Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Dietary Assessment
2.3. Depression Assessment
2.4. Physical Health Assessment
2.5. Other Assessment
2.6. Statistical Analysis
3. Results
3.1. Baseline Descriptive Statistics
3.2. Baseline Characteristics by Quartile of PRAL and Depression
3.3. Mean SF-36 Physical Health Composite Score
3.4. Independent Impact of Dietary Acid Load and Depression on Physical Health
3.5. Joint Impact of Dietary Acid Load and Depression on Physical Health
3.6. Secondary Analyses: Independent Impacts of Dietary Acid Load and Depression on Physical Health Based on Age and Hormone Receptor Status
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Value (n = 2944) |
---|---|
Age, mean (SD) | 50.8 (8.8) |
Alcohol, n (%) | |
Abstainer | 928 (31.5) |
Drinker | 2016 (60.5) |
BMI, n (%) | |
Normal | 1265 (43) |
Overweight | 907 (30.8) |
Obese | 772 (26.2) |
Smoking Status, n (%) | |
Current | 133 (4.5) |
Former | 1224 (41.6) |
Never | 1587 (53.9) |
Ethnicity, n (%) | |
White | 2515 (85.4) |
Menopause, N (%) | |
Premenopausal | 327 (11.1) |
Perimenopausal | 274 (9.3) |
Postmenopausal | 2339 (79.5) |
Depression, n (%) | |
Depressed | 608 (20.7) |
Not depressed | 2336 (79.4) |
Radiation, n (%) | |
Yes | 1808 (61.4) |
No | 1132 (38.5) |
Chemotherapy, n (%) | |
Yes | 2052 (69.7) |
No | 890 (30.2) |
Stage, N (%) | |
I | 1138 (38.7) |
II | 1659 (56.4) |
IIIA | 147 (5.0) |
METS, n (%) | |
0–600 | 1468 (49.8) |
600–1200 | 688 (23.4) |
>1200 | 788 (26.8) |
PRAL Score (mEq/day) | Depression | |||||||
---|---|---|---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | p-Value | Depressed | Not Depressed | p-Value | |
Age at Dx, mean (SD) | 52.1 (8.1) | 52.4 (8.6) | 50.8 (8.8) | 48.8 (9.0) | <0.0001 | 49.5 (8.6) | 51.1 (8.9) | <0.0001 |
BMI (kg/m2), n (%) | <0.0001 | <0.0001 | ||||||
Normal | 257 (59.9) | 391 (50.2) | 337 (38.4) | 280 (32.6) | 220 (36.2) | 1045 (44.7) | ||
Overweight | 116 (27.0) | 230 (29.5) | 316 (36.0) | 245 (28.6) | 181 (29.8) | 726 (31.1) | ||
Obese | 56 (13.1) | 158 (20.3) | 225 (25.6) | 333 (38.8) | 207 (34.1) | 565 (24.2) | ||
Ethnicity, n (%) | <0.0001 | 0.0022 | ||||||
White, non-Hispanic | 391 (91.1) | 698 (89.6) | 750 (85.4) | 676 (78.8) | 503 (82.7) | 2012 (86.1) | ||
Menopause, n (%) | 0.0001 | 0.0021 | ||||||
Premenopausal | 31 (7.3) | 67 (8.6) | 98 (11.1) | 131 (15.2) | 67 (11.0) | 260 (11.1) | ||
Perimenopausal | 34 (8.0) | 65 (8.4) | 84 (9.5) | 91 (10.6) | 79 (13.0) | 195 (8.4) | ||
Postmenopausal | 360 (84.7) | 642 (82.7) | 700 (79.1) | 637 (74.1) | 460 (75.7) | 1879 (80.4) | ||
Radiation, n (%) | 0.4423 | 0.2758 | ||||||
Yes | 265 (61.8) | 493 (63.3) | 519 (59.1) | 531 (61.9) | 380 (62.5) | 1428 (61.1) | ||
No | 164 (38.2) | 286 (36.7) | 357 (40.7) | 325 (37.9) | 226 (37.2) | 906 (38.8) | ||
Chemotherapy, n (%) | 0.0117 | 0.3829 | ||||||
Yes | 283 (66.0) | 512 (65.7) | 631 (71.9) | 626 (73.0) | 436 (71.7) | 1616 (69.2) | ||
No | 146 (34.0) | 266 (34.2) | 246 (28.0) | 232 (27.0) | 172 (28.3) | 718 (30.7) | ||
Stage, n (%) | 0.5610 | 0.2306 | ||||||
I | 169 (39.4) | 297 (38.1) | 332 (37.8) | 340 (39.6) | 251 (41.3) | 887 (38.0) | ||
II | 238 (55.5) | 449 (57.6) | 506 (57.6) | 466 (54.3) | 324 (53.3) | 1335 (57.2) | ||
IIIA | 22 (5.1) | 33 (4.2) | 40 (4.6) | 52 (6.1) | 33 (5.4) | 114 (4.9) | ||
METS, n (%) | <0.0001 | <0.0001 | ||||||
0–600 | 144 (33.6) | 341 (43.8) | 473 (53.9) | 510 (59.4) | 360 (59.2) | 1108 (47.4) | ||
600–1200 | 114 (26.6) | 206 (26.4) | 206 (23.5) | 162 (18.9) | 134 (22.0) | 554 (23.7) | ||
>1200 | 171 (39.9) | 232 (29.8) | 199 (22.7) | 186 (21.7) | 114 (18.8) | 674 (28.9) | ||
Smoking status, n (%) | 0.2777 | 0.1718 | ||||||
Former | 193 (45.0) | 325 (41.7) | 360 (41.0) | 346 (40.3) | 259 (42.6) | 965 (41.3) | ||
Current | 10 (2.3) | 37 (4.8) | 41 (4.7) | 45 (5.2) | 35 (5.8) | 98 (4.2) | ||
Never | 226 (52.7) | 417 (53.5) | 477 (54.3) | 467 (54.4) | 314 (51.6) | 1273 (54.5) |
PRAL Score (mEq/day) | NEAP Score (mEq/day) | Depression | ||||||
---|---|---|---|---|---|---|---|---|
Q1 | Q4 β (p-Value) | p-Trend | Q1 | Q4 β (p-Value) | p-Trend | Not Depressed | Depressed β (p-Value) | |
Physical function | ||||||||
Age-adjusted | Ref | −7.79 (<0.0001) | <0.001 | Ref | −7.78 (<0.0001) | <0.0001 | Ref | −9.18 (<0.0001) |
Multi-model | Ref | −2.00 (0.001) | 0.01 | Ref | −2.08 (0.0015) | 0.0008 | Ref | −6.77 (<0.0001) |
Physical role limitation | ||||||||
Age-adjusted | Ref | −6.57 (<0.0001) | <0.0001 | Ref | −8.01 (<0.0001) | <0.0001 | Ref | −21.09 (<0.0001) |
Multi-model | Ref | −1.00 (0.44) | 0.04 | Ref | −1.94 (0.14) | 0.03 | Ref | −18.4 (<0.0001) |
Bodily pain | ||||||||
Age-adjusted | Ref | −5.18 (<0.0001) | <0.0001 | Ref | −5.91 (<0.0001) | <0.0001 | Ref | −13.78 (<0.0001) |
Multi-model | Ref | −0.89 (0.28) | 0.32 | Ref | −1.37 (0.11) | 0.002 | Ref | −11.71 (<0.0001) |
General health | ||||||||
Age-adjusted | Ref | −4.90 (<0.0001) | <0.0001 | Ref | −5.65 (<0.0001) | <0.0001 | Ref | −13.35 (<0.0001) |
Multi-model | Ref | −7.70 (0.30) | 0.07 | Ref | −1.24 (0.08) | 0.09 | Ref | −11.32 (<0.0001) |
Overall physical health | ||||||||
Age-adjusted | Ref | −6.09 (<0.0001) | <0.0001 | Ref | −6.79 (<0.0001) | <0.0001 | Ref | −14.37 (<0.0001) |
Multi-model | Ref | −1.12 (0.10) | 0.058 | Ref | −1.56 (0.03) | 0.005 | Ref | −12.07 (<0.0001) |
PRAL Score (mEq/day) | ||
---|---|---|
<Median Odds Ratio (95% Confidence Interval) | ≥Median OR (95% Confidence Interval) | |
Physical function | ||
Not depressed | Ref | 1.28 (1.11–1.47) ** |
Depressed | 2.36 (1.86–2.99) ** | 2.75 (2.18–3.47) ** |
Physical role limitation | ||
Not depressed | Ref | 1.15 (1.00–1.31) * |
Depressed | 2.32 (1.86–2.91) ** | 2.47 (2.03–3.00) ** |
Bodily pain | ||
Not depressed | Ref | 1.16 (1.03–1.31) * |
Depressed | 2.06 (1.66–2.55) ** | 2.56 (2.10–3.12) ** |
General health | ||
Not depressed | Ref | 1.15 (1.02–1.30) * |
Depressed | 2.78 (2.21–3.50) ** | 3.30 (2.67–4.08) ** |
Overall physical health | ||
Not depressed | Ref | 1.16 (1.02–1.31) * |
Depressed | 2.49 (1.99–3.11) ** | 3.10 (2.53–3.80) ** |
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Tessou, K.D.; Lemus, H.; Hsu, F.-C.; Pierce, J.; Hong, S.; Brown, L.; Wu, T. Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors. Nutrients 2021, 13, 2422. https://doi.org/10.3390/nu13072422
Tessou KD, Lemus H, Hsu F-C, Pierce J, Hong S, Brown L, Wu T. Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors. Nutrients. 2021; 13(7):2422. https://doi.org/10.3390/nu13072422
Chicago/Turabian StyleTessou, K. Daniel, Hector Lemus, Fang-Chi Hsu, John Pierce, Suzi Hong, Lauren Brown, and Tianying Wu. 2021. "Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors" Nutrients 13, no. 7: 2422. https://doi.org/10.3390/nu13072422
APA StyleTessou, K. D., Lemus, H., Hsu, F.-C., Pierce, J., Hong, S., Brown, L., & Wu, T. (2021). Independent and Joint Impacts of Acid-Producing Diets and Depression on Physical Health among Breast Cancer Survivors. Nutrients, 13(7), 2422. https://doi.org/10.3390/nu13072422