Objective: Dietary acid load contributes to metabolic acidosis, which leads to inflammation and cell transformation, closely linked to cancer development. The epidemiologic evidence associating diet-dependent acid load and cancer risk, particularly for prostate cancer, is severely limited, based on a single study. Therefore, we sought to explore this association in the present study. Patients and Methods: A case-control study was performed in 1292 patients (323 cases and 969 age-frequency and urban/rural residence matched controls), through a multi-topic inquiry including a food frequency questionnaire. Food-derived nutrients were calculated from available databases. Dietary acid load was calculated based on two validated measures (Potential Renal Acid Load score and Net Endogenous Acid Production score). Odds ratios and their 95% confidence intervals were estimated by logistic regression, adjusting for potential confounders. Results: We found direct associations between dietary acid load and prostate cancer risk. Both acid load scores were significantly associated with an increased prostate cancer risk (odds ratios =1.56 and =1.81 for highest Potential Renal Acid Load and Net Endogenous Acid Production, respectively). Linear trends were found in both risk estimates. Conclusions: A high dietary acid load may contribute to prostate cancer development. Both acid load scores were directly associated with animal-based foods (mainly meat) intake, and inversely associated with plant-based foods intake. Our findings are consistent with previous studies associating certain dietary patterns with an increased prostate cancer risk. However, further research is warranted to confirm the present findings.
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