The association between dietary acid load and odds of prostate cancer: a case-control study

Sanaz Mehranfar; Yahya Jalilpiran; Haleh Rahimi; Alireza Jafari; Leila Setayesh; Cain C. T. Clark; Shiva Faghih

doi:10.1186/s41043-025-00811-8

The association between dietary acid load and odds of prostate cancer: a case-control study

Sanaz Mehranfar
, Yahya Jalilpiran
, Haleh Rahimi
, Alireza Jafari
, Leila Setayesh
, Cain C. T. Clark
, Shiva Faghih

Tehran University of Medical Sciences
York University
Shiraz University of Medical Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and objective: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population. Methods: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs). Results: Both PRAL (OR = 5.44; 95% CI = 2.09–14.17) and NEAP (OR = 4.88; 95% CI = 2.22–13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11–8.65) and NEAP (OR = 3.88; 95% CI = 1.26–9.55) were significantly associated with increased odds of PC. Conclusion: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

Original language	English
Article number	72
Number of pages	10
Journal	Journal of Health, Population and Nutrition
Volume	44
Issue number	1
Early online date	8 Mar 2025
DOIs	https://doi.org/10.1186/s41043-025-00811-8
Publication status	Published - Dec 2025

Bibliographical note

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the
licensed material..

Funding

This study was financially supported by the Students Research Committee, Shiraz University of Medical Sciences (grant number: 93-01-21-9059).

Funders	Funder number
Shiraz University of Medical Sciences	93-01-21-9059

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Dietary acid load
Prostate cancer
Case-control
Associated factors
NEAP
PRAL

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10.1186/s41043-025-00811-8Licence: CC BY-NC-ND

s41043-025-00811-8Final published version, 1.33 MBLicence: CC BY-NC-ND

Cite this

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title = "The association between dietary acid load and odds of prostate cancer: a case-control study",

abstract = "Background and objective: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population. Methods: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs). Results: Both PRAL (OR = 5.44; 95\% CI = 2.09–14.17) and NEAP (OR = 4.88; 95\% CI = 2.22–13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95\% CI = 1.11–8.65) and NEAP (OR = 3.88; 95\% CI = 1.26–9.55) were significantly associated with increased odds of PC. Conclusion: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.",

keywords = "Dietary acid load, Prostate cancer, Case-control, Associated factors, NEAP, PRAL",

author = "Sanaz Mehranfar and Yahya Jalilpiran and Haleh Rahimi and Alireza Jafari and Leila Setayesh and Clark, \{Cain C. T.\} and Shiva Faghih",

note = " Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material..",

year = "2025",

month = dec,

doi = "10.1186/s41043-025-00811-8",

language = "English",

volume = "44",

journal = "Journal of Health, Population and Nutrition",

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T1 - The association between dietary acid load and odds of prostate cancer

T2 - a case-control study

AU - Mehranfar, Sanaz

AU - Jalilpiran, Yahya

AU - Rahimi, Haleh

AU - Jafari, Alireza

AU - Setayesh, Leila

AU - Clark, Cain C. T.

AU - Faghih, Shiva

N1 - Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material..

PY - 2025/12

Y1 - 2025/12

N2 - Background and objective: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population. Methods: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs). Results: Both PRAL (OR = 5.44; 95% CI = 2.09–14.17) and NEAP (OR = 4.88; 95% CI = 2.22–13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11–8.65) and NEAP (OR = 3.88; 95% CI = 1.26–9.55) were significantly associated with increased odds of PC. Conclusion: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

AB - Background and objective: Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population. Methods: One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs). Results: Both PRAL (OR = 5.44; 95% CI = 2.09–14.17) and NEAP (OR = 4.88; 95% CI = 2.22–13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11–8.65) and NEAP (OR = 3.88; 95% CI = 1.26–9.55) were significantly associated with increased odds of PC. Conclusion: Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

KW - Dietary acid load

KW - Prostate cancer

KW - Case-control

KW - Associated factors

KW - NEAP

KW - PRAL

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DO - 10.1186/s41043-025-00811-8

M3 - Article

SN - 1606-0997

VL - 44

JO - Journal of Health, Population and Nutrition

JF - Journal of Health, Population and Nutrition

IS - 1

M1 - 72

ER -

The association between dietary acid load and odds of prostate cancer: a case-control study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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