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Yetişkinlerde Diyet Asit Yükü ve Mental Sağlık Arasındaki İlişki: Pilot Çalışma

Year 2026, Volume: 17 Issue: 1 , 7 - 15 , 20.04.2026
https://doi.org/10.22312/sdusbed.1596235
https://izlik.org/JA87WK68JL

Abstract

Amaç: Yetişkinlerde diyet asit yükünün depresyon, anksiyete ve stres üzerine etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmaya 18 yaş ve üzeri ve herhangi bir kronik hastalığı olmayan 251 yetişkin katılımcı (%49 erkek, %51 kadın) dahil edilmiştir. Veriler, anket aracılığıyla toplanmıştır. Anket genel bilgiler, Godin Boş Zaman Fiziksel Aktivite Anketi, Depresyon, Anksiyete Stres (DASS)-21 Ölçeği ve 24 saatlik retrospektif besin tüketim kaydından oluşmaktadır. Diyet asit yükünü değerlendirmek için potansiyel renal asit yükü (PRAL) ve net endojen asit üretimi (NEAP) hesaplamaları kullanılmıştır. Bulgular: Yüksek PRAL ve NEAP gruplarında yaş anlamlı olarak daha düşük, bekar katılımcıların oranı anlamlı olarak daha yüksektir (p<0.05). Diyet asit yükü ile DASS-21 arasında anlamlı bir ilişki bulunamamıştır (p<0.05). Diyet enerjisi, protein, B12 vitamini, niasin, fosfor, çinko alımı ve kırmızı et tüketimi yüksek PRAL ve NEAP gruplarında anlamlı olarak daha yüksektir (p<0.05). Buna karşılık diyet posası, antioksidan, C vitamini, potasyum alımı ve meyve tüketimi anlamlı olarak daha düşüktür (p<0.05). Tiamin, magnezyum ve demirin diyetle alımının artması anksiyete alt ölçek puanında anlamlı bir azalma ile ilişkiliyken (p<0.05); sebze tüketiminin artması DASS-21 toplam ve stres alt ölçek puanlarında anlamlı bir azalma ile ilişkilidir (p<0.05). Sonuç: Bu çalışmada diyet asit yükü ile mental sağlık arasında bir ilişki gösterilememiştir. Ancak batı tarzı beslenme alışkanlıkları ve meyve ve sebze tüketiminin azaltılması diyetin asit yükünü artırarak uzun vadede sağlık sorunlarına neden olabilir.

References

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  • 2. Wieërs ML, Beynon-Cobb B, Visser WJ, Attaye I. Dietary acid load in health and disease. Pflügers Archiv-European Journal of Physiology. 2024;476(4):427-43. doi: 10.1007/s00424-024-02910-7.
  • 3. Frassetto L, Banerjee T, Powe N, Sebastian A. Acid Balance, Dietary Acid Load, and Bone Effects—A Controversial Subject. Nutrients. 2018;10(4):517. doi: 10.3390/nu10040517.
  • 4. Bahari H, Seifi N, Foroumandi E, Kourepaz F, Shahabi HE, Ervin K, et al. Dietary acid load, depression, and anxiety: results of a population-based study. BMC psychiatry. 2023;23(1):679. doi: 10.1186/s12888-023-05163-3.
  • 5. Milajerdi A, Hassanzadeh Keshteli A, Haghighatdoost F, Azadbakht L, Esmaillzadeh A, Adibi P. Dietary acid load in relation to depression and anxiety in adults. Journal of Human Nutrition and Dietetics. 2020;33(1):48-55. doi: 10.1111/jhn.12658.
  • 6. Mirzababaei A, Mehranfar S, Shiraseb F, Abaj F, Hajishizari S, Clark CC, et al. The association of dietary acid-base load with psychological disorders, sleep and circadian rhythm among obese and overweight women: a cross-sectional study. British Journal of Diabetes. 2023;23(2):86-93. doi: 10.15277/bjd.2023.425.
  • 7. Mozaffari H, Siassi F, Guilani B, Askari M, Azadbakht L. Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study. Complementary Therapies in Medicine. 2020;53:102503. doi: 10.1016/j.ctim.2020.102503.
  • 8. Bühlmeier J, Harris C, Koletzko S, Lehmann I, Bauer C-P, Schikowski T, et al. Dietary Acid Load and Mental Health Outcomes in Children and Adolescents: Results from the GINIplus and LISA Birth Cohort Studies. Nutrients. 2018;10(5):582. doi: 10.3390/nu10050582.
  • 9. Godin G, Shephard R. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141-6. PMID: 4053261.
  • 10. Godin G. The Godin-Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada. 2011;4(1):18-22. doi: 10.14288/hfjc.v4i1.82.
  • 11. Yerlisu Lapa T, Yağar G. Serbest Zaman Egzersiz Anketinin Türkçe Geçerlik Güvenirlik Çalışması. 2Uluslararası Spor Bilimleri, Turizm ve Rekreasyon Öğrenci Kongresi; 28-30 Mayıs; Afyon, Türkiye2015. p. 74-5.
  • 12. Lovibond S, editor The nature and measurement of anxiety, stress and depression. 18th Annual Conference of the Australian Psychological Society, University of Western Australia, May; 1983.
  • 13. Lovibond S. Manual for the depression anxiety stress scales. Psychology Foundation of Australia. 1995. doi: 10.1037/t01004-000.
  • 14. Yılmaz Ö, Boz H, Arslan A. Depresyon Anksiyete Stres Ölçeğinin (DASS 21) Türkçe kisa formunun geçerlilik-güvenilirlik çalişmasi. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2(2):78-91.
  • 15. Banerjee T, Crews DC, Wesson DE, Tilea AM, Saran R, Ríos-Burrows N, et al. High dietary acid load predicts ESRD among adults with CKD. Journal of the American Society of Nephrology. 2015;26(7):1693-700. doi: 10.1681/ASN.2014040332.
  • 16. Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. The American journal of clinical nutrition. 1994;59(6):1356-61. doi: 10.1093/ajcn/59.6.1356.
  • 17. Frassetto LA, Todd KM, Morris Jr RC, Sebastian A. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. The American journal of clinical nutrition. 1998;68(3):576-83. doi: 10.1093/ajcn/68.3.576.
  • 18. Abbasalizad Farhangi M, Nikniaz L, Nikniaz Z. Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis. PloS one. 2019;14(5):e0216547. doi: 10.1371/journal.pone.0216547.
  • 19. Sarma S, Sockalingam S, Dash S. Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications. Diabetes, Obesity and Metabolism. 2021;23:3-16. doi: 10.1111/dom.14290.
  • 20. Pascoe M, Bailey AP, Craike M, Carter T, Patten R, Stepto N, et al. Physical activity and exercise in youth mental health promotion: a scoping review. BMJ open sport & exercise medicine. 2020;6(1):e000677. doi: 10.1136/bmjsem-2019-000677.
  • 21. Detopoulou P, Dedes V, Pylarinou I, Syka D, Tzirogiannis K, Panoutsopoulos GI. Dietary acid load is associated with waist circumference in university students with low adherence to the Mediterranean diet: The potential role of ultra-processed foods. Clinical Nutrition ESPEN. 2023;56:43-51. doi: 10.1016/j.clnesp.2023.05.005.
  • 22. Remer T, Manz F. Potential Renal Acid Load of Foods and its Influence on Urine pH. Journal of the American Dietetic Association. 1995;95(7):791-7. doi: 10.1016/S0002-8223(95)00219-7.
  • 23. Mrowicka M, Mrowicki J, Dragan G, Majsterek I. The importance of thiamine (vitamin B1) in humans. Bioscience Reports. 2023;43(10):BSR20230374. doi: 10.1042/BSR20230374.
  • 24. Dhir S, Tarasenko M, Napoli E, Giulivi C. Neurological, psychiatric, and biochemical aspects of thiamine deficiency in children and adults. Frontiers in psychiatry. 2019;10:447129. doi: 10.3389/fpsyt.2019.00207.
  • 25. Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020;12(6):1661. doi: 10.3390/nu12061661.
  • 26. Totten MS, Davenport TS, Edwards LF, Howell JM. Trace Minerals and Anxiety: A Review of Zinc, Copper, Iron, and Selenium. Dietetics. 2023;2(1):83-103. doi: 10.3390/dietetics2010008.
  • 27. Semiz M, Uslu A, Korkmaz S, Demir S, Parlak I, Sencan M, et al. Assessment of subjective sleep quality in iron deficiency anaemia. African health sciences. 2015;15(2):621-7. doi: 10.4314/ahs.v15i2.40.
  • 28. Radavelli-Bagatini S, Blekkenhorst LC, Sim M, Prince RL, Bondonno NP, Bondonno CP, et al. Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan. Clinical Nutrition. 2021;40(5):2860-7. doi: 10.1016/j.clnu.2021.03.043.
  • 29. Radavelli-Bagatini S, Sim M, Blekkenhorst LC, Bondonno NP, Bondonno CP, Woodman R, et al. Associations of specific types of fruit and vegetables with perceived stress in adults: the AusDiab study. European Journal of Nutrition. 2022;61(6):2929-38. doi: 10.1007/s00394-022-02848-5.

Association of Dietary Acid Load and Mental Health in Adults: Pilot Study

Year 2026, Volume: 17 Issue: 1 , 7 - 15 , 20.04.2026
https://doi.org/10.22312/sdusbed.1596235
https://izlik.org/JA87WK68JL

Abstract

Objective: It was aimed to evaluate the effect of dietary acid load on depression, anxiety and stress in adults. Methods: Two hundred and fifty-one adult participants (49% male, 51% female) aged 18 years and over and without any chronic disease were included in the study. The data was collected via a questionnaire. The questionnaire consists of general information, Godin Leisure Time Physical Activity Questionnaire, Depression, Anxiety Stress (DASS)-21 Scale and 24-hour retrospective food consumption record. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) calculations were used to assess dietary acid load. Results: Age was significantly lower, and the ratio of single participants was significantly higher in the high PRAL and NEAP groups (p<0.05). No significant relationship was found between dietary acid load and DASS-21 (p<0.05). Dietary energy, protein, vitamin B12, niacin, phosphorus, zinc intake and red meat consumption were significantly higher in the high PRAL and NEAP groups (p<0.05). On the contrary, dietary fiber, antioxidant, vitamin C, potassium intake and fruit consumption were significantly lower (p<0.05). While increased dietary intake of thiamine, magnesium, and iron was significantly associated with a decrease in anxiety subscale score (p<0.05); increased vegetable consumption was significantly associated with a decrease in DASS-21 scale and stress subscale scores (p<0.05). Conclusion: This study did not demonstrate a relationship between dietary acid load and mental health. However, western style eating habits and reduced fruit and vegetable consumption can increase the acid load of the diet, causing health problems in the long term.

References

  • 1. Osuna-Padilla I, Leal-Escobar G, Garza-García C, Rodríguez-Castellanos F. Dietary acid load: mechanisms and evidence of its health repercussions. Nefrología (English Edition). 2019;39(4):343-54. doi: 10.1016/j.nefro.2018.10.005.
  • 2. Wieërs ML, Beynon-Cobb B, Visser WJ, Attaye I. Dietary acid load in health and disease. Pflügers Archiv-European Journal of Physiology. 2024;476(4):427-43. doi: 10.1007/s00424-024-02910-7.
  • 3. Frassetto L, Banerjee T, Powe N, Sebastian A. Acid Balance, Dietary Acid Load, and Bone Effects—A Controversial Subject. Nutrients. 2018;10(4):517. doi: 10.3390/nu10040517.
  • 4. Bahari H, Seifi N, Foroumandi E, Kourepaz F, Shahabi HE, Ervin K, et al. Dietary acid load, depression, and anxiety: results of a population-based study. BMC psychiatry. 2023;23(1):679. doi: 10.1186/s12888-023-05163-3.
  • 5. Milajerdi A, Hassanzadeh Keshteli A, Haghighatdoost F, Azadbakht L, Esmaillzadeh A, Adibi P. Dietary acid load in relation to depression and anxiety in adults. Journal of Human Nutrition and Dietetics. 2020;33(1):48-55. doi: 10.1111/jhn.12658.
  • 6. Mirzababaei A, Mehranfar S, Shiraseb F, Abaj F, Hajishizari S, Clark CC, et al. The association of dietary acid-base load with psychological disorders, sleep and circadian rhythm among obese and overweight women: a cross-sectional study. British Journal of Diabetes. 2023;23(2):86-93. doi: 10.15277/bjd.2023.425.
  • 7. Mozaffari H, Siassi F, Guilani B, Askari M, Azadbakht L. Association of dietary acid-base load and psychological disorders among Iranian women: A cross-sectional study. Complementary Therapies in Medicine. 2020;53:102503. doi: 10.1016/j.ctim.2020.102503.
  • 8. Bühlmeier J, Harris C, Koletzko S, Lehmann I, Bauer C-P, Schikowski T, et al. Dietary Acid Load and Mental Health Outcomes in Children and Adolescents: Results from the GINIplus and LISA Birth Cohort Studies. Nutrients. 2018;10(5):582. doi: 10.3390/nu10050582.
  • 9. Godin G, Shephard R. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141-6. PMID: 4053261.
  • 10. Godin G. The Godin-Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada. 2011;4(1):18-22. doi: 10.14288/hfjc.v4i1.82.
  • 11. Yerlisu Lapa T, Yağar G. Serbest Zaman Egzersiz Anketinin Türkçe Geçerlik Güvenirlik Çalışması. 2Uluslararası Spor Bilimleri, Turizm ve Rekreasyon Öğrenci Kongresi; 28-30 Mayıs; Afyon, Türkiye2015. p. 74-5.
  • 12. Lovibond S, editor The nature and measurement of anxiety, stress and depression. 18th Annual Conference of the Australian Psychological Society, University of Western Australia, May; 1983.
  • 13. Lovibond S. Manual for the depression anxiety stress scales. Psychology Foundation of Australia. 1995. doi: 10.1037/t01004-000.
  • 14. Yılmaz Ö, Boz H, Arslan A. Depresyon Anksiyete Stres Ölçeğinin (DASS 21) Türkçe kisa formunun geçerlilik-güvenilirlik çalişmasi. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2(2):78-91.
  • 15. Banerjee T, Crews DC, Wesson DE, Tilea AM, Saran R, Ríos-Burrows N, et al. High dietary acid load predicts ESRD among adults with CKD. Journal of the American Society of Nephrology. 2015;26(7):1693-700. doi: 10.1681/ASN.2014040332.
  • 16. Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. The American journal of clinical nutrition. 1994;59(6):1356-61. doi: 10.1093/ajcn/59.6.1356.
  • 17. Frassetto LA, Todd KM, Morris Jr RC, Sebastian A. Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents. The American journal of clinical nutrition. 1998;68(3):576-83. doi: 10.1093/ajcn/68.3.576.
  • 18. Abbasalizad Farhangi M, Nikniaz L, Nikniaz Z. Higher dietary acid load potentially increases serum triglyceride and obesity prevalence in adults: An updated systematic review and meta-analysis. PloS one. 2019;14(5):e0216547. doi: 10.1371/journal.pone.0216547.
  • 19. Sarma S, Sockalingam S, Dash S. Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications. Diabetes, Obesity and Metabolism. 2021;23:3-16. doi: 10.1111/dom.14290.
  • 20. Pascoe M, Bailey AP, Craike M, Carter T, Patten R, Stepto N, et al. Physical activity and exercise in youth mental health promotion: a scoping review. BMJ open sport & exercise medicine. 2020;6(1):e000677. doi: 10.1136/bmjsem-2019-000677.
  • 21. Detopoulou P, Dedes V, Pylarinou I, Syka D, Tzirogiannis K, Panoutsopoulos GI. Dietary acid load is associated with waist circumference in university students with low adherence to the Mediterranean diet: The potential role of ultra-processed foods. Clinical Nutrition ESPEN. 2023;56:43-51. doi: 10.1016/j.clnesp.2023.05.005.
  • 22. Remer T, Manz F. Potential Renal Acid Load of Foods and its Influence on Urine pH. Journal of the American Dietetic Association. 1995;95(7):791-7. doi: 10.1016/S0002-8223(95)00219-7.
  • 23. Mrowicka M, Mrowicki J, Dragan G, Majsterek I. The importance of thiamine (vitamin B1) in humans. Bioscience Reports. 2023;43(10):BSR20230374. doi: 10.1042/BSR20230374.
  • 24. Dhir S, Tarasenko M, Napoli E, Giulivi C. Neurological, psychiatric, and biochemical aspects of thiamine deficiency in children and adults. Frontiers in psychiatry. 2019;10:447129. doi: 10.3389/fpsyt.2019.00207.
  • 25. Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020;12(6):1661. doi: 10.3390/nu12061661.
  • 26. Totten MS, Davenport TS, Edwards LF, Howell JM. Trace Minerals and Anxiety: A Review of Zinc, Copper, Iron, and Selenium. Dietetics. 2023;2(1):83-103. doi: 10.3390/dietetics2010008.
  • 27. Semiz M, Uslu A, Korkmaz S, Demir S, Parlak I, Sencan M, et al. Assessment of subjective sleep quality in iron deficiency anaemia. African health sciences. 2015;15(2):621-7. doi: 10.4314/ahs.v15i2.40.
  • 28. Radavelli-Bagatini S, Blekkenhorst LC, Sim M, Prince RL, Bondonno NP, Bondonno CP, et al. Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan. Clinical Nutrition. 2021;40(5):2860-7. doi: 10.1016/j.clnu.2021.03.043.
  • 29. Radavelli-Bagatini S, Sim M, Blekkenhorst LC, Bondonno NP, Bondonno CP, Woodman R, et al. Associations of specific types of fruit and vegetables with perceived stress in adults: the AusDiab study. European Journal of Nutrition. 2022;61(6):2929-38. doi: 10.1007/s00394-022-02848-5.
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Details

Primary Language English
Subjects Nutrition and Dietetics (Other)
Journal Section Research Article
Authors

Büşra Atabilen Pınar 0000-0002-8485-1763

Submission Date December 4, 2024
Acceptance Date July 4, 2025
Publication Date April 20, 2026
DOI https://doi.org/10.22312/sdusbed.1596235
IZ https://izlik.org/JA87WK68JL
Published in Issue Year 2026 Volume: 17 Issue: 1

Cite

Vancouver 1.Büşra Atabilen Pınar. Association of Dietary Acid Load and Mental Health in Adults: Pilot Study. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2026 Apr. 1;17(1):7-15. doi:10.22312/sdusbed.1596235