Determination of the relationship between dietary acid load and nutritional status of patients with TYPE 2 diabetes

In this study, it was aimed to investigate the relationship between dietary acid load and nutritional status of patients with Type 2 diabetes and to compare it with healthy individuals. This study was carried out on 51 individuals with Type 2 diabetes between the ages of 30-65 and 59 control female and male individuals with similar age and gender distribution, who applied to Ankara Baskent University Hospital Endocrinology and Metabolism Diseases Polyclinic between November 2019 and December 2020. The demographic characteristics, general health status, nutritional habits, blood pressure and biochemical findings, anthropometric measurements and body information analyzes of the individuals were taken by the researcher and recorded in the questionnaire form. The International Physical Activity Questionnaire (IPAQ) was used to determine the physical activity status of individuals, and the Nutritional Knowledge Level for Adults (YETBİD) was used to measure their nutritional knowledge level. In order to determine the daily energy and nutrient intakes of individuals and to calculate their dietary acid load, 3-day Food Consumption Records of the individuals were taken. From these records, the daily protein, phosphorus, potassium, calcium and magnesium intake averages of the individuals were calculated and dietary acid loads were calculated by using these nutrients in the potential renal acid load (PRAL) formula. The mean age of individuals with Type 2 diabetes was 51.5±7.31 years, and the individuals in the control group were 48.6±8.54 years (p>0.05). The PRAL levels of men and women in the Type 2 DM group (-0.2±8.03, 8.2±8.61, respectively) were similar to those of the men and women in the control group (2.7±9.25, 10.1±7.77, respectively) (p>0.05). In the Type 2 DM group, the PRAL average of individuals aged 60 and over was found to be the lowest compared to other age groups (p>0.05), while the PRAL average of individuals aged 30-39 in the control group was found to be the highest compared to other age groups (p>0.05). It was determined that the PRAL value decreased as the duration of diabetes increased in the Type 2 DM group (p<0.05). No significant correlation was found between the anthropometric measurements (BMI, waist and hip circumference, waist/hip and waist/height ratio) and body analyzes (lean body mass, body fat percentage and body fluid amount) and PRAL averages of men and women individuals in the Type 2 DM group. It was determined that the PRAL value increased as BMI, waist circumference and body fat percentage of individuals with Type 2 DM increased (p<0.05). While a positive correlation was found between serum triglyceride and ALT levels and PRAL values of individuals in the Type 2 DM group, a negative correlation was found with diastolic blood pressure (p<0.05). A positive correlation was found between daily dietary protein and cholesterol intake and PRAL value of individuals in the Type 2 DM group (p<0.05). In individuals with Type 2 DM, an increase in serum triglyceride, HDL and LDL cholesterol levels caused an increase in PRAL value, while an increase in serum total cholesterol and diastolic blood pressure caused a decrease in PRAL value (p<0.05). While the percentages of energy coming from protein were found to be sufficient for the individuals participating in the study, the percentage coming from fat was found to be much higher than the recommendations (p>0.05). It was determined that potassium, calcium and magnesium intakes of all individuals were insufficient according to DRI (p>0.05). While a negative relationship was determined between the daily consumption of vitamin C and potassium and PRAL values of individuals in the Type 2 DM group; a positive correlation was determined with niacin, vitamin B12 and zinc intakes (p<0.05). A negative correlation was found between the consumption of milk, yoghurt, vegetables and fruits and PRAL value of individuals in the Type 2 DM group, and a positive correlation with red meat intake (p<0.05). No significant difference was determined between genders in terms of YETBİD level and PRAL averages of Type 2 DM and the control groups (p>0.05). No relationship was observed between dietary acid load and diabetes in this study. But men are at risk of having a higher dietary acid load. Since male individuals are at risk of having a higher dietary acid load, a gender-specific approach can be developed. When the nutritional status of the individuals are evaluated, the importance of the subject of dietary acid load shoul be taken into account. More studies are needed to explain the relationship between type 2 diabetes and dietary acid load.