Dietary acid load and the risk of cancer: a systematic review and dose-response meta-analysis of observational studies

Bahrami, Alireza; Khalesi, Saman; Ghafouri-Taleghani, Fatemeh; Alibeyk, Sepide; Hajigholam-Saryazdi, Maryam; Haghighi, Shirin; Hejazi, Ehsan

doi:10.1097/cej.0000000000000748

Cited by 8 publications

(12 citation statements)

References 43 publications

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“…To the best of our knowledge, this is the first case‐control study to examine such an association in the English‐speaking scientific literature. Our findings are in line with two previous meta‐analyses that observed a significant association between higher DAL scores and the risk of cancer 30,31 …”

Section: Discussionsupporting

confidence: 93%

“…Our findings are in line with two previous meta-analyses that observed a significant association between higher DAL scores and the risk of cancer. 30,31 T A B L E 4 Crude and adjusted odds ratios (OR) of esophageal cancer for acid load scores (PRAL and NEAP). p-values for their linear trends Several plausible pathophysiological mechanisms may explain the observed associations.…”

Section: Discussionmentioning

confidence: 99%

“…26,27 Chronic tissue inflammation may thus stimulate carcinogenesis or tumor progression; 28,29 and adherence to an acidogenic diet has been associated with an increased risk for some types of cancers. 30 Two recently published independent meta-analyses revealed positive associations of a high DAL and a higher risk of cancer incidence. 30,31 A high DAL has been associated with the following malignancies in large epidemiological studies on cancer: prostate, 32 bladder, 33 breast, 34,35 lung, 36 colorectum, 37 head and neck, 38 and pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

“…30 Two recently published independent meta-analyses revealed positive associations of a high DAL and a higher risk of cancer incidence. 30,31 A high DAL has been associated with the following malignancies in large epidemiological studies on cancer: prostate, 32 bladder, 33 breast, 34,35 lung, 36 colorectum, 37 head and neck, 38 and pancreatic cancer. 39 The reservation must be made that investigations in this particular field are still scarce, and whether a high DAL may increase the risk for EC has not yet been examined in particular.…”

Section: Introductionmentioning

confidence: 99%

“…The composition of diet may also influence the body's acid–base balance 26 and a regular consumption of acidogenic dietary components may increase dietary acid load (DAL), which has been closely linked to chronic low‐grade inflammation and subsequent cell transformation 26,27 . Chronic tissue inflammation may thus stimulate carcinogenesis or tumor progression; 28,29 and adherence to an acidogenic diet has been associated with an increased risk for some types of cancers 30 . Two recently published independent meta‐analyses revealed positive associations of a high DAL and a higher risk of cancer incidence 30,31 …”

Section: Introductionmentioning

confidence: 99%

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Dietary acid load and esophageal cancer risk: A case‐control study

et al. 2022

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Background: A high dietary acid load (DAL) can produce metabolic acidosis, which is linked to cancer development through mechanisms of inflammation and cell transformation. There is limited epidemiological evidence linking DAL and cancer risk; however, none of the published studies focused on DAL and esophageal cancer (EC) risk in particular. Therefore, we sought to explore this association in the present study. Methods: A case-control study was performed in 1295 male patients (185 squamous cell EC cases and 1110 age-frequency and urban/rural residence matched controls) through a multitopic inquiry, including a food frequency questionnaire. Food-derived nutrients were calculated from available databases. The DAL was calculated based on two validated measures: Potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (OR) and their 95% confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusting for confounders. Results: We found direct, significant associations between dietary acid load and EC risk: (OR = 2.28, 95% CI: 1.44-3.61, ptrend <0.0001) and (OR = 2.17, 95% CI: 1.38-3.41, ptrend <0.0001) for highest PRAL and NEAP tertiles, respectively. Our data raise the possibility that a high DAL may contribute to EC development. Both acid load scores were directly associated with animal-based foods (mainly meat) and inversely associated with the intake of plant-based foods. Conclusion:To the best of our knowledge, this is the first epidemiological casecontrol study analyzing associations of DAL and squamous cell EC risk. Further research is warranted to confirm our findings.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dietary acid load and esophageal cancer risk: A case‐control study

et al. 2022

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Dietary acid load in health and disease

Wieërs,

Beynon-Cobb,

Visser

et al. 2024

Pflugers Arch - Eur J Physiol

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Maintaining an appropriate acid–base equilibrium is crucial for human health. A primary influencer of this equilibrium is diet, as foods are metabolized into non-volatile acids or bases. Dietary acid load (DAL) is a measure of the acid load derived from diet, taking into account both the potential renal acid load (PRAL) from food components like protein, potassium, phosphorus, calcium, and magnesium, and the organic acids from foods, which are metabolized to bicarbonate and thus have an alkalinizing effect. Current Western diets are characterized by a high DAL, due to large amounts of animal protein and processed foods. A chronic low-grade metabolic acidosis can occur following a Western diet and is associated with increased morbidity and mortality. Nutritional advice focusing on DAL, rather than macronutrients, is gaining rapid attention as it provides a more holistic approach to managing health. However, current evidence for the role of DAL is mainly associative, and underlying mechanisms are poorly understood. This review focusses on the role of DAL in multiple conditions such as obesity, cardiovascular health, impaired kidney function, and cancer.

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