Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;13(19):2759-2766.
doi: 10.1111/1759-7714.14612. Epub 2022 Aug 21.

Dietary acid load and esophageal cancer risk: A case-control study

Alvaro Luis Ronco  1 , Wilner Martínez-López  2 , Juan M Calderón  3 , Maximilian Andreas Storz  4
Affiliations

Dietary acid load and esophageal cancer risk: A case-control study

Alvaro Luis Ronco et al. Thorac Cancer. 2022 Oct.

Abstract

Background: A high dietary acid load (DAL) can produce metabolic acidosis, which is linked to cancer development through mechanisms of inflammation and cell transformation. There is limited epidemiological evidence linking DAL and cancer risk; however, none of the published studies focused on DAL and esophageal cancer (EC) risk in particular. Therefore, we sought to explore this association in the present study.

Methods: A case-control study was performed in 1295 male patients (185 squamous cell EC cases and 1110 age-frequency and urban/rural residence matched controls) through a multitopic inquiry, including a food frequency questionnaire. Food-derived nutrients were calculated from available databases. The DAL was calculated based on two validated measures: Potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (OR) and their 95% confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusting for confounders.

Results: We found direct, significant associations between dietary acid load and EC risk: (OR = 2.28, 95% CI: 1.44-3.61, ptrend <0.0001) and (OR = 2.17, 95% CI: 1.38-3.41, ptrend <0.0001) for highest PRAL and NEAP tertiles, respectively. Our data raise the possibility that a high DAL may contribute to EC development. Both acid load scores were directly associated with animal-based foods (mainly meat) and inversely associated with the intake of plant-based foods.

Conclusion: To the best of our knowledge, this is the first epidemiological case-control study analyzing associations of DAL and squamous cell EC risk. Further research is warranted to confirm our findings.

Keywords: NEAP; PRAL; cancer; dietary acid load; epidemiology; esophagus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. - PubMed
    1. Uhlenhopp DJ, Then EO, Sunkara T, Gaduputi V. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol. 2020;13(6):1010–21. - PubMed
    1. Jiang N, Ge XL, Zhang ZY, Liu J, Wang PP, Sun XC, et al. <p>prognostic factors for patients with esophageal cancer receiving definitive radiotherapy alone: a retrospective analysis. CMAR. 2021;13:3229–34. - PMC - PubMed
    1. Stabellini N, Chandar AK, Chak A, Barda AJ, Dmukauskas M, Waite K, et al. Sex differences in esophageal cancer overall and by histological subtype. Sci Rep. 2022;12(1):5248. - PMC - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics. CA A Cancer J Clin. 2019;69:7–34. - PubMed

Publication types