PRAL and Insulin resistance: After stratifying participants by physical activity levels, stronger associations between dietary acid load scores and insulin resistance risk were found for those engaging in low-level exercise than with high-level exercise (HR for fifth vs. first quartile of PRAL: 1.33, 95% CI: 1.10–1.62, Ptrend = 0.0078; HR for fifth vs. first quartile of NEAP: 1.36, 95% CI: 1.11–1.66, Ptrend = 0.0106).