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

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

doi:10.3390/ijerph19010374

Abstract

Dietary acid load (DAL) may be associated with all-cause mortality (ACM) and breast cancer-specific mortality (BCM), and these associations may be modified by serum polychlorinated biphenyl (PCB) levels. Participants included 519 women diagnosed with first primary in situ or invasive breast cancer in 1996/1997 with available lipid-corrected PCB data. After a median of 17 years, there were 217 deaths (73 BCM). Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from a baseline food frequency questionnaire estimated DAL. Cox regression estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PRAL and NEAP with mortality. We evaluated effect measure modification by total serum PCB levels (>median vs. ≤median). PRAL quartile 4 versus quartile 1 was associated with an ACM HR of 1.31 (95%CI = 0.90–1.92). In the upper median of PCBs, ACM HRs were 1.43 (95%CI = 0.96–2.11) and 1.40 (95%CI = 0.94–2.07) for PRAL and NEAP upper medians, respectively. In the lower median of PCBs, the upper median of NEAP was inversely associated with BCM (HR = 0.40, 95%CI = 0.19–0.85). DAL may be associated with increased risk of all-cause mortality following breast cancer among women with high total serum PCB levels, but inversely associated with breast cancer mortality among women with low PCB levels.

Highlights

We examined whether this association was modified by total levels of serum polychlorinated biphenyls (PCBs), synthetic, organic and toxic compounds given that the kidneys serve the important role of maintaining acid–base balance of the body [17,18] and PCBs have been associated with nephropathy [19] and are hypothesized to increase the risk of breast cancer mortality [20,21]
In the lower median of PCB levels, higher net endogenous acid production (NEAP) scores were inversely associated with mortality, while in the upper median of PCB levels, higher Dietary acid load (DAL) was associated with an increased risk of all-cause mortality (ACM)
We did not find a strong relationship between baseline DAL and mortality following breast cancer, there was a modest increase in risk of ACM among women with higher PCB levels and higher DAL

Summary

Introduction

In 2012, the American Cancer Society (ACS) published its nutrition and physical activity guidelines, which included recommendations of balancing caloric intake with physical activity, eating five or more vegetable and fruit servings each day, and limiting the consumption of processed and red meat [1]. Since publication of the ACS guidelines, numerous observational epidemiologic studies and randomized clinical trials (RCTs) have been conducted to elucidate the role of diet on breast cancer risk and to refine dietary recommendations for women with breast cancer. In these studies, higher adherence to the Chinese Food Pagoda and to the Dietary Approaches to Stop Hypertension diets was.

Methods

Results

Discussion

Conclusion