risk, insulin resistance, and low psychological resilience and poor sleep quality.