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Fowler ME, Akinyemiju TF. Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. Int J Cancer 2017; 141:2215-2227. [PMID: 28795402 DOI: 10.1002/ijc.30922] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/27/2017] [Accepted: 07/25/2017] [Indexed: 01/08/2023]
Abstract
Proinflammatory dietary patterns have been associated with increased cancer risk and mortality. We present a systematic review and meta-analysis of the current published literature on a dietary inflammatory index (DII) score and its association with cancer risk and mortality outcomes. Published articles from online databases (PubMed, Scopus, and Embase) examining the association between DII and any cancer risk, incidence, or mortality between 1980 and November 2016 were selected for review. Results of studies meeting inclusion criteria were summarized and meta-analyzed using STATA to generate summary measures of association across studies. Sixty-three published articles were identified from the search, and following title, abstract and full-text review, twenty-four studies met inclusion criteria. All articles calculated DII scores based on study-specific food-frequency questionnaires using methodology from the same article. Of the 24 included studies, 13 were case-control, 6 were prospective cohort, 1 was a retrospective cohort, 3 were RCTs, and 1 did not specify study design. The most common cancers examined were colorectal, breast, lung, and prostate. Individuals in the highest versus lowest DII categories had 25% increased risk of overall cancer incidence (RR: 1.25, 95% CI: 1.16-1.35), 75% higher odds of cancer (OR: 1.75, 95% CI: 1.43-2.16) and 67% increased risk of cancer mortality (RR: 1.67, 95% CI: 1.13-2.48). Upon stratification for cancer type, positive associations remained (RRbreast : RR: 1.12, 95% CI: 1.03-1.22) (RRcolorectal : 1.33, 95% CI: 1.22-1.46) (RRlung : 1.30, 95% CI: 1.13-1.50). There were consistent and significant positive associations between higher DII and cancer incidence and mortality across cancer types, study populations, and study design.
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Affiliation(s)
- Mackenzie E Fowler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Tomi F Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.,Department of Epidemiology, University of Kentucky, Lexington, KY
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Shivappa N, Blair CK, Prizment AE, Jacobs DR, Hébert JR. Dietary inflammatory index and risk of renal cancer in the Iowa Women's Health Study. Eur J Nutr 2017; 57:1207-1213. [PMID: 28251340 DOI: 10.1007/s00394-017-1403-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 02/10/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The association between inflammatory potential of diet and renal cancer risk has not been investigated. METHODS In this study, we explored the association between the dietary inflammatory index (DII) and risk of renal cancer in the Iowa Women's Health Study. From 1986 to 2011, 33,817 women initially recruited at 55-69 years of age were followed for incident renal cancers (n = 263). The DII was computed based on dietary intake assessed using a reproducible and valid 121-item food frequency questionnaire. Cox proportional hazards regression was used to estimate hazard ratios (HR) adjusting for age, body mass index, energy intake, smoking status, education, pack years of smoking, hypertension, and hormone replacement therapy. RESULTS Multivariable analyses revealed positive association between higher DII scores and renal cancer risk (HR for DIIcontinuous: 1.07 per unit increase in DII (corresponding to 10% change in the DII range in the current study); 95% CI 1.00, 1.15; HR for DIItertile3vs1 = 1.52; 95% CI 1.09, 2.13). Stratified analyses produced slightly stronger associations between DII and renal cancer risk among women with BMI <30 kg/m2 (HRTertile3vs1 = 1.57; 95% CI = 1.04, 2.36) and ever smokers (HRtertile3vs1 = 2.35; 95% CI = 1.22, 4.55), although the corresponding interaction p values were not significant. CONCLUSION Pro-inflammatory diet, as indicated by higher DII scores, was associated with increased renal cancer risk.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA. .,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. .,Connecting Health Innovation, 1417 Gregg St, Columbia, SC, 29250, USA.
| | - Cindy K Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, 87131, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA
| | - Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Connecting Health Innovation, 1417 Gregg St, Columbia, SC, 29250, USA
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