Dietary acid load and its association with mental health outcomes in female adolescents: a cross-sectional study

Since it is a rising issue, mental health problems such as depression, anxiety, and stress have gained a lot of attention worldwide, specifically in adolescent generations. In this study, we aimed to explore the association between dietary acid load (DAL) and mental health outcomes in adolescent girls. This cross-sectional study was conducted on 263 adolescent Iranian girls aged 15–18. Dietary intake data of each individual were collected through food frequency questionnaires designed for Iranian people and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) indices were calculated. Depression, anxiety, and stress status of participants were assessed using the Persian version of the Depression, Anxiety, and Stress Scale-21. After adjusting results for energy intake and body mass index, the odds of reporting symptoms of depression was 21% and 68% higher in those in the second and third tertiles of PRAL scores, respectively, compared with those in the first tertile (P = 0.042). The same results were seen between NEAP tertiles, with increasing NEAP scores being associated with a 30% and 63% increase in the odds of reporting symptoms of depression (P = 0.043). Significant positive associations were also observed between both PRAL and NEAP scores and the odds of reporting symptoms of anxiety and stress. Our findings all point to an association between higher DAL and a marked increase in the burden of affective disorders, particularly depression and anxiety in adolescent girls. These results emphasize the potential of dietary interventions aimed at the reduction of dietary acid load to improve mental health outcomes in all, explicitly adolescent girls. Further longitudinal studies are necessary and suggested.