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The present study aimed to investigate the association between dietary acid load and the risk of type 2 diabetes (T2D) in Iranian adults.

This was a case–control study including 125 newly diagnosed T2D patients as cases and 190 healthy individuals as controls. A 168-item semi-quantitative food frequency questionnaire was applied to collect the participant's dietary intake information. Potential renal acid load (PRAL), net endogenous acid production (NEAP), protein/potassium ratio, animal protein/potassium ratio, and plant protein/potassium ratio were derived from the nutrient intake.

We found that higher PRAL and NEAP scores are positively associated with the chance of T2D in the unadjusted model. Such that, when multiple potential confounders were taken into account, participants in the highest tertile of PRAL (OR: 4.37; 95% CI: 1.35–14.18) and NEAP score (OR: 2.24; 95% CI: 1.01–7.03 …