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Association Between Dietary Acid Load and Risk of Osteoporotic Fractures in Adults: A Systematic Review and Meta-Analysis of Observational Studies Publisher Pubmed



Mirzababaei A1 ; Daneshvar M1 ; Basirat V2 ; Asbaghi O3 ; Daneshzad E4
Authors
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Authors Affiliations
  1. 1. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran
  3. 3. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

Source: BMC Musculoskeletal Disorders Published:2025


Abstract

Aim: We aimed to systematically review and conduct a meta-analysis of the available evidence about the association between dietary acid load (DAL) and fractures in adults. Method: Relevant studies were searched through Web of Science, Scopus, PubMed, and Google Scholar until October 2024. The random-effect model was used to calculate the pooled Odd ratios (OR) and 95% confidence intervals (CIs). Publication bias was evaluated by statistical test of Egger. Subgroup analyses were conducted by study confounders. Moreover, the quality of studies was asessed using the Newcastle Ottawa Scale which is designed for observational studies. Results: Six studies were included in this review. According to the methodological heterogeneity between studies and their different charactristics, we performed the analysis based on random-effect model that indicated a marginally significant association between DAL and risk of fracture (N event = 5275, Pooled OR: 1.10; 95% CI: 0.99–1.21, P = 0.073) (I2 = 12.9%; P = 0.321). According to subgroup analysis, there was no significant association between DAL and risk of fracture in the cross-sectional effect sizes (N event = 337, OR:0.69; 95%CI:0.47–1.00). There was a significant association between DAL and a greater risk of fracture in cohort studies (N event = 4938, OR:1.12; 95%CI:1.03–1.22, P = 0.006). Also, high-quality studies (OR:1.12; 95%CI:1.03–1.22; P = 0.006) showed a significant association between DAL and fracture risk. Conclusion: DAL was marginally related to a higher risk of fracture. This finding is a trigger for bone health management with a healthy balanced dietary intake. © The Author(s) 2025.
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