SavedAdd your journal

Journals / Bilecik Şeyh Edebali Üniversitesi Sağlık Bilimleri Fakültesi Dergisi / 2026 / Volume: 4 Issue: 1

A Study to Examine the Relationship Between Dietary Acid Load and Oral Health-Related Quality of Life in Adolescents

Adolesanlarda Diyet Asit Yükü ile Ağız Sağlığıyla ilgili Yaşam Kalitesi Arasındaki İlişkiyi İncelemeye Yönelik Bir Araştırma

Emine Elibol(ANKARA YILDIRIM BEYAZIT UNIVERSITY)0000-0002-6166-0825
Ayşe Nur Esen(ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0009-0007-7048-1478
Emine Demirci(ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0009-0001-7946-1752
Nural Erzurum Alim(ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0001-9931-0639
Pages
—
Publication Date
2026-01-01
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, these findings indicate that adolescents with a higher dietary acid load have poorer oral health outcomes and a lower oral health-related quality of life.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:This study aimed to examine the relationship between dietary acid load and oral health-related quality of life in adolescents.
📊
Key Findings & Data:A total of 374 adolescents participated by completing a demographic questionnaire and the Oral Health Impact Profile-14 (OHIP-14) scale.
💡
Conclusion & Impact:In conclusion, these findings indicate that adolescents with a higher dietary acid load have poorer oral health outcomes and a lower oral health-related quality of life.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Dietary acid load · Oral health · Quality of life

Abstract

This study aimed to examine the relationship between dietary acid load and oral health-related quality of life in adolescents. A total of 374 adolescents participated by completing a demographic questionnaire and the Oral Health Impact Profile-14 (OHIP-14) scale. Additionally, 24-hour recall food consumption records were gathered. The dietary acid load (DAL) was evaluated through the calculation of net endogenous acid production (NEAP) and potential renal acid load (PRAL). Data analysis was conducted using the SPSS 24 software package. Students who regularly visited the dentist had higher OHIP-14, NEAP, and PRAL values than those who did not (p<0.05). The OHIP-14 scale score of students with mouth sores was 11.75±11.12 compared to 6.88±7.18 in those without sores (p<0.05). Furthermore, DAL was shown to have a positive effect on the total score of the OHIP-14 scale (p<0.05). In conclusion, these findings indicate that adolescents with a higher dietary acid load have poorer oral health outcomes and a lower oral health-related quality of life. These results highlight the potential impact of dietary patterns on oral health and emphasize the importance of promoting balanced, alkaline-rich diets during adolescence.

Özet

Bu çalışmada, adolesanlarda diyet asit yükü ile ağız sağlığı ile ilişkili yaşam kalitesi arasındaki ilişkinin incelenmesi amaçlanmıştır. Toplam 374 adolesana, demografik yapı anketi ve Ağız Sağlığı Etki Profili-14 (OHIP-14) ölçeği uygulanmıştır ve 24 saatlik geriye dönük besin tüketim kayıtları toplandı. Diyet asit yükü (DAL), potansiyel böbrek asit yükü (PRAL) ve net endojen asit üretimi (NEAP) hesaplanarak değerlendirilmiştir. Veri analizi SPSS 24 yazılım paketi kullanılarak yapılmıştır. Düzenli olarak diş hekimine giden öğrencilerin OHIP-14, NEAP ve PRAL değerleri gitmeyenlere göre daha yüksek saptanmıştır (p<0,05). Ağız yarası olan öğrencilerin OHIP-14 ölçek puanı 11,75±11,12 iken, yarası olmayan öğrencilerin OHIP-14 ölçek puanı 6,88±7,18 olarak bulunmuştur (p<0,05). Ayrıca, diyet asit yükünün OHIP-14 ölçeğinin toplam puanı üzerinde olumlu bir etkisi olduğu saptanmıştır (p<0,05). Sonuç olarak; bu bulgular, diyet asit yükü yüksek olan ergenlerde ağız sağlığı sonuçlarının daha kötü ve yaşam kalitesinin daha düşük olduğunu göstermektedir. Bu sonuçlar, beslenme alışkanlıklarının ağız sağlığı üzerindeki potansiyel etkisini vurgulamakta ve ergenlik döneminde dengeli, alkali yönünden zengin diyetlerin teşvik edilmesinin önemine dikkat çekmektedir.

🔖

Cite This Article

Elibol, E., Esen, A. N., Demirci, E., Alim, N. E. (2026). A Study to Examine the Relationship Between Dietary Acid Load and Oral Health-Related Quality of Life in Adolescents. Bilecik Şeyh Edebali Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, Volume: 4 Issue: 1. https://doi.org/10.61535/bseusbfd.1638663

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (57)

  1. Alexy, U., Kersting, M., & Remer, T. (2008). Potential renal acid load in the diet of children and adolescents: impact of food groups, age and time trends. Public Health Nutr., 11(3), 300-306. https://doi.org/10.1017/S1368980007000328
  2. Alexy, U., Remer, T., Manz, F., Neu, C.M., & Schoenau, E. (2005). Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children. Am J Clin Nutr, 82(5), 1107–1114. https://doi.org/10.1093/ajcn/82.5.1107
  3. Alshloul, M. N. (2023). Oral health knowledge, attitude, and practice among school children in Abha-Saudi Arabia. The Journal of School Nursing, 39(4), 295-304. https://doi.org/10.1177/10598405211012981
  4. Apelbaum, D. N., Pomarico, L., Graciene, A., & Valente, L. R. (2011). Erosão ácida em Odontopediatria: um desafio dos nossos dias Acid erosion in Pediatric Dentistry: a challenge of our days. Revista Brasileira de Odontologia, 68(2), 229–232.
  5. Başol, M.E., Karaağaçlıoğlu, L., & Yılmaz, B. (2014). Türkçe Ağız Sağlığı Etki Ölçeğinin geliştirilmesi-OHIP-14-TR. Turkiye Klinikleri J Dental Sci, 20(2), 85-92. https://tr-scales.arabpsychology.com/wp-content/uploads/pdf/agiz-sagligi-etki-olcegi-toad.pdf adresinden erişildi.
  6. Bühlmeier, J., Harris, C., Koletzko, S., Lehmann, I., Bauer, C.P., Schikowski, T., … & Libuda, L. (2018). Dietary acid load and mental health outcomes in children and adolescents: results from the GINIplus and LISA birth cohort studies. Nutrients, 10(5), 582. https://doi.org/10.3390/nu10050582
  7. Čanković, D., Mastilović, G., Canković, M., Radić, I., Harhaji, S., & Canković, S. (2021). The association between the frequency of dental visits and independent factors among adults aged 20 years and over in Serbia. Vojnosanitetski Pregled, 78(8), 874-881. https://doi.org/10.2298/VSP190924006C
  8. Chamut, S., Alhassan, M., Hameedaldeen, A., Kaplish, S., Yang, A.H., Wade, C.G., … Chandel, T. (2024). Every bite counts to achieve oral health: a scoping review on diet and oral health preventive practices. Int J Equity Health, 23(1), 261. https://doi.org/10.1186/s12939-024-02279-0
  9. Chapain, K. P., Rampal, K. G., Gaulee-Pokhrel, K., Adhikari, C., Hamal, D., & Pokhrel, K. N. (2023). Influence of gender and oral health knowledge on DMFT index: a cross sectional study among school children in Kaski District, Nepal. BMC Oral Health, 23(1), 59. https://doi.org/10.1186/s12903-023-02755-z
  10. Cooke, L.J., & Wardle, J. (2005). Age and gender differences in children’s food preferences. British Journal of Nutrition, 93(5), 741-6. https://doi.org/10.1079/bjn20051389
  11. Das, P., Mishra, L., Jena, D., Govind, S., Panda, S., & Lapinska, B. (2022). Oral health-related quality of life in children and adolescents with a traumatic injury of permanent teeth and the impact on their families: A systematic review. Int J Environ Res Public Health, 19(5), 3087. https://doi.org/10.3390/ijerph19053087
  12. DiNicolantonio, J.J., & O’Keefe, J. (2021). Low-grade metabolic acidosis as a driver of chronic disease: A 21st century public health crisis. Open Heart, 8(2), e001730. https://doi.org/10.1136/openhrt-2021-001730
  13. Dolati, S., Razmjouei, S., Alizadeh, M., Faghfouri, A.H., & Moridpour, A.H. (2024). A high dietary acid load can potentially exacerbate cardiometabolic risk factors: An updated systematic review and meta-analysis of observational studies. Nutrition, Metabolism and Cardiovascular Diseases, 34(3), 569-580. https://doi.org/10.1016/j.numecd.2024.01.013
  14. Dumuid, D., Olds, T., Lewis, L.K., Martin-Fernández, J.A., Katzmarzyk, P.T., Barreira, T., … Maher, C. International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) research group. (2017). Health-related quality of life and lifestyle behavior clusters in school-aged children from 12 countries. J Pediatr, 183, 178-183.e2. https://doi.org/10.1016/j.jpeds.2016.12.048
  15. Ebispro for Windows, Stuttgart, Germany; Turkish Version (BeBiS 9), (2021), Pasifik Elektirik Elektronik Ltd. Şti. (www.bebis.com.tr); Istanbul.
  16. Elibol, E., & Karabudak, E. (2016). Hemodiyaliz hastalarında diyet asit yükü (DAL) ile kardiyovasküler risk etmenleri arasındaki ilişki: Pilot çalışma. Beslenme ve Diyet Dergisi, 44(1), 38-46. https://beslenmevediyetdergisi.org/index.php/bdd/article/view/79/50 adresinden erişildi.
  17. Frassetto, L.A., Todd, K.M., Morris, R.C. Jr. & Sebastian, A. (1998) Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents, American Journal of Clinical Nutrition, 68(3), 576–583. https://doi.org/10.1093/ajcn/68.3.576.
  18. Ghasemi, F., Abbasi, K., Ghiasvand, R., Clark, C.C.T., & Rouhani, M.H. (2023). The association between dietary acid load and risk of attention-deficit hyperactivity disorder: a case-control study. Child Neuropsychology, 29, 474–485. https://doi.org/10.1080/09297049.2022.2099536.
  19. Gholami, F., Naghshi, S., Samadi, M., Rasaei, N., & Mirzaei, K. (2022). Dietary acid load and bone health: A systematic review and meta-analysis of observational studies. Frontiers in Nutrition, 9, 869132. https://doi.org/10.3389/fnut.2022.869132
  20. Herter, J., Lederer, A.K., Ronco, A.L., Hannibal, L., Huber, R., & Storz, M.A. (2023). Dietary acid load correlates with serum amino acid concentrations after a four-week intervention with vegan vs. meat-rich diets: A secondary data analysis. Nutrients, 15(13), 2942. https://doi.org/10.3390/nu15132942
  21. Jawdekar, A. M., Kamath, S., Kale, S., & Mistry, L. (2022). Assessment of oral health-related quality of life (OHRQoL) in children with molar incisor hypomineralization (MIH) - A systematic review and meta-analysis of observational studies. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 40(4), 368-376. https://doi.org/10.4103/jisppd.jisppd_27_23
  22. Kantorowicz, M., Olszewska-Czyż, I., Lipska, W., Kolarzyk, E., Chomyszyn-Gajewska, M., Darczuk, D., & Kaczmarzyk, T. (2022). Impact of dietary habits on the incidence of oral diseases. Dent Med Probl, 59(4), 547–554. https://doi.org/10.17219/dmp/134749
  23. Kaur, H. (2023). Diet, nutrition and oral health. International Dental Journal of Student's Research, 11(1), 1-4. https://doi.org/10.18231/j.idjsr.2023.002
  24. Konyalıgil, N., Çiçek, B., Tekin, T., & Sönmez, M. Ü. (2022). Evaluation of the relationship between quality of life and dietary acid load in obese women. Karya Journal of Health Science, 3(2), 145-149. https://doi.org/10.52831/kjhs.1137880
  25. Lennon, E.J., Lemann, J. Jr. & Litzow, J.R. (1966) ‘The effect of diet and stool composition on the net external acid balance of normal subjects’, Journal of Clinical Investigation, 45, 1601–1607. https://doi.org/10.1172/JCI105466.
  26. Lohman, T. G., Roche, A. F., & Martorell, R. (1988). Anthropometric standardization reference manual. Human Kinetics Books.
  27. López, M., Moreno, G., Lugo, G., & Marcano, G. (2020). Dietary acid load in children with chronic kidney disease. European Journal of Clinical Nutrition, 74, 57–62. https://doi.org/10.1038/s41430-020-0687-3
  28. López-Sayers, M., Bernal, J., & López, M. (2015). Dietary potential renal acid load in Venezuelan children. Nutrición Hospitalaria, 31(5), 2054-2061. https://doi.org/10.3305/nh.2015.31.5.8187.
  29. Luzardo, M.L. (2025). Effects of higher dietary acid load: a narrative review with special emphasis in children. Pediatric Nephrology, 40(1), 25-37. https://doi.org/10.1007/s00467-024-06466-7
  30. Mladenović, N., & Ugrinović, H. (2024). Specificities of acid-base balance disorders in children. Galenika Medical Journal, 3(9), 21–28. https://doi.org/10.5937/galmed2411020m
  31. Muros, J. J., Salvador-Pérez, F., Zurita-Ortega, F., Gámez-Sánchez, V. M., & Knox, E. (2017). The association between healthy lifestyle behaviors and health-related quality of life among adolescents. Journal of Pediatrics (Rio J), 93(4), 406-412. https://doi.org/10.1016/j.jped.2016.10.005
  32. Naito, M. (2023). Quality of life assessment in oral health. Annals of Japan Prosthodontic Society. https://doi.org/10.2186/ajps.15.164
  33. Nepaul, P., & Mahomed, O. (2020). Influence of parents’ oral health knowledge and attitudes on oral health practices of children (5–12 years) in a rural school in KwaZulu-Natal, South Africa. Journal of International Society of Preventive and Community Dentistry, 10(5), 605-612. https://doi.org/10.4103/jispcd.JISPCD_273_20
  34. Noor, A. (2025). Improving oral health and quality of life in vulnerable populations. Journal of Medical Internet Research. https://doi.org/10.2196/preprints.60310.
  35. Omara, M., Stamm, T., & Bekes, K. (2021). Four‐dimensional oral health‐related quality of life impact in children: A systematic review. Journal of Oral Rehabilitation, 48(3), 293-304. https://doi.org/10.1111/joor.13066
  36. Özdemir, D. S. (2023). Çocuk hastaların diş hekimine başvuru nedenleri. Journal of International Dental Sciences, 9(1), 26-33. https://doi.org/10.21306/dishekimligi.1220703
  37. Pérez-Rodrigo, C., Ribas, L., Serra-Majem, L., & Aranceta, J. (2003). Food preferences of Spanish children and young people: the enKid study. European Journal of Clinical Nutrition, 57 Suppl 1, S45-8. https://doi.org/10.1038/sj.ejcn.1601814
  38. Rakıcıoğlu, N., Tek, N., Ayaz, A., & Pekcan, A. (2010). Yemek ve besin fotoğraf kataloğu ölçü ve miktarlar (9th edit). Ankara: Nobel Tıp Kitabevleri.
  39. Portella, P.D., Menoncin, B.L.V., de Souza, J.F., de Menezes, J.V.N.B., Fraiz, F.C., & Assunção, L.R.D.S. (2019). Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: A hierarchical approach. Int J Paediatr Dent, 29(4), 496-506. https://doi.org/10.1111/ipd.12482
  40. Rafiq, T., Aqeel, R., Javed, M., Yousaf, L., Bano, S., & Akbar, A. (2024). Diet and oral health: An investigation into the impact of Pakistani dietary habits on oral disease prevalence. Cureus, 16(10), e71423. https://doi.org/10.7759/cureus.71423
  41. Remer, T., Dimitriou, T., & Manz, F. (2003). Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. American Journal of Clinical Nutrition, 77(5), 1255–1260. https://doi.org/10.1093/ajcn/77.5.1255
  42. Remer, T. & Manz, F. (1994) ‘Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein’, American Journal of Clinical Nutrition, 59, 1356–1361. https://doi.org/10.1093/ajcn/59.6.1356
  43. Remer, T. & Manz, F. (1995) ‘Potential renal acid load of foods and its influence on urine pH’, Journal of the American Dietetic Association, 95(7), 791–797. https://doi.org/10.1016/S0002-8223(95)00219-7
  44. Sahın, N., & Gunsen, U. (2023). Dietary acid load and cardiovascular diseases. Critical Reviews in Food Science and Nutrition, 63(28), 9033-9038. https://doi.org/10.1080/10408398.2022.2066063
  45. Sharma, V., Yadav, A., Thakur, A., Dubey, S., Mohanty, L., & Paul, R. (2019). Knowledge about oral health, hygiene and practices among under-graduate and post-graduate dental students in the state of Jharkhand in Eastern India. International Journal of Research in Health and Allied Sciences, 5(5), 1–6. https://ijrhas.com/uploadfiles/1Oralhealthvol5issue5p1-6.20190927122524.pdf adresinden erişildi.
  46. Shi, L., Libuda, L., Schönau, E., Frassetto, L., & Remer, T. (2012). Long term higher urinary calcium excretion within the normal physiologic range predicts impaired bone status of the proximal radius in healthy children with higher potential renal acid load. Bone, 50(5), 1026–1031. https://doi.org/10.1016/j.bone.2012.01.026
  47. Slade, G.D., & Spencer, A.J. (1994). Development and evaluation of the Oral Health Impact Profile. Community Dent Health, 11(1), 3-11. https://pubmed.ncbi.nlm.nih.gov/8193981/ adresinden erişildi.
  48. Sravani, M., Collins, S., & Iyengar, A. (2024). Assessment of dietary acid load in children with chronic kidney disease: An observational study. Indian Journal of Nephrology, 34(1), 50-55. https://doi.org/10.4103/ijn.ijn_29_23
  49. Staberg, M., Norén, J.G., Gahnberg, L., Ghaderi, A., Kadesjö, C., & Robertson, A. (2016). Behavioural characteristics in externalising children with low and elevated risk for dental caries. European Archives of Paediatric Dentistry, 17(6), 475-484. https://doi.org/10.1007/s40368-016-0256-6
  50. Suresh, C., Veeraraghavan, V. P., Jayaraman, S., Gayathri, R., & Kavitha, S. (2022). Awareness about the significance of acid–base balance of saliva in maintaining oral health. Journal of Advanced Pharmaceutical Technology & Research, 13(Suppl 1), S325–S329. https://doi.org/10.4103/japtr.japtr_402_22
  51. Vidal, A., Pineda, C., Raya, A.I., Rios, R., Espartero, A., Muñoz-Castañeda, J.R., Rodriguez, M., Aguilera-Tejero, E., & Lopez, I. (2022). Oral acid load down-regulates fibroblast growth factor 23. Nutrients, 14(5), 1041. https://doi.org/10.3390/nu14051041
  52. Williams, R.S., Heilbronn, L.K., Chen, D.L., Coster, A.C., Greenfield, J.R., & Samocha-Bonet, D. (2016). Dietary acid load, metabolic acidosis and insulin resistance - Lessons from cross-sectional and overfeeding studies in humans. Clin Nutr., 35(5), 1084-1090. https://doi.org/10.1016/j.clnu.2015.08.002
  53. World Health Organization (WHO). Body Mass Index (BMI). Retrieved from https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed October 18, 2024.
  54. Yahia, E. M., García-Solís, P., & Celis, M. E. (2019). Contribution of fruits and vegetables to human nutrition and health. In Postharvest physiology and biochemistry of fruits and vegetables (pp. 19–45). Chelmsford, UK: Woodland Publishing.
  55. Yahia, E. M., Maldonado-Celis, M. E., & Svendsen, M. (2017). The contribution of fruit and vegetable consumption to human health. In Fruit and vegetable phytochemicals: Chemistry and human health (Vol. 2, p. 52). Hoboken, New Jersey: John Wiley & Sons. https://doi.org/10.1002/9781119158042.ch1
  56. Zare, M.J., Madani, S., & Ahmadi, A. (2024). Association between dietary acid load and depression, anxiety, and stress: A systematic review. International Journal of Nutrition Sciences, 10(1). https://doi.org/10.30476/ijns.2024.101366.1308
  57. Zervaki, K., Yiannakouris, N., Sdrali, D., & Costarelli, V. (2017). Diet quality, disordered eating, and health-related quality of life in Greek adolescents. Nutrition & Food Science, 47(4), 511–521. https://doi.org/10.1108/NFS-12-2016-0189