scholarly journals Associations between Dietary Acid Load and Biomarkers of Inflammation and Hyperglycemia in Breast Cancer Survivors

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1913 ◽  
Author(s):  
Tianying Wu ◽  
Phoebe Seaver ◽  
Hector Lemus ◽  
Kathryn Hollenbach ◽  
Emily Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Acidosis ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Acid Base Balance ◽  
Acid Base ◽  
Dietary Acid Load ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load

Metabolic acidosis can lead to inflammation, tissue damage, and cancer metastasis. Dietary acid load contributes to metabolic acidosis if endogenous acid–base balance is not properly regulated. Breast cancer survivors have reduced capacities to adjust their acid–base balance; yet, the associations between dietary acid load and inflammation and hyperglycemia have not been examined among them. We analyzed data collected from 3042 breast cancer survivors enrolled in the Women’s Healthy Eating and Living (WHEL) Study who had provided detailed dietary intakes and measurements of plasma C-reactive protein (CRP) and hemoglobin A1c (HbA1c). Using a cross-sectional design, we found positive associations between dietary acid load and plasma CRP and HbA1c. In the multivariable-adjusted models, compared to women with the lowest quartile, the intakes of dietary acid load among women with the highest quartile showed 30–33% increases of CRP and 6–9% increases of HbA1c. Our study is the first to demonstrate positive associations between dietary acid load and CRP and HbA1c in breast cancer survivors. Our study identifies a novel dietary factor that may lead to inflammation and hyperglycemia, both of which are strong risk factors for breast cancer recurrence and comorbidities.

scholarly journals Dietary Acid Load, Past Smoking Intensity and Mortality Among Breast Cancer Survivors

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 147-147
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
John Pierce
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Dietary Guidelines ◽  
Acid Base Balance ◽  
Dietary Acid Load ◽  
Smoking Intensity ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load

Abstract Cancer survivors are at accelerated risk of aging and more susceptible to unhealthy diets and lifestyles than people without cancers. However, current dietary guidelines for cancer survivors not quite different from that for general healthy population. Further, these guidelines are not specific for cancer survivors who are past smokers. Acid-producing diet can accelerate aging and stimulate cancer development if acid-base balance is not regulated properly. Cancer survivors and past smokers have reduced capacities to adjust acid-base balance. Thus, we conducted prospective cohort analyses among 2950 early-stage breast cancer survivors who enrolled in the Women’s Healthy Eating and Living study and provided dietary information through 24-hour recalls at baseline and during follow-up. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score, and net endogenous acid production (NEAP) score. We assessed past smoking intensity by pack-years of smoking. After an average of 7.3 years of follow-up, there were 295 total death, and 249 breast cancer-specific death. Increased PRAL and NEAP scores were positively associated with total mortality and breast cancer-specific mortality (p for trend <0.1 for PRAL and <0.01 for NEAP). Further, dietary acid load and pack-years of smoking had joint positive associations with mortalities (Comparing the highest to the lowest categories, risk increased by 2.5-3 times; P for trend <0.01 for both PRAL and NEAP). Our study provides valuable evidence for adding dietary acid load to dietary guidelines for breast cancer survivors and developing specific guidelines for past smokers.

scholarly journals Increased Acid-Producing Diet and Past Smoking Intensity Are Associated with Worse Prognoses among Breast Cancer Survivors: A Prospective Cohort Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1817 ◽  
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
John P. Pierce
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Total Mortality ◽  
Dietary Guidelines ◽  
Acid Base Balance ◽  
Dietary Acid Load ◽  
Smoking Intensity ◽  
Dietary Acid ◽  
Acid Load

Current dietary guidelines do not consider cancer survivors’ and past smokers’ low capacity to regulate their acid–base balance. People with a low capacity to regulate their acid–base balance are more susceptible to acid-producing diets. We studied a cohort of 2950 early stage breast cancer survivors who provided dietary information at baseline and during follow-up. We assessed the intakes of acid-producing diets via two commonly used dietary acid load scores: potential renal acid load (PRAL) and net endogenous acid production (NEAP). We assessed past smoking intensity by pack-years of smoking. After an average of 7.3 years of follow-up, there were 295 total deaths, 249 breast cancer-specific deaths, and 490 cases of recurrent breast cancer. Increased intakes of dietary acid load and pack-years of smoking were each independently and jointly associated with increased total mortality and breast cancer-specific mortality; tests for trends and overall associations were statistically significant for NEAP and marginally significant for PRAL. Compared to women in the lowest tertile of NEAP and pack-year of smoking = 0, women in the highest tertile of NEAP and pack-years of smoking >15 had the greatest increased risk of total mortality (HR = 3.23, 95%CI 1.99–5.26). Further, dietary acid scores were associated with increased breast cancer recurrence among women with pack-years of smoking >0 but not in those with pack-years of smoking = 0 (p values for interactions <0.05). Our study provides valuable evidence for adding dietary acid load scores to dietary guidelines for breast cancer survivors and developing specific guidelines for past smokers among these survivors.

scholarly journals Hemoglobin A1c Levels Modify Associations between Dietary Acid Load and Breast Cancer Recurrence

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 578 ◽  
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
Shunran Wang ◽  
David Luong ◽  
John P. Pierce
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load ◽  
Hba1c Levels

Background: Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however, researchers have not examined whether hyperglycemia can modify the association between dietary acid load and breast cancer recurrence. Methods: We studied 3081 early-stage breast cancer survivors enrolled in the Women’s Healthy Eating and Living study who provided dietary information through 24-h recalls at baseline and during follow-up and had measurements of hemoglobin A1c (HbA1c) at baseline. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Results: After an average of 7.3 years of follow-up, dietary acid load was positively associated with recurrence when baseline HbA1c levels were ≥ 5.6% (median level) and ≥5.7% (pre-diabetic cut-point). In the stratum with HbA1c ≥ 5.6%, comparing the highest to the lowest quartile of dietary acid load, the multivariable-adjusted hazard ratio was 2.15 (95% confidence interval [CI] 1.34-3.48) for PRAL and was 2.31 (95% CI 1.42-3.74) for NEAP. No associations were observed in the stratum with HbA1c levels were <5.6%. P-values for interactions were 0.01 for PRAL and 0.05 for NEAP. Conclusions: Our study demonstrated for the first time that even at or above normal to high HbA1c levels, dietary acid load was associated with increased risk of breast cancer recurrence among breast cancer survivors. Impacts: Our study provides strong evidence for developing specific dietary acid load guidelines based on HbA1c levels.

scholarly journals Dietary Acid Load, Smoking Intensity and Total Mortality

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 89-89
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
Shunran Shunran Wang ◽  
John Pierece
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Total Mortality ◽  
Dietary Acid Load ◽  
Smoking Intensity ◽  
Dietary Acid ◽  
Acid Load ◽  
Former Smokers ◽  
Never Smokers

Abstract Objectives Former smokers comprise 30–40% among breast cancer survivors. Smoking can cause many biological damages which can still exist in past smokers and make them more susceptible to certain dietary and environmental challenges. Past smokers may have accelerated aging process than never smokers. Limited studies have examined the impacts of dietary acid load total mortality among breast cancer survivors who are never or former smokers. Methods We leveraged an existing cohort, the Women's Healthy Eating and Living (WHEL) Study, which enrolled 3088 women with early stage breast cancer at baseline. This cohort collected dietary information through 24-hour recalls at years 0, 1, and 4, which enabled us to measure dietary acid load accurately and longitudinally. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score, and net endogenous acid production (NEAP) score. This cohort also assessed past smoking history by pack-years which allowed us to carefully and accurately past smoking intensity. Results In this study, we found that dietary acid load itself was not significantly associated with total mortality among never smokers but significantly associated with total mortality among past smokers who had pack-years &gt;0. When we evaluated the joint impact of dietary acid load and pack-years, women with dietary acid load above median and pack-years ≥15 had 2.38 (95% CI 1.58–3.59) times of risk of total mortality as compared to the reference group (women with dietary acid load below median and pack-years = 0). Conclusions Results from our study will be important for patient care and aid in creating tailored precision nutrition recommendation for breast cancer survivors who are former smoker. Funding Sources University internal funds, NIH/NCI.

scholarly journals Keseimbangan asam-basa tubuh dan kejadian sindrom metabolik pada remaja obesitas

2017 ◽  
Vol 14 (1) ◽  
pp. 36
Author(s):  
Firdananda Fikri Jauharany ◽  
Nurmasari Widyastuti
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Acid Base Balance ◽  
Acid Base ◽  
Dietary Acid Load ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load

Background: The prevalence of metabolic syndrome increased in young population, indicated by the rise in obesity among children and adolescent. The Western dietary pattern was one of the causes. A Western diet rich in animal protein can produce acid during the metabolic process and may cause an acid-excess in the body (dietary acid load). This process was contributed to acid-base balance through the metabolism of sulfur-containing amino acids (cysteine and methionine) which produce H+ ions as well as lowering the pH.Objective: To examine the association between acid-base balance and components of metabolic syndrome among obese adolescent.Method: A cross-sectional study was conducted on 40 obese adolescents in Semarang high school. We measured Potential Renal Acid Load (PRAL) score and pH urine as an acid-base indicator. MetS are defined ≥ 3 following risk factors: waist circumference ≥90th percentile, blood pressure ≥90th percentile, triglycerides ≥110 mg/dl, HDL levels ≤40 mg/dl, and fasting blood glucose levels ≥110 mg/dl. Normality test used the Shapiro-Wilk test (n <50). The bivariate analysis used Pearson test, Rank-Spearman test, and Chi-Square test. The multivariate analysis used Multivariate Linear Regression analysis of Backward.Results: PRAL score was associated with waist circumference (r=0,347; p=0,028), sistolic blood pressure (r=0,590; p=<0,001), diastolic blood pressure (r=0,668; p=<0,001), and triglyceride levels (r=0,362; p=0,022). pH urin was not associated with any risk factors of MetS.Conclusion: High dietary acid load may be a risk factor for the development of MetS.

scholarly journals Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2422
Author(s):  
K. Daniel Tessou ◽  
Hector Lemus ◽  
Fang-Chi Hsu ◽  
John Pierce ◽  
Suzi Hong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Confidence Interval ◽  
Physical Health ◽  
Cancer Survivors ◽  
Physical Function ◽  
Odds Ratio ◽  
Breast Cancer Survivors ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load

The purpose of this study was to examine the independent and joint associations of acid-producing diets and depressive symptoms with physical health among breast cancer survivors. We studied a cohort of 2944 early stage breast cancer survivors who provided dietary, physical health, demographic, and lifestyle information at baseline, year 1, and year 4. We assessed the intakes of acid-producing diets via two commonly used dietary acid load scores: potential renal acid load (PRAL) and net endogenous acid production (NEAP). Physical health was measured using the Rand 36-Item Short Form Health Survey (SF-36), consisting of physical functioning, role limitation due to physical function, bodily pain, general health, and overall physical health subscales. Increased dietary acid load and depression were each independently and significantly associated with reduced physical health subscales and overall physical health. Further, dietary acid load and depression were jointly associated with worse physical health. For instance, depressed women with dietary acid load higher than median reported 2.75 times the risk (odds ratio = 2.75; 95% confidence interval: 2.18–3.47) of reduced physical function and 3.10 times the risk of poor physical health (odds ratio = 3.10; 95% confidence interval: 2.53–3.80) compared to non-depressed women with dietary acid load lower than median. Our results highlight the need of controlling acid-producing diets and the access of mental care for breast cancer survivors.

scholarly journals Hemoglobin A1c Levels Modify Associations Between Dietary Acid Load and Breast Cancer Recurrence

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 362-362
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
Shunran Shunran Wang ◽  
John Pierece
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load ◽  
Hba1c Levels

Abstract Objectives Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however, researchers have not examined whether hyperglycemia can modify the association between dietary acid load and breast cancer recurrence. Methods We studied 3081 early-stage breast cancer survivors enrolled in the Women's Healthy Eating and Living study who provided dietary information through 24-hour recalls at baseline and during follow-up and had measurements of hemoglobin A1c (HbA1c) at baseline. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score, and net endogenous acid production (NEAP) score. Results After an average of 7.3 years of follow-up, dietary acid load was positively associated with recurrence when baseline HbA1c levels were ≥5.6% (median level) and ≥5.7% (pre-diabetic cut-point). In the stratum with HbA1c ≥ 5.6%, comparing the highest to the lowest quartile of dietary acid load, the multivariable-adjusted hazard ratio was 2.15 (95%CI 1.34–3.48) for PRAL and was 2.31 (95%CI 1.42–3.74) for NEAP. No associations were observed in the stratum with HbA1c levels were &lt;5.6%. P-values for interactions were 0.01 for PRAL and 0.05 for NEAP. Conclusions Our study demonstrated for the first time that even at or above normal to high HbHbA1c levels, dietary acid load was associated increased risk of breast cancer recurrence among breast cancer survivors. Funding Sources California Tobacco Research Foundation NIH/NCI.

scholarly journals Dietary Acid Load in Relation to Inflammation and Glycemic Status in Women with Breast Cancer (P18-095-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Tianying Wu ◽  
John Pierce ◽  
Phoebe Seaver
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Acid Production ◽  
Breast Cancer Survivors ◽  
Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load

Abstract Objectives To determine the associations between dietary acid load and serum C-reactive protein (CRP) and hemoglobin A1c (HbA1c) among breast cancer survivors. We hypothesized that high dietary acid load is positively associated with CRP and HbA1c. Methods Using a cross-sectional design, we analyzed data collected from 3088 breast cancer survivors enrolled in the Women's Healthy Eating and Living (WHEL) Study who had provided detailed four randomly selected self-reported 24-hr dietary recalls over a three-week period followed by a blood sample that was used to validate the dietary self reports and measure of plasma CRP and HbA1c from washed red blood cells. Two commonly used dietary acid load scores were created, namely the potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. The PRAL score takes into account the intestinal absorption rates for contributing nutrient ionic balances for protein, potassium, calcium and magnesium and the dissociation of phosphate at pH 7.4. The NEAP score uses total protein and potassium intake as the main components involved in acid production. Results PRAL and NEAP were both positively associated with plasma CRP and HbA1c. In multivariable adjusted models, compared to women in the lowest quartile, those in the highest quartile of PRAL and NEAP had 32% and 31% increases in CRP, respectively and 9% and 6% increases in HbA1c, respectively after adjustment for total calorie intakes, age, body mass index, breast cancer stage, hormone receptor status, and type of chemotherapy. Conclusions This is the first demonstration that dietary acid load is associated with CRP and HbA1c in breast cancer patients. Our study identifies a novel dietary factor that may lead to inflammation and hyperglycemia, both of which are strong risk factors for breast cancer recurrence and other comorbidities. Funding Sources SDSU start-up funds.

scholarly journals U-Shaped Association between Dietary Acid Load and Risk of Osteoporotic Fractures in 2 Populations at High Cardiovascular Risk

2020 ◽  
Vol 151 (1) ◽  
pp. 152-161
Author(s):  
Jesús Francisco García-Gavilán ◽  
Alfredo Martínez ◽  
Jadwiga Konieczna ◽  
Rafael Mico-Perez ◽  
Ana García-Arellano ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Osteoporotic Fractures ◽  
Heart Association ◽  
Acid Base Balance ◽  
High Cardiovascular Risk ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid ◽  
Acid Load ◽  
Predimed Study

ABSTRACT Background Bone contributes to maintaining the acid-base balance as a buffering system for blood pH. Diet composition also affects acid-base balance. Several studies have linked an imbalance in the acid-base system to changes in the density and structure of bone mass, although some prospective studies and meta-analyses suggest that acid load has no deleterious effect on bone. Objective The aim of this study was to examine the associations between potential renal acid load (PRAL) and net endogenous acid production (NEAP) and the risk of osteoporotic fractures and bone mineral density (BMD) in 2 middle-aged and elderly Mediterranean populations. Methods We conducted a longitudinal analysis including 870 participants from the PREvención con DIeta MEDiterranea (PREDIMED) Study and a cross-sectional analysis including 1134 participants from the PREDIMED-Plus study. Participants were adults, aged 55–80 y, either at high cardiovascular risk (PREDIMED) or overweight/obese with metabolic syndrome (PREDIMED-Plus), as defined by the International Diabetes Federation, the American Heart Association, and the National Heart Association. PRAL and NEAP were calculated from validated food-frequency questionnaires. BMD was measured using DXA scans. Fracture information was obtained from medical records. The association between mean PRAL and NEAP and fracture risk was assessed using multivariable-adjusted Cox models. BMD differences between tertiles of baseline PRAL and NEAP were evaluated by means of ANCOVA. Results A total 114 new fracture events were documented in the PREDIMED study after a mean of 5.2 y of intervention and 8.9 y of total follow-up. Participants in the first and third PRAL and NEAP tertiles had a higher risk of osteoporotic fracture compared with the second tertile, showing a characteristically U-shaped association [HR (95% CI): 1.73 (1.03, 2.91) in tertile 1 and 1.91 (1.14, 3.19) in tertile 3 for PRAL, and 1.83 (1.08, 3.09) in tertile 1 and 1.87 (1.10, 3.17) in tertile 3 for NEAP]. Compared with the participants in tertile 1, the participants in the top PRAL and NEAP tertiles had lower BMD [PRAL: mean total femur BMD: 1.029 ± 0.007 and 1.007 ± 0.007 g/cm2; P = 0.006 (tertiles 1 and 3); NEAP: mean total femur BMD: 1.032 ± 0.007 and 1.009 ± 0.007 g/cm2; P = 0.017 (tertiles 1 and 3)]. Conclusions The results of our study suggest that both high and low dietary acid are associated with a higher risk of osteoporotic fractures, although only high dietary acid was found to have a negative relation to BMD in senior adults with existing chronic health conditions. This trial was registered at http://www.isrctn.com/ as ISRCTN3573963 (PREDIMED) and ISRCTN89898870 (PREDIMED-Plus).

scholarly journals Acid-Producing Diet and Depressive Symptoms among Breast Cancer Survivors: A Longitudinal Study

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3183
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
John P. Pierce
Keyword(s):  
Breast Cancer ◽  
Depressive Symptoms ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Net Endogenous Acid Production ◽  
Practical Strategy ◽  
Younger Age ◽  
Dietary Acid ◽  
Acid Load

The incidence of depression is two-to-three times higher in cancer survivors than the general population. Acid-producing diets may play important roles in the development of depression. Cancer survivors are more susceptible to acid-producing diets, yet few prospective studies have investigated the association of acid-producing diets with depression among breast cancer survivors. We leveraged a large cohort of 2975 early stage breast cancer survivors, which collected detailed dietary data via 24-h recalls. Potential renal acid load (PRAL) and net endogenous acid production (NEAP), two commonly used dietary acid load scores, were used to estimate acid-producing diets. Intakes of PRAL and NEAP were assessed at baseline and years one and four. Increased PRAL and NEAP were each independently associated with increased depression in the longitudinal analyses, after adjusting for covariates. The magnitude of the associations was stronger for PRAL than NEAP. Women with the highest quartile intakes of PRAL had 1.34 (95% CI 1.11–1.62) times the risk of depression compared to women with the lowest quartile. Furthermore, we also observed a joint impact of PRAL and younger age on depression, as well as a joint impact of PRAL and physical activity on depression. Decreasing the consumption of acid-producing diets may be a novel and practical strategy for reducing depressive symptoms among breast cancer survivors, especially those who are younger and have a sedentary lifestyle.

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