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Alternative Healthy Eating Index 2010, Dietary Inflammatory Index and risk of mortality: results from the Whitehall II cohort study and meta-analysis of previous Dietary Inflammatory Index and mortality studies. Br J Nutr 2017; 118:210-221. [PMID: 28831955 DOI: 10.1017/s0007114517001908] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We aimed to examine the association between the Alternative Healthy Eating Index updated in 2010 (AHEI-2010), the Dietary Inflammatory Index (DIITM) and risk of mortality in the Whitehall II study. We also conducted a meta-analysis on the DII-based results from previous studies to summarise the overall evidence. Data on dietary behaviour assessed by self-administered repeated FFQ and on mortality status were available for 7627 participants from the Whitehall II cohort. Cox proportional hazards regression models were performed to assess the association between cumulative average of AHEI-2010 and DII scores and mortality risk. During 22 years of follow-up, 1001 participants died (450 from cancer, 264 from CVD). Both AHEI-2010 (mean=48·7 (sd 10·0)) and DII (mean=0·37 (sd 1·41)) were associated with all-cause mortality. The fully adjusted hazard ratio (HR) per sd, were 0·82; 95 % CI 0·76, 0·88 for AHEI-2010 and 1·18; 95 % CI 1·08, 1·29 for DII. Significant associations were also observed with cardiovascular and cancer mortality risk. For DII, a meta-analysis (using fixed effects) from this and four previous studies showed a positive association of DII score with all-cause (HR=1·04; 95 % CI 1·03, 1·05, 28 891deaths), cardiovascular (HR=1·05; 95 % CI 1·03, 1·07, 10 424 deaths) and cancer mortality (HR=1·05; 95 % CI 1·03, 1·07, n 8269).The present study confirms the validity to assess overall diet through AHEI-2010 and DII in the Whitehall II cohort and highlights the importance of considering diet indices related to inflammation when evaluating all-cause, cardiovascular and cancer mortality risk.
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102
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Tabung FK, Steck SE, Ma Y, Liese AD, Zhang J, Lane DS, Ho GYF, Hou L, Snetselaar L, Ockene JK, Hebert JR. Changes in the Inflammatory Potential of Diet Over Time and Risk of Colorectal Cancer in Postmenopausal Women. Am J Epidemiol 2017; 186:514-523. [PMID: 28486621 DOI: 10.1093/aje/kwx115] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022] Open
Abstract
We examined the associations between changes in dietary inflammatory potential and risk of colorectal cancer (CRC) in 87,042 postmenopausal women recruited from 1993-1998 by the Women's Health Initiative, conducted in the United States. Food frequency questionnaire data were used to compute patterns of change in dietary inflammatory index (DII) scores and cumulative average DII scores over 3 years. Cox regression models were used to estimate hazard ratios for CRC risk. After a median of 16.2 years of follow-up, 1,038 CRC cases were diagnosed. DII changes were not substantially associated with overall CRC, but proximal colon cancer risk was higher in the proinflammatory-change DII group than in the antiinflammatory-stable DII group (hazard ratio = 1.32, 95% confidence interval: 1.01, 1.74). Among nonusers of nonsteroidal antiinflammatory drugs (NSAIDs) (Pinteraction = 0.055), the proinflammatory-stable DII group was at increased risk of overall CRC and proximal colon cancer. Also among nonusers of NSAIDs, risks of overall CRC, colon cancer, and proximal colon cancer were higher in the highest quintile compared with the lowest cumulative average DII quintile (65%, 61%, and 91% higher risk, respectively). Dietary changes toward, or a history of, proinflammatory diets are associated with an elevated risk of colon cancer, particularly for proximal colon cancer and among nonusers of NSAIDs.
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103
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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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104
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Tabung FK, Smith-Warner SA, Chavarro JE, Fung TT, Hu FB, Willett WC, Giovannucci EL. An Empirical Dietary Inflammatory Pattern Score Enhances Prediction of Circulating Inflammatory Biomarkers in Adults. J Nutr 2017; 147:1567-1577. [PMID: 28659407 PMCID: PMC5525108 DOI: 10.3945/jn.117.248377] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/27/2017] [Accepted: 06/05/2017] [Indexed: 01/14/2023] Open
Abstract
Background: Two indexes exist to describe dietary inflammatory potential: an empirical dietary inflammatory pattern (EDIP) composed of food groups as reported on a food-frequency questionnaire (FFQ) and a literature-derived dietary inflammatory index (DII) composed mainly of nutrients.Objective: We compared the ability of the 2 indexes to predict concentrations of inflammatory markers and hypothesized that the EDIP would be more predictive because it was derived on the basis of circulating inflammatory markers.Methods: Both EDIP and DII scores were calculated from FFQ data reported by 5826 women in the Nurses' Health Study II and 5227 men in the Health Professionals Follow-Up Study. We used multivariable-adjusted linear regression analyses to calculate relative differences in concentrations of 4 plasma inflammatory markers-C-reactive protein (CRP; milligrams per liter), interleukin 6 (IL-6; picograms per milliliter), tumor necrosis factor α receptor 2 (TNFαR2; picograms per milliliter), and adiponectin (nanograms per milliliter)-in quintiles of the dietary indexes.Results: Spearman correlations between the EDIP and DII scores were modest (r = 0.29 and 0.21 for women and men, respectively; all P < 0.0001). Higher scores on both dietary indexes were associated with higher concentrations of inflammatory markers, although they were associated with lower adiponectin concentrations and there was no association between the DII and adiponectin in men. For example, percentage differences in concentrations of biomarkers in quintile 5 generally were higher (lower for adiponectin) than in quintile 1 (for the EDIP and DII, respectively-women: CRP, +60% and +49%; IL-6, +23% and +21%; TNFαR2, +7% and +4%; adiponectin, -21% and -14%; men: CRP, +38% and +29%; IL-6, +14% and +24%; TNFαR2, +9% and +5%; adiponectin, -16% and -4%.)Conclusion: Despite design differences, the EDIP and DII both assess dietary inflammatory potential in men and women, with the EDIP showing a greater ability to predict concentrations of plasma inflammatory markers.
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Affiliation(s)
- Fred K Tabung
- Departments of Nutrition and .,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Stephanie A Smith-Warner
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jorge E Chavarro
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Teresa T Fung
- Departments of Nutrition and,Department of Nutrition, Simmons College, Boston, MA
| | - Frank B Hu
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Walter C Willett
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Edward L Giovannucci
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
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105
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Shivappa N, Hébert JR, Rosato V, Rossi M, Montella M, Serraino D, La Vecchia C. Dietary Inflammatory Index and Renal Cell Carcinoma Risk in an Italian Case-Control Study. Nutr Cancer 2017; 69:833-839. [PMID: 28718670 PMCID: PMC6089838 DOI: 10.1080/01635581.2017.1339815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The relation between diet-related inflammation and renal cell carcinoma (RCC) has not been investigated. METHODS In this study, we explored the association between the dietary inflammatory index (DII) and RCC in an Italian case-control study conducted between 1992 and 2004. Cases were 767 patients with incident, histologically confirmed RCC. Controls were 1534 subjects admitted to the same hospitals as cases for various acute, nonneoplastic conditions. The DII was computed based on dietary intake assessed using a reproducible and valid 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models conditioned on age, sex, and center, and adjusted for recognized confounding factors, including total energy intake. RESULTS Subjects in the highest quartile of DII scores (i.e., with the most proinflammatory diets) had a higher risk of RCC compared to subjects in the lowest quartile [OR 1.41, 95% confidence interval (CI) 1.02, 1.97; p-trend = 0.04)]. Apparently stronger associations were observed among females (OR 1.68, 95% CI 0.93, 3.03), subjects aged <60 yr (OR 1.77, 95% CI 1.05, 2.98), body mass index ≥25 kg/m2 (OR 1.64, 95% CI 1.07, 2.51), and ever smokers (OR 1.66, 95% CI 1.08, 2.57), in the absence of significant heterogeneity. CONCLUSION A proinflammatory diet is associated with increased RCC 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 Innovations LLC, Columbia, SC, 29201, 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 Innovations LLC, Columbia, SC, 29201, USA
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, 29208, USA
| | - Valentina Rosato
- Department of Clinical Sciences and Community Health. Università degli Studi di Milano, Milan, Italy
- Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health. Università degli Studi di Milano, Milan, Italy
| | - Maurizio Montella
- SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano (PN), Italy
| | - Diego Serraino
- Dipartimento di Epidemiologia, ‘Fondazione G. Pascale’, Istituto Nazionale Tumori, Naples, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health. Università degli Studi di Milano, Milan, Italy
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106
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Fan Y, Jin X, Man C, Gao Z, Wang X. Meta-analysis of the association between the inflammatory potential of diet and colorectal cancer risk. Oncotarget 2017; 8:59592-59600. [PMID: 28938662 PMCID: PMC5601758 DOI: 10.18632/oncotarget.19233] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/30/2017] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The inflammatory potential of diet has been inconsistently linked to colorectal cancer (CRC) risk. This meta-analysis aimed to evaluate the association of the inflammatory potential of diet, as estimated by the dietary inflammatory index (DII) score, with CRC risk. MATERIALS AND METHODS The PubMed and Embase databases were searched for relevant studies from inception to February 2017. All cohort and case-control studies investigating the association of the DII score with CRC risk were selected. RESULTS Four prospective cohorts and four case-control studies, which enrolled a total of 880,380 participants, were included. The pooled adjusted risk ratio (RR) of CRC for the highest DII score versus the lowest category was 1.43 (95% confidence interval [CI]: 1.26-1.62). When stratified by study design, the RRs for the case-control and cohort studies were 1.27 (95% CI: 1.16-1.38) and 1.81 (95% CI: 1.48-2.22), respectively. Subgroup analysis showed that individuals with the highest category of DII score were independently associated with CRC risk in men (RR=1.51; 95% CI: 1.29-1.76), women (RR=1.25; 95% CI: 1.10-1.41), colon cancer (RR=1.39; 95% CI: 1.19-1.62), and rectal cancer (RR=1.32; 95% CI: 1.01-1.74). However, the pooled RR was 1.07 (95% CI: 0.87-1.31) for rectal cancer among the prospective cohort studies. CONCLUSIONS As estimated by a high DII score, pro-inflammatory diet is independently associated with increased CRC risk. This finding confirms that low inflammatory potential diet may reduce CRC risk. However, the gender- and cancer site-specific associations of the DII score with CRC risk need to be further investigated.
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Affiliation(s)
- Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Xin Jin
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Changfeng Man
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Zhenjun Gao
- Department of Digestive Disease, Central Hospital of Shanghai Qingpu District, Shanghai, 201700, China
| | - Xiaoyan Wang
- Department of Digestive Disease, The First People's Hospital of Suqian City, Suqian, Jiangsu, 223800, China
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107
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Abstract
BACKGROUND & AIMS The deleterious effect of cariogenic dietary patterns on tooth loss is well characterized, but the contribution of diet-borne systemic inflammation to loss of teeth remains uncharted. Recent efforts have unveiled a protective role of single nutrients to periodontal health. However, the assessment of overall diet as a modifiable risk factor for oral health remains elusive. Thus, the aim of this study was to assess the association between diet-borne systemic inflammation and tooth loss in a representative sample of the US adult non-institutionalized population. METHODS A cross-sectional analysis of a sample of participants of the 2009-2010 and 2011-2012 continuous NHANES receiving an oral exam and providing dietary recall data was performed. Dietary inflammatory potential was assessed by the Dietary Inflammatory Index (DII), a composite measure computed based on the association between nutrients and systemic pro-inflammatory cytokine levels. The outcome measure was prevalent tooth loss. Numbers of missing teeth were regressed across quartiles of the DII using multivariable linear regression models. RESULTS 6887 eligible NHANES participants were included in the analysis; participants in the highest quartile of the DII index (pro-inflammatory diet) had an average [95% CI] of 0.84 [0.24, 1.45] additional more teeth lost as compared to those in the lowest quartile of DII (anti-inflammatory diet) (p = 0.015), after adjusting for known confounders. This significant association remained in subgroup analyses, including the lowest tertiles of energy-adjusted carbohydrate intake, and in persons aged ≥50 years. CONCLUSIONS Adherence to an anti-inflammatory diet is associated with fewer missing teeth. These results suggest protective dietary patterns as a modifiable protective factor for tooth loss in the US adult population and support the incorporation of tooth loss prevention in the agenda of dietary public health interventions to prevent chronic inflammatory diseases.
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108
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Dietary inflammatory index and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study. Br J Nutr 2017; 117:1323-1331. [PMID: 28571591 DOI: 10.1017/s0007114517001131] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The dietary inflammatory index (DIITM) is a novel composite score based on a range of nutrients and foods known to be associated with inflammation. DII scores have been linked to the risk of a number of cancers, including oesophageal squamous cell cancer and oesophageal adenocarcinoma (OAC). Given that OAC stems from acid reflux and that the oesophageal epithelium undergoes a metaplasia-dysplasia transition from the resulting inflammation, it is plausible that a high DII score (indicating a pro-inflammatory diet) may exacerbate risk of OAC and its precursor conditions. The aim of this analytical study was to explore the association between energy-adjusted dietary inflammatory index (E-DIITM) in relation to risk of reflux oesophagitis, Barrett's oesophagus and OAC. Between 2002 and 2005, reflux oesophagitis (n 219), Barrett's oesophagus (n 220) and OAC (n 224) patients, and population-based controls (n 256), were recruited to the Factors influencing the Barrett's Adenocarcinoma Relationship study in Northern Ireland and the Republic of Ireland. E-DII scores were derived from a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of oesophageal lesions according to E-DII intakes, adjusting for potential confounders. High E-DII scores were associated with borderline increase in odds of reflux oesophagitis (OR 1·87; 95 % CI 0·93, 3·73), and significantly increased odds of Barrett's oesophagus (OR 2·05; 95 % CI 1·22, 3·47), and OAC (OR 2·29; 95 % CI 1·32, 3·96), when comparing the highest with the lowest tertiles of E-DII scores. In conclusion, a pro-inflammatory diet may exacerbate the risk of the inflammation-metaplasia-adenocarcinoma pathway in oesophageal carcinogenesis.
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109
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Zaslavsky O, Zelber-Sagi S, Hebert JR, Steck SE, Shivappa N, Tabung FK, Wirth MD, Bu Y, Shikany JM, Orchard T, Wallace RB, Snetselaar L, Tinker LF. Biomarker-calibrated nutrient intake and healthy diet index associations with mortality risks among older and frail women from the Women's Health Initiative. Am J Clin Nutr 2017; 105:1399-1407. [PMID: 28424183 PMCID: PMC5445680 DOI: 10.3945/ajcn.116.151530] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/24/2017] [Indexed: 01/26/2023] Open
Abstract
Background: Although studies to date have confirmed the association between nutrition and frailty, the impact of dietary intake and dietary patterns on survivorship in those with frailty is yet to be examined in a well-powered cohort with validated frailty status. Moreover, previous studies were limited by measurement error from dietary self-reports.Objective: We derived biomarker-calibrated dietary energy and protein intakes to address dietary self-report error. Using these data, we then evaluated the association of mortality in older women with frailty and dietary intake and healthy diet indexes, such as the alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII).Design: The analytic sample included 10,034 women aged 65-84 y with frailty and complete dietary data from the Women's Health Initiative Observational Study. Frailty was assessed with modified Fried's criteria. Dietary data were collected by food-frequency questionnaire.Results: Over a mean follow-up period of 12.4 y, 3259 (31%) deaths occurred. The HRs showed progressively decreased rates of mortality in women with higher calibrated dietary energy intakes (P-trend = 0.003), higher calibrated dietary protein intakes (P-trend = 0.03), higher aMED scores (P-trend = 0.006), and higher DASH scores (P-trend = 0.02). Although the adjusted point estimates of HRs (95% CIs) for frail women scoring in the second, third, and fourth quartiles on DII measures were 1.15 (1.03, 1.27), 1.28 (1.15, 1.42), and 1.24 (1.12, 1.38), respectively, compared with women in the first quartile, no overall effect was observed across quartiles (P-trend = 0.35). Subgroup analyses by chronic morbidity or smoking status or by excluding women with early death did not substantially change these findings.Conclusions: The current study highlights the importance of nutrition in older, frail women. Diet quality and quantity should be considered in managing persons with frailty.
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Affiliation(s)
| | - Shira Zelber-Sagi
- Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel
| | - James R Hebert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Fred K Tabung
- Department of Nutrition and Epidemiology, Harvard University, Cambridge, MA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Yunqi Bu
- Department of Biostatistics, University of Washington, Seattle, WA
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama, Birmingham, AL
| | - Tonya Orchard
- College of Education and Human Ecology, Ohio State University, Columbus, OH
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA; and
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA; and
| | - Lesley F Tinker
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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110
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Sharma I, Zhu Y, Woodrow JR, Mulay S, Parfrey PS, Mclaughlin JR, Hebert JR, Shivappa N, Li Y, Zhou X, Wang PP. Inflammatory diet and risk for colorectal cancer: A population-based case-control study in Newfoundland, Canada. Nutrition 2017; 42:69-74. [PMID: 28870481 DOI: 10.1016/j.nut.2017.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/08/2017] [Accepted: 05/17/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Chronic inflammation is implicated in causing cancer. Diet plays an important role in regulating chronic inflammation by altering circulating levels of inflammatory biomarkers. Effect of single food or nutrient on cancer often is inconclusive; perhaps due to dietary interactions and multicolinearity. The aim of this study was to determine prediagnostic inflammatory potential of overall diet in relation to risk for colorectal cancer (CRC). METHODS In all, 547 patients with CRC from Newfoundland Familial Colorectal Cancer Registry and 685 controls from the general population were identified. Data on sociodemographic, medical history, lifestyle, and a 169-item food frequency questionnaire were collected retrospectively from both groups. Energy-adjusted Dietary Inflammatory Index (DII) score was calculated and used as both categorical and continuous variables for analysis. Odds ratio was estimated using multivariable logistic regression after adjusting potential confounders. A linear test for trend was performed using the median value in each quartile. RESULTS Overall energy-adjusted mean DII score was -0.81 (range -5.19 to 6.93). Cases (-0.73 ± 1.5) had slightly higher DII scores than controls (-0.89 ± 1.6; P = 0.04). After adjusting the potential confounders, a statistically significant association was found between DII score and CRC risk. Using DII as a continuous variable (odds ratio [OR]continuous 1.10, 95% confidence interval [CI] 1.01-1.20) and categorical variable (ORquartile 1 versus 4 1.65, 95% CI 1.13-2.42; Ptrend = 0.02). CONCLUSION Our findings indicate that proinflammatory diets are associated with an increased risk for CRC in the Newfoundland population.
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Affiliation(s)
- Ishor Sharma
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Yun Zhu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Jennifer R Woodrow
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Shree Mulay
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Patrick S Parfrey
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - James R Hebert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA; Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA; Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Yuming Li
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of Chinese People's Armed Police Force, Tianjin, China
| | - Xin Zhou
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Logistics University of Chinese People's Armed Police Force, Tianjin, China
| | - Peizhong Peter Wang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
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111
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Ramallal R, Toledo E, Martínez JA, Shivappa N, Hébert JR, Martínez-González MA, Ruiz-Canela M. Inflammatory potential of diet, weight gain, and incidence of overweight/obesity: The SUN cohort. Obesity (Silver Spring) 2017; 25:997-1005. [PMID: 28544794 DOI: 10.1002/oby.21833] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study prospectively assessed the association of the inflammatory potential of a diet using the dietary inflammatory index (DII) with average yearly weight changes and incident overweight/obesity. METHODS Seven thousand and twenty-seven university graduates with body mass index <25 from the Seguimiento Universidad de Navarra (SUN) cohort were followed up during a median of 8.1 years. The DII, a validated tool based on scientific evidence to appraise the relationship between dietary parameters and inflammatory biomarkers, was used. A validated food-frequency questionnaire was used to assess intake of total energy, food, and nutrients, from which DII scores were calculated at baseline and after 10 years of follow-up. RESULTS After a median follow-up of 8.1 years, 1,433 incident cases of overweight or obesity were observed. Hazard ratios for overweight/obesity were calculated, including multivariable time-dependent Cox regression models with repeated measures of diet. The hazard ratio for subjects in the highest quartile (most pro-inflammatory diet) was 1.32 (95% confidence interval 1.08-1.60) compared with participants in the lowest quartile (most anti-inflammatory diet), with a significant linear dose-response relationship (P = 0.004). Consistently, increases in average yearly weight gains were significantly associated with proinflammatory diets. CONCLUSIONS A proinflammatory diet was significantly associated with a higher annual weight gain and higher risk of developing new-onset overweight or obesity.
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Affiliation(s)
- Raúl Ramallal
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Department of Cardiology, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Servicio Navarro de Salud, Pamplona, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Ciber de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Dietary inflammatory index and non-Hodgkin lymphoma risk in an Italian case-control study. Cancer Causes Control 2017; 28:791-799. [PMID: 28503716 DOI: 10.1007/s10552-017-0905-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND While dietary factors have been shown to play an important etiologic role in non-Hodgkin lymphoma (NHL), little is known about the association between inflammatory properties of diet and NHL risk. METHODS We explored the association between the dietary inflammatory index (DII) and NHL risk in a multicenter Italian case-control study conducted between 1999 and 2014. Cases were 536 subjects with incident, histologically confirmed NHL from three areas in Italy. Controls were 984 subjects admitted to the same network of hospitals as the cases for acute, nonmalignant conditions, unrelated to diet. DII scores were computed based on 30 nutrients and food items assessed using a reproducible and validated 78-item food-frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake, and other recognized confounding factors. RESULTS Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of NHL compared with subjects in the lowest quartile (i.e., with the most anti-inflammatory diets) (ORQuartile4vs1 1.61, 95% confidence interval CI 1.07-2.43; p-trend = 0.01). Stratified analyses produced stronger associations between DII and NHL among males (ORQuartile4vs1 2.14; 95% CI 1.25-3.67) with significant heterogeneity (p value = 0.02); when analyzed by histologic subtype, a significant association was observed with diffuse large B-cell lymphoma (ORQuartile4vs1 1.84; 95% CI 1.09-3.10). CONCLUSION A pro-inflammatory diet, as indicated by higher DII scores, is associated with elevated odds of NHL, especially among males.
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Orchard T, Yildiz V, Steck SE, Hébert JR, Ma Y, Cauley JA, Li W, Mossavar-Rahmani Y, Johnson KC, Sattari M, LeBoff M, Wactawski-Wende J, Jackson RD. Dietary Inflammatory Index, Bone Mineral Density, and Risk of Fracture in Postmenopausal Women: Results From the Women's Health Initiative. J Bone Miner Res 2017; 32:1136-1146. [PMID: 28019686 PMCID: PMC5413384 DOI: 10.1002/jbmr.3070] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 12/18/2022]
Abstract
Previous studies suggest that bone loss and fracture risk are associated with higher inflammatory milieu, potentially modifiable by diet. The primary objective of this analysis was to evaluate the association of the dietary inflammatory index (DII), a measure of the inflammatory potential of diet, with risk of hip, lower-arm, and total fracture using longitudinal data from the Women's Health Initiative Observational Study and Clinical Trials. Secondarily, we evaluated changes in bone mineral density (BMD) and DII scores. DII scores were calculated from baseline food frequency questionnaires (FFQs) completed by 160,191 participants (mean age 63 years) without history of hip fracture at enrollment. Year 3 FFQs were used to calculate a DII change score. Fractures were reported at least annually; hip fractures were confirmed by medical records. Hazard ratios for fractures were computed using multivariable-adjusted Cox proportional hazard models, further stratified by age and race/ethnicity. Pairwise comparisons of changes in hip BMD, measured by dual-energy X-ray absorptiometry from baseline, year 3, and year 6 were analyzed by quartile (Q1 = least inflammatory diet) of baseline DII scores in a subgroup of women (n = 10,290). Mean DII score improved significantly over 3 years (p < 0.01), but change was not associated with fracture risk. Baseline DII score was only associated with hip fracture risk in younger white women (HR Q4,1.48; 95% CI, 1.09 to 2.01; p = 0.01). There were no significant associations among white women older than 63 years or other races/ethnicities. Women with the least inflammatory DII scores had less loss of hip BMD (p = 0.01) by year 6, despite lower baseline hip BMD, versus women with the most inflammatory DII scores. In conclusion, a less inflammatory dietary pattern was associated with less BMD loss in postmenopausal women. A more inflammatory diet was associated with increased hip fracture risk only in white women younger than 63 years. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Tonya Orchard
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Vedat Yildiz
- Women's Health Initiative Midwest Regional Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Susan E Steck
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jane A Cauley
- Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wenjun Li
- Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Maryam Sattari
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Meryl LeBoff
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Rebecca D Jackson
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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114
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Zhang ZQ, Cao WT, Shivappa N, Hebert JR, Li BL, He J, Tang XY, Liang YY, Chen YM. Association Between Diet Inflammatory Index and Osteoporotic Hip Fracture in Elderly Chinese Population. J Am Med Dir Assoc 2017; 18:671-677. [PMID: 28411093 DOI: 10.1016/j.jamda.2017.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic inflammation provides the substrate for various mechanisms involved in osteoporotic fracture. The Dietary Inflammatory Index (DII) could shed light on the effect of the inflammatory potential of the diet on osteoporotic hip fracture. OBJECTIVE This study tested the hypothesis that higher DII scores are associated with greater hip fracture risk in an elderly Chinese population. METHODS A 1:1 age- (±3 years), sex- and region-matched case-control study of 1050 pairs (female/male: 781/269) of elderly (age range = 52-83 years) Chinese was conducted in Guangdong, China (2009-2015). Cases were newly diagnosed (within 2 weeks) hip fracture patients and controls were recruited from either communities (n = 835 controls) or the hospital (n = 215). DII scores were calculated from self-reports using a validated 79-item food frequency questionnaire. Odds ratios (ORs) and their 95% confidence intervals (CIs) of the risk of hip fracture for DII scores were estimated from conditional logistic regression. RESULTS The multivariable-adjusted ORs (95% CIs) for hip fracture across quartiles of DII scores were 1 (reference), 1.42 (1.01, 1.99), 1.63 (1.16, 2.28), and 2.44 (1.73, 3.45) (P trend <.001). Comparing extreme quartiles, the adjusted ORs (95% CIs) for hip fractures were 2.08 (1.38, 3.12) for female and 4.30 (1.89, 9.80) for male participants, respectively (P interaction = .26). When stratified by the source of controls, a dose-response positive relationship was observed between DII scores and hip fracture risk among community-based controls but not those from the hospital (P interaction = .16). CONCLUSIONS A proinflammatory diet appears to be positively associated with hip fracture risk.
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Affiliation(s)
- Zhe-Qing Zhang
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China; Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wen-Ting Cao
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC
| | - Bao-Lin Li
- Guangzhou Orthopaedics Trauma Hospital, Guangzhou, China
| | - Juan He
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xin-Yi Tang
- The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ya-Yong Liang
- The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Ming Chen
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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115
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The association between Dietary Inflammatory Index scores and the prevalence of colorectal adenoma. Public Health Nutr 2017; 20:1609-1616. [DOI: 10.1017/s1368980017000453] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractObjectiveThe Dietary Inflammatory Index (DII)TM, which was developed to characterize the inflammatory potential of a person’s diet, has been shown to be associated with inflammatory conditions such as cancer. The present study aimed to investigate the association between DII scores and colorectal adenoma (CRA), a pre-cancerous condition.DesignResponses to baseline dietary questionnaires were used calculate DII scores. In a cross-sectional study design, the association between DII scores and CRA prevalence was determined in men and women separately using logistic regression models.SettingTen cancer screening centres across the USA.SubjectsParticipants were those included in the screening arm of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.ResultsAmong the 44 278 individuals included in these analyses, men with diets in the most inflammatory quartile of DII scores had higher odds of all types of CRA (advanced, non-advanced and multiple (>1)) compared with those with diets in the least inflammatory quartile of DII scores. In fully adjusted models, compared with those with DII scores in quartile 1 (least inflammatory), males with DII scores in quartile 3 (adjusted odds ratio (aOR)=1·28; 95 % CI 1·12, 1·47) and quartile 4 (aOR=1·41; 95 % CI 1·23, 1·62) were more likely to have prevalent distal CRA. Higher DII scores, representing a more inflammatory diet, also were weakly associated with a higher prevalence of CRA in women.ConclusionsImplementing an anti-inflammatory diet may be an effective means of primary prevention of CRA, especially in men.
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116
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Shivappa N, Blair CK, Prizment AE, Jacobs DR, Hébert JR. Prospective study of the dietary inflammatory index and risk of breast cancer in postmenopausal women. Mol Nutr Food Res 2017; 61. [PMID: 27860246 DOI: 10.1002/mnfr.201600592] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/26/2016] [Accepted: 11/04/2016] [Indexed: 12/23/2022]
Abstract
SCOPE Diet in relation to breast cancer etiology has been studied widely, but results have remained inconsistent. Various dietary components including fruits, vegetables, and meat have been implicated through their effects on inflammation. Using data from the Iowa Women's Health Study we examine prospectively the association between the dietary inflammatory index (DII) and breast cancer incidence. METHODS AND RESULTS DII scores were computed based on baseline dietary intake assessed by a validated 121-item food frequency questionnaire in a cohort of 34 700 women, aged 55-69 years at recruitment in 1986 and followed for incident breast cancer. During the 25-year follow-up period (1986-2011), 2910 incident breast cancer cases were identified. We used Cox proportional hazards regression to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CI). We found positive associations between DII scores and breast cancer risk (HR for DIItertiles : T3 vs T1 = 1.11; 95% CI: 1.00, 1.22), with stronger associations in obese women (HR for DIIcontinuous : 1.05 per unit increase in DII; 95% CI: 1.02, 1.12; HR for DIItertiles : T3 vs T1 = 1.35; 95% CI: 1.10, 1.66, p-value for interaction = 0.02). CONCLUSION A proinflammatory diet, as indicated by higher DII scores, appears to increase the risk of developing breast cancer, especially in obese postmenopausal women.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Cindy K Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Shivappa N, Hébert JR, Steck SE, Hofseth LJ, Shehadah I, Bani-Hani KE, Al-Jaberi T, Al-Nusairr M, Heath D, Tayyem R. Dietary inflammatory index and odds of colorectal cancer in a case-control study from Jordan. Appl Physiol Nutr Metab 2017; 42:744-749. [PMID: 28226219 DOI: 10.1139/apnm-2017-0035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dietary components that promote inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet and CRC has been investigated in several developed or Western countries. Despite the fact that dietary choices in the Middle East differ markedly from those in the West, results have not been reported from any study conducted in a Middle-Eastern population. We examined the association between dietary inflammatory index (DII) scores and CRC in a case-control study conducted in Jordan. This study included 153 histopathologically confirmed CRC cases and 202 disease-free control subjects' frequency matched on age, sex, and occupation. Data were collected between January 2010 and December 2012, using interviewer-administered questionnaires. DII scores were computed from dietary data reported using a food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, sex, education, physical activity, body mass index, smoking, and family history of CRC. Subjects with higher DII scores were at increased odds of CRC, with the DII being used both as a continuous variable (ORcontinuous = 1.45, 95% CI: 1.13-1.85; 1-unit increase corresponding to ≈20% of its range in the current study) and as a categorical variable (ORtertile 3 vs tertile 1 = 2.13, 95%CI: 1.23-3.72). Our results, based on a Jordanian population, add to the growing literature indicating that a pro-inflammatory diet is associated with increased odds of CRC.
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Affiliation(s)
- Nitin Shivappa
- a Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.,b Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.,c Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R Hébert
- a Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.,b Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.,c Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Susan E Steck
- b Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Lorne J Hofseth
- d South Carolina College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA
| | - Ihab Shehadah
- e Gastroenterology Division, King Hussein Cancer Center, P.O. Box 1269, Amman 11941, Jordan
| | - Kamal E Bani-Hani
- f Faculty of Medicine, Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan
| | - Tareq Al-Jaberi
- g Department of Surgery, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Majed Al-Nusairr
- h Division of Gastroenterology, Prince Hamza Hospital, P.O. Box 86, Amman 11118, Jordan
| | - Dennis Heath
- i Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Reema Tayyem
- j Department of Nutrition and Food Technology, The University of Jordan, Faculty of Agriculture, P.O. Box 2920, Amman 11941, Jordan
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Tabung FK, Fung TT, Chavarro JE, Smith-Warner SA, Willett WC, Giovannucci EL. Associations between adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and biomarkers of inflammation, hormonal, and insulin response. Int J Cancer 2017; 140:764-776. [PMID: 27798951 PMCID: PMC5167632 DOI: 10.1002/ijc.30494] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/28/2016] [Accepted: 10/17/2016] [Indexed: 12/26/2022]
Abstract
Adherence to the 2007 WCRF/AICR cancer prevention recommendations has been associated with lower cancer risk but the underlying biological mechanisms have not been elucidated. We utilized dietary and lifestyle data from 11,342 women in the Nurses' Health Study and 8,136 men in the Health Professionals Follow-up Study, to investigate associations between adherence scores and markers of inflammation, hormonal and insulin response. Two scores ranging from 0 to 3 were constructed to assess adherence to the energy balance-related recommendations (weight management, physical activity, energy density); and the plant, animal foods and alcohol intake recommendations; with higher scores indicating greater adherence. The following biomarkers were assessed in plasma samples donated by chronic disease-free women (1990) and men (1994): C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α receptor 2 (TNFαR2) and adiponectin for inflammation; estrone and estradiol for hormonal response in women, C-peptide for hyperinsulinemia; and triglycerides/high density lipoprotein-cholesterol (TG/HDL) ratio for insulin resistance. In multivariable-adjusted linear regression analyses, we estimated relative concentrations of biomarkers across adherence categories. There was a significant trend of lower (higher for adiponectin) biomarker concentrations with higher adherence to the energy balance recommendations (all p trend <0.0001). Comparing the highest (3) to the lowest recommendation category (0-1), the percent difference in relative concentrations of biomarkers was CRP, -69%; IL6, -41%; TNFαR2, -13%; adiponectin, +36%; C-peptide, -43%; TG/HDL, -43%; estrone, -31%; and estradiol, -43%; in women; and CRP, -59%; IL6, -42%; TNFαR2, -10%; adiponectin, +22%; C-peptide, -44%; and TG/HDL, -40%; in men. In contrast, associations between adherence to the plant, animal foods and alcohol intake recommendations and biomarker concentrations were weaker, and mostly nonsignificant. The healthier biomarker profile associated with greater adherence to the WCRF/AICR cancer prevention recommendations is driven mainly by adherence to the energy balance-related recommendations.
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Affiliation(s)
- Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Simmons College, Boston, MA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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119
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Harmon BE, Wirth MD, Boushey CJ, Wilkens LR, Draluck E, Shivappa N, Steck SE, Hofseth L, Haiman CA, Le Marchand L, Hébert JR. The Dietary Inflammatory Index Is Associated with Colorectal Cancer Risk in the Multiethnic Cohort. J Nutr 2017; 147:430-438. [PMID: 28179489 DOI: 10.3945/jn.116.242529] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/03/2016] [Accepted: 01/09/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Diet is known to influence systemic inflammation, a recognized risk factor for colorectal cancer (CRC). Studies in ethnically diverse populations that examine the association between dietary inflammatory potential and CRC incidence are limited.Objectives: We used the Dietary Inflammatory Index to clarify the relation between the inflammatory potential of diet and CRC incidence across racial/ethnic groups. We hypothesized that proinflammatory diets would be associated with an increased risk of CRC, and that these associations may differ across racial/ethnic groups.Methods: The Multiethnic Cohort (MEC) follows a prospective study design. It includes 190,963 white, African-American, native Hawaiian, Japanese-American, and Latino men and women aged 45-75 y at recruitment and followed over 20 y. Participants completed a food frequency questionnaire from which energy-adjusted Dietary Inflammatory Index (E-DII) scores were computed and categorized into quartiles. CRC incidence was documented through linkage to cancer registry programs. Cox proportional hazards regression was used to estimate HRs and 95% CIs, adjusting for known or expected CRC risk factors.Results: Among all participants, more-proinflammatory diets (highest quartile compared with lowest quartile) were associated with an increased risk of CRC (HR: 1.21; 95% CI: 1.11, 1.32). However, the effect size was larger for men (HR: 1.28; 95% CI: 1.13, 1.45) than for women (HR: 1.16; 95% CI: 1.02, 1.33), although the interaction term for sex was not statistically significant (P-interaction = 0.17). When stratified by race/ethnicity, the association was significantly different between groups for men (P-interaction = 0.01), although not for women (P-interaction = 0.20). Significant associations with HRs ranging from 2.33 to 1.04 were observed in white, Japanese-American, and Latino men, and native Hawaiian women.Conclusions: Overall, more-proinflammatory diets, as identified by the E-DII, were associated with increased CRC risk in MEC participants across racial/ethnic groups. This study adds to the evidence suggesting that diets with high proinflammatory potential may increase CRC risk.
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Affiliation(s)
- Brook E Harmon
- School of Public Health, University of Memphis, Memphis, TN;
| | - Michael D Wirth
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | | | - Emma Draluck
- School of Public Health, University of Memphis, Memphis, TN
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Susan E Steck
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Lorne Hofseth
- South Carolina College of Pharmacy, University of South Carolina, Columbia, SC; and
| | - Christopher A Haiman
- Cancer Center, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| | | | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
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120
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Long-term associations between inflammatory dietary scores in relation to long-term C-reactive protein status measured 12 years later: findings from the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort. Br J Nutr 2017; 117:306-314. [PMID: 28166841 DOI: 10.1017/s0007114517000034] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic low-grade inflammation has been recognised as a key underlying mechanism for several chronic diseases, including cancer and CVD. Nutrition represents a host of key modifiable factors that influence chronic inflammation. Dietary inflammatory scores were developed to assess the inflammatory potential of the diet and have been associated with inflammatory biomarkers in cross-sectional and short-term longitudinal studies. The objective of this study was to investigate the relationship between the dietary inflammatory index (DII), the alternate dietary inflammatory index (ADII) and long-term C-reactive protein (CRP). We also tested age as an effect modifier of this relationship. Participants were selected in the Supplémentation en Vitamines et Minéraux Antioxydants study, which included subjects aged 45-60 years old for men and 35-60 years old for women in 1994. Participants with ≥3 24-h dietary records at baseline and a CRP measurement at the 12-year follow-up evaluation were included in the present study (n 1980). The relationships between the DII and ADII and elevated CRP (>3 mg/l) were investigated using logistic multivariable regression. All analyses were stratified by age (cut-off at median age=50 years old). The overall associations between DII and ADII and long-term CRP were not statistically significant (P trend across tertiles=0·16 for DII and 0·10 for ADII). A quantitative interaction was found between ADII score and age (P=0·16 for ADII, 0·36 for DII). In stratified analyses the ADII was significantly prospectively associated with CRP only in younger participants: OR tertile 3 v. tertile 1: 1·79 (95 % CI 1·04, 3·07). Pro-inflammatory diets may have long-term effect on CRP only in younger subjects.
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Shivappa N, Hébert JR, Rosato V, Rossi M, Libra M, Montella M, Serraino D, La Vecchia C. Dietary Inflammatory Index and Risk of Bladder Cancer in a Large Italian Case-control Study. Urology 2017; 100:84-89. [PMID: 27693878 PMCID: PMC5274575 DOI: 10.1016/j.urology.2016.09.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/06/2016] [Accepted: 09/14/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the association between diet in relation to its inflammatory property and bladder cancer (BC) risk. METHODS In this study we explored the association between the dietary inflammatory index (DII) and BC risk in an Italian case-control study conducted between 2003 and 2014. Cases were 690 patients with incident and histologically confirmed BC from 4 areas in Italy. Controls were 665 cancer-free subjects admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The DII was computed based on dietary intake assessed using a reproducible and valid 80-item food frequency questionnaire. Odds ratios (OR) were estimated through logistic regression models adjusting for age, sex, total energy intake, and other recognized confounding factors. RESULTS Subjects in the highest quartile of DII scores (ie, with a more pro-inflammatory diet) had a higher risk of BC compared to subjects in the lowest quartile (ie, with an anti-inflammatory diet) (ORQuartile4vs1 = 1.97; 95% [confidence interval], 1.28, 3.03; P trend = .003). Stratified analyses produced stronger associations between DII and BC risk among females (ORQuartile4vs1 = 5.73; 95% CI = 1.46, 22.44), older ≥65 years (ORQuartile4vs1 = 2.45; 95% CI = 1.38, 4.34), subjects with higher education ≥7 years (ORQuartile4vs1 = 2.22; 95% CI = 1.27, 3.88), and never smokers (ORQuartile4vs1 = 4.04; 95% CI = 1.51, 10.80). CONCLUSION A pro-inflammatory diet as indicated by higher DII scores is associated with increased BC risk.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC; Connecting Health Innovations LLC, Columbia, SC
| | - Valentina Rosato
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Libra
- Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, Università di Catania, Catania, Italy
| | - Maurizio Montella
- Unit of Epidemiology, "Fondazione G. Pascale", Istituto Nazionale Tumori, Naples, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Shivappa N, Wirth MD, Hurley TG, Hébert JR. Association between the dietary inflammatory index (DII) and telomere length and C-reactive protein from the National Health and Nutrition Examination Survey-1999-2002. Mol Nutr Food Res 2017; 61. [PMID: 27878970 DOI: 10.1002/mnfr.201600630] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/04/2016] [Accepted: 11/16/2016] [Indexed: 12/22/2022]
Abstract
SCOPE Leukocyte telomere length (LTL) is an important biomarker of aging. This study examined whether inflammatory potential of diet, as measured by the Dietary Inflammatory IndexTM (DII) has an impact on telomere shortening in the National Health and Nutrition Examination Survey (NHANES). We also carried out validation of the DII with C-reactive protein (CRP). METHODS AND RESULTS Data came from NHANES 1999-2002. LTL and CRP were assayed from leukocyte DNA and serum specimens, respectively. The DII was calculated from food intakes assessed using 24-h dietary recalls and expressed per 1000 calories consumed. Associations were examined using survey-based multivariable linear regression for log-transformed LTL. After multivariable adjustment, higher DII scores (i.e. relatively more pro inflammatory) were associated with shorter LTL both when used as continuous (b = -0.003; 95% confidence interval [CI] = -0.005, -0.0002) and as quartiles (bDIIquartile4vs1 = -0.013; 95% CI = -0.025, -0.001; Ptrend = .03). In this same sample the DII also was associated with CRP ≥3 mg/L (ORDIIcontinuous = 1.10; 95% CI = 1.06, 1.16). CONCLUSION In these NHANES data there was an association between DII and LTL. This study also provided a successful construct validation of the DII using CRP in a nationally representative sample. These results are consistent with the hypothesis that diet-associated inflammation determines LTL.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program,, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Michael D Wirth
- Cancer Prevention and Control Program,, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Thomas G Hurley
- Cancer Prevention and Control Program,, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program,, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
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Sardo Molmenti CL, Steck SE, Thomson CA, Hibler EA, Yang J, Shivappa N, Greenlee H, Wirth MD, Neugut AI, Jacobs ET, Hébert JR. Dietary Inflammatory Index and Risk of Colorectal Adenoma Recurrence: A Pooled Analysis. Nutr Cancer 2017; 69:238-247. [PMID: 28094571 DOI: 10.1080/01635581.2017.1263752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
No studies have evaluated the association between the dietary inflammatory index (DII) and colorectal adenoma recurrence. DII scores were calculated from a baseline food frequency questionnaire. Participants (n = 1727) were 40-80 years of age, enrolled in two Phase III clinical trials, who had ≥1 colorectal adenoma(s) removed within 6 months of study registration, and a follow-up colonoscopy during the trial. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). No statistically significant associations were found between DII and odds of colorectal adenoma recurrence [ORs (95% CIs) = 0.93 (0.73, 1.18) and 0.95 (0.73, 1.22)] for subjects in the second and third DII tertiles, respectively, compared to those in the lowest tertile (Ptrend = 0.72). No associations were found for recurrent colorectal adenoma characteristics, including advanced recurrent adenomas, large size, villous histology, or anatomic location. While our study did not support an association between a proinflammatory diet and colorectal adenoma recurrence, future studies are warranted to elucidate the role of a proinflammatory diet on the early stages of colorectal carcinogenesis.
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Affiliation(s)
- C L Sardo Molmenti
- a Department of Epidemiology , Mailman School of Public Health, Columbia University , New York , New York , USA.,b Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , New York , New York , USA.,c Department of Occupational Medicine, Epidemiology, and Prevention , Hofstra Northwell School of Medicine , Hempstead , New York , USA
| | - S E Steck
- d Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,e Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA
| | - C A Thomson
- f University of Arizona Cancer Center , Tucson , Arizona , USA.,g Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson , Arizona , USA
| | - E A Hibler
- h Department of Preventive Medicine , Feinburg School of Medicine, Northwestern University , Chicago, Illinois , USA
| | - J Yang
- a Department of Epidemiology , Mailman School of Public Health, Columbia University , New York , New York , USA
| | - N Shivappa
- d Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,e Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA.,i Connecting Health Innovations , LLC , Columbia , South Carolina , USA
| | - H Greenlee
- a Department of Epidemiology , Mailman School of Public Health, Columbia University , New York , New York , USA.,b Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , New York , New York , USA
| | - M D Wirth
- d Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,e Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA.,i Connecting Health Innovations , LLC , Columbia , South Carolina , USA
| | - A I Neugut
- a Department of Epidemiology , Mailman School of Public Health, Columbia University , New York , New York , USA.,b Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , New York , New York , USA
| | - E T Jacobs
- f University of Arizona Cancer Center , Tucson , Arizona , USA.,g Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson , Arizona , USA
| | - J R Hébert
- d Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,e Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA.,i Connecting Health Innovations , LLC , Columbia , South Carolina , USA
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Wirth MD, Shivappa N, Davis L, Hurley TG, Ortaglia A, Drayton R, Blair SN, Hébert JR. Construct Validation of the Dietary Inflammatory Index among African Americans. J Nutr Health Aging 2017; 21:487-491. [PMID: 28448077 PMCID: PMC5547883 DOI: 10.1007/s12603-016-0775-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Chronic inflammation is linked to many chronic conditions. One of the strongest modulators of chronic inflammation is diet. The Dietary Inflammatory Index (DII) measures dietary inflammatory potential and has been validated previously, but not among African Americans (AAs). DESIGN Cross-sectional analysis using baseline data from the Healthy Eating and Active Living in the Spirit (HEALS) intervention study. SETTING Baseline data collection occurred between 2009 and 2012 in or near Columbia, SC. PARTICIPANTS African-American churchgoers. MEASUREMENTS Baseline data collection included c-reactive protein (CRP) and interleukin-6 from blood draws, anthropometric measures, and numerous questionnaires. The questionnaires included a food frequency questionnaire which was used for DII calculation. The main analyses were performed using quantile regression. RESULTS Subjects in the highest DII quartile (i.e., more pro-inflammatory) were younger, more likely to be married, and had less education and greater BMI. Individuals in DII quartile 4 had statistically significantly greater CRP at the 75th and 90th percentiles of CRP versus those in quartile 1 (i.e., more anti-inflammatory). CONCLUSION Construct validation provides support for using the DII in research among AA populations. Future research should explore avenues to promote more anti-inflammatory diets, with use of the DII, among AA populations to reduce risk of chronic disease.
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Affiliation(s)
- M D Wirth
- Michael Wirth, MSPH, PhD, Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Room 233, Columbia, SC 29208. Phone: (803) 576-5646. Fax: (803) 576-5624.
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Abstract
Recent evidence suggests that a pro-inflammatory diet could be associated with prostate cancer (PC) risk. To evaluate the association between dietary inflammatory index (DII) and PC risk as well as aggressiveness, we conducted a case-control study in Mexico City. Cases were 394 individuals with incident, histologically confirmed PC, who were matched by age (±5 years) with 794 population controls. Dietary information was obtained through a semi-quantitative FFQ with a 3-year frame of reference before diagnosis, for cases, or interview, for controls. On the basis of twenty-eight food parameters, we estimated the energy-adjusted DII (E-DII). According to the Gleason score at diagnosis, PC cases were categorised as high (≥8), moderate (=7) and low (≤6) PC risk. Independent, unconditional logistic regression models adjusted for potential confounders were used to estimate PC risk and PC aggressiveness. There were no significant associations between overall PC risk and E-DII (OR3rd v. 1st tertile 1·18; 95 % CI 0·85, 1·63; P=0·33) or among men with high-risk PC (Gleason≥8) (OR 1·46; 95 % CI 0·88, 2·42; P=0·14). These results do not support the hypothesis that a pro-inflammatory diet is related to PC risk and PC aggressiveness. However, further studies with larger sample sizes, with sufficient statistical power and of varying designs should be conducted to address this hypothesis.
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Inflammatory Properties of Diet and Glucose-Insulin Homeostasis in a Cohort of Iranian Adults. Nutrients 2016; 8:nu8110735. [PMID: 27869717 PMCID: PMC5133119 DOI: 10.3390/nu8110735] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/07/2016] [Accepted: 11/15/2016] [Indexed: 12/21/2022] Open
Abstract
We aimed to investigate associations of the dietary inflammatory index (DII) with glucose-insulin homeostasis markers, and the risk of glucose intolerance. This cross-sectional study included 2975 adults from the Tehran Lipid and Glucose Study. Fasting plasma glucose (FPG), 2-h post-load glucose (2h-PG), and fasting serum insulin were measured. Homeostatic model assessment of insulin resistance index (HOMA-IR) and β-cell function (HOMA-B), and the quantitative insulin sensitivity check index (QUICKI) were calculated. Glucose tolerance abnormalities included impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM). DII scores were positively associated with 2h-PG (β = 0.04; p = 0.05). There was no significant linear trend across quartiles of DII for adjusted means of glucose-insulin homeostasis markers. Participants in the highest quartile of DII score tended to have higher FPG compared to those in the second quartile of DII score (5.46 vs. 5.38 mmol/L, p = 0.07) and higher fasting insulin and HOMA-IR compared to those in the lowest quartile (8.52 vs. 8.12 µU/mL for fasting insulin, p = 0.07; 2.06 vs. 1.96 for HOMA-IR, p = 0.08). No significant associations were observed between DII and risk of IFG, IGT, T2DM, and insulin resistance. Among glucose-insulin homeostasis markers, DII had a positive weak association only with 2h-PG.
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Development and validation of empirical indices to assess the insulinaemic potential of diet and lifestyle. Br J Nutr 2016; 116:1787-1798. [PMID: 27821188 DOI: 10.1017/s0007114516003755] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The glycaemic and insulin indices assess postprandial glycaemic and insulin response to foods, respectively, which may not reflect the long-term effects of diet on insulin response. We developed and evaluated the validity of four empirical indices to assess the insulinaemic potential of usual diets and lifestyles, using dietary, lifestyle and biomarker data from the Nurses' Health Study (NHS, n 5812 for hyperinsulinaemia, n 3929 for insulin resistance). The four indices were as follows: the empirical dietary index for hyperinsulinaemia (EDIH) and the empirical lifestyle index for hyperinsulinaemia (ELIH); the empirical dietary index for insulin resistance (EDIR) and the empirical lifestyle index for insulin resistance (ELIR). We entered thirty-nine FFQ-derived food groups in stepwise linear regression models, and defined indices as patterns most predictive of fasting plasma C-peptide, for the hyperinsulinaemia pathway (EDIH and ELIH), and of theTAG:HDL-cholesterol ratio, for the insulin-resistance pathway (EDIR and ELIR). We evaluated the validity of indices in two independent samples from NHS-II and Health Professionals Follow-up Study (HPFS) using multivariable-adjusted linear regression analyses to calculate relative concentrations of biomarkers. The EDIH is comprised of eighteen food groups; thirteen were positively associated with C-peptide and five were inversely associated. The EDIR is comprised of eighteen food groups; ten were positively associated with TAG:HDL-cholesterol and eight were inversely associated. Lifestyle indices had fewer dietary components, and included BMI and physical activity as components. In the validation samples, all indices significantly predicted biomarker concentrations - for example, the relative concentrations of the corresponding biomarkers comparing extreme index quintiles in the HPFS were EDIH, 1·29 (95 % CI 1·22, 1·37); ELIH, 1·78 (95 % CI 1·68, 1·88); EDIR, 1·44 (95 % CI 1·34, 1·55); and ELIR, 2·03 (95 % CI 1·89, 2·19); all P trend<0·0001. The robust associations of these novel hypothesis-driven indices with insulin response biomarker concentrations suggest their usefulness in assessing the ability of whole diets and lifestyles to stimulate and/or sustain insulin secretion.
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Ghanadi K, Shayanrad B, Ahmadi SAY, Shahsavar F, Eliasy H. Colorectal cancer and the KIR genes in the human genome: A meta-analysis. GENOMICS DATA 2016; 10:118-126. [PMID: 27843767 PMCID: PMC5099266 DOI: 10.1016/j.gdata.2016.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/21/2016] [Accepted: 10/30/2016] [Indexed: 02/07/2023]
Abstract
Colorectal cancer is one of the most common types of inflammation-based cancers and is occurred due to growth and spread of cancer cells in colon and/or rectum. Previously genetic association of cell cycle genes, both proto-oncogenes and the tumor suppressors has been proved. But there were few studies about association of immune related genes such as killer-cell immunoglobulin-like receptors (KIRs). Thus we intend to perform a meta-analysis to find the association of different genes of KIR and susceptibility to be affected by colorectal cancer. The overall population of the four studies investigated in our meta-analysis was 953 individuals (470 individuals with colorectal cancer and 483 individuals in control groups). After the analyses, we concluded that colorectal cancer is affected by KIR2DS5 and also there were no protecting gene. This result shows the inflammatory basis of this cancer. In other words, in contrast to leukemia and blood cancers, colorectal cancers seem to be affected by hyper activity of natural killer-cells (NKs). Whys and therefore of this paradox, is suggested to be investigated further.
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Affiliation(s)
- Koroush Ghanadi
- Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Bahareh Shayanrad
- Department of Immunology, Lorestan University of Medical Sciences, Khorramabad, Iran; Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Farhad Shahsavar
- Department of Immunology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hossein Eliasy
- Research Office for the History of Persian Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Shivappa N, Hébert JR, Ferraroni M, La Vecchia C, Rossi M. Association between Dietary Inflammatory Index and Gastric Cancer Risk in an Italian Case-Control Study. Nutr Cancer 2016; 68:1262-1268. [PMID: 27636679 PMCID: PMC5154551 DOI: 10.1080/01635581.2016.1224367] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this study, we explored the association between the dietary inflammatory index (DII) and gastric cancer risk in an Italian case-control study. MATERIALS AND METHODS Cases were 230 patients with incident, histologically confirmed cases of gastric cancer from the Greater Milan area, Northern Italy. Controls were 547 frequency-matched subjects admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The DII was computed using a reproducible and valid 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models conditioned on age and sex and adjusted for recognized confounding factors, including total energy intake. RESULTS Subjects with the most pro-inflammatory diet had a higher risk of gastric cancer compared to subjects with the most anti-inflammatory diet (ORQuartile4vs1 = 2.35, 95% confidence interval, 1.32, 4.20; P-trend = 0.004). CONCLUSION These results indicate that a pro-inflammatory diet, as indicated by higher DII score, was associated with increased risk of gastric cancer.
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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 Innovations LLC, Columbia, SC, 29229, 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 Innovations LLC, Columbia, SC, 29229, USA
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, 29208, USA
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
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Block KI, Gyllenhaal C, Lowe L, Amedei A, Amin ARMR, Amin A, Aquilano K, Arbiser J, Arreola A, Arzumanyan A, Ashraf SS, Azmi AS, Benencia F, Bhakta D, Bilsland A, Bishayee A, Blain SW, Block PB, Boosani CS, Carey TE, Carnero A, Carotenuto M, Casey SC, Chakrabarti M, Chaturvedi R, Chen GZ, Chen H, Chen S, Chen YC, Choi BK, Ciriolo MR, Coley HM, Collins AR, Connell M, Crawford S, Curran CS, Dabrosin C, Damia G, Dasgupta S, DeBerardinis RJ, Decker WK, Dhawan P, Diehl AME, Dong JT, Dou QP, Drew JE, Elkord E, El-Rayes B, Feitelson MA, Felsher DW, Ferguson LR, Fimognari C, Firestone GL, Frezza C, Fujii H, Fuster MM, Generali D, Georgakilas AG, Gieseler F, Gilbertson M, Green MF, Grue B, Guha G, Halicka D, Helferich WG, Heneberg P, Hentosh P, Hirschey MD, Hofseth LJ, Holcombe RF, Honoki K, Hsu HY, Huang GS, Jensen LD, Jiang WG, Jones LW, Karpowicz PA, Keith WN, Kerkar SP, Khan GN, Khatami M, Ko YH, Kucuk O, Kulathinal RJ, Kumar NB, Kwon BS, Le A, Lea MA, Lee HY, Lichtor T, Lin LT, Locasale JW, Lokeshwar BL, Longo VD, Lyssiotis CA, MacKenzie KL, Malhotra M, Marino M, Martinez-Chantar ML, Matheu A, Maxwell C, McDonnell E, Meeker AK, Mehrmohamadi M, Mehta K, Michelotti GA, Mohammad RM, Mohammed SI, Morre DJ, Muralidhar V, Muqbil I, Murphy MP, Nagaraju GP, Nahta R, Niccolai E, Nowsheen S, Panis C, Pantano F, Parslow VR, Pawelec G, Pedersen PL, Poore B, Poudyal D, Prakash S, Prince M, Raffaghello L, Rathmell JC, Rathmell WK, Ray SK, Reichrath J, Rezazadeh S, Ribatti D, Ricciardiello L, Robey RB, Rodier F, Rupasinghe HPV, Russo GL, Ryan EP, Samadi AK, Sanchez-Garcia I, Sanders AJ, Santini D, Sarkar M, Sasada T, Saxena NK, Shackelford RE, Shantha Kumara HMC, Sharma D, Shin DM, Sidransky D, Siegelin MD, Signori E, Singh N, Sivanand S, Sliva D, Smythe C, Spagnuolo C, Stafforini DM, Stagg J, Subbarayan PR, Sundin T, Talib WH, Thompson SK, Tran PT, Ungefroren H, Vander Heiden MG, Venkateswaran V, Vinay DS, Vlachostergios PJ, Wang Z, Wellen KE, Whelan RL, Yang ES, Yang H, Yang X, Yaswen P, Yedjou C, Yin X, Zhu J, Zollo M. Designing a broad-spectrum integrative approach for cancer prevention and treatment. Semin Cancer Biol 2016; 35 Suppl:S276-S304. [PMID: 26590477 DOI: 10.1016/j.semcancer.2015.09.007] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 08/12/2015] [Accepted: 09/14/2015] [Indexed: 12/14/2022]
Abstract
Targeted therapies and the consequent adoption of "personalized" oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity "broad-spectrum" therapeutic approach that could simultaneously target many key pathways and mechanisms. Using cancer hallmark phenotypes and the tumor microenvironment to account for the various aspects of relevant cancer biology, interdisciplinary teams reviewed each hallmark area and nominated a wide range of high-priority targets (74 in total) that could be modified to improve patient outcomes. For these targets, corresponding low-toxicity therapeutic approaches were then suggested, many of which were phytochemicals. Proposed actions on each target and all of the approaches were further reviewed for known effects on other hallmark areas and the tumor microenvironment. Potential contrary or procarcinogenic effects were found for 3.9% of the relationships between targets and hallmarks, and mixed evidence of complementary and contrary relationships was found for 7.1%. Approximately 67% of the relationships revealed potentially complementary effects, and the remainder had no known relationship. Among the approaches, 1.1% had contrary, 2.8% had mixed and 62.1% had complementary relationships. These results suggest that a broad-spectrum approach should be feasible from a safety standpoint. This novel approach has potential to be relatively inexpensive, it should help us address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered.
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Affiliation(s)
- Keith I Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, United States.
| | | | - Leroy Lowe
- Getting to Know Cancer, Truro, Nova Scotia, Canada; Lancaster Environment Centre, Lancaster University, Bailrigg, Lancaster, United Kingdom.
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A R M Ruhul Amin
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Amr Amin
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Katia Aquilano
- Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Jack Arbiser
- Winship Cancer Institute of Emory University, Atlanta, GA, United States; Atlanta Veterans Administration Medical Center, Atlanta, GA, United States; Department of Dermatology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Alexandra Arreola
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Alla Arzumanyan
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - S Salman Ashraf
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Asfar S Azmi
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Fabian Benencia
- Department of Biomedical Sciences, Ohio University, Athens, OH, United States
| | - Dipita Bhakta
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, Tamil Nadu, India
| | | | - Anupam Bishayee
- Department of Pharmaceutical Sciences, College of Pharmacy, Larkin Health Sciences Institute, Miami, FL, United States
| | - Stacy W Blain
- Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, NY, United States
| | - Penny B Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, United States
| | - Chandra S Boosani
- Department of BioMedical Sciences, School of Medicine, Creighton University, Omaha, NE, United States
| | - Thomas E Carey
- Head and Neck Cancer Biology Laboratory, University of Michigan, Ann Arbor, MI, United States
| | - Amancio Carnero
- Instituto de Biomedicina de Sevilla, Consejo Superior de Investigaciones Cientificas, Seville, Spain
| | - Marianeve Carotenuto
- Centro di Ingegneria Genetica e Biotecnologia Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Stephanie C Casey
- Stanford University, Division of Oncology, Department of Medicine and Pathology, Stanford, CA, United States
| | - Mrinmay Chakrabarti
- Department of Pathology, Microbiology, and Immunology, University of South Carolina, School of Medicine, Columbia, SC, United States
| | - Rupesh Chaturvedi
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Georgia Zhuo Chen
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Helen Chen
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Sophie Chen
- Ovarian and Prostate Cancer Research Laboratory, Guildford, Surrey, United Kingdom
| | - Yi Charlie Chen
- Department of Biology, Alderson Broaddus University, Philippi, WV, United States
| | - Beom K Choi
- Cancer Immunology Branch, Division of Cancer Biology, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | | | - Helen M Coley
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Andrew R Collins
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marisa Connell
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Sarah Crawford
- Cancer Biology Research Laboratory, Southern Connecticut State University, New Haven, CT, United States
| | - Colleen S Curran
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Charlotta Dabrosin
- Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Giovanna Damia
- Department of Oncology, Istituto Di Ricovero e Cura a Carattere Scientifico - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Santanu Dasgupta
- Department of Cellular and Molecular Biology, the University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Ralph J DeBerardinis
- Children's Medical Center Research Institute, University of Texas - Southwestern Medical Center, Dallas, TX, United States
| | - William K Decker
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Punita Dhawan
- Department of Surgery and Cancer Biology, Division of Surgical Oncology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Anna Mae E Diehl
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Jin-Tang Dong
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Q Ping Dou
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Janice E Drew
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Eyad Elkord
- College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Bassel El-Rayes
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, United States
| | - Mark A Feitelson
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - Dean W Felsher
- Stanford University, Division of Oncology, Department of Medicine and Pathology, Stanford, CA, United States
| | - Lynnette R Ferguson
- Discipline of Nutrition and Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Carmela Fimognari
- Dipartimento di Scienze per la Qualità della Vita Alma Mater Studiorum-Università di Bologna, Rimini, Italy
| | - Gary L Firestone
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, United States
| | - Christian Frezza
- Medical Research Council Cancer Unit, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Hiromasa Fujii
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Mark M Fuster
- Medicine and Research Services, Veterans Affairs San Diego Healthcare System & University of California, San Diego, CA, United States
| | - Daniele Generali
- Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Molecular Therapy and Pharmacogenomics Unit, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Alexandros G Georgakilas
- Physics Department, School of Applied Mathematics and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Frank Gieseler
- First Department of Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | - Michelle F Green
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Brendan Grue
- Departments of Environmental Science, Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gunjan Guha
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, Tamil Nadu, India
| | - Dorota Halicka
- Department of Pathology, New York Medical College, Valhalla, NY, United States
| | | | - Petr Heneberg
- Charles University in Prague, Third Faculty of Medicine, Prague, Czech Republic
| | - Patricia Hentosh
- School of Medical Laboratory and Radiation Sciences, Old Dominion University, Norfolk, VA, United States
| | - Matthew D Hirschey
- Department of Medicine, Duke University Medical Center, Durham, NC, United States; Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Lorne J Hofseth
- College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Randall F Holcombe
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, United States
| | - Kanya Honoki
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Hsue-Yin Hsu
- Department of Life Sciences, Tzu-Chi University, Hualien, Taiwan
| | - Gloria S Huang
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States
| | - Lasse D Jensen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Wen G Jiang
- Cardiff University School of Medicine, Heath Park, Cardiff, United Kingdom
| | - Lee W Jones
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | | | | | - Sid P Kerkar
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | | | - Mahin Khatami
- Inflammation and Cancer Research, National Cancer Institute (Retired), National Institutes of Health, Bethesda, MD, United States
| | - Young H Ko
- University of Maryland BioPark, Innovation Center, KoDiscovery, Baltimore, MD, United States
| | - Omer Kucuk
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Rob J Kulathinal
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - Nagi B Kumar
- Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, FL, United States
| | - Byoung S Kwon
- Cancer Immunology Branch, Division of Cancer Biology, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Anne Le
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michael A Lea
- New Jersey Medical School, Rutgers University, Newark, NJ, United States
| | - Ho-Young Lee
- College of Pharmacy, Seoul National University, South Korea
| | - Terry Lichtor
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States
| | - Liang-Tzung Lin
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jason W Locasale
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Bal L Lokeshwar
- Department of Medicine, Georgia Regents University Cancer Center, Augusta, GA, United States
| | - Valter D Longo
- Andrus Gerontology Center, Division of Biogerontology, University of Southern California, Los Angeles, CA, United States
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology and Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, MI, United States
| | - Karen L MacKenzie
- Children's Cancer Institute Australia, Kensington, New South Wales, Australia
| | - Meenakshi Malhotra
- Department of Biomedical Engineering, McGill University, Montréal, Canada
| | - Maria Marino
- Department of Science, University Roma Tre, Rome, Italy
| | - Maria L Martinez-Chantar
- Metabolomic Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Technology Park of Bizkaia, Bizkaia, Spain
| | | | - Christopher Maxwell
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Eoin McDonnell
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Alan K Meeker
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mahya Mehrmohamadi
- Field of Genetics, Genomics, and Development, Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY, United States
| | - Kapil Mehta
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gregory A Michelotti
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Ramzi M Mohammad
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Sulma I Mohammed
- Department of Comparative Pathobiology, Purdue University Center for Cancer Research, West Lafayette, IN, United States
| | - D James Morre
- Mor-NuCo, Inc, Purdue Research Park, West Lafayette, IN, United States
| | - Vinayak Muralidhar
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA, United States; Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Irfana Muqbil
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Michael P Murphy
- MRC Mitochondrial Biology Unit, Wellcome Trust-MRC Building, Hills Road, Cambridge, United Kingdom
| | | | - Rita Nahta
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | | | - Somaira Nowsheen
- Medical Scientist Training Program, Mayo Graduate School, Mayo Medical School, Mayo Clinic, Rochester, MN, United States
| | - Carolina Panis
- Laboratory of Inflammatory Mediators, State University of West Paraná, UNIOESTE, Paraná, Brazil
| | - Francesco Pantano
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| | - Virginia R Parslow
- Discipline of Nutrition and Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen, Tübingen, Germany
| | - Peter L Pedersen
- Departments of Biological Chemistry and Oncology, Member at Large, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
| | - Brad Poore
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Deepak Poudyal
- College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Satya Prakash
- Department of Biomedical Engineering, McGill University, Montréal, Canada
| | - Mark Prince
- Department of Otolaryngology-Head and Neck, Medical School, University of Michigan, Ann Arbor, MI, United States
| | | | - Jeffrey C Rathmell
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - W Kimryn Rathmell
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Swapan K Ray
- Department of Pathology, Microbiology, and Immunology, University of South Carolina, School of Medicine, Columbia, SC, United States
| | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, Clinic for Dermatology, Venerology and Allergology, The Saarland University Hospital, Homburg, Germany
| | - Sarallah Rezazadeh
- Department of Biology, University of Rochester, Rochester, NY, United States
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy & National Cancer Institute Giovanni Paolo II, Bari, Italy
| | - Luigi Ricciardiello
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - R Brooks Robey
- White River Junction Veterans Affairs Medical Center, White River Junction, VT, United States; Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Francis Rodier
- Centre de Rechercher du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, Montréal, Quebec, Canada; Université de Montréal, Département de Radiologie, Radio-Oncologie et Médicine Nucléaire, Montréal, Quebec, Canada
| | - H P Vasantha Rupasinghe
- Department of Environmental Sciences, Faculty of Agriculture and Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gian Luigi Russo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Elizabeth P Ryan
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Isidro Sanchez-Garcia
- Experimental Therapeutics and Translational Oncology Program, Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain
| | - Andrew J Sanders
- Cardiff University School of Medicine, Heath Park, Cardiff, United Kingdom
| | - Daniele Santini
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| | - Malancha Sarkar
- Department of Biology, University of Miami, Miami, FL, United States
| | - Tetsuro Sasada
- Department of Immunology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Neeraj K Saxena
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rodney E Shackelford
- Department of Pathology, Louisiana State University, Health Shreveport, Shreveport, LA, United States
| | - H M C Shantha Kumara
- Department of Surgery, St. Luke's Roosevelt Hospital, New York, NY, United States
| | - Dipali Sharma
- Department of Oncology, Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, United States
| | - Dong M Shin
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Markus David Siegelin
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, United States
| | - Emanuela Signori
- National Research Council, Institute of Translational Pharmacology, Rome, Italy
| | - Neetu Singh
- Advanced Molecular Science Research Centre (Centre for Advanced Research), King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sharanya Sivanand
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Sliva
- DSTest Laboratories, Purdue Research Park, Indianapolis, IN, United States
| | - Carl Smythe
- Department of Biomedical Science, Sheffield Cancer Research Centre, University of Sheffield, Sheffield, United Kingdom
| | - Carmela Spagnuolo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Diana M Stafforini
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - John Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Faculté de Pharmacie et Institut du Cancer de Montréal, Montréal, Quebec, Canada
| | - Pochi R Subbarayan
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Tabetha Sundin
- Department of Molecular Diagnostics, Sentara Healthcare, Norfolk, VA, United States
| | - Wamidh H Talib
- Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman, Jordan
| | - Sarah K Thompson
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Phuoc T Tran
- Departments of Radiation Oncology & Molecular Radiation Sciences, Oncology and Urology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Hendrik Ungefroren
- First Department of Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Matthew G Vander Heiden
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Vasundara Venkateswaran
- Department of Surgery, University of Toronto, Division of Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dass S Vinay
- Section of Clinical Immunology, Allergy, and Rheumatology, Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Panagiotis J Vlachostergios
- Department of Internal Medicine, New York University Lutheran Medical Center, Brooklyn, New York, NY, United States
| | - Zongwei Wang
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Kathryn E Wellen
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Richard L Whelan
- Department of Surgery, St. Luke's Roosevelt Hospital, New York, NY, United States
| | - Eddy S Yang
- Department of Radiation Oncology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, United States
| | - Huanjie Yang
- The School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Xujuan Yang
- University of Illinois at Urbana Champaign, Champaign, IL, United States
| | - Paul Yaswen
- Life Sciences Division, Lawrence Berkeley National Lab, Berkeley, CA, United States
| | - Clement Yedjou
- Department of Biology, Jackson State University, Jackson, MS, United States
| | - Xin Yin
- Medicine and Research Services, Veterans Affairs San Diego Healthcare System & University of California, San Diego, CA, United States
| | - Jiyue Zhu
- Washington State University College of Pharmacy, Spokane, WA, United States
| | - Massimo Zollo
- Centro di Ingegneria Genetica e Biotecnologia Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, Federico II, Via Pansini 5, 80131 Naples, Italy
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Shivappa N, Hébert JR, Zucchetto A, Montella M, Libra M, Garavello W, Rossi M, La Vecchia C, Serraino D. Increased Risk of Nasopharyngeal Carcinoma with Increasing Levels of Diet-Associated Inflammation in an Italian Case-Control Study. Nutr Cancer 2016; 68:1123-30. [PMID: 27564524 DOI: 10.1080/01635581.2016.1216137] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Components of diet can modulate inflammation and therefore may have an important role in the development of nasopharyngeal carcinoma (NPC). Little is known about the inflammatory potential of diet in relation to nasopharyngeal carcinogenesis. METHODS Data from an Italian multicenter case-control study conducted between 1992 and 2008 and including 198 cases with incident, histologically confirmed NPC, and 594 controls hospitalized for acute nonneoplastic diseases were used to estimate the relation between a dietary inflammatory index (DII) and the risk of NPC. The DII was computed based on the intake of selected dietary factors assessed by a validated 78-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) adjusted for study center, place of living, sex, age, year of interview, education, tobacco smoking, alcohol drinking, and energy intake using the residual method. RESULTS Subjects with higher DII scores had an increased risk of NPC, with each DII point increasing risk by nearly 20% [OR: 1.19; 95% confidence interval (CI): 1.05-1.36]. Compared to subjects in the lowest DII tertile, those in the highest tertile had >60% higher risk of NPC (OR: 1.64; 95% CI: 1.06-2.55; Ptrend = 0.04). CONCLUSION These results indicate that inflammatory potential of diet plays a role in NPC.
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Affiliation(s)
- Nitin Shivappa
- a South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,b Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA.,c Connecting Health Innovations LLC , Columbia , South Carolina , USA
| | - James R Hébert
- a South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina , Columbia , South Carolina , USA.,b Department of Epidemiology and Biostatistics , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA.,c Connecting Health Innovations LLC , Columbia , South Carolina , USA
| | - Antonella Zucchetto
- d Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute , Aviano , Italy
| | - Maurizio Montella
- e Department of Epidemiology , 'Fondazione G. Pascale', Istituto Nazionale Tumori , Naples , Italy
| | - Massimo Libra
- f Department of Biomedical and Biotechnological Sciences , University of Catania , Catania , Italy
| | - Werner Garavello
- g Department of Surgery and Translational Medicine , University of Milano-Bicocca , Milan , Italy
| | - Marta Rossi
- h Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy
| | - Carlo La Vecchia
- h Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy
| | - Diego Serraino
- d Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute , Aviano , Italy
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Tabung FK, Smith-Warner SA, Chavarro JE, Wu K, Fuchs CS, Hu FB, Chan AT, Willett WC, Giovannucci EL. Development and Validation of an Empirical Dietary Inflammatory Index. J Nutr 2016; 146:1560-70. [PMID: 27358416 PMCID: PMC4958288 DOI: 10.3945/jn.115.228718] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/23/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Knowledge on specific biological pathways mediating disease occurrence (e.g., inflammation) may be utilized to construct hypotheses-driven dietary patterns that take advantage of current evidence on disease-related hypotheses and the statistical methods of a posteriori patterns. OBJECTIVE We developed and validated an empirical dietary inflammatory index (EDII) based on food groups. METHODS We entered 39 pre-defined food groups in reduced rank regression models followed by stepwise linear regression analyses in the Nurses' Health Study (NHS, n = 5230) to identify a dietary pattern most predictive of 3 plasma inflammatory markers: interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor α receptor 2 (TNFαR2). We evaluated the construct validity of the EDII in 2 independent samples from NHS-II (n = 1002) and Health Professionals Follow-up Study (HPFS, n = 2632) using multivariable-adjusted linear regression models to examine how well the EDII predicted concentrations of IL-6, CRP, TNFαR2, adiponectin, and an overall inflammatory marker score combining all biomarkers. RESULTS The EDII is the weighted sum of 18 food groups; 9 are anti-inflammatory and 9 proinflammatory. In NHS-II and HPFS, the EDII significantly predicted concentrations of all biomarkers. For example, the relative concentrations comparing extreme EDII quintiles in NHS-II were: adiponectin, 0.88 (95% CI, 0.80, 0.96), P-trend = 0.003; and CRP, 1.52 (95% CI, 1.18, 1.97), P-trend = 0.002. Corresponding associations in HPFS were: 0.87 (95% CI, 0.82, 0.92), P-trend < 0.0001; and 1.23 (95% CI, 1.09, 1.40), P-trend = 0.002. CONCLUSION The EDII represents, to our knowledge, a novel, hypothesis-driven, empirically derived dietary pattern that assesses diet quality based on its inflammatory potential. Its strong construct validity in independent samples of women and men indicates its usefulness in assessing the inflammatory potential of whole diets. Additionally, the EDII may be calculated in a standardized and reproducible manner across different populations thus circumventing a major limitation of dietary patterns derived from the same study in which they are applied.
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Affiliation(s)
- Fred K Tabung
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;
| | - Stephanie A Smith-Warner
- Department of Nutrition and,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jorge E Chavarro
- Department of Nutrition and,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA
| | | | - Charles S Fuchs
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA;,Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA; and
| | - Frank B Hu
- Department of Nutrition and,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA
| | - Andrew T Chan
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Division of Gastroenterology and,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA
| | - Walter C Willett
- Department of Nutrition and,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA
| | - Edward L Giovannucci
- Department of Nutrition and,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA
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Dietary Inflammatory Index and Risk of Colorectal Cancer: A Case-Control Study in Korea. Nutrients 2016; 8:nu8080469. [PMID: 27483316 PMCID: PMC4997382 DOI: 10.3390/nu8080469] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/20/2016] [Accepted: 07/27/2016] [Indexed: 12/16/2022] Open
Abstract
The role of diet-associated inflammation in colorectal cancer is of interest. Accordingly, we aimed to examine whether the dietary inflammatory index (DII) was associated with the risk of colorectal cancer in a case-control study conducted in Korea. The DII was based on dietary intake, which was determined by a 106-item semi-quantitative food frequency questionnaire completed by 923 colorectal cancer cases and 1846 controls. Logistic regression was used to estimate odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by the anatomical site of the cancer, sex, and other risk factors. Higher DII scores were associated with an increased incidence of colorectal cancer (OR (95% CI) = 2.16 (1.71, 2.73) for highest vs. lowest tertile). The magnitude differed by anatomical site and sex. This association was slightly weaker in subjects with proximal colon cancer (1.68 (1.08, 2.61)) and was stronger in women (2.50 (1.64, 3.82)). Additionally, stronger associations were observed in subjects who were older than 50 years (p for interaction = 0.004) and engaged in physical activity (p for interaction < 0.001). Results from this study suggest that diet-associated inflammation may increase the risk of colorectal cancer, and this effect may differ by certain factors, such as anatomical site, age, sex, and lifestyle.
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Vargas AJ, Neuhouser ML, George SM, Thomson CA, Ho GYF, Rohan TE, Kato I, Nassir R, Hou L, Manson JE. Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study. Am J Epidemiol 2016; 184:23-32. [PMID: 27267948 DOI: 10.1093/aje/kwv304] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/29/2015] [Indexed: 02/07/2023] Open
Abstract
Diet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993-2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and <0.01 for quintiles 3-5 vs. quintile 1, respectively) and DASH score (hazard ratios were 0.72, 0.74, and 0.78 with P values of <0.01, <0.01, and 0.03 for quintiles 3-5 vs. quintile 1, respectively), but not other diet scores, were associated with a lower risk of CRC in adjusted models. No diet scores were significantly associated with CRC-specific mortality. Closer adherence to HEI-2010 and DASH dietary recommendations was inversely associated with risk of CRC in this large cohort of postmenopausal women.
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Shivappa N, Hébert JR, Behrooz M, Rashidkhani B. Dietary Inflammatory Index and Risk of Multiple Sclerosis in a Case-Control Study from Iran. Neuroepidemiology 2016; 47:26-31. [PMID: 27362443 PMCID: PMC5468099 DOI: 10.1159/000445874] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/31/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Diet and inflammation have been suggested to be important risk factors for multiple sclerosis (MS). OBJECTIVES In this study, we examined the ability of the dietary inflammatory index (DII) to predict MS in a case-control study conducted in Iran. METHODS This study included 68 MS cases and 140 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Logistic regression models were used to estimate ORs adjusted for age, energy, sex, body mass index, season of birth, rubella history, history of routine exercise before MS, smoking and history of consumption of cow's milk in the first 2 years of life. RESULTS Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of MS, with the DII being used both as a continuous variable (ORcontinuous 1.66; 95% CI 1.19-2.31; 1 unit increase corresponding to ≈15% of its range in the current study) and a categorical variable (ORDII (>1.43 vs.≤1.43) 2.68; 95% CI 1.15-6.26). CONCLUSIONS These results indicate that a pro-inflammatory diet is associated with increased risk of MS.
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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
| | - 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
| | - Maryam Behrooz
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shivappa N, Hébert JR, Rosato V, Rossi M, Montella M, Serraino D, La Vecchia C. Dietary inflammatory index and ovarian cancer risk in a large Italian case-control study. Cancer Causes Control 2016; 27:897-906. [PMID: 27262447 PMCID: PMC4925244 DOI: 10.1007/s10552-016-0767-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND While inflammation has been shown to play an important etiologic role in ovarian carcinogenesis, little is known about the association between inflammatory properties of diet and ovarian cancer risk. METHODS We explored the association between the dietary inflammatory index (DII) and ovarian cancer risk in a multicentric Italian case-control study conducted between 1992 and 1999. Cases were 1,031 women with incident, histologically confirmed ovarian cancer from four areas in Italy. Controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive-tract diseases or committed to long-term modifications of diet. DII scores were computed based on 31 nutrients and food items assessed using a reproducible and validated 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake and other recognized confounding factors. RESULTS Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of ovarian cancer compared to subjects in the lowest quartile (i.e., with an anti-inflammatory diet) (ORQuartile4vs1 1.47, 95% confidence interval, CI, 1.07, 2.01; p trend = 0.009). When analyses were carried out using continuous DII, a significant positive association with ovarian cancer was observed: the OR for one-unit increment in DII score (corresponding to approximately 8 % of its range in the current study, +6.0 to -6.20) was 1.08 (95% CI 1.02, 1.14). CONCLUSION A pro-inflammatory diet as indicated by higher DII scores is associated with increased ovarian 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 Innovations LLC, Columbia, SC, 29201, 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 Innovations LLC, Columbia, SC, 29201, USA
| | - Valentina Rosato
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Montella
- Dipartimento di Epidemiologia, 'Fondazione G. Pascale', Istituto Nazionale Tumori, Naples, Italy
| | - Diego Serraino
- SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, PN, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Hodge AM, Bassett JK, Shivappa N, Hébert JR, English DR, Giles GG, Severi G. Dietary inflammatory index, Mediterranean diet score, and lung cancer: a prospective study. Cancer Causes Control 2016; 27:907-17. [PMID: 27294725 DOI: 10.1007/s10552-016-0770-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/01/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate prospectively the associations of Dietary Inflammatory Index (DII) and Mediterranean Diet Score (MDS) with lung cancer. METHODS We used data from men and women aged 40-69 years at recruitment in 1990-1994, who were participants in the Melbourne Collaborative Cohort Study (n = 35,303). A total of 403 incident lung cancer cases were identified over an average 18-year follow-up. Hazard ratios (HR) were estimated using Cox regression, adjusting for smoking status and other risk factors, with age as the time metric. RESULTS An inverse correlation was observed between the DII and MDS (ρ = -0.45), consistent with a higher DII being pro-inflammatory and less 'healthy,' while a high MDS reflects a 'healthier' diet. The DII was positively associated with risk of lung cancer in current smokers [HRQ4 vs Q1 = 1.70 (1.02, 2.82); Ptrend = 0.008] (p interaction between DII quartiles and smoking status = 0.03). The MDS was inversely associated with lung cancer risk overall [HR7-9 vs 0-3 = 0.64 (0.45, 0.90); Ptrend = 0.005] and for current smokers (HR7-9 vs 0-3 = 0.38 (0.19, 0.75); Ptrend = 0.005) (p interaction between MDS categories and smoking status = 0.31). CONCLUSIONS The MDS showed an inverse association with lung cancer risk, especially for current smokers. A high DII, indicating a more pro-inflammatory diet, was associated with risk of lung cancer only for current smokers. A healthy diet may reduce the risk of lung cancer, especially in smokers.
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Affiliation(s)
- A M Hodge
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia.
| | - J K Bassett
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - N 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
| | - J 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
| | - D R English
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Level 3, 207 Bouverie St, University of Melbourne, VIC, 3010, Australia
| | - G G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Level 3, 207 Bouverie St, University of Melbourne, VIC, 3010, Australia
| | - G Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Gustave Roussy, 94805, Villejuif, France
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- HuGeF, Human Genetics Foundation, 10126, Torino, Italy
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Tabung FK, Steck SE, Liese AD, Zhang J, Ma Y, Caan B, Chlebowski RT, Freudenheim JL, Hou L, Mossavar-Rahmani Y, Shivappa N, Vitolins MZ, Wactawski-Wende J, Ockene JK, Hébert JR. Association between dietary inflammatory potential and breast cancer incidence and death: results from the Women's Health Initiative. Br J Cancer 2016; 114:1277-85. [PMID: 27100730 PMCID: PMC4891517 DOI: 10.1038/bjc.2016.98] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/02/2016] [Accepted: 03/13/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diet modulates inflammation and inflammatory markers have been associated with cancer outcomes. In the Women's Health Initiative, we investigated associations between a dietary inflammatory index (DII) and invasive breast cancer incidence and death. METHODS The DII was calculated from a baseline food frequency questionnaire in 122 788 postmenopausal women, enrolled from 1993 to 1998 with no prior cancer, and followed until 29 August 2014. With median follow-up of 16.02 years, there were 7495 breast cancer cases and 667 breast cancer deaths. We used Cox regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by DII quintiles (Q) for incidence of overall breast cancer, breast cancer subtypes, and deaths from breast cancer. The lowest quintile (representing the most anti-inflammatory diet) was the reference. RESULTS The DII was not associated with incidence of overall breast cancer (HRQ5vsQ1, 0.99; 95% CI, 0.91-1.07; Ptrend=0.83 for overall breast cancer). In a full cohort analysis, a higher risk of death from breast cancer was associated with consumption of more pro-inflammatory diets at baseline, after controlling for multiple potential confounders (HRQ5vsQ1, 1.33; 95% CI, 1.01-1.76; Ptrend=0.03). CONCLUSIONS Future studies are needed to examine the inflammatory potential of post-diagnosis diet given the suggestion from the current study that dietary inflammatory potential before diagnosis is related to breast cancer death.
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Affiliation(s)
- Fred K Tabung
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Bette Caan
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LABioMed), Torrance, CA, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lifang Hou
- Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
| | - Mara Z Vitolins
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
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Hébert JR, Frongillo EA, Adams SA, Turner-McGrievy GM, Hurley TG, Miller DR, Ockene IS. Perspective: Randomized Controlled Trials Are Not a Panacea for Diet-Related Research. Adv Nutr 2016; 7:423-32. [PMID: 27184269 PMCID: PMC4863268 DOI: 10.3945/an.115.011023] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Research into the role of diet in health faces a number of methodologic challenges in the choice of study design, measurement methods, and analytic options. Heavier reliance on randomized controlled trial (RCT) designs is suggested as a way to solve these challenges. We present and discuss 7 inherent and practical considerations with special relevance to RCTs designed to study diet: 1) the need for narrow focus; 2) the choice of subjects and exposures; 3) blinding of the intervention; 4) perceived asymmetry of treatment in relation to need; 5) temporal relations between dietary exposures and putative outcomes; 6) strict adherence to the intervention protocol, despite potential clinical counter-indications; and 7) the need to maintain methodologic rigor, including measuring diet carefully and frequently. Alternatives, including observational studies and adaptive intervention designs, are presented and discussed. Given high noise-to-signal ratios interjected by using inaccurate assessment methods in studies with weak or inappropriate study designs (including RCTs), it is conceivable and indeed likely that effects of diet are underestimated. No matter which designs are used, studies will require continued improvement in the assessment of dietary intake. As technology continues to improve, there is potential for enhanced accuracy and reduced user burden of dietary assessments that are applicable to a wide variety of study designs, including RCTs.
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Affiliation(s)
- James R Hébert
- Cancer Prevention and Control Program, Departments of Epidemiology and Biostatistics, and
| | - Edward A Frongillo
- Health Promotion, Education and Behavior, Arnold School of Public Health
| | - Swann A Adams
- Cancer Prevention and Control Program, Departments of Epidemiology and Biostatistics, and College of Nursing, University of South Carolina, Columbia, SC
| | | | | | - Donald R Miller
- Department of Health Policy and Management, Boston University School of Public Health, Boston, MA; Center for Healthcare Organization and Implementation Research, Bedford Veterans Administration Medical Center, Bedford, MA; and
| | - Ira S Ockene
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
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Antwi SO, Oberg AL, Shivappa N, Bamlet WR, Chaffee KG, Steck SE, Hébert JR, Petersen GM. Pancreatic cancer: associations of inflammatory potential of diet, cigarette smoking and long-standing diabetes. Carcinogenesis 2016; 37:481-90. [PMID: 26905587 PMCID: PMC4843052 DOI: 10.1093/carcin/bgw022] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 02/04/2016] [Accepted: 02/11/2016] [Indexed: 01/02/2023] Open
Abstract
Epidemiologic studies show strong associations between pancreatic cancer (PC) and inflammatory stimuli or conditions such as cigarette smoking and diabetes, suggesting that inflammation may play a key role in PC. Studies of dietary patterns and cancer outcomes also suggest that diet might influence an individual's risk of PC by modulating inflammation. We therefore examined independent and joint associations between inflammatory potential of diet, cigarette smoking and long-standing (≥5 years) type II diabetes in relation to risk of PC. Analyses included data from 817 cases and 1756 controls. Inflammatory potential of diet was measured using the dietary inflammatory index (DII), calculated from dietary intake assessed via a 144-item food frequency questionnaire, and adjusted for energy intake. Information on smoking and diabetes were obtained via risk factor questionnaires. Associations were examined using multivariable-adjusted logistic regression. Higher DII scores, reflecting a more proinflammatory diet, were associated with increased risk of PC [odds ratio (OR)Quintile 5 versus 1 = 2.54, 95% confidence interval (CI) = 1.87-3.46, P trend < 0.0001]. Excess risk of PC also was observed among former (OR = 1.29, 95% CI = 1.07-1.54) and current (OR = 3.40, 95% CI = 2.28-5.07) smokers compared with never smokers, and among participants with long-standing diabetes (OR = 3.09, 95% CI = 2.02-4.72) compared with nondiabetics. Joint associations were observed for the combined effects of having greater than median DII score, and being a current smoker (OR = 4.79, 95% CI = 3.00-7.65) or having long-standing diabetes (OR = 6.03, 95% CI = 3.41-10.85). These findings suggest that a proinflammatory diet may act as cofactor with cigarette smoking and diabetes to increase risk of PC beyond the risk of any of these factors alone.
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Affiliation(s)
- Samuel O. Antwi
- Division of Epidemiology and
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN 55905, USA and
- Cancer Prevention and Control Program and
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Ann L. Oberg
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN 55905, USA and
| | - Nitin Shivappa
- Cancer Prevention and Control Program and
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - William R. Bamlet
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN 55905, USA and
| | - Kari G. Chaffee
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN 55905, USA and
| | - Susan E. Steck
- Cancer Prevention and Control Program and
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program and
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Gloria M. Petersen
- *To whom correspondence should be addressed. Tel: +1 5075 381563; Fax: +1 5072 662478;
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Sokol A, Wirth MD, Manczuk M, Shivappa N, Zatonska K, Hurley TG, Hébert JR. Association between the dietary inflammatory index, waist-to-hip ratio and metabolic syndrome. Nutr Res 2016; 36:1298-1303. [PMID: 27865615 DOI: 10.1016/j.nutres.2016.04.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 01/02/2023]
Abstract
Inflammation due to poor diet may contribute to the development of metabolic syndrome (MetSyn). The Dietary Inflammatory Index (DII) was created to characterize diet on a scale from anti- to pro-inflammatory. Our hypothesis was that higher (i.e., more pro-inflammatory) DII scores are associated with an increased prevalence of MetSyn compared to those with lower (i.e., more anti-inflammatory) DII scores. Data from the Polish-Norwegian (PONS) Study were analyzed using logistic and linear regression procedures in SAS (version 9.4). Comparisons of interest were between the first and fourth DII quartiles; analyses were stratified by sex. Mean waist-to-hip ratio (WHR) and diastolic blood pressure were greater among those in DII quartile 4 compared to 1. No statistically significantly increased MetSyn risks were observed for DII quartile 4 among men or women. Men in DII quartile 4 had elevated odds of fulfilling the waist component of MetSyn (odds ratio=1.65, 95% confidence interval=1.01-2.69). Although this study benefited from the DII and large sample sizes for both men and women, its cross-sectional nature and use of self-reported data may limit interpretation of results. Further work must be done in longitudinal studies to understand whether pro-inflammatory diets are associated with an increased risk of MetSyn, its components or other metabolic-related conditions. Additionally, further examination of the DII in relation to body habitus will be needed to understand the role of pro-inflammatory diets on anthropometrics, as observed in this study.
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Affiliation(s)
- Alexis Sokol
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Department of Health Services Policy and Management, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Connecting Health Innovations, LLC, Columbia, SC, USA.
| | - Marta Manczuk
- Department of Cancer Epidemiology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology 5, Roentgen Street, 02-781, Warsaw, Poland
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Katarzyna Zatonska
- Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Thomas G Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
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Kesse-Guyot E, Assmann KE, Andreeva VA, Touvier M, Neufcourt L, Shivappa N, Hébert JR, Wirth MD, Hercberg S, Galan P, Julia C. Long-term association between the dietary inflammatory index and cognitive functioning: findings from the SU.VI.MAX study. Eur J Nutr 2016; 56:1647-1655. [PMID: 27055851 DOI: 10.1007/s00394-016-1211-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 03/31/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Inflammation is a ubiquitous underlying mechanism of the links between diet and cognitive functioning. No study has yet evaluated the overall inflammatory potential of the diet, using the dietary inflammatory index (DII), in relation to cognitive functioning. In a French cohort of middle-aged adults, we evaluated the association between the DII, assessed in midlife, and cognitive performance evaluated 13 years later. METHODS The DII is a literature-derived dietary index developed to determine the inflammatory potential of diet. The DII was estimated at baseline (1994-1996) among 3080 subjects of the SU.VI.MAX (supplementation with antioxidant vitamins and minerals) cohort. Cognitive performance was assessed in 2007-2009 via a battery of standardized neuropsychological tests. Principal component analysis was performed to extract a summary score of cognitive performance. Multivariable-adjusted linear regression analyses were performed to provide regression coefficients and 95 % confidence intervals (95 % CI). RESULTS In a multivariate model, a strong inverse association was observed between a higher DII (reflecting a more inflammatory diet) and overall cognitive functioning (mean difference Q4 vs. Q1 = -1.76; 95 % CI = -2.81, -0.72, P for trend =0.002). With regard to specific cognitive domains, similar associations were observed with scores reflecting verbal memory, but not executive functioning. CONCLUSION This study suggests that a pro-inflammatory diet at midlife might be associated with subsequent lower cognitive functioning. A diet exhibiting anti-inflammatory properties may help to maintain cognitive health during aging. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov (number NCT00272428).
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France.
| | - Karen E Assmann
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Valentina A Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Lola Neufcourt
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - 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 Innovations, LLC, Columbia, SC, 29229, 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 Innovations, LLC, Columbia, SC, 29229, USA
| | - Michael D Wirth
- 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 Innovations, LLC, Columbia, SC, 29229, USA
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
- Département de Santé Publique, Hôpital Avicenne, 93017, Bobigny Cedex, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Chantal Julia
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam COMUE Sorbonne Paris Cité, SMBH Université Paris 13, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France
- Département de Santé Publique, Hôpital Avicenne, 93017, Bobigny Cedex, France
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Graffouillère L, Deschasaux M, Mariotti F, Neufcourt L, Shivappa N, Hébert JR, Wirth MD, Latino-Martel P, Hercberg S, Galan P, Julia C, Kesse-Guyot E, Touvier M. The Dietary Inflammatory Index Is Associated with Prostate Cancer Risk in French Middle-Aged Adults in a Prospective Study. J Nutr 2016; 146:785-791. [PMID: 26962176 PMCID: PMC4807649 DOI: 10.3945/jn.115.225623] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic inflammation is one of the mechanisms involved in carcinogenesis. Diet is a major source of pro- and anti-inflammatory compounds. The Dietary Inflammatory Index (DII) was designed to estimate its overall inflammatory potential. OBJECTIVE Our objective was to investigate the associations between the DII and overall, breast, and prostate cancer risks. METHODS This prospective study included 6542 participants [3771 women and 2771 men with a mean ± SD age of 49.2 ± 6.4 y and a BMI (in kg/m2) of 24.0 ± 3.6 at baseline] from the Supplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) cohort who completed at least six 24-h dietary records during the first 2 y of follow-up. The DII was based on 36 food variables. Higher scores corresponded to more proinflammatory diets. A total of 559 incident cancers were diagnosed (median follow-up, 12.6 y), including 158 female breast and 123 prostate cancers (the 2 main cancer sites in this cohort). Associations were characterized by multivariable Cox proportional hazards models. Stratified analyses were performed according to the median of usual daily alcohol intake. RESULTS Sex-specific quartiles of the DII were positively associated with prostate cancer risk [quartile (Q) 4 compared with Q1, HR: 2.08; 95% CI: 1.06, 4.09] but not with overall or breast cancer risks. There was an interaction between the DII and alcohol intake (grams per day) on overall cancer risk (P-interaction = 0.02): the DII was positively associated with overall cancer risk in low-to-moderate alcohol drinkers (Q4 compared with Q1 HR: 1.75; 95% CI: 1.15, 2.68; P-trend = 0.02), whereas no association was detected in higher consumers of alcohol (P-trend = 0.8). This interaction was also observed for breast cancer (P-interaction = 0.001). CONCLUSION Consistent with mechanistic data, findings from this study indicated that proinflammatory diets are associated with increased prostate cancer risk and, in low-to-moderate alcohol drinkers, with increased overall and breast cancer risk. The SU.VI.MAX trial was registered at clinicaltrials.gov as NCT00272428.
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Affiliation(s)
- Laurie Graffouillère
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - Mélanie Deschasaux
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - François Mariotti
- UMR 914 Nutrition Physiology and Ingestive Behavior, AgroParisTech, Research Center in Human Nutrition from the Ile-de-France region, Paris, France;,UMR 914 Nutrition Physiology and Ingestive Behavior, French National Institute for Agricultural Research (Inra), Research Center in Human Nutrition from the Ile-de-France region, Paris, France
| | - Lola Neufcourt
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC;,Connecting Health Innovations, Columbia, SC; and
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC;,Connecting Health Innovations, Columbia, SC; and
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC;,Connecting Health Innovations, Columbia, SC; and
| | - Paule Latino-Martel
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France;,Public Health Department, Avicenne Hospital, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France;,Connecting Health Innovations, Columbia, SC; and
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institute of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (Inra) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 5, 7, 13 Universities, Bobigny, France;
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Kizil M, Tengilimoglu-Metin MM, Gumus D, Sevim S, Turkoglu İ, Mandiroglu F. Dietary inflammatory index is associated with serum C-reactive protein and protein energy wasting in hemodialysis patients: A cross-sectional study. Nutr Res Pract 2016; 10:404-10. [PMID: 27478547 PMCID: PMC4958643 DOI: 10.4162/nrp.2016.10.4.404] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/31/2015] [Accepted: 02/14/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVE Malnutrition and inflammation are reported as the most powerful predictors of mortality and morbidity in hemodialysis (HD) patients. Diet has a key role in modulating inflammation and dietary inflammatory index (DII) is a new tool for assessment of inflammatory potential of diet. The aim of this study was to evaluate the application of DII on dietary intake of HD patients and examine the associations between DII and malnutrition-inflammation markers. SUBJECTS/METHODS A total of 105 subjects were recruited for this cross-sectional study. Anthropometric measurements, 3-day dietary recall, and pre-dialysis biochemical parameters were recorded for each subject. Subjective global assessment (SGA), which was previously validated for HD patients, and malnutrition inflammation score (MIS) were used for the diagnosis of protein energy wasting. DII was calculated according to average of 3-day dietary recall data. RESULTS DII showed significant correlation with reliable malnutrition and inflammation indicators including SGA (r = 0.28, P < 0.01), MIS (r = 0.28, P < 0.01), and serum C-reactive protein (CRP) (r = 0.35, P < 0.001) in HD patients. When the study population was divided into three subgroups according to their DII score, significant increasing trends across the tertiles of DII were observed for SGA score (P = 0.035), serum CRP (P = 0.001), dietary energy (P < 0.001), total fat (P < 0.001), saturated fatty acids (P < 0.001), polyunsaturated fatty acids (P = 0.006), and omega-6 fatty acids (P = 0.01) intakes. CONCLUSION This study shows that DII is a good tool for assessing the overall inflammatory potential of diet in HD patients.
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Affiliation(s)
- Mevlude Kizil
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey
| | - M Merve Tengilimoglu-Metin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey
| | - Damla Gumus
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey
| | - Sumeyra Sevim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey
| | - İnci Turkoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100 Sıhhiye, Ankara, Turkey
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Graffouillère L, Deschasaux M, Mariotti F, Neufcourt L, Shivappa N, Hébert JR, Wirth MD, Latino-Martel P, Hercberg S, Galan P, Julia C, Kesse-Guyot E, Touvier M. Prospective association between the Dietary Inflammatory Index and mortality: modulation by antioxidant supplementation in the SU.VI.MAX randomized controlled trial. Am J Clin Nutr 2016; 103:878-85. [PMID: 26864363 PMCID: PMC4763501 DOI: 10.3945/ajcn.115.126243] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/28/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic inflammation is a central mechanism involved in cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, 4 leading causes of mortality. Diet is a major source of pro- and anti-inflammatory bioactive compounds. The Dietary Inflammatory Index (DII) was designed to estimate the overall inflammatory potential of the diet. OBJECTIVE Our aim was to study the prospective association between the DII and mortality, as well as assess whether antioxidant supplementation could modulate this association. DESIGN The Supplémentation en Vitamines et Minéraux Antioxydants study was a randomized, double-blind, placebo-controlled trial in which participants received low-dose antioxidants or a placebo from 1994 to 2002. In this observational prospective analysis, 8089 participants (mean ± SD age at baseline: 49.0 ± 6.3 y) were followed between 1994 and 2007 (median: 12.4 y). The DII was calculated from repeated 24-h dietary records; higher scores correspond to more proinflammatory diets. A total of 207 deaths occurred during follow-up, including 123 due to cancer and 41 due to cardiovascular events. Multivariate Cox proportional hazards models were computed. RESULTS Sex-specific tertiles of the DII were positively associated with cardiovascular + cancer mortality (HR for tertile 3 compared with tertile 1 = 1.53; 95% CI: 1.01, 2.32; P-trend = 0.05) and specific cancer mortality (HR for tertile 3 compared with tertile 1 = 1.83; 95% CI: 1.12, 2.99; P-trend = 0.02). The corresponding P value was 0.07 for all-cause mortality. The DII was statistically significantly associated with increased all-cause mortality in the placebo group (HR for tertile 3 compared with tertile 1 = 2.10; 95% CI: 1.15, 3.84; P-trend = 0.02) but not in the antioxidant-supplemented group (P-trend = 0.8; P-interaction = 0.098). CONCLUSION These results suggest that a proinflammatory diet is associated with increased all-cause and cancer mortality and antioxidants may counteract some of the proinflammatory effects of the diet. This trial was registered at clinicaltrials.gov as NCT00272428.
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Affiliation(s)
- Laurie Graffouillère
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - François Mariotti
- AgroParisTech and INRA, Research Center in Human Nutrition from the Ile-de-France region, Mixt Research Unit 914 Nutrition Physiology and Ingestive Behavior, Paris, France
| | - Lola Neufcourt
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - Nitin Shivappa
- Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and
| | - James R Hébert
- Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and
| | - Michael D Wirth
- Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and
| | - Paule Latino-Martel
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;
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146
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Deng FE, Shivappa N, Tang Y, Mann JR, Hebert JR. Association between diet-related inflammation, all-cause, all-cancer, and cardiovascular disease mortality, with special focus on prediabetics: findings from NHANES III. Eur J Nutr 2016; 56:1085-1093. [PMID: 26825592 DOI: 10.1007/s00394-016-1158-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/12/2016] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Chronic inflammation is associated with increased risk of cancer, cardiovascular disease (CVD), and diabetes. The role of pro-inflammatory diet in the risk of cancer mortality and CVD mortality in prediabetics is unclear. We examined the relationship between diet-associated inflammation, as measured by dietary inflammatory index (DII) score, and mortality, with special focus on prediabetics. METHODS This prospective cohort study used data from the Third National Health and Nutrition Examination Survey (NHANES III). We categorized 13,280 eligible participants, ages 20-90 years, according to glycosylated hemoglobin (HgbA1c) level and identified 2681 with prediabetes, defined as a glycosylated hemoglobin percentage of 5.7-6.4. Computation of DII scores and all statistical analyses were conducted in 2015. The DII was computed based on baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Over follow-up ranging between 135 and 168 person-months, a total of 3016 deaths were identified, including 676 cancer, 192 lung cancer, 176 digestive-tract cancer, and 1328 CVD deaths. Cox proportional hazard regression was used to estimate hazard ratios. RESULTS The prevalence of prediabetes was 20.19 %. After controlling for age, sex, race, HgbA1c, current smoking, physical activity, BMI, and systolic blood pressure, DII scores in tertile III (vs tertile I) was significantly associated with mortality from all causes (HR 1.39, 95 % CI 1.13, 1.72), CVD (HR 1.44, 95 % CI 1.02, 2.04), all cancers (HR 2.02, 95 % CI 1.27, 3.21), and digestive-tract cancer (HR 2.89, 95 % CI 1.08, 7.71). Findings for lung cancer (HR 2.01, 95 % CI 0.93, 4.34) suggested a likely effect. These results were moderately enhanced after additional adjustment for serum low-density lipoprotein and triglyceride and following eliminating deaths during the first year. CONCLUSIONS A pro-inflammatory diet, as indicated by higher DII scores, is associated with an increased risk of all-cause, CVD, all-cancer, and digestive-tract cancer mortality among prediabetic subjects.
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Affiliation(s)
- Fang Emily Deng
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC, 29203, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - YiFan Tang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Joshua R Mann
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC, 29203, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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147
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Shivappa N, Hébert JR, Polesel J, Zucchetto A, Crispo A, Montella M, Franceschi S, Rossi M, La Vecchia C, Serraino D. Inflammatory potential of diet and risk for hepatocellular cancer in a case-control study from Italy. Br J Nutr 2016; 115:324-31. [PMID: 26556602 DOI: 10.1017/s0007114515004419] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Inflammation and diet have been suggested to be important risk factors for hepatocellular cancer (HCC). This Italian multicentre hospital-based case-control study conducted between 1999 and 2002 and including 185 cases with incident, histologically confirmed HCC, and 404 controls hospitalised for acute non-neoplastic diseases provided an opportunity to investigate the association between HCC and the dietary inflammatory index (DII). The DII was computed on the basis of dietary intake assessed 2 years before the date of interview by a validated sixty-three-item FFQ. Logistic regression models were used to estimate OR adjusted for age, sex, study centre, education, BMI, smoking, physical activity, serum markers of hepatitis B and C infection and energy intake. Energy adjustment for DII was performed using the residual method. Participants in the highest tertile of DII scores (i.e. with a more pro-inflammatory diet) had a higher risk for HCC (ORtertile 3 v, 1 2·43; 95 % CI 1·27, 4·68; P trend=0·03). When stratified by the presence or absence of hepatitis B/C infection and sex, DII was strongly associated with HCC in hepatitis B- and C-negative participants (ORtertile 3 v. 1 4·18; 95 % CI 1·53, 11·39; P trend=0·02) and among males (ORtertile 3 v. 1 3·60; 95 % CI 1·65, 7·87; P trend=0·001). These results indicate that a pro-inflammatory diet is associated with increased risk for HCC, in those without a history of hepatitis B/C infection and among males.
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Affiliation(s)
- Nitin Shivappa
- 1Cancer Prevention and Control Program,University of South Carolina,Columbia,SC 29208,USA
| | - James R Hébert
- 1Cancer Prevention and Control Program,University of South Carolina,Columbia,SC 29208,USA
| | - Jerry Polesel
- 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy
| | - Antonella Zucchetto
- 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy
| | - Anna Crispo
- 4Department of Epidemiology,'Fondazione G. Pascale',Istituto Nazionale Tumori,80133 Naples,Italy
| | - Maurizio Montella
- 4Department of Epidemiology,'Fondazione G. Pascale',Istituto Nazionale Tumori,80133 Naples,Italy
| | - Silvia Franceschi
- 5Infections and Cancer Epidemiology Group,International Agency for Research on Cancer,Lyon 69372,France
| | - Marta Rossi
- 6Department of Clinical Sciences and Community Health,Università degli Studi di Milano,via G. Venezian 1,20133 Milan,Italy
| | - Carlo La Vecchia
- 6Department of Clinical Sciences and Community Health,Università degli Studi di Milano,via G. Venezian 1,20133 Milan,Italy
| | - Diego Serraino
- 3Epidemiology and Biostatistics Unit,CRO Aviano,National Cancer Institute,33081 Aviano,Italy
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Inflammatory potential of diet and all-cause, cardiovascular, and cancer mortality in National Health and Nutrition Examination Survey III Study. Eur J Nutr 2015; 56:683-692. [PMID: 26644215 DOI: 10.1007/s00394-015-1112-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Various dietary components have been studied in relation to overall mortality; however, little is known about the relationship between the inflammatory potential of overall diet and mortality. MATERIALS AND METHODS We examined the association between the dietary inflammatory index (DII) and mortality in the National Health and Nutrition Examination Survey III follow-up study. The DII was computed from baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence interval (95 % CI). During the follow-up, 2795 deaths were identified, including 1233 due to cardiovascular disease (CVD), and 615 due to cancer, 158 of which were due to digestive-tract cancers. RESULTS Multivariate Cox proportional hazards regression analyses, adjusting for age, race, diabetes status, hypertension, physical activity, body mass index, poverty index, and smoking, revealed positive associations between higher DII scores and mortality. Comparing subjects in DII tertile 3 versus tertile 1, significant associations were noted for all-cause mortality (HRTertile3vs1 1.34; 95 % CI 1.19-1.51, P trend < 0.0001), CVD mortality (HRTertile3vs1 1.46; 95 % CI 1.18-1.81, P trend = 0.0006), cancer mortality (HRTertile3vs1 1.46; 95 % CI 1.10-1.96, P trend = 0.01), and digestive-tract cancer mortality (HRTertile3vs1 2.10; 95 % CI 1.15-3.84, P trend = 0.03). CONCLUSION These results indicate that a pro-inflammatory diet, as indicated by higher DII scores, was associated with higher risk of all-cause, CVD, and cancer mortality.
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149
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Wirth MD, Shivappa N, Hurley TG, Hébert JR. Association between previously diagnosed circulatory conditions and a dietary inflammatory index. Nutr Res 2015; 36:227-33. [PMID: 26923509 DOI: 10.1016/j.nutres.2015.11.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/24/2015] [Accepted: 11/26/2015] [Indexed: 12/18/2022]
Abstract
Inflammation is a key contributor to the development or recurrence of circulatory disorders. Diet is a strong modifier of inflammation. It was hypothesized that more pro-inflammatory diets, as indicated by higher Dietary Inflammatory Index (DII) scores, would be associated with self-reported previously diagnosed circulatory disorders using National Health and Nutrition Examination Survey (NHANES) data. This analysis included NHANES respondents from 2005-2010 (n = 15,693). The DII was calculated from micro and macronutrients derived from a single 24-hour recall. Logistic regression, stratified by sex and adjusted for important covariates, was used to determine the odds of previous circulatory disorder diagnoses by quartile of DII scores. Excluding hypertension, which had a prevalence of 30%, the prevalence of any circulatory disorder was 8%. Those in DII quartile 4 were 1.30 (95%CI = 1.06-1.58) times more likely to have a previous circulatory disorder (excluding hypertension) compared to those in DII quartile 1. Similar findings were observed for specific CVDs including congestive heart failure, stroke, and heart attack. Participants in DII quartile 4 were more likely to have a diagnosis of hypertension compared to those in DII quartile 1 (prevalence odds ratio = 1.19, 95%CI = 1.05-1.34). Results tended to be stronger among females. Individuals with a previous circulatory disorder diagnosis from NHANES appear to have more pro-inflammatory diets compared to those without a previous diagnosis. Because inflammation is an important factor related to recurrence of circulatory disorders, the DII could be used in treatment programs to monitor dietary modulators of inflammation among individuals with these conditions.
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Affiliation(s)
- Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC 29201.
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC 29201
| | - Thomas G Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208; Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC 29201
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150
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Steck SE, Guinter M, Zheng J, Thomson CA. Index-based dietary patterns and colorectal cancer risk: a systematic review. Adv Nutr 2015; 6:763-73. [PMID: 26567200 PMCID: PMC4642428 DOI: 10.3945/an.115.009746] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.
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Affiliation(s)
- Susan E Steck
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Mark Guinter
- Department of Epidemiology and Biostatistics and,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics and,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; and
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health and,Arizona Cancer Center, University of Arizona, Tucson, AZ
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