Dietary acid load is associated with quality of life in overweight and obese adult in Iranian women: a cross sectional study

Epidemiologic investigations have shown that dietary acid load (DAL) is associated with some limited quality of life (QoL) markers; however, according to the documents available so far, the association of this dietary pattern with QoL among overweight and obese women is not clear. Therefore, this study aimed to evaluate the association of DAL and QoL among overweight and obese adult women. This cross-sectional study included 377 overweight and obese women. A validated food frequency questionnaire (FFQ) was used to assess dietary intake. DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP). QoL was assessed using the 36-item Short-Form Health Survey (SF-36). Linear regression models were applied with progressive adjustment for potential confounders including age, body mass index, physical activity, smoking, marital status, education, occupation, supplement use, and total energy intake. In crude analyses, both NEAP and PRAL were positively associated with the General Health and Physical Functioning domains of the SF-36. After adjustment for age, body mass index, physical activity, smoking status, marital status, educational level, occupational status, supplement use, and total energy intake (Model 2), higher NEAP remained significantly associated with General Health (β = 3.23, 95% CI: 0.05, 6.40; P = 0.04). The association with Physical Functioning was no longer statistically significant (β = 2.72, 95% CI: -0.33, 5.78; P = 0.08). Higher PRAL also showed a borderline positive association with General Health (β = 3.15, 95% CI: -0.11, 6.43; P = 0.05) and Physical Functioning (β = 3.09, 95% CI: -0.05, 6.25; P = 0.05) after adjusting all confounders. No significant associations were observed between DAL indices and total SF-36 scores after multivariable adjustment. In this cross-sectional study, higher dietary acid load was associated with better general health and physical functioning among overweight and obese Iranian women. These findings should be confirmed in prospective studies.