Mahjourian Mohammad Matin, Abbasi Hanieh, Hanjani Nazanin Asghari, Hajian Parisa Nezhad, Azadbakht Leila
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
BMC Public Health. 2025 Aug 22;25(1):2891. doi: 10.1186/s12889-025-24249-z.
The rapid increase in the global elderly population poses significant mental health challenges. Dietary factors, particularly dietary acid load, are increasingly recognized as influential factors in mental health and psychological well-being. This study aims to elucidate the associations of dietary acid load with psychological disorders, sleep quality, and mood among Iranian Older Adults.
This study included a randomly selected sample of 398 elderly individuals. Their dietary habits were examined using a validated food frequency questionnaire (FFQ). To estimate dietary acid load, three well-established indices were employed: potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL). Mental health status was evaluated by applying the Iranian version of the Depression, Anxiety, and Stress Scale (DASS-21), which has been validated for accuracy. Furthermore, participants' sleep quality and mood were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Profile of Mood States (POMS), respectively.
In fully adjusted models controlling for demographic, dietary, and lifestyle variables (e.g., age, BMI, socioeconomic status, caffeine intake), individuals in the highest tertile of the DAL index exhibited greater levels of stress than those in the lowest tertile (OR: 3.06, 95% CI = 1.43-6.57, p = 0.003). Elevated PRAL values were also linked to increased depressive symptoms (OR: 2.18, 95% CI = 1.04-4.58, p = 0.032). Higher levels of all three dietary acid load indices were significantly associated with poorer sleep quality (p < 0.05). However, no statistically significant associations were identified between dietary acid load and either anxiety or mood status (p > 0.05).
Elderly individuals with elevated PRAL and DAL values showed increased symptoms of depression and stress, respectively. Additionally, higher dietary acid load was associated with poorer sleep quality. Prospective studies and clinical trials are needed to validate these relationships and to better understand the underlying mechanisms.
全球老年人口的迅速增长带来了重大的心理健康挑战。饮食因素，特别是饮食酸负荷，越来越被认为是影响心理健康和幸福感的因素。本研究旨在阐明伊朗老年人饮食酸负荷与心理障碍、睡眠质量和情绪之间的关联。
本研究随机选取了398名老年人作为样本。使用经过验证的食物频率问卷（FFQ）对他们的饮食习惯进行了调查。为了估计饮食酸负荷，采用了三个成熟的指标：潜在肾酸负荷（PRAL）、净内源性酸产生（NEAP）和饮食酸负荷（DAL）。通过应用已验证准确性的伊朗版抑郁、焦虑和压力量表（DASS - 21）来评估心理健康状况。此外，分别通过匹兹堡睡眠质量指数（PSQI）和情绪状态剖面图（POMS）对参与者的睡眠质量和情绪进行了评估。
在控制了人口统计学、饮食和生活方式变量（如年龄、体重指数、社会经济地位、咖啡因摄入量）的完全调整模型中，DAL指数最高三分位数的个体比最低三分位数的个体表现出更高的压力水平（比值比：3.06，95%置信区间 = 1.43 - 6.57，p = 0.003）。PRAL值升高也与抑郁症状增加有关（比值比：2.18，95%置信区间 = 1.04 - 4.58，p = 0.032）。所有三个饮食酸负荷指数的较高水平均与较差的睡眠质量显著相关（p < 0.05）。然而，未发现饮食酸负荷与焦虑或情绪状态之间存在统计学上的显著关联（p > 0.05）。
PRAL和DAL值升高的老年人分别表现出抑郁和压力症状增加。此外，较高的饮食酸负荷与较差的睡眠质量有关。需要进行前瞻性研究和临床试验来验证这些关系，并更好地理解其潜在机制。
