Dietary Acid Load, Smoking Intensity and Total Mortality

Abstract

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 >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.