The Association of Dietary Acid-Base Load with Psychological Disorders, Sleep, and Circadian Rhythm among Obese and Overweight Women: A Cross-Sectional Study

Abstract Background: Epidemiologic studies have reported that dietary acid load is associated with psychological disorders through different pathways. We aimed to examine the association of dietary acid-base load with Psychological Disorders, Sleep and circadian rhythm. Methods: This study was performed on 404 female subjects ≥18 years old. We evaluated potential renal acid load (PRAL), net endogenous acid production (NEAP) score by a valid food frequency questionnaire (FFQ) for Iran of with 147 items. To assess psychological disorders, an Iranian validated version of depression, anxiety, and stress scale (DASS-21) was used. The Pittsburgh Sleep Quality Index (PSQI) and morning-evening questionnaire (MEQ) were applied to evaluate sleep quality and circadian rhythm status respectively. Results: Considering a wide range of confounding variables, compared with the low adherence, a significant positive association was observed between dietary acid-base load and severe depression (OR PRAL =1.10, 95%CI=1.01-1.19, P=0.02) and (OR NEAP =2.46, 95%CI=1.41-14.61, P=0.02). Women in the high dietary acid base load category had higher anxiety (ORPRAL=1.12,95%CI=1.02-1.23, P=0.01) and (ORNEAP=1.80,95%CI=1.12-10.72, P=0.01). There was a strong positive relationship between dietary acid-base load and sleep disturbance (P<0.05). Additionally, circadian rhythm assessment showed that those with greater commitment to PRAL had 23% higher risk of being completely E-type, while odds of being completely M-type, was decreased by 15% and 12% across higher adherence to PRAL and NEAP. Conclusion: Women with higher dietary acid-base load score had greater odds for depression, anxiety, psychological distress, sleep disturbance and circadian rhythm compared to lower ones.