Topical Area: Nutritional Epidemiology, Aging and Chronic Disease
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.
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.
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.
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