Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study

Abstract

Metabolic acidosis, which can be affected by dietary acid-base load, seems to be associated with psychological disorders through different pathways. Given limited evidence on dietary acid-base load, we aimed to examine the association of dietary acid-base load with psychological disorders in Iranian women. This cross-sectional study was performed on 447 female subjects (20-50 years old). Dietary intake was assessed using a valid food frequency questionnaire for Iran. Dietary acid-base load was calculated through different indices including potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). To assess psychological disorders, an Iranian validated version of depression, anxiety, and stress scale (DASS-21) was used. The mean value of PRAL, NEAP, and DAL were -8.87mEq/da, 37.94mEq/day, and 30.77mEq/day, respectively. Considering a wide range of confounding variables, compared with the first tertile, a significant positive association was observed between dietary acid-base load and depression (ORPRAL: 3.63; 95 CI:1.97, 6.71; P-trend= 0.0001) (ORNEAP:3.42; 95 CI: 1.87, 6.23; P-trend= 0.0001) (ORDAL: 3.02; 95 CI: 1.64, 5.58; P-trend= 0.0001). Women in the high dietary acid-base load category had higher anxiety (ORPRAL: 3.31; 95 CI: 1.81, 6.06; P-trend= 0.0001) (ORNEAP:3.47; 95 CI: 1.90, 6.33; P-trend= 0.0001) (ORDAL: 3.25; 95 CI: 1.76, 5.98; P-trend= 0.0001). Moreover, there was a strong positive relationship between dietary acid-base load and psychologicaldistress (ORPRAL: 3.79; 95 CI: 2.09, 6.90; P-trend= 0.0001) (ORNEAP: 3.67; 95 CI: 2.04, 6.58; P-trend= 0.0001) (ORDAL: 3.00; 95 CI: 1.66, 5.43; P-trend= 0.0001). Women with higher dietary acid-base load score had greater odds for depression, anxiety, and psychological distress compared to lower ones.