Dietary Acid Load, Serum Polychlorinated Biphenyl Levels, and Mortality Following Breast Cancer in the Long Island Breast Cancer Study Project

Chronister, Briana N.C.; Wu, Tianying; Santella, Regina M.; Neugut, Alfred I.; Wolff, Mary S.; Chen, Jia; Teitelbaum, Susan L.; Parada, Humberto

doi:10.3390/ijerph19010374

Cited by 5 publications

(6 citation statements)

References 48 publications

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“…The differences, however, were not statistically significant. DAL scores were positive throughout (> 0 mEq/d), and suggested that cancer survivors in general consumed an acidifying diet that has been associated with adverse effects in the existing studies in cancer survivors [ 27 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…DAL scores in the range of 50 mEq/d to 60 mEq/d have been associated with adverse health effects and repercussions in analyses using data from the WHEL study in breast cancer survivors [ 27 – 30 ]. Comparable PRAL and NEAP scores have also been associated with an increased mortality in breast cancer survivors [ 27 ], and may contribute to reduced overall physical health [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Local inflammation subsequent to an acidic microenvironment may initiate genomic instability on normal cells through the activation of cytokines, which may stimulate tumor invasion and metastases [ 15 , 16 , 67 ]. The combined evidence from basic research [ 13 – 16 ] and epidemiological investigations [ 29 , 30 , 32 , 33 ] warrants consideration, and additional trials should investigate potential adverse effect of a high DAL in cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

“…Afterwards, we performed sub-analyses stratified by specific cancer sites, including prostate cancer and breast cancer. Breast and prostate cancer were chosen in light of their aforementioned associations with DAL [ 20 , 22 , 27 – 30 ], and because of the modest case numbers (at least 60 cases for each cancer type) per cycle.…”

Section: Methodsmentioning

confidence: 99%

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Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Storz

Ronco

2022

BMC Nutr

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Background Diet is an important determinant of systemic pH and acid–base regulation. A frequent consumption of acid-inducing foods (including processed meats and cheese) combined with a low intake of base-inducing foods (such as fruits, legumes and vegetables) increases Dietary Acid Load (DAL), which has been associated with an increased risk for certain cancers. DAL also appears to be of paramount importance in cancer survivors, in whom it was associated with increased mortality and poor overall physical health. Literature on DAL in cancer survivors, however, is scarce and limited to a few studies. Methods Using cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES), we sought to quantify DAL in U.S. cancer survivors and contrasted the results to the general population. DAL was estimated using established formulas (Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP)). Results Our study comprised 19,413 participants, of which 1444 were self-reported cancer survivors. Almost 63% of cancer survivors were female (weighted proportion) with a mean age of 61.75 (0.51) years. DAL scores were consistently higher in cancer survivors (as compared to the general population) after adjustment for confounders in multivariate regression models. These differences, however, were not statistically significant (p = 0.506 for NEAPF, 0.768 for PRALR and 0.468 for NEAPR, respectively). Notably, DAL scores were positive throughout (> 0 mEq/d) in cancer survivors, suggesting an acidifying diet. Specific examples include mean PRALR scores > 11 mEq/d in cancer survivors aged 55 years and mean NEAPF scores > 50 mEq/d in cancer survivors aged 40–60 years). Conclusions The acidifying diet in this sample of cancer survivors warrants caution and requires further investigation. Comparably high DAL scores have been associated with adverse health outcomes and an increased mortality in previous studies in breast cancer survivors. Thus, increased awareness as well as additional clinical trials in this field are urgently warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Storz

Ronco

2022

BMC Nutr

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“…Diets with high intakes of protein (e.g., meat) and low intakes of fruit and vegetables are acid-producing diets. Our group has shown that breast cancer survivors are susceptible to acid-producing diets, resulting in an increased risk of mortality, depression, and reduced physical function [ 20 , 21 , 22 , 23 ]. Cancer survivors have a lower capacity to adjust acid-base balance than the general population [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Independent and Joint Associations of Pessimism, Total Calorie Intake and Acid-Producing Diets with Insomnia Symptoms among Breast Cancer Survivors

Arevalo

Hsu

et al. 2022

JCM

Self Cite

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Insomnia is prevalent in up to 40% of breast cancer survivors. Few studies have examined pessimism and dietary factors as risk factors for insomnia among breast cancer survivors. We leveraged a cohort of 2944 breast cancer survivors who enrolled in the Women’s Healthy Eating and Living study; these survivors provided dietary, insomnia, mental health, demographic, and lifestyle information at baseline and at 1- and 4-year follow-up assessments. Insomnia symptoms were assessed using the Women’s Health Initiative (WHI)-Insomnia Rating Scale, and pessimism was assessed using the Life Orientation Test Revised (LOT-R). Total calorie intake and acid-producing diets were assessed using 24 h dietary recalls. Multivariable-adjusted generalized estimating equation (GEE) models were used to test the independent and joint effects of psychological and dietary factors on insomnia. In the multivariable model, women in the third tertile of pessimism had greater odds (OR = 1.57 95% CI [1.37–1.79]) of insomnia when compared to women in the lowest tertile. Total calorie intake and acid-producing diets were each independently and significantly associated with insomnia symptoms. Further, pessimism and calorie intake/acid-producing diets were jointly associated with insomnia. For instance, women with pessimism scores in tertile 3 and total calorie intakes < median reported 2 times the odds (OR = 2.09; 95% CI [1.51–3.47]) of insomnia compared to women with pessimism score in tertile 1 and calorie intakes < median. Our results highlight the need for patient care regarding mental health, and recommendations of healthy dietary intakes for breast cancer survivors.

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Dietary acid load and cirrhosis-related mortality: a prospective cohort study

Pashayee-Khamene,

Heidari,

Fotros

et al. 2024

Sci Rep

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As a global health concern, cirrhosis contributes significantly to morbidity and mortality. This prospective cohort study aimed to investigate the association between dietary acid load (DAL) and cirrhosis-related mortality. Present study was conducted on 121 patients with newly diagnosed cirrhosis who were followed up for 48 months. Anthropometric measures, nutritional status and dietary intakes were assessed and DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Participants in the high PRAL and NEAP scores had significantly higher intakes of grains and lower intakes of fruits and vegetables. Also, the intake of dairy products and legumes, nuts and seeds decreased significantly with increasing NEAP score. After adjustment of all the confounders, the risk of mortality in the second and third tertiles of PRAL was 5.9 times and 10.97 higher than those in the first tertile, respectively (P trend: 0.006). Similarly, comparing the risk of mortality in the second and third tertiles with the first tertile of NEAP showed a 4.46-fold and 12.3-fold increased risk, respectively (P trend: 0.010). Our findings suggested that DAL was significantly associated with cirrhosis-related mortality and highlight the need for further research to understand the underlying mechanisms and establish optimal DAL levels in cirrhotic patients.

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Dietary Acid Load, Serum Polychlorinated Biphenyl Levels, and Mortality Following Breast Cancer in the Long Island Breast Cancer Study Project

Cited by 5 publications

References 48 publications

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

Independent and Joint Associations of Pessimism, Total Calorie Intake and Acid-Producing Diets with Insomnia Symptoms among Breast Cancer Survivors

Dietary acid load and cirrhosis-related mortality: a prospective cohort study

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