Association of Dietary Acid Load with Metabolic Syndrome-Related Parameters Following Eating Habit Modification in Korean Adults.

Forty of 48 recruited Korean adults with at least one metabolic syndrome risk factor completed the 8-week eating habit modification intervention.

• Participants were Korean adults aged ≥19 years with at least one MetS risk factor
• Recruited via public advertisement
• 48 participants were recruited and 40 completed the intervention
• Assessments included anthropometric and biochemical parameters, Nutrition Quotient (NQ) scores, and nutrient intake
• Trial registration number: KCT0011528

Overall improvements were observed in Nutrition Quotient scores, body composition, blood pressure, and glycemic parameters following the 8-week intervention.

• Improvements were seen in total NQ scores and domain-specific NQ scores
• Body composition parameters improved over the 8-week period
• Blood pressure showed improvement following the intervention
• Glycemic parameters also improved following eating habit modification

Mean dietary acid load scores did not change significantly across all participants after FDR correction, although NEAP showed a modest non-significant decrease.

• Both PRAL and NEAP were used as expressions of dietary acid load
• The overall change in mean DAL scores was not statistically significant after false discovery rate (FDR) correction
• NEAP showed a modest decrease that did not reach statistical significance after FDR correction

Baseline PRAL and NEAP values did not differ between participants with and without metabolic syndrome risk improvement.

• Participants were categorized into improved and non-improved groups based on MetS risk factor changes
• No significant between-group differences in baseline DAL indices (PRAL or NEAP) were found
• This suggests baseline dietary acid load did not predict subsequent metabolic improvement

At weeks 4 and 8, DAL indices tended to decrease in the metabolically improved group and increase in the non-improved group, with a significant between-group difference observed only for the 8-week change in NEAP after FDR correction.

• DAL indices trended downward in the improved group and upward in the non-improved group at both weeks 4 and 8
• A statistically significant between-group difference was observed specifically for the 8-week change in NEAP
• This difference survived FDR correction
• No significant between-group difference was found for PRAL after FDR correction

Cross-sectional associations between DAL indices and adiposity-related parameters were observed at week 8, particularly when DAL was expressed as NEAP, but these were not significant at baseline after FDR adjustment.

• No significant associations between DAL indices and MetS-related parameters were detected at baseline after FDR adjustment
• At week 8, cross-sectional associations between DAL and adiposity-related parameters were observed
• Associations were particularly evident when DAL was expressed as NEAP rather than PRAL
• Change-to-change analyses did not remain significant after FDR correction

The absence of significant change-to-change correlations after FDR correction limits causal interpretation of the association between dietary acid load and metabolic improvement.

• While cross-sectional associations between NEAP and adiposity-related parameters were observed at week 8, change-to-change analyses did not survive FDR correction
• The study is described as 'exploratory'
• Authors conclude that larger randomized controlled trials are needed to determine whether modification of DAL independently contributes to metabolic improvement