ASPO Abstracts
dietary acid load and invasive breast cancer recurrence
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Background: Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the
association between dietary acid load and invasive breast cancer recurrence among breast cancer survivors, who
are susceptible to metabolic acidosis. Methods: We studied 3042 early-stage breast cancer survivors enrolled in
the Women’s Healthy Eating and Living Study who provided dietary information through 24-hour recalls at
baseline and during follow-up. We assessed dietary acid load using two commonly dietary acid load scores,
potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score.
Results: After an average of 7.4 years of follow-up, dietary acid load was not associated with total invasive
recurrence in the whole cohort in both crude- and multivariable-adjusted analyses. However, we found dietary
acid load was strongly associated with invasive recurrence in women who had higher intensity of smoking history
and who had high hemoglobin A1c (HbA1c) levels. The multivariable-adjusted hazard ratios between extreme
quartile intakes of PRAL were 1.34 (95%CI 1.00-1.98) and 2.4 (95%CI 1.2-3.5) among women with history of
pack-years>0 and with HbA1c≥5.6% at baseline. No associations were found in women with pack-years =0 or
with HbA1c <5.6% . P-value for interactions were 0.02 for pack-year strata and 0.01 for HbA1c strata. Similar
trends of associations were found for NEAP within different pack-year strata and HbA1c strata. .
Conclusions: Our study for the first time demonstrated that impacts of dietary acid load on invasive breast cancer
recurrence in special subgroups.
Impacts: Our study provides preliminary data for making specific guidelines of dietary acid load based on different
subgroups.
Keywords: dietary acid load, recurrence, hemoglobin A1c, pack-years