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

Tianying Wu,Fang-Chi Hsu,John P Pierce

doi:10.3390/cancers12113183

Abstract

Simple SummaryDepressive symptoms, which are highly prevalent among breast cancer survivors, can significantly influence quality of life and increase total mortality. The aim of our prospective study was to determine whether acid-producing diets have an adverse impact on depression. Our study demonstrated that a higher consumption of acid-producing diets was significantly associated with depressive symptoms among breast cancer survivors, especially among those who were younger than 55 and had a sedentary lifestyle.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.

Highlights

The incidence rate for depression is two-to-three times higher in the cancer population compared to their healthy counterparts [1]
In multivariate model 2 used in Table 3, we examined the joint associations of Potential renal acid load (PRAL) and age with depression (CES-D ≥ 5 vs. Center for Epidemiologic Studies Depression Scale (CES-D) < 5)
Our Our study is the first study among breast cancer survivors to demonstrate study is the firstlongitudinal longitudinal study among breast cancer survivors to demonstrate that acid- that acid-producing diets were associated depression; the associations were stronger in had women producing diets were associated with with depression; the associations were stronger in women who who had breast diagnosed before

Summary

Introduction

The incidence rate for depression is two-to-three times higher in the cancer population compared to their healthy counterparts [1]. Depression has been shown to be strongly associated with poor quality of life [2], all-cause mortality [3], and cancer-specific mortality [4,5]. Cancers 2020, 12, 3183 emphasized that cancer survivors face higher risks of depression [6]. Some possible risk factors have been suggested for depression in cancer survivors [7]. Observational studies have shown that metabolic syndrome [12], social support [13,14], severe life difficulties [9], and poor diet quality [15] were associated with depression in cancer survivors

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