Dietary Acid Load, Serum Polychlorinated Biphenyl Levels, and Mortality Following Breast Cancer in the Long Island Breast Cancer Study Project

Briana N. C. Chronister, Tianying Wu, Regina M. Santella, Alfred I. Neugut, Mary S. Wolff, Jia Chen, Susan L. Teitelbaum and Humberto Parada
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Briana N. C. Chronister: Herbert Wertheim School of Public Health, University of California, San Diego, CA 92093, USA
Tianying Wu: School of Public Health, San Diego State University, San Diego, CA 92182, USA
Regina M. Santella: Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10027, USA
Alfred I. Neugut: Department of Medicine, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10027, USA
Mary S. Wolff: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Jia Chen: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Susan L. Teitelbaum: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Humberto Parada: School of Public Health, San Diego State University, San Diego, CA 92182, USA

IJERPH, 2021, vol. 19, issue 1, 1-13

Abstract: Dietary acid load (DAL) may be associated with all-cause mortality (ACM) and breast cancer-specific mortality (BCM), and these associations may be modified by serum polychlorinated biphenyl (PCB) levels. Participants included 519 women diagnosed with first primary in situ or invasive breast cancer in 1996/1997 with available lipid-corrected PCB data. After a median of 17 years, there were 217 deaths (73 BCM). Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from a baseline food frequency questionnaire estimated DAL. Cox regression estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between PRAL and NEAP with mortality. We evaluated effect measure modification by total serum PCB levels (>median vs. ≤median). PRAL quartile 4 versus quartile 1 was associated with an ACM HR of 1.31 (95%CI = 0.90–1.92). In the upper median of PCBs, ACM HRs were 1.43 (95%CI = 0.96–2.11) and 1.40 (95%CI = 0.94–2.07) for PRAL and NEAP upper medians, respectively. In the lower median of PCBs, the upper median of NEAP was inversely associated with BCM (HR = 0.40, 95%CI = 0.19–0.85). DAL may be associated with increased risk of all-cause mortality following breast cancer among women with high total serum PCB levels, but inversely associated with breast cancer mortality among women with low PCB levels.

Keywords: dietary acid load; potential renal acid load; net endogenous acid production; breast cancer; mortality; survival; polychlorinated biphenyls (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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