Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-14T11:32:27.124Z Has data issue: false hasContentIssue false

The association of diet-dependent acid load with colorectal cancer risk: a case–control study in Korea

Published online by Cambridge University Press:  31 August 2023

Tao Thi Tran
Affiliation:
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, South Korea
Madhawa Gunathilake
Affiliation:
Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
Jeonghee Lee
Affiliation:
Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
Jae Hwan Oh
Affiliation:
Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
Hee Jin Chang
Affiliation:
Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
Dae Kyung Sohn
Affiliation:
Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, South Korea
Aesun Shin
Affiliation:
Department of Preventive Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
Jeongseon Kim*
Affiliation:
Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do 10408, South Korea
*
*Corresponding author: Jeongseon Kim, email jskim@ncc.re.kr

Abstract

Acid–base disequilibrium is a contributor to cancer development because it affects molecular activities such as insulin-like growth factor 1 levels and adiponectin production. However, evidence of an association of diet-induced acid–base imbalance with colorectal cancer (CRC) is limited. We examined whether colorectal carcinogenesis is attributable to a diet with a high acid load. We recruited a total of 923 CRC cases and 1846 controls at the National Cancer Center in Korea for inclusion in a case–control study. We collected information on nutrient intake and specific clinical parameters of CRC by using a semiquantitative FFQ and medical records, respectively. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) were used to estimate diet-dependent acid load. We used an unconditional logistic regression model to analyse the association. Dietary acid load scores had a positive association with the odds of CRC (OR = 2·31 (95 % CI 1·79, 2·99) and OR = 2·14 (95 % CI 1·66, 2·76) for PRAL and NEAP, respectively, Pfor trend < 0·001). A stronger positive association was observed for females (OR = 3·09, 95 % CI 1·93, 4·94) than for males (OR = 1·71, 95 % CI 1·27, 2·31). Furthermore, acidogenic diets appeared to affect rectal cancer more strongly than colon cancer in females. Our study contributes to reinforcing epidemiological evidence regarding a detrimental effect of acidogenic diets on colorectal carcinogenesis. Thus, it is important to pay attention to the balance of acidogenic (e.g. poultry and red meat) and alkalinogenic foods (e.g. fruits and vegetables) in CRC prevention, especially for females.

Type
Research Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sung, H, Ferlay, J, Siegel, RL, et al. (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71, 209249.Google Scholar
Kang, MJ, Won, YJ, Lee, JJ, et al. (2022) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2019. Cancer Res Treat 54, 330344.Google Scholar
World Cancer Research Fund International (2018) Diet, Nutrition, Physical Activity and Colorectal Cancer. London: World Cancer Research Fund International.Google Scholar
Khil, H, Kim, SM, Hong, S, et al. (2021) Time trends of colorectal cancer incidence and associated lifestyle factors in South Korea. Sci Rep 11, 2413.Google Scholar
Kant, S & Deepa, (2016) Impact of western lifestyle on cancer progression. Int J Health Sci 4, 305310.Google Scholar
Mehta, RS, Song, M, Nishihara, R, et al. (2017) Dietary patterns and risk of colorectal cancer: analysis by tumor location and molecular subtypes. Gastroenterology 152, 19441953.e1.CrossRefGoogle Scholar
Robey, IF (2012) Examining the relationship between diet-induced acidosis and cancer. Nutr Metab 9, 72.Google Scholar
Remer, T (2000) Influence of diet on acid-base balance. Semin Dial 13, 221226.Google Scholar
Keramati, M, Kheirouri, S, Musazadeh, V, et al. (2022) Association of high dietary acid load with the risk of cancer: a systematic review and meta-analysis of observational studies. Front Nutr 9, 816797.Google Scholar
Osuna-Padilla, IA, Leal-Escobar, G, Garza-García, CA, et al. (2019) Dietary acid load: mechanisms and evidence of its health repercussions. Nefrologia 39, 343354.Google Scholar
Müller, A, Zimmermann-Klemd, AM, Lederer, AK, et al. (2021) A vegan diet is associated with a significant reduction in dietary acid load: post hoc analysis of a randomized controlled trial in healthy individuals. Int J Environ Res Public Health 18, 9998.Google Scholar
Penniston, KL, Nakada, SY, Holmes, RP, et al. (2008) Quantitative assessment of citric acid in lemon juice, lime juice, and commercially-available fruit juice products. J Endourol 22, 567570.Google Scholar
Hamidianshirazi, M & Ekramzadeh, M (2021) Dietary acid load and chronic kidney disease. Saudi J Kidney Dis Transpl 32, 15111522.Google Scholar
Lee, KW & Shin, D (2020) Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study. Nutr J 19, 137.Google Scholar
Ronco, AL, Martínez-López, W, Calderón, JM, et al. (2021) Dietary acid load and lung cancer risk: a case-control study in men. Cancer Treat Res Commun 28, 100382.Google Scholar
Carnauba, RA, Baptistella, AB, Paschoal, V, et al. (2017) Diet-induced low-grade metabolic acidosis and clinical outcomes: a review. Nutrients 9, 538.Google Scholar
Jafari Nasab, S, Rafiee, P, Bahrami, A, et al. (2021) Diet-dependent acid load and the risk of colorectal cancer and adenoma: a case–control study. Public Health Nutr 24, 44744481.Google Scholar
Remer, T & Manz, F (1994) Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr 59, 13561361.Google Scholar
Frassetto, LA, Todd, KM, Morris, RC, et al. (1998) Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. Am J Clin Nutr 68, 576583.Google Scholar
Park, YM, Steck, SE, Fung, TT, et al. (2019) Higher diet-dependent acid load is associated with risk of breast cancer: findings from the sister study. Int J Cancer 144, 18341843.Google Scholar
Ronco, A, Martínez-López, W, Mendoza, B, et al. (2021) Epidemiologic evidence for association between a high dietary acid load and the breast cancer risk. Sci Med J 3, 166176.Google Scholar
Safabakhsh, M, Imani, H, Yaseri, M, et al. (2020) Higher dietary acid load is not associated with risk of breast cancer in Iranian women. Cancer Rep 3, e1212.Google Scholar
Wu, T, Hsu, FC & Pierce, JP (2020) Increased acid-producing diet and past smoking intensity are associated with worse prognoses among breast cancer survivors: a prospective cohort study. J Clin Med 9, 1817.Google Scholar
Ronco, A, Storz, M, Martínez-López, W, et al. (2022) Dietary acid load and bladder cancer risk: an epidemiologic case-control study. Multidiscip Cancer Investig 6, 112.Google Scholar
Ronco, A, Martínez-López, W, Calderón, J, et al. (2022) Dietary acid load and risk of gastric cancer: a case-control study. World Cancer Res J 9, e2403.Google Scholar
Ronco, AL, Martínez-López, W, Calderón, JM, et al. (2023) Dietary acid load and risk of head and neck and oral cavity cancers: an epidemiologic study. Oral Sci Int 20, 7887.Google Scholar
Shi, LW, Wu, YL, Hu, JJ, et al. (2021) Dietary acid load and the risk of pancreatic cancer: a prospective cohort study. Cancer Epidemiol Biomarkers Prev 30, 10091019.Google Scholar
Ronco, AL, Martínez-López, W, Calderón, JM, et al. (2022) Dietary acid load and esophageal cancer risk: a case-control study. Thorac Cancer 13, 27592766.Google Scholar
Milajerdi, A, Shayanfar, M, Benisi-Kohansal, S, et al. (2022) A case-control study on dietary acid load in relation to glioma. Nutr Cancer 74, 16441651.CrossRefGoogle ScholarPubMed
Ronco, A, Martínez-López, W, Calderón, J, et al. (2020) Dietary acid load and colorectal cancer risk: a case-control study. World Cancer Res J 7, e1750.Google Scholar
Kim, J-G, Kim, J-S & Kim, J-G (2019) Trends of food supply and nutrient intake in South Korea over the past 30 years. Curr Res Nutr Food Sci 7, 8595.Google Scholar
Kim, Y, Lee, J, Oh, JH, et al. (2021) The association between coffee consumption and risk of colorectal cancer in a Korean population. Nutrients 13, 2753.Google Scholar
Jun, S, Lee, J, Oh, JH, et al. (2022) Association of the inflammatory balance of diet and lifestyle with colorectal cancer among Korean adults: a case-control study. Epidemiol Health 44, e2022084.Google Scholar
Ahn, Y, Kwon, E, Shim, JE, et al. (2007) Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 61, 14351441.Google Scholar
Remer, T, Dimitriou, T & Manz, F (2003) Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. Am J Clin Nutr 77, 12551260.Google Scholar
Willett, W & Stampfer, MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124, 1727.Google Scholar
Willett, WC, Howe, GR & Kushi, LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65, 1220S1228S.Google Scholar
Tabung, FK, Brown, LS & Fung, TT (2017) Dietary patterns and colorectal cancer risk: a review of 17 years of evidence (2000–2016). Curr Colorectal Cancer Rep 13, 440454.Google Scholar
Park, Y, Lee, J, Oh, JH, et al. (2016) Dietary patterns and colorectal cancer risk in a Korean population: a case-control study. Med (Baltimore) 95, e3759.Google Scholar
Storz, MA & Ronco, AL (2022) Reduced dietary acid load in U.S. vegetarian adults: results from the National Health and Nutrition Examination Survey. Food Sci Nutr 10, 20912100.Google Scholar
Kahleova, H, McCann, J, Alwarith, J, et al. (2021) A plant-based diet in overweight adults in a 16-week randomized clinical trial: the role of dietary acid load. Clin Nutr ESPEN 44, 150158.Google Scholar
Cosgrove, K & Johnston, CS (2017) Examining the impact of adherence to a vegan diet on acid-base balance in healthy adults. Plant Foods Hum Nutr 72, 308313.CrossRefGoogle ScholarPubMed
Storz, MA, Ronco, AL & Hannibal, L (2022) Observational and clinical evidence that plant-based nutrition reduces dietary acid load. J Nutr Sci 11, e93.Google Scholar
Gunathilake, M, Lee, J, Choi, IJ, et al. (2020) Identification of dietary pattern networks associated with gastric cancer using gaussian graphical models: a case-control study. Cancers (Basel) 12, 1044.Google Scholar
Kim, JH, Lee, J, Choi, IJ, et al. (2021) Dietary patterns and gastric cancer risk in a Korean population: a case-control study. Eur J Nutr 60, 389397.Google Scholar
Izadi, V, Farabad, E & Azadbakht, L (2012) Serum adiponectin level and different kinds of cancer: a review of recent evidence. ISRN Oncol 2012, 982769.Google Scholar
Larsson, SC, Lee, WH, Kar, S, et al. (2021) Assessing the role of cortisol in cancer: a wide-ranged Mendelian randomisation study. Br J Cancer 125, 10251029.Google Scholar
Belfiore, A & Malaguarnera, R (2011) Insulin receptor and cancer. Endocr-Relat Cancer 18, R125147.Google Scholar
Giovannucci, E, Pollak, M, Liu, Y, et al. (2003) Nutritional predictors of insulin-like growth factor I and their relationships to cancer in men. Cancer Epidemiol Biomarkers Prev 12, 8489.Google Scholar
Hoppe, C, Udam, TR, Lauritzen, L, et al. (2004) Animal protein intake, serum insulin-like growth factor I, and growth in healthy 2·5-year-old Danish children. Am J Clin Nutr 80, 447452.Google Scholar
Hatami, E, Abbasi, K, Salehi-sahlabadi, A, et al. (2022) Dietary acid load and risk of type 2 diabetes mellitus: a case–control study. Clin Nutr ESPEN 48, 308312.Google Scholar
Abshirini, M, Bagheri, F, Mahaki, B, et al. (2019) The dietary acid load is higher in subjects with prediabetes who are at greater risk of diabetes: a case–control study. Diabetol Metab Syndr 11, 52.Google Scholar
Park, H, Cho, S, Woo, H, et al. (2017) Fasting glucose and risk of colorectal cancer in the Korean Multi-center Cancer Cohort. PLoS One 12, e0188465.Google Scholar
Tran, TT, Gunathilake, M, Lee, J, et al. (2022) Association between metabolic syndrome and its components and incident colorectal cancer in a prospective cohort study. Cancer 128, 12301241.Google Scholar
Hietavala, EM, Stout, JR, Frassetto, LA, et al. (2017) Dietary acid load and renal function have varying effects on blood acid-base status and exercise performance across age and sex. Appl Physiol Nutr Metab 42, 13301340.Google Scholar
Mansordehghan, M, Daneshzad, E, Basirat, V, et al. (2022) The association between dietary acid load and body composition in physical education students aged 18–25 years. J Health Popul Nutr 41, 58.Google Scholar
Zhang, X, Wu, K, Giovannucci, EL, et al. (2015) Early life body fatness and risk of colorectal cancer in U.S. women and men-results from two large cohort studies. Cancer Epidemiol Biomarkers Prev 24, 690697.Google Scholar
Lee, DH, Keum, N, Hu, FB, et al. (2018) Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ 362, k2575.Google Scholar
Faure, AM, Fischer, K, Dawson-Hughes, B, et al. (2017) Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporos Int 28, 34513462.Google Scholar
Wei, EK, Giovannucci, E, Wu, K, et al. (2004) Comparison of risk factors for colon and rectal cancer. Int J Cancer 108, 433442.Google Scholar
Kapiteijn, E, Liefers, GJ, Los, LC, et al. (2001) Mechanisms of oncogenesis in colon v. rectal cancer. J Pathol 195, 171178.Google Scholar
Supplementary material: File

Tran et al. supplementary material

Tables S1 and S2

Download Tran et al. supplementary material(File)
File 17.9 KB