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Dong J, Gao M, Li L, Pan X, Chen SY, Li J, Smith-Warner SA, Li X, Wang H, Zheng J. Associations of Dietary Inflammatory Potential with Esophageal Precancerous Lesions and Esophageal Squamous-Cell Cancer: A Cross-Sectional Study. Nutrients 2023; 15:4078. [PMID: 37764860 PMCID: PMC10537352 DOI: 10.3390/nu15184078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic inflammation plays a central role in the progression from esophageal precancerous lesions (EPLs) to esophageal squamous-cell cancer (ESCC). However, few studies have investigated the relationship between the overall inflammatory potential of diets and EPLs and ESCC. We aimed to study the association between the Dietary Inflammatory Index (DII) and EPLs and ESCC. As part of the National Cohort of Esophageal Cancer (NCEC) in China, 3967 residents (1993 men and 1974 women) aged from 40 to 69 years living in Yanting County received free gastroscopy screenings from 2017 to 2019. Dietary intake during the past year was assessed at enrollment of the cohort before screening and DII scores were calculated based on 28 food parameters. EPLs (classified into mild, moderate, and severe dysplasia) and ESCC were histologically confirmed by biopsy. Multivariable logistic regression was used to examine the associations of DII scores with EPLs and ESCC. A total of 312 participants were diagnosed with EPLs (226 with mild dysplasia, 40 with moderate dysplasia, and 46 with severe dysplasia) and 72 were diagnosed with ESCC. A statistically significant positive association was observed between DII scores and overall EPLs (ORT3 vs. T1 = 1.45, 95%CI = 1.01-2.09); the association was similar but not statistically significant for mild dysplasia (ORone-unit-increment = 1.11, 95%CI = 0.95-1.34) and for moderate and severe dysplasia combined (ORone-unit-increment = 1.15, 95%CI = 0.87-1.51). The association with ESCC was similar in magnitude but not significant, likely due to the small number of cases. In this cross-sectional study of a population in China at high risk of ESCC, DII scores were positively associated with odds of EPLs and ESCC. Consumption of anti-inflammatory foods may be beneficial to prevent EPLs and ESCC.
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Affiliation(s)
- Jingwen Dong
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA; (J.D.); (S.-Y.C.); (S.A.S.-W.)
| | - Min Gao
- School of Public Health, Capital Medical University, Beijing 100069, China;
| | - Lin Li
- Cancer Prevention and Treatment Office, Yanting Cancer Hospital, Mianyang 621600, China; (L.L.); (J.L.)
| | - Xiaoyu Pan
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA;
| | - Sheng-Yin Chen
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA; (J.D.); (S.-Y.C.); (S.A.S.-W.)
| | - Jun Li
- Cancer Prevention and Treatment Office, Yanting Cancer Hospital, Mianyang 621600, China; (L.L.); (J.L.)
| | - Stephanie A. Smith-Warner
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA; (J.D.); (S.-Y.C.); (S.A.S.-W.)
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA;
| | - Xiaoguang Li
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.L.); (H.W.)
| | - Hui Wang
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.L.); (H.W.)
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Wang M, Lu X, Zheng X, Liu J. The relationship between dietary inflammatory index values and thyroid function in the US adult population: An analysis of the NHANES 2007-2012 cohort. Immun Inflamm Dis 2023; 11:e1016. [PMID: 37773715 PMCID: PMC10510473 DOI: 10.1002/iid3.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE Researchers have developed the Dietary Inflammatory Index (DII) as a tool to quantify the inflammatory potential of a given diet. Higher DII scores indicated a more proinflammatory diet. While inflammation is known to have a strong impact on thyroid function, the precise nature of the association between DII scores and thyroid function has yet to be clarified. This study was conducted with the goal of exploring this relationship in a representative population of adults from the United States. METHODS For this study, we used data from the National Health and Nutrition Examination Survey (NHANES). Standardized questionnaires were used to collect demographic and dietary data from the participants, and laboratory tests were used to collect data on the participants' thyroid parameters and other relevant data. Linear regression models and smoothed curve fitting were used to assess the relationship between DII scores and thyroid function, with weighted data analyses and subgroup analyses being conducted as appropriate. RESULTS In total, 7712 subjects were recruited from the NHANES 2007-2012 cohort. Their weighted mean age was 44.87 (0.47) years, mean DII score was 1.41 (0.05). Mean FT3 was 3.20 (0.01) pg/mL and mean TT4 was 7.81 (0.03) µg/dL. In adjusted analyses, higher DII values were related to increases in FT3 (β = .007; p = .027) and TT4 (β = .050; p = .005) levels. Subgroup analyses showed a negative correlation between FT3 levels and DII scores in a population with high urinary iodine concentrations. CONCLUSION These data indicate that the consumption of a more proinflammatory diet, as evidenced by elevated DII scores, is correlated with significant increases in FT3 and TT4 levels. However, for people with high urinary iodine concentrations, a more proinflammatory diet was associated with lower FT3 levels. Additional research will be vital to clarify the mechanistic basis for these findings.
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Affiliation(s)
- Mingzheng Wang
- Department of Breast and ThyroidJinhua Central HospitalJinhuaZhejiangChina
| | - Xiaofeng Lu
- Department of Breast and ThyroidJinhua Central HospitalJinhuaZhejiangChina
| | - Xiaogang Zheng
- Department of Breast and ThyroidJinhua Central HospitalJinhuaZhejiangChina
| | - Junru Liu
- Department of Endocrinology and MetabolismJinhua People's HospitalJinhuaZhejiangChina
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Zhang XQ, Miao CW, Liu LP, Wang CL, Chen JZ, Li WH, Hu XD. The prognostic value of 11 th Japanese classification and 8 th AJCC staging systems in Chinese patients with esophageal squamous cell carcinoma. J Cardiothorac Surg 2023; 18:251. [PMID: 37612706 PMCID: PMC10463410 DOI: 10.1186/s13019-023-02350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/09/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Two staging systems, the 8th staging system by the American Joint Committee on Cancer (AJCC) and the 11th Japanese classification by Japan Esophageal Society (JES), are currently applied in the clinic for predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC). The differences between the two staging systems have been widely researched. However, little studies focus on the differences in specific staging between the two systems. Therefore, we aimed to compare the performance of different staging in predicting overall survival (OS) of Chinese patients with ESCC. METHODS This retrospective study included 268 patients who underwent radical esophagectomy and mediastinal lymph node dissection for ESCC between January 2008 and December 2013. Patients were staged by the 8th AJCC and 11th JES staging systems. OS was estimated using the Kaplan-Meier method and compared between N stages and between stage groupings using the log-rank test. Cox proportional hazards regression analysis was performed to identify factors independently related to outcome. Further, we compared the concordance indexes (C-indexes) of the two staging systems. RESULTS The mean age was 61.25 ± 7.056 years, median follow-up was 44.82 months, and 5-year OS rate was 47%. The OS was well predicted by the 8th AJCC N staging (P < 0.001) and the 11th JES N staging (P < 0.001), with a c-index of 0.638 (95% CI: 0.592-0.683) for AJCC N staging and 0.627 (95% CI: 0.583-0.670) for JES N staging (P = 0.13). In addition, the OS was also well predicted by stage groupings of the 8th AJCC (P < 0.001) and the 11th JES systems (P < 0.001), with a c-index of 0.658 (95% CI: 0.616-0.699) for 8th AJCC stage grouping and 0.629 (95% CI: 0.589-0.668) for the11th JES stage grouping (P = 0.211). CONCLUSIONS The prognostic effect of 11th JES staging system is comparable with that of AJCC 8th staging system for patients with ESCC. Therefore, both systems are applicable to clinical practice.
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Affiliation(s)
- Xi-Qin Zhang
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Xingning People's Hospital, Xingning, 514599, Guangdong, China
| | - Chuan-Wang Miao
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Lan-Pin Liu
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Cun-Liang Wang
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Jia-Zhen Chen
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Wan-Hu Li
- Shandong First Medical University, Jinan, 250000, Shandong, China
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Xu-Dong Hu
- Shandong First Medical University, Jinan, 250000, Shandong, China.
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China.
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Sheikh M, Roshandel G, McCormack V, Malekzadeh R. Current Status and Future Prospects for Esophageal Cancer. Cancers (Basel) 2023; 15:765. [PMID: 36765722 PMCID: PMC9913274 DOI: 10.3390/cancers15030765] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Esophageal cancer (EC) is the ninth most common cancer and the sixth leading cause of cancer deaths worldwide. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are the two main histological subtypes with distinct epidemiological and clinical features. While the global incidence of ESCC is declining, the incidence of EAC is increasing in many countries. Decades of epidemiologic research have identified distinct environmental exposures for ESCC and EAC subtypes. Recent advances in understanding the genomic aspects of EC have advanced our understanding of EC causes and led to using specific genomic alterations in EC tumors as biomarkers for early diagnosis, treatment, and prognosis of this cancer. Nevertheless, the prognosis of EC is still poor, with a five-year survival rate of less than 20%. Currently, there are significant challenges for early detection and secondary prevention for both ESCC and EAC subtypes, but Cytosponge™ is shifting this position for EAC. Primary prevention remains the preferred strategy for reducing the global burden of EC. In this review, we will summarize recent advances, current status, and future prospects of the studies related to epidemiology, time trends, environmental risk factors, prevention, early diagnosis, and treatment for both EC subtypes.
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Affiliation(s)
- Mahdi Sheikh
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 49341-74515, Iran
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 69007 Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 14117-13135, Iran
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Shi Y, Zhou W. Interactive Effects of Dietary Inflammatory Index with BMI for the Risk of Stroke among Adults in the United States: Insight from NHANES 2011-2018. J Nutr Health Aging 2023; 27:277-284. [PMID: 37170435 DOI: 10.1007/s12603-023-1904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND AIM Research on the correlation between Dietary Inflammation Index (DII) and stroke is limited. Patients with high body mass index (BMI), as a high-risk group for stroke, require attention. Therefore, we aimed to examine the interactive effects of dietary inflammation and BMI on the risk of stroke among adults in the United States. METHODS AND RESULTS Overall, 9,384 participants were included in this study. The exposure variable was the DII, which was calculated based on the overall inflammatory effect score, and the outcome was stroke. Overall, there was a positive relationship between DII (as a continuous variable) and stroke. Increased level of DII was significantly associated with increased risk of stroke (odds ratio [OR]: 1.21, 95% CI: 1.06-1.38), which was enhanced by higher BMI (OR: 1.35, 95% CI: 1.15-1.58) with significant additive interactions. There was a significant secondary interaction of copresence of BMI ≥25 kg/m2, systolic blood pressure (SBP) ≥140 mmHg, and high DII for increased stroke, with a further increase in OR to 1.41 (1.19-1.67). CONCLUSIONS This cross-sectional study shows that the relationship between higher DII levels and the significant increase in stroke prevalence was further amplified in patients with SBP ≥140 mmHg and higher BMI.
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Affiliation(s)
- Y Shi
- Wei Zhou, MPH, Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.No. 1 Minde Road, Nanchang of Jiangxi, 330006, China,
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Liu S, Jiang H, Zhang D, Luo J, Zhang H. The Association between Smoking Cessation and Depressive Symptoms: Diet Quality Plays a Mediating Role. Nutrients 2022; 14:nu14153047. [PMID: 35893901 PMCID: PMC9331914 DOI: 10.3390/nu14153047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/07/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: This cross-sectional study aimed to explore the association between smoking cessation and depressive symptoms and investigate the mediating role of dietary quality. Methods: We used data from the 2007–2014 National Health and Nutrition Examination Survey. Logistic regression models were applied to evaluate the associations between smoking cessation and depressive symptoms. Stratified analysis was performed according to different HEI levels. We examined the mediating role of HEI in the relationship between depressive symptoms and cessation duration using the Karlson–Holm–Breen (KHB) method. Results: A total of 20,004 participants aged 20 years or older were included in the analyses. There were significant correlations between years for smoking cessation and depressive symptoms (OR: 0.985, 95% CI: 0.971~0.999) after adjusting for correlation covariables. A likelihood ratio test showed that there was an interaction between smoking cessation and diet quality (p = 0.047). In the mediation analysis, we estimated that the increase in HEI scores after quitting smoking could explain the 6.91% decline in depressive symptoms. Conclusion: In this cross-sectional study, smoking cessation showed a protective effect on depressive symptoms and that diet quality can influence and mediate this association.
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Affiliation(s)
- Shuo Liu
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266000, China; (S.L.); (D.Z.); (J.L.)
| | - Hongbin Jiang
- Department of Primary Care, Qingdao Municipal Hospital, Qingdao 266000, China;
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266000, China; (S.L.); (D.Z.); (J.L.)
| | - Jia Luo
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao 266000, China; (S.L.); (D.Z.); (J.L.)
| | - Hua Zhang
- Department of Epidemiology and Health Statistics, The College of Public Health of Qingdao University, Qingdao 266000, China
- Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao 266034, China
- Correspondence: ; Tel.: +86-0532-85650292
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Lopez-Pentecost M, Crane TE, Garcia DO, Kohler LN, Wertheim BC, Hebert JR, Steck SE, Shivappa N, Santiago-Torres M, Neuhouser ML, Hatsu IE, Snetselaar L, Datta M, Kroenke CH, Sarto GE, Thomson CA. Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women's Health Initiative (WHI). ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 30:811-822. [PMID: 35602929 PMCID: PMC9119584 DOI: 10.1007/s10389-020-01342-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/07/2020] [Indexed: 01/27/2023]
Abstract
Aim To investigate the association between dietary patterns and total and obesity-related cancers risk. Additionally, to examine if acculturation modifies this relationship. Subject and Methods Dietary intake of postmenopausal Hispanic women (N=5,482) enrolled in the Women's Health Initiative was estimated from a Food Frequency Questionnaire and used to calculate dietary pattern scores; Healthy Eating Index-2015 (HEI-2015), Mexican Diet (MexD) score, alternate Mediterranean Diet Score (aMED), and the energy adjusted-Dietary Inflammatory Index (E-DII™). Associations were evaluated using Cox proportional hazards regression models. Results 631 cancers and 396 obesity-related cancers were diagnosed over a mean-follow up of 12 years. Across dietary scores, there were no significant associations with cancer risk or mortality. Trend analysis suggest a potentially lower risk for total cancer related to the highest MexD score (HR 0.68, 95% CI 0.45-1.04, P-trend=0.03), and lower risk for obesity-related cancer mortality related to the highest score category for MexD (HR 0.65, 95% CI 0.37-1.16, P-trend=0.02), and aMED (HR 0.87, 95% CI 0.45-1.67, P-trend=0.04). Further analysis suggests less acculturated women with higher MexD scores had 56% lower risk for any cancer (HR 0.44, 95% CI 0.22-0.88, P-trend=0.03) and 83% lower risk for cancer mortality (HR 0.17, 95% CI 0.04-0.76, P-trend=0.01) compared to more acculturated Hispanic women. Conclusions Dietary patterns were not associated with cancer risk and mortality in postmenopausal Hispanic women. Less-acculturated, Spanish-preferred speakers, who reported consuming a more traditional Mexican diet may experience a lower risk for cancer and cancer mortality.
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Affiliation(s)
- Melissa Lopez-Pentecost
- Clinical Translational Sciences, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Tracy E. Crane
- University of Arizona Cancer Center, Tucson, AZ, USA
- Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - David O. Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Lindsay N. Kohler
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - James R. Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - 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, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - Margarita Santiago-Torres
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Irene E. Hatsu
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, OH, USA
| | - Linda Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Mridul Datta
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Gloria E. Sarto
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Cynthia A. Thomson
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Ghosh NR, Jones LA. Dietary risk factors for esophageal cancer based on World Health Organization regions. Nutrition 2021; 95:111552. [PMID: 34999383 DOI: 10.1016/j.nut.2021.111552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Esophageal cancer (EC) has become one of the most alarming cancers in the world. There are significant differences in incidence and risk factors associated with the two most common histological subtypes of EC, esophageal squamous cell carcinoma and esophageal adenocarcinoma, between regions. This systematic review was undertaken to analyze dietary risk factors specific to EC and its two subtypes based on World Health Organization regions. METHODS A systematic search of five databases (Global Health, Google Scholar, PubMed, Scopus, and Web of Science) for the past 5 y (2015-2020) was conducted from March 2020 to July 2020. Titles and abstracts were screened to determine the primary inclusion eligibility, followed by an examination of the full-text articles. Finally, 59 articles were reviewed to identify EC risk factors and compare these by region. Data were extracted using a table developed by the research team. Risk factors found in >50% of regions were highlighted. RESULTS The study identified some major dietary risk factors for EC that were previously reported, as well as some uncommon dietary risk factors, such as salty foods and beverages, unpiped drinking water, sugar-related factors (e.g., sweet intake), and foods with high glycemic index. CONCLUSIONS EC risk factors extend beyond those previously identified. Targeting all EC risk factors by region will assist the World Health Organization and other health agencies in providing a tailored, culturally appropriate response to effectively reduce the incidence and prevalence of EC within a region.
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Affiliation(s)
- Nirjhar R Ghosh
- Department of Nutrition, Texas A&M University, College Station, Texas.
| | - Lori A Jones
- Department of Nutrition and Dietetics, Saint Louis University, St. Louis, Missouri
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The Association between the Dietary Inflammatory Index and Thyroid Function in U.S. Adult Males. Nutrients 2021; 13:nu13103330. [PMID: 34684331 PMCID: PMC8540204 DOI: 10.3390/nu13103330] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 02/05/2023] Open
Abstract
Thyroid function has a close link with inflammation. However, it is still unknown whether the dietary inflammatory potential is associated with thyroid function. We aimed to assess the relationship among them using the data from the National Health and Nutrition Examination Survey (NHANES). This study was a cross-sectional study, where weighted multivariable linear regression, subgroup analyses, and interaction terms were employed. Thyroid function was assessed by eight indexes, including total and free T4 and T3, Tg, TgAb, TPOAb, and TSH. A total of 2346 male participants aged ≥20 years with an average age of 50.74 ± 17.68 years were enrolled. The mean DII score among participants was −0.46 ± 1.73, ranging from −4.12 to 4.41, and mean total thyroxine (T4) was 7.61 ± 1.51 μg/dL. We found a positive association between DII and total T4 (β = 0.07; p = 0.0044). Using subgroup analysis, this association became stronger in both the iodine-deficient and obese group (iodine-deficient group: β = 0.15, p < 0.0001; obese group: β = 0.14, p < 0.0001). In conclusion, men adhering to a more pro-inflammatory diet appeared to have higher total T4 levels. However, these hormone variations were still within the normal clinical range and more well-designed studies are still needed to validate the causal relationship between DII and thyroid function.
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Nojomi M, Tehrani Banihashemi A, Niksima H, Hashemian M, Mottaghi A, Malekzaddeh R. The relationship between dietary patterns, dietary quality index, and dietary inflammatory index with the risk of all types of cancer: Golestan cohort study. Med J Islam Repub Iran 2021; 35:48. [PMID: 34268236 PMCID: PMC8271224 DOI: 10.47176/mjiri.35.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Indexed: 01/29/2023] Open
Abstract
Background: Dietary patterns and diet quality index (DQI) are widely discussed in relation with different health conditions and have recently been taken into consideration for all cancer types. Since chronic inflammation has been recognized as an important biologic risk factor for cancer occurrence, especially in epithelial tissues, proinflammatory or anti-inflammatory characteristics of diet has become the center of attention. In the present study, we aimed to identify whether a specific dietary pattern, Mediterranean dietary score (MDs), and dietary inflammatory index (DII) were associated with overall cancer risk in Iranian population.
Methods: This study was performed in the context of the Golestan cohort study. Participants with extreme daily energy intake or those who did not answer more than 30 question of the Food Frequency questionnaire (FFQ) were excluded. Dietary patterns, MDs, and DII were measured from FFQ. Age, sex, total energy, place of residence, smoking, wealth score, ethnicity, opiate use, BMI, education, marital status, and physical activity score were considered as confounding variables. Using Cox proportional hazards regression models, hazard ratios (HRs) and 95% confidence interval of cancer were estimated.
Results: HRs (95% CIs) of all cancers by quartiles of Western dietary pattern, DII, and MDs showed that the forth quartile of the Western dietary pattern is attributed to 23% higher cancer risk (HRs: 1.23, CI: 1.09-1.40, P< 0.001, adjusted for age and sex) compared to the first quartile. It also remained significant after further adjustments (HRs = 1.20, CI: 1.06-1.36, P< 0.001). There was a higher cancer risk in the fourth quartile of DII in comparison with the first quartile (HRs = 1.16, CI: 1.01-1.32, P trend < 0.001, adjusted for age and sex). The lower adherence to the Mediterranean dietary pattern also largely contributes to 27% higher cancer risk (HRs: 1.27, CI: 1.12-1.44), P trend < 0.001, adjusted for age and sex), which also remained remarkable after further adjustments ((HRs =1.19, CI: 1.05-1.35, P trend < 0.001).
Conclusion: Cancer is highly correlated to dietary intake and dietary patterns, such as the Western dietary pattern, while the Mediterranean diet score was inversely associated with cancer risk. Further investigations are required to get a broader insight into cancer determinants in population.
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Affiliation(s)
- Marzieh Nojomi
- Preventive Medicine & Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Department of Sociology & Anthropology, Nipissing University, North Bay, Ontario, Canada
| | - Arash Tehrani Banihashemi
- Preventive Medicine & Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Niksima
- Preventive Medicine & Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Hashemian
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Azadeh Mottaghi
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzaddeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Kayamba V. Nutrition and upper gastrointestinal cancers: An overview of current understandings. Semin Cancer Biol 2021; 83:605-616. [DOI: 10.1016/j.semcancer.2021.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023]
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12
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Barekzai AM, Aminianfar A, Mousavi SM, Esmaillzadeh A. The Association between Dietary Inflammatory Potential and Gastric Cancer: A Case Control Study. Nutr Cancer 2021; 74:463-471. [PMID: 33560151 DOI: 10.1080/01635581.2021.1883682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE No report is available about diet-disease associations in the understudied region of Afghanistan. Although the inflammatory potential of diet has been linked with several cancers, information about gastric cancer is scarce. The present study aimed to investigate the relationship between the inflammatory potential of the diet and odds of gastric cancer in Afghanistan. METHODS In this hospital-based case-control study, we enrolled 90 newly-diagnosed cases of gastric cancer and 180 age (±5) and sex-matched controls. All cases were pathologically confirmed gastric cancer patients, with no history of any type of other pathologically confirmed cancers. Controls were healthy individuals and relatives of patients in the hospital. Dietary assessment was done by a pre-tested food frequency questionnaire. DII was calculated based on energy-adjusted amounts of several foods and nutrients with inflammatory or anti-inflammatory potential, as introduced by earlier studies. RESULTS Mean age of study participants was 54 years, of them 73% were males. After adjustment for age and sex, individuals in the highest tertile of the inflammatory potential of the diet were 2.47 times (95% CI: 1.31-4.66) more likely to have gastric cancer compared with those in the lowest tertile. Further adjustment for other potential confounders did not substantially affect the association; such that participants with the greatest inflammatory potential of the diet had approximately 3.59 times (95% CI: 1.16-11.02) increased odds of gastric cancer than those with the lowest adherence. Additional adjustment for BMI strengthened the association (OR: 3.75; 95% CI: 1.14-12.30). CONCLUSION We found a significant positive association between inflammatory potential of the diet and risk of gastric cancer. Further studies with prospective nature are required to confirm this association.
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Affiliation(s)
- Ahmad Mujtaba Barekzai
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Science, Kashan, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Chen QJ, Ou L, Li K, Ou FR. Meta-analysis of the relationship between Dietary Inflammatory Index and esophageal cancer risk. Medicine (Baltimore) 2020; 99:e23539. [PMID: 33285771 PMCID: PMC7717753 DOI: 10.1097/md.0000000000023539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Diet is closely related to the occurrence of esophageal cancer (EC). Dietary Inflammatory Index (DII), as a novel index that describes the inflammatory potential of diet, was widely used in many diseases. OBJECTIVE To systematically analyze the relationship between DII and the risk of esophageal cancer. METHODS We mainly searched relative studies in PubMed, Cochrane library, Web of Science, and other literature database. The random-effect model was used for meta-analysis, and subgroup analysis and sensitivity analysis were used to detect the origin of heterogeneity. RESULTS We finally obtained 6 articles (8 studies). All studies were case-control studies which consisted of 1961 cases and 3577 controls. In this study, compared with the lowest DII category, the highest DII category had a higher risk of esophageal cancer, and the pooled odds ratio (OR) of the 8 studies were 2.54 (95% confidence interval (CI): 1.90-3.40; I = 65.7%, P = .005). Furthermore, regardless of the differences in published year, DII components, geographic location, and study quality, there was still an increased risk of esophageal cancer in the highest DII category compared with the lowest DII category. CONCLUSIONS Our results inferred that DII was positively correlated with esophageal cancer risk and it could be used as a tool to predict the esophageal cancer risk and evaluate human health.
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Affiliation(s)
- Qiu-Jin Chen
- Department of Clinical Nutrition, The First Hospital of China Medical University
| | - Liang Ou
- Department of Pneumoconiosis, School of Public Health, China Medical University
| | - Kai Li
- Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Feng-Rong Ou
- Department of Clinical Nutrition, The First Hospital of China Medical University
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14
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Sleep quality and Dietary Inflammatory Index among university students: a cross-sectional study. Sleep Breath 2020; 25:2221-2229. [PMID: 32829458 DOI: 10.1007/s11325-020-02169-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Evidence indicates that most college students face reduced sleep quality due to unhealthy dietary habits and hectic daily schedules. While the relationship between sleep quality and general health has been the subject of intensive research, little is known about the association between sleep and its relation with the inflammatory potential of the diet until recently. This study aimed to investigate the association between Energy-Adjusted Dietary Inflammatory Index (E-DII®) scores and sleep quality in a group of students from the University of Sharjah (UOS). METHODS A cross-sectional study design was followed, and convenience sampling was used. Participants were assessed for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), E-DII scores were derived from a semi-quantitative food frequency questionnaire (FFQ), and physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). Chi-square tests and two-sample t tests were used to find an association between E-DII scores and sleep quality. RESULTS A total of 379 college students were included in the study of whom 64 % were female and 81% were between 18 and 21 years of age. Two-thirds of participants experienced poor sleep quality. Although results were trending in the hypothesized direction, no significant association was found between E-DII scores and sleep quality. Among the individual components of sleep quality, a direct significant association was found between E-DII scores and day dysfunction (P = 0.03). CONCLUSIONS These results suggest that a pro-inflammatory diet maybe related to increased day dysfunction among UOS students. Consuming a more anti-inflammatory diet may reduce daytime dysfunction. Further prospective and controlled studies are required to confirm this association, and to explore other attributes and their sequelae on sleep quality.
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15
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Moazzen S, van der Sloot KWJ, Vonk RJ, de Bock GH, Alizadeh BZ. Diet Quality and Upper Gastrointestinal Cancers Risk: A Meta-Analysis and Critical Assessment of Evidence Quality. Nutrients 2020; 12:E1863. [PMID: 32585822 PMCID: PMC7353231 DOI: 10.3390/nu12061863] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
We aimed to assess the effect of a high-quality diet on the risk of upper gastrointestinal cancer and to evaluate the overall quality of our findings by searching PubMed, EMBASE, Web of Science, Cochrane, and the references of related articles to February 2020. Two reviewers independently retrieved the data and performed the quality assessments. We defined the highest-quality diet as that with the lowest Diet Inflammatory Index category and the highest Mediterranean Diet Score category. Overall odds ratios and 95% confidence intervals were estimated for upper gastrointestinal cancer risk comparing the highest- versus lowest-diet quality. A random-effects meta-analysis was then applied with Review Manager, and the quality of the overall findings was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation approach. The highest-quality diets were significantly associated with reduced risk of upper gastrointestinal cancers, achieving odds ratios of 0.59 (95% confidence interval: 0.48-0.72) for the Diet Inflammatory Index, pooling the findings from nine studies, and 0.72 (95% confidence interval: 0.61-0.88) for the Mediterranean Diet Score, pooling the findings from 11 studies. We observed a minimum of 69% heterogeneity in the pooled results. The pooled results were graded as low quality of evidence. Although it may be possible to offer evidence-based general dietary advice for the prevention of upper gastrointestinal cancers, the evidence is currently of insufficient quality to develop dietary recommendations.
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Affiliation(s)
- Sara Moazzen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (K.W.J.v.d.S.); (G.H.d.B.); (B.Z.A.)
| | - Kimberley W. J. van der Sloot
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (K.W.J.v.d.S.); (G.H.d.B.); (B.Z.A.)
| | - Roel J. Vonk
- Department of Celbiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands;
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (K.W.J.v.d.S.); (G.H.d.B.); (B.Z.A.)
| | - Behrooz Z. Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (K.W.J.v.d.S.); (G.H.d.B.); (B.Z.A.)
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16
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Hua R, Liang G, Yang F. Meta-analysis of the association between dietary inflammatory index (DII) and upper aerodigestive tract cancer risk. Medicine (Baltimore) 2020; 99:e19879. [PMID: 32332658 PMCID: PMC7220683 DOI: 10.1097/md.0000000000019879] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Epidemiological studies have reported an inconsistent relationship between dietary inflammatory index (DII) and upper aerodigestive tract (UADT) cancer risk. However, no systematic review or meta-analysis has been reported up to now. To quantify the association between DII and UADT cancer risk, we performed this meta-analysis. METHODS The PubMed, EMBASE, Web of Science and Cochrane Library database were searched for relevant studies from inception December 2018. All case-control studies investigating the association between DII and UADT cancer risk were selected. RESULTS A total of 9 case-control studies were identified, involving 13,714 participants. The adjusted pooled OR of UADT cancer for the highest (the most pro-inflammatory diet) vs lowest (the most anti-inflammatory diet) DII categories were 2.27 (95% CI: 1.89-2.73). Subgroup analysis showed that individuals with the highest category of DII score were independently associated with esophagus cancer (OR = 2.53, 95% CI: 1.74-3.68), oral cavity cancer (OR = 2.23, 95% CI: 1.73-2.86), pharyngeal cancer (OR = 2.02, 95% CI: 1.54-2.64), and laryngeal cancer (OR = 2.05, 95% CI: 0.85-4.93). CONCLUSION This meta-analysis suggested that the most pro-inflammatory diets (the highest DII scores) are associated with increased UADT cancer risk. However, the association between DII and laryngeal cancer risk need to be further investigated.
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Affiliation(s)
- Rongyu Hua
- School of Nursing, Zhejiang Chinese Medical University
| | - Guanmian Liang
- Department of Nursing, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences & Cancer Hospital of the University of Chinese Academy of Sciences & Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Fangying Yang
- Department of Nursing, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences & Cancer Hospital of the University of Chinese Academy of Sciences & Zhejiang Cancer Hospital, Hangzhou 310022, China
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17
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Zahedi H, Djalalinia S, Asayesh H, Mansourian M, Esmaeili Abdar Z, Mahdavi Gorabi A, Ansari H, Noroozi M, Qorbani M. A Higher Dietary Inflammatory Index Score is Associated with a Higher Risk of Incidence and Mortality of Cancer: A Comprehensive Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:15. [PMID: 32175055 PMCID: PMC7050224 DOI: 10.4103/ijpvm.ijpvm_332_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 04/18/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Inflamation is widely known as an adaptive pathophysiological response in a variety of cancers. There is an expanding body of research on the key role of diet in inflammation, a risk factor for all types of cancer. Dietary inflammatory index (DII) was recently develpoed to evalute the inflammatory potential of a diet either as anti-inflammatory or pro-inflammatory. In fact, several studies have shown the association of DII and risk of different cancer types. The aim of this meta-analysis was to investigate the association of DII with risk of incidence and mortality of any cancer types. Methods: We searched PubMed-Medline, Scopus, and Web of Science databases for pertient studies util January, 2017. All studies conducted to investigate the association of DII and incidence, mortality, and hospitalization of all cancer types were included. According to degree of heterogeneity, fixed- or random-effect model was employed by STATA software. Results: Total 38 studies were eligible for the meta-analysis. The results show that a higher level of DII increases the risk for all cancer types incidence by 32% (OR: 1.32; 95% CI: 1.22-1.42) including digestive tract cancers (OR: 1.55; 95% CI: 1.33-1.78), hormone-dependent cancers (OR: 1.14; 95% CI: 1.04-1.24), respiratory tract cancers (OR: 1.64; 95% CI: 1.11-2.17), and urothelial cancers (OR: 1.36; 95% CI: 1.01-1.73). Moreover, a higher level of DII is in association with a higher risk for mortality caused by all types of cancer by 16% (OR: 1.16; 95% CI: 1.01-1.32). In addition, meta-regression analysis reveals that the design of study can have a significant effect on the association of DII and incidence of all cancer types (slope: 0.54; P= 0.05). The stratified meta-analysis shows that the association of DII and incidence of all cancer types in case-control studies (OR: 1.53; 95% CI: 1.36-1.71) were more prominent than cohort studies (OR: 1.18; 95% CI: 1.07-1.30). Conclusions: This study shows that a higher level of DII is associated with a higher risk of incidence and mortality of all cancer types. The findings of the present study suggest that modifying inflammatory properties of dietary patterns can reduce the risk of incidence and mortality of all cancer types.
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Affiliation(s)
- Hoda Zahedi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili Abdar
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ansari
- Assistant Professor, Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Noroozi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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18
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Zhu J, Ling Y, Mi S, Chen H, Fan J, Cai S, Fan C, Shen Q, Li Y. Association between dietary inflammatory index and upper aerodigestive tract cancer risk: A systematic review and dose-response meta-analysis. Oral Oncol 2020; 103:104587. [PMID: 32050153 DOI: 10.1016/j.oraloncology.2020.104587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/17/2020] [Accepted: 02/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The relationship between dietary inflammatory index (DII) and upper aerodigestive tract (UADT) cancer risk have been investigated in a growing number of epidemiological studies. However, their findings were inconsistent, and no systematic review or meta-analysis has been conducted up to now. This meta-analysis was carried out to examine potential dose-response relationship between DII score and UADT cancer risk. MATERIAL AND METHODS A systematic search was conducted for relevant studies in PubMed and Web of Science up to March 28, 2019. Categorical meta-analysis as well as linear and non-linear dose-response meta-analysis were performed to evaluate association between DII and UADT cancer risk. RESULTS Nine case-control studies with a total of 4138 cases and 15,326 healthy controls were eligible in the present meta-analysis. The pooled odds ratios (ORs) of UADT cancer risk were 2.07 [95% confidence interval (CI): 1.82, 2.35] for the highest DII score compared with the lowest and 1.53 (95% CI: 1.39, 1.69) for higher DII score compared with lower score, respectively. Furthermore, a one-unit increment in DII score was associated with an increased risk of 18% for UADT cancers (OR: 1.18; 95% CI: 1.15, 1.21). An upward trend towards a positive association between elevated DII score and UADT cancer risk was also observed in non-linear dose-response meta-analysis. CONCLUSIONS The present meta-analysis provides evidence of highly pro-inflammatory diets that might increase risk of UADT cancers. Therefore, reducing pro-inflammatory components in diets should be considered to prevent and control UADT cancers.
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Affiliation(s)
- Jiahao Zhu
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuxiao Ling
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Shuai Mi
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hanzhu Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiayao Fan
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Shaofang Cai
- Department of Science and Education, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Chunhong Fan
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Qing Shen
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yingjun Li
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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19
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Veronese N, Cisternino AM, Shivappa N, Hebert JR, Notarnicola M, Reddavide R, Inguaggiato R, Guerra V, Logroscino A, Rotolo O, Chiloiro M, Leandro G, De Leonardis G, Tutino V, Misciagna G, Fontana L, Caruso MG. Dietary inflammatory index and mortality: a cohort longitudinal study in a Mediterranean area. J Hum Nutr Diet 2019; 33:138-146. [PMID: 31829488 DOI: 10.1111/jhn.12701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Higher Dietary Inflammatory Index (DII®) scores are associated with increased morbidity and mortality. However, little is known about the effects of DII on mortality in Mediterranean countries. Therefore, in the present study, we aimed to investigate the potential association between DII scores and overall, cancer and cardiovascular disease (CVD) mortality in people living in a Mediterranean area. METHODS DII scores were calculated using a validated food-frequency questionnaire. DII scores were then categorised into tertiles. Mortality was ascertained via death certificates. The association between DII scores with overall and cause-specific mortality was assessed via a multivariable Cox's regression analysis and reported as hazard ratios (HRs) with their 95% confidence intervals (CIs). RESULTS The study included 1565 participants (mean age 65.5 years; females 44.7%). After a median follow-up of 12 years (2005-2017), 366 (23.4%) participants died. After adjusting for 17 potential confounders, people with higher DII scores had an increased risk of death compared to those in the lowest (most anti-inflammatory) tertile (HR = 1.38; 95% CI = 1.04-1.82 for the second tertile; HR = 1.38; 95% CI = 1.03-1.86 for the third tertile). Each 1 SD increase in DII score increased the risk of death by 13%. No association was found between DII scores and cancer or CVD death when considered separately. CONCLUSIONS Higher DII scores were associated with a significantly higher mortality risk, whereas the association with cause-specific mortality was less clear. These findings highlight the potential importance of diet in modulating inflammation and preventing death.
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Affiliation(s)
- N Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - A M Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - N Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - J R Hebert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - M Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - R Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - R Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - V Guerra
- Clinical Trial Unit, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - A Logroscino
- Thoracic Medical Oncology, I.R.C.C.S. 'Giovanni Paolo II', Bari, Italy
| | - O Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - M Chiloiro
- Radiology Unit, Hospital San Giacomo, Bari, Italy
| | - G Leandro
- Unit of Gastroenterology, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - G De Leonardis
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - V Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - G Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, Bari, Italy
| | - L Fontana
- Central Clinical School and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Department of Clinical and Experimental Sciences, Brescia University Medical School, Brescia, Italy
| | - M G Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
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20
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Phillips CM, Chen LW, Heude B, Bernard JY, Harvey NC, Duijts L, Mensink-Bout SM, Polanska K, Mancano G, Suderman M, Shivappa N, Hébert JR. Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review. Nutrients 2019; 11:E1873. [PMID: 31408965 PMCID: PMC6722630 DOI: 10.3390/nu11081873] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children's DII (C-DII) scores and new avenues of investigation in this field of nutritional research.
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Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
- HRB Centre for Diet and Health Research, School of Public Health, University College Cork, Western Gateway Building, Western Rd, Cork, Co. Cork, Ireland.
| | - Ling-Wei Chen
- HRB Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Barbara Heude
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Jonathan Y Bernard
- Research Team on the Early Life Origins of Health (EAROH), Centre for Research in Epidemiology and Statistics (CRESS), INSERM, Université de Paris, F-94807 Villejuif, France
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - 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
| | - 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
- Connecting Health Innovations LLC, Columbia, SC 29201, USA
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21
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Shivappa N, Hébert JR, Mirsafa F, Rashidkhani B. Increased Inflammatory Potential of Diet Is Associated with Increased Risk of Bladder Cancer in an Iranian Case-Control Study. Nutr Cancer 2019; 71:1086-1093. [PMID: 30964343 DOI: 10.1080/01635581.2019.1597902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Purpose: Various aspects of diet have been implicated to play a role in the etiology of bladder cancer. Studies examining this association have been conducted primarily in Western countries but none in Middle Eastern Countries. Method: We examined the association between the dietary inflammatory index (DII®) and bladder cancer in an Iranian case-control study. A total of 56 incident cases with a mean age of 60 years and 109 controls with a mean age of 57 years, attending the same hospital as the cases during the same time period, were recruited. The DII is a literature-derived index developed to determine the inflammatory potential of diet and was computed using a validated food frequency questionnaire. Logistic regression was used to estimate odds ratios, with DII fit as continuous and as a dichotomous variable. Results: Multivariate analyses revealed that subjects with higher DII score (>-0.12) are at higher risk of bladder cancer [odds ratio (OR) = 2.46; 95% CI = 1.12-5.41, P value = 0.02)] compared to subjects with lower DII scores (≤-0.12). Stratified results showed stronger association was among current/ex-smokers (ORDII (>-0.12/≤-0.12) = 3.30; 95% CI = 1.07-10.16). Conclusion: These data suggest a pro-inflammatory diet may be a risk factor for bladder cancer among Iranians.
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Affiliation(s)
- 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
| | - 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
| | - Faezeh Mirsafa
- Community Nutrition Department, 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
- Community Nutrition Department, 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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22
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Wang XY, Fang AP, Chen PY, Liao GC, Zhang YJ, Shivappa N, Hébert JR, Chen YM, Zhu HL. High dietary inflammatory index scores are associated with an elevated risk of hepatocellular carcinoma in a case-control study. Food Funct 2019; 9:5832-5842. [PMID: 30357201 DOI: 10.1039/c8fo01190g] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Chronic inflammation and diet play crucial roles in the development of hepatocellular carcinoma (HCC); yet the association between dietary inflammatory potential and risk of HCC has rarely been investigated. This study aimed to examine whether a higher dietary inflammatory index (DII®) score (indicating a pro-inflammatory diet) is associated with an increased risk of HCC in a matched case-control study conducted between September 2013 and October 2017 in South China. A total of 659 cases with newly diagnosed, previously untreated HCC and 659 controls individually matched on age (±3 years) and sex were included in this study. DII scores were computed based on dietary intake information collected via a validated 79-item food frequency questionnaire (FFQ) during the one year prior to diagnosis (for the cases) or interview (for the controls). Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) between the DII score and the risk of HCC, adjusted for age, energy intake, body mass index, physical activity, marital status, education, household income, smoking status, and hepatitis B virus (HBV) infection status. Compared with subjects in the lowest DII tertile, subjects in the highest tertile had an elevated risk of HCC (fully adjusted OR: 3.22, 95% CI: 1.30-7.98, P-trend = 0.009). In stratified analyses, a significantly positive association was observed only in men, individuals with lower education level, smokers and non-alcohol drinkers. In conclusion, a higher DII score, representing a more inflammatory diet, was associated with an increased risk of HCC, in men, individuals with lower education level, smokers and non-alcohol drinkers.
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Affiliation(s)
- Xiao-Yan Wang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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23
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McMahon DM, Burch JB, Hébert JR, Hardin JW, Zhang J, Wirth MD, Youngstedt SD, Shivappa N, Jacobsen SJ, Caan B, Van Den Eeden SK. Diet-related inflammation and risk of prostate cancer in the California Men's Health Study. Ann Epidemiol 2019; 29:30-38. [PMID: 30503073 PMCID: PMC6388401 DOI: 10.1016/j.annepidem.2018.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of the study was to examine the relationship between proinflammatory diet and prostate cancer risk. METHODS Energy-adjusted Dietary Inflammatory Index (E-DII) scores were computed among 40,161 participants in the California Men's Health Study. Over 9.7 ± 3.8 years of follow-up, 2707 incident prostate cancer cases were diagnosed and categorized as low-, intermediate-, or high-risk, based on disease grade and stage. Accelerated failure-time models assessed time to diagnosis of prostate cancer. Cox proportional hazard models estimated hazard ratios (HR) and 95% confidence intervals (95% CI). Nonlinear effects of E-DII were modeled as third-order polynomials. RESULTS Time to prostate cancer diagnosis did not differ by E-DII quartile. The HR for high-risk prostate cancer increased in the third E-DII quartile (HRQ3 vs. Q1 = 1.36; 95% CI: 1.04-1.76), but not in the fourth (HRQ4 vs. Q1 = 0.99; 95% CI: 0.74-1.32, Ptrend = .74), suggesting a nonlinear dose-response. HR curves for prostate cancer increased exponentially above an E-DII threshold of ≈+3.0. HR curves for high-risk prostate cancer had a much steeper incline above an E-DII threshold of ≈+2.5. Curves were higher among Blacks and Whites relative to other races and among overweight or obese men. No relationship was observed between E-DII scores and intermediate- or low-risk disease. CONCLUSIONS Relationships between proinflammatory diet and prostate cancer risk may be nonlinear, with an increased risk above an E-DII threshold of ≈+2.5.
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Affiliation(s)
- Daria M McMahon
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - James B Burch
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia; Cancer Prevention and Control Program, University of South Carolina, Columbia; WJB Dorn Department of Veterans Affairs Medical Center, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia; Cancer Prevention and Control Program, University of South Carolina, Columbia; Connecting Health Innovations, LLC, Columbia, SC.
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia; Cancer Prevention and Control Program, University of South Carolina, Columbia; Connecting Health Innovations, LLC, Columbia, SC
| | - Shawn D Youngstedt
- College of Nursing and Health Innovation, Arizona State University, Phoenix; Phoenix VA Health Care System, Phoenix, AZ
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia; Cancer Prevention and Control Program, University of South Carolina, Columbia; Connecting Health Innovations, LLC, Columbia, SC
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland
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24
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Pan P, Dombkowski AA, Wang LS, Stoner GD. A nutrigenetic approach for investigating the chemopreventive effects of black raspberries during the development of preneoplastic esophagi in rats. JOURNAL OF BERRY RESEARCH 2018; 8:263-274. [PMID: 30613310 PMCID: PMC6319902 DOI: 10.3233/jbr-180346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Large epidemiological studies have shown that diets high in fruits reduce the risk of esophageal squamous cell carcinoma (ESCC). OBJECTIVE The current study investigated the effects of black raspberries (BRBs) on gene expression during the development of preneoplastic esophagi in rats. METHODS Using a post-initiation protocol, F344 rats were injected with N-nitrosomethylbenzylamine (NMBA) and then fed either a control diet or 5% BRBs. At weeks 9, 15, and 35, we euthanized subgroups of the rats and collected preneoplastic esophagi to isolate RNA samples for DNA microarray. RESULTS Along the development of NMBA-induced preneoplastic esophagi, NMBA injections led to differential expression of 1181 genes comparing to control rats, and dietary BRBs modulated 428 genes in esophagi from NMBA-treated rats. There are 137 common genes between 1181 and 428 gene sets, and BRBs significantly reversed the expression of 133 genes. These genes are associated with multiple gene oncology functions. BRBs induced an 8.8-fold gene enrichment on the pathway of inflammatory response and regulated 10 genes involved in this pathway. Among them, BRBs significantly reversed the expression of pro-inflammatory cytokines, such as CCL2, S100A8, and IL19. CONCLUSIONS BRBs exhibit strong anti-inflammatory effects against NMBA-induced rat esophageal tumorigenesis.
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Affiliation(s)
- Pan Pan
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alan A. Dombkowski
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
| | - Li-Shu Wang
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gary D. Stoner
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
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25
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Association between inflammatory potential of diet and risk of lung cancer among smokers in a prospective study in Singapore. Eur J Nutr 2018; 58:2755-2766. [PMID: 30255403 DOI: 10.1007/s00394-018-1825-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 09/18/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Diet and inflammation have been suggested to be important risk factors for lung cancer. We examined the ability of the dietary inflammatory index (DII®) to predict lung cancer in the Singapore Chinese Health Study (SCHS). The DII is a diet quality index based on the literature linking foods and nutrients with inflammatory biomarkers. PATIENTS AND METHODS Using data from the SCHS for 60,232 participants, including 1851 lung cancer cases, we investigated the associations of baseline DII scores calculated from a food frequency questionnaire with risk of developing lung cancer over an average of 17.6 years of follow-up. Hazard ratios (HR) were estimated using Cox regression, adjusting for smoking status and other risk factors. RESULTS After excluding cancers diagnosed in the first 2 years of follow-up, the DII was non-significantly associated with risk of lung cancer (HRQ5vsQ1 = 1.13; 95% CI 0.94-1.35; P-trend = 0.24) after adjusting for age, dialect group, sex, interview year, education, body mass index, total calorie intake, physical activity and various smoking variables. In stratified analysis, stronger, statistically significant associations were evident in current smokers (HR 1.44; 95% CI 1.11-1.86; Ptrend = 0.03, P for interaction = 0.003) and in male ever-smokers (HRQ5vsQ1 = 1.37; 95% CI 1.07-1.77; P-trend = 0.03). CONCLUSION A pro-inflammatory diet, as shown by higher DII scores, is associated with an elevated risk of lung cancer for subjects with a history of smoking. Public health measures should be adopted to promote consumption of a healthy, anti-inflammatory diet to reduce the risk of lung cancer, especially in current and former smokers.
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26
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Jayedi A, Emadi A, Shab-Bidar S. Dietary Inflammatory Index and Site-Specific Cancer Risk: A Systematic Review and Dose-Response Meta-Analysis. Adv Nutr 2018; 9:388-403. [PMID: 30032224 PMCID: PMC6054175 DOI: 10.1093/advances/nmy015] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 03/06/2018] [Indexed: 12/12/2022] Open
Abstract
Existing evidence suggests a link between the inflammatory potential of diet and risk of cancer. This study aimed to test the linear and potential nonlinear dose-response associations of the Dietary Inflammatory Index (DII), as being representative of inflammatory features of the diet, and site-specific cancer risk. A systematic search was conducted with the use of PubMed and Scopus from 2014 to November 2017. Prospective cohort or case-control studies reporting the risk estimates of any cancer type for ≥3 categories of the DII were selected. Studies that reported the association between continuous DII score and cancer risk were also included. Pooled RRs were calculated by using a random-effects model. Eleven prospective cohort studies (total n = 1,187,474) with 28,614 incident cases and 29 case-control studies with 19,718 cases and 33,229 controls were identified. The pooled RRs for a 1-unit increment in the DII were as follows: colorectal cancer, 1.06 (95% CI: 1.04, 1.08; I2 = 72.5%; n = 9); breast cancer, 1.03 (95% CI: 1.00, 1.07; I2 = 84.0%; n = 7); prostate cancer, 1.06 (95% CI: 0.97, 1.15; I2 = 56.2%; n = 6); pancreatic cancer, 1.16 (95% CI: 1.05, 1.28; I2 = 61.6%; n = 2); ovarian cancer, 1.08 (95% CI: 1.03, 1.13; I2 = 0%; n = 2); esophageal squamous cell carcinoma, 1.24 (95% CI: 1.10, 1.38; I2 = 64.3%; n = 2); renal cell carcinoma, 1.08 (95% CI: 1.02, 1.13; I2 = 0%; n = 2); and esophageal adenocarcinoma, 1.26 (95% CI: 1.13, 1.39; I2 = 0%; n = 2). A nonlinear dose-response meta-analysis showed that, after a somewhat unchanged risk within initial scores of the DII, the risk of colorectal cancer increased linearly with increasing DII score. In the analyses of breast and prostate cancers, the risk increased with a very slight trend with increasing DII score. In conclusion, the results showed that dietary habits with high inflammatory features might increase the risk of site-specific cancers.
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Affiliation(s)
- Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Emadi
- Department of Information Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
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27
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Abe M, Shivappa N, Ito H, Oze I, Abe T, Shimizu Y, Hasegawa Y, Kiyohara C, Nomura M, Ogawa Y, Hebert JR, Matsuo K. Dietary inflammatory index and risk of upper aerodigestive tract cancer in Japanese adults. Oncotarget 2018; 9:24028-24040. [PMID: 29844870 PMCID: PMC5963633 DOI: 10.18632/oncotarget.25288] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 04/13/2018] [Indexed: 01/10/2023] Open
Abstract
Background The inflammatory potential of diet that has been shown to be associated with cancer risk. We examined the association between dietary inflammatory potential as measured by the dietary inflammatory index (DII®) and risk of upper aerodigestive tract cancers in a Japanese case-control study. Results A positive association was observed between increasing DII scores and overall upper aerodigestive tract cancers, and across anatomic subsites. For upper aerodigestive tract cancers, the ORQ4vsQ1 = 1.73 (95% CI: 1.37–2.20); head and neck cancer, the ORQ4vsQ1 was 1.92 (95% CI: 1.42–2.59); and for esophageal cancer, the ORQ4vsQ1 was1.71 (95% CI: 1.54–1.90). Risks for hypopharyngeal and nasopharyngeal cancers were greatly elevated: (ORQ4vsQ1 = 4.05 (95% CI: 1.24–13.25) for hypopharyngeal cancer and ORQ4vsQ1 = 4.99 (95% CI: 1.14–21.79) for nasopharyngeal cancer. Conclusion A more pro-inflammatory diet was associated with an elevated risk of upper aerodigestive tract cancers after accounting for important confounders. All anatomic subsites, except larynx, showed the consistently elevated risk with increasing DII score. Those subsites with known etiological associations with persistent infection showed the largest elevation in risk. These results warrant further evaluation in future studies. Materials and Methods This is a case-control study of 1,028 cases and 3,081 age- and sex-matched non-cancer controls recruited at Aichi Cancer Center. DII scores were computed based on estimates of macro- and micro-nutrients from a self-administered food frequency questionnaire. Scores were further categorized into quartiles (based on the distribution in controls). Conditional logistic regression models were fit to estimate odds ratio (OR) and 95% confidence intervals (CIs) adjusted for smoking, ethanol consumption, alcohol flushing, number of teeth, and occupation group.
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Affiliation(s)
- Makiko Abe
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, 812-8582, Japan.,Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan.,Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan
| | - 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
| | - Hidemi Ito
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Isao Oze
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan
| | - Tetsuya Abe
- Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Yasuhiro Shimizu
- Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Chikako Kiyohara
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Masatoshi Nomura
- Department of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, 830-0011, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, 812-8582, Japan.,Department of Molecular and Cellular Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
| | - James R Hebert
- 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
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, 464-8681, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
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28
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Shivappa N, Wirth MD, Murphy EA, Hurley TG, Hébert JR. Association between the Dietary Inflammatory Index (DII) and urinary enterolignans and C-reactive protein from the National Health and Nutrition Examination Survey-2003-2008. Eur J Nutr 2018; 58:797-805. [PMID: 29675557 DOI: 10.1007/s00394-018-1690-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/13/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Enterolignans are important biomarkers of microbiota diversity, with higher levels indicating greater diversity. Diet and inflammation have been shown to play a role in maintaining microbiota diversity. This study examined whether inflammatory potential of diet, as measured by the Dietary Inflammatory Index (DII®) has an impact on levels of urinary enterolignans in the National Health and Nutrition Examination Survey (NHANES) 2003-2008. We also carried out construct validation of the DII with C-reactive protein (CRP). METHODS Data came from NHANES 2003-2008. Enterolignans [enterodiol (END) and enterolactone (ENL)] and CRP were assayed from urine and serum specimens, respectively. Energy-adjusted DII (E-DII) scores were calculated from food intakes assessed using 24-h dietary recalls and expressed per 1000 calories consumed. Associations were examined using survey-based multivariable linear and logistic regression for enterolignans, and logistic regression for CRP. RESULTS After multivariable adjustment, higher E-DII scores (i.e., indicating a relatively more pro-inflammatory diet) were associated with lower levels of creatinine-normalized END [beta coefficient (b)DIIquartile4vs1 = - 1.22; 95% CI = - 0.69, - 1.74; Ptrend ≤ 0.001] and ENL (bDIIquartile4vs1 = - 7.80; 95% CI = - 5.33, - 10.26; Ptrend ≤ 0.001). A positive association was also observed when enterolignans were dichotomized based on the cut-off of the 75th percentile value. In this same sample, the E-DII also was associated with CRP ≥ 3 mg/l (ORDIIcontinuous = 1.12; 95% CI 1.05, 1.19). CONCLUSION In these NHANES data, there was an association between E-DII score and enterolignans. This study also provided construct validation of the E-DII using CRP in a nationally representative sample. The results indicate that dietary inflammatory potential is associated with urinary enterolignans, a potential marker for microbiota diversity. However, studies are required to understand the direct association between DII and microbiota.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA. .,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA. .,College of Nursing, 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, Room 233, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,College of Nursing, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC, 29201, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, 29209, USA
| | - Thomas G Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, 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, Room 233, 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, 1417 Gregg Street, Columbia, SC, 29201, USA
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29
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Agudo A, Cayssials V, Bonet C, Tjønneland A, Overvad K, Boutron-Ruault MC, Affret A, Fagherazzi G, Katzke V, Schübel R, Trichopoulou A, Karakatsani A, La Vecchia C, Palli D, Grioni S, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita B, Peeters PH, Weiderpass E, Skeie G, Nøst TH, Lasheras C, Rodríguez-Barranco M, Amiano P, Chirlaque MD, Ardanaz E, Ohlsson B, Dias JA, Nilsson LM, Myte R, Khaw KT, Perez-Cornago A, Gunter M, Huybrechts I, Cross AJ, Tsilidis K, Riboli E, Jakszyn P. Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr 2018; 107:607-616. [PMID: 29635497 DOI: 10.1093/ajcn/nqy002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/26/2017] [Indexed: 12/13/2022] Open
Abstract
Background Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. Objective We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. Design A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. Results The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Conclusions Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.
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Affiliation(s)
- Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Valerie Cayssials
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Aurélie Affret
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Guy Fagherazzi
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Ruth Schübel
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic-M.P.Arezzo" Hospital, Ragusa, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Salvatore Panico
- Dipartamento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Theresa H Nøst
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Cristina Lasheras
- Departamento de Biología Funcional, Facultad de Medicina, Universidad de Oviedo, Asturias, Spain
| | - Miguel Rodríguez-Barranco
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Pilar Amiano
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain
- BioDonostia Research Institute, San Sebastian, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Navarra Public Health Institute, IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - Bodil Ohlsson
- Lund University, Skane University Hospital, Division of Internal Medicine, Malmö, Sweden
| | - Joana A Dias
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University. Malmö, Sweden
| | - Lena M Nilsson
- Public Health and Clinical Medicine, Nutritional Research and
| | - Robin Myte
- Public Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- University of Cambridge, Cambridge, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Amanda J Cross
- School of Public Health, Imperial College London, United Kingdom
| | - Kostas Tsilidis
- School of Public Health, Imperial College London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- School of Public Health, Imperial College London, United Kingdom
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Facultat Ciències Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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Dietary inflammatory index and risk of oesophageal cancer in Xinjiang Uyghur Autonomous Region, China. Br J Nutr 2018; 119:1068-1075. [PMID: 29502539 DOI: 10.1017/s0007114518000405] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Diet has been shown to have an effect on both inflammation and oesophageal cancer. This study investigated the association between the dietary inflammatory index (DII®) and the risk of oesophageal cancer in Xinjiang Uyghur Autonomous Region, China. A case-control study was conducted during 2008-2009 in Urumqi and Shihezi. DII scores were calculated based on dietary intake assessed by a validated FFQ administered to 359 incident oesophageal cancer patients and 380 hospital-based controls. Higher DII scores indicate more pro-inflammatory diets. Logistic regression analyses were performed to assess the association between DII scores and oesophageal cancer risk. Oesophageal cancer patients had a significantly higher median DII score (-0·35; interquartile range (IQR)=-2·25, 1·86) than that of controls (-1·41; IQR -3·07, 0·40). Multivariable logistic analysis revealed a positive association between higher DII scores and oesophageal cancer risk (ORQuartile 4 v. 1 2·55; 95 % CI 1·61, 4·06; P trend<0·001). A pro-inflammatory diet appears to be associated with an increased risk of oesophageal cancer in Xinjiang Uyghur Autonomous Region. Specific carcinogenic mechanisms are discussed. Accumulating evidence, to which the study contributes, indicates that encouraging the intake of more anti-inflammatory foods may be a strategy to protect against oesophageal cancer in this high-risk area of China.
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Li D, Hao X, Li J, Wu Z, Chen S, Lin J, Li X, Dong Y, Na Z, Zhang Y, Dai H, Song Y. Dose-response relation between dietary inflammatory index and human cancer risk: evidence from 44 epidemiologic studies involving 1,082,092 participants. Am J Clin Nutr 2018; 107:371-388. [PMID: 29566194 DOI: 10.1093/ajcn/nqx064] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/06/2017] [Indexed: 12/15/2022] Open
Abstract
Background A newly developed dietary inflammatory index (DII) to evaluate the inflammatory potential of diets was published recently. Many studies have investigated the link between diet-related inflammation and human cancer risk, but the results remain controversial. Objective We sought to determine the dose-response relation between DII and human cancer risk based on published epidemiologic literature. Design To summarize evidence, we performed a dose-response meta-analysis to investigate the association between DII and cancer incidence. We systematically searched PubMed, Embase, Web of Science, and the Cochrane library up to 5 November 2017. After data extraction, pooled RRs were calculated and dose-response analyses were performed using a restricted cubic spline model with 4 knots. Subgroup analyses, sensitivity analyses, and tests for publication bias were also performed. Results In all, 44 high-quality studies with 1,082,092 participants were included. The results showed that an elevated DII (continuous-RR: 1.13; 95% CI: 1.09, 1.16; category DIIhighest vs lowest-RR: 1.58; 95% CI: 1.45, 1.72) independently indicated higher cancer risk except for lung cancer and Australian studies. A linear dose-response relation between DII and overall cancer risk was found, with an 8.3% increase in the risk of cancer per DII score. The pooled RR of DII and cancer risk was 1.86 (95% CI: 1.63, 2.13) from 30 case-control studies but was lower in 14 prospective cohorts (RR: 1.29; 95% CI: 1.19, 1.40). The sensitivity analysis and Egger's test supported the main results. Conclusions Our analysis indicated that higher DII is significantly correlated with cancer risk. More prospective studies with large sample sizes, involving more ethnic groups and different cancer types, are required in the future. This review was registered with PROSPERO as CRD42017077075.
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Affiliation(s)
| | | | | | - Zhenhai Wu
- Department of Oncology, Zhejiang Hospital, Hangzhou, Zejiang, PR China
| | | | | | | | | | - Zhijing Na
- The Second Clinical Academy of China Medical University, Shenyang, Liaoning, PR China
| | - Yalin Zhang
- Clinical Nutrition, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Huixu Dai
- Clinical Epidemiology and Evidence-based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, PR China
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Shivappa N, Hebert JR, Neshatbini Tehrani A, Bayzai B, Naja F, Rashidkhani B. A Pro-Inflammatory Diet Is Associated With an Increased Odds of Depression Symptoms Among Iranian Female Adolescents: A Cross-Sectional Study. Front Psychiatry 2018; 9:400. [PMID: 30210375 PMCID: PMC6124384 DOI: 10.3389/fpsyt.2018.00400] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/09/2018] [Indexed: 01/24/2023] Open
Abstract
Background: The relation between dietary inflammation and risk of depression has not been widely explored. We examined the association between the inflammatory effect of the diet and the odds of depression among Iranian female adolescents. Methods: Using a stratified cluster sampling technique, 300 female adolescents aged 15-18 years were recruited from schools in Tehran between years 2014-2015. Depression was assessed using the Depression, Anxiety and Stress Scale (DASS)- a 21-point scale. The dietary inflammatory index (DII®) was used to evaluate the inflammatory potential of the diet. Dietary intake was assessed using a validated food frequency questionnaire. In addition to descriptive statistics, multivariable linear and logistic regression were used to calculate confounder-adjusted beta estimates and odds ratios. Results: In total, 88 females (30%) had at least a moderate level of depressive symptoms (DASS > 6). Females with the most pro-inflammatory diet had higher DASS depression score (β = 1.67; 95% CI = 0.03, 3.31) and were at 3.96 (95% CI = 1.12, 13.97) times higher odds of having at least moderate depressive symptoms, compared to females with the least anti-inflammatory diets. Conclusion: These data suggest that Iranian adolescent females eating a pro-inflammatory diet, as indicated by higher DII scores, had greater odds of having at least moderate depressive symptoms.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Asal Neshatbini Tehrani
- 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
| | - Bita Bayzai
- 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
| | - Farah Naja
- Nutrition and Food Sciences Department, American University of Beirut, Beirut, Lebanon
| | - 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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Kanellos PT, Kaliora AC, Protogerou AD, Tentolouris N, Perrea DN, Karathanos VT. The effect of raisins on biomarkers of endothelial function and oxidant damage; an open-label and randomized controlled intervention. Food Res Int 2017; 102:674-680. [DOI: 10.1016/j.foodres.2017.09.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 01/22/2023]
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Lee S, Lee J, Choi IJ, Kim YW, Ryu KW, Kim YI, Oh JK, Tran BT, Kim J. Dietary inflammatory index and the risk of gastric cancer in a Korean population. Oncotarget 2017; 8:85452-85462. [PMID: 29156732 PMCID: PMC5689622 DOI: 10.18632/oncotarget.20008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 06/10/2017] [Indexed: 12/12/2022] Open
Abstract
We aimed to investigate the association with the Dietary Inflammatory Index (DII™) on the risk of gastric cancer and whether histological type modifies this association. From March 2011 to December 2014, 388 cases and 776 controls were enrolled at the National Cancer Center. Utilizing a food frequency questionnaire, thirty-five food components were used to score the DII. The tertile distribution of DII for controls was as follows: T1: <0.96, T2: 0.96-2.97, and T3: ≥2.97. To investigate the association between DII and the gastric cancer risk, multivariable logistic models were constructed. In subgroup analyses, histological types including intestinal and diffuse types were examined. As the DII increased, gastric cancer risk increased (p-value for trend =0.007). Participants in the highest DII tertile had a greater gastric cancer risk compared to those in the lowest tertile [Odds Ratio (OR) =1.63, 95% Confidence Interval (CI) 1.15-2.29]. Stratification by sex revealed that men who were in the highest DII tertile showed a greater risk of intestinal type (OR=2.03, 95% CI 1.09-3.77). Participants positive for H. pylori infection had higher risk of intestinal type (OR=2.16, 95% CI 1.21-3.87). In this case-control study, we found a significantly positive association with a pro-inflammatory diet on gastric cancer risk, after adjusting for covariates. Future studies are suggested to prospectively examine the effect of a pro-inflammatory diet on gastric cancer risk.
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Affiliation(s)
- Sunghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
- Department of Food and Nutrition, College of Health Science, Kangwon National University, Samcheok, South Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Young-Woo Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Keun Won Ryu
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Young-Il Kim
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Binh Thang Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
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Kim JH, Kim J. Index-Based Dietary Patterns and the Risk of Prostate Cancer. Clin Nutr Res 2017; 6:229-246. [PMID: 29124044 PMCID: PMC5665745 DOI: 10.7762/cnr.2017.6.4.229] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/15/2017] [Accepted: 07/18/2017] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer is the second leading cause for cancer incidence in male. Although this high incidence is due to prostate specific antigen screening, other risk-factors, such as diet, might also be involved. The results of previous studies on the association between prostate cancer risk and individual dietary components have been conflicting. Thus, evaluation by dietary pattern analysis rather than individual dietary factors is suggested. The purpose of this study was to review the association of prostate cancer with a priori dietary indices, which are less studied and reviewed to date compared to a posteriori indices. Studies reviewed in this research were published from January 1997 to March 2017. Seventeen studies with nine indices were selected. In Mediterranean Diet Score (MDS), all four studies were non-significant. In Dietary Inflammatory Index (DII), 3 out of 4 studies significantly increased risk by 1.33-2.39 times, suggesting that a higher pro-inflammatory diet may be a possible prostate cancer risk factor. In Oxidative Balance Score (OBS), 2 out of 5 studies had decreased risk by 0.28 and 0.34 times, whereas 1 study had increased risk by 1.17 times. Among other indices, Healthy Eating Index (HEI) and prostate cancer dietary index were associated with decreased risk, while the results from 2 studies of Low Carbohydrate, High Protein Diet (LCHP) score were conflicting. In conclusion, we observed that it is insufficient to support the association between a priori indices and prostate cancer risk, except for MDS and DII, which had relatively constant results among studies. Therefore, further studies are required to identify consistent criteria for each a priori index, and should be conducted actively in various populations.
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Affiliation(s)
- Ji Hyun Kim
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Jeongseon Kim
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
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36
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Fowler ME, Akinyemiju TF. Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. Int J Cancer 2017; 141:2215-2227. [PMID: 28795402 DOI: 10.1002/ijc.30922] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/27/2017] [Accepted: 07/25/2017] [Indexed: 01/08/2023]
Abstract
Proinflammatory dietary patterns have been associated with increased cancer risk and mortality. We present a systematic review and meta-analysis of the current published literature on a dietary inflammatory index (DII) score and its association with cancer risk and mortality outcomes. Published articles from online databases (PubMed, Scopus, and Embase) examining the association between DII and any cancer risk, incidence, or mortality between 1980 and November 2016 were selected for review. Results of studies meeting inclusion criteria were summarized and meta-analyzed using STATA to generate summary measures of association across studies. Sixty-three published articles were identified from the search, and following title, abstract and full-text review, twenty-four studies met inclusion criteria. All articles calculated DII scores based on study-specific food-frequency questionnaires using methodology from the same article. Of the 24 included studies, 13 were case-control, 6 were prospective cohort, 1 was a retrospective cohort, 3 were RCTs, and 1 did not specify study design. The most common cancers examined were colorectal, breast, lung, and prostate. Individuals in the highest versus lowest DII categories had 25% increased risk of overall cancer incidence (RR: 1.25, 95% CI: 1.16-1.35), 75% higher odds of cancer (OR: 1.75, 95% CI: 1.43-2.16) and 67% increased risk of cancer mortality (RR: 1.67, 95% CI: 1.13-2.48). Upon stratification for cancer type, positive associations remained (RRbreast : RR: 1.12, 95% CI: 1.03-1.22) (RRcolorectal : 1.33, 95% CI: 1.22-1.46) (RRlung : 1.30, 95% CI: 1.13-1.50). There were consistent and significant positive associations between higher DII and cancer incidence and mortality across cancer types, study populations, and study design.
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Affiliation(s)
- Mackenzie E Fowler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Tomi F Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.,Department of Epidemiology, University of Kentucky, Lexington, KY
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Shivappa N, 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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A higher Dietary Inflammatory Index score is associated with a higher risk of breast cancer among Chinese women: a case-control study. Br J Nutr 2017; 117:1358-1367. [PMID: 28580895 DOI: 10.1017/s0007114517001192] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Previous studies have investigated the association between dietary inflammatory potential and the development of cancer. For breast cancer the results have been equivocal. The present study aimed to investigate whether higher Dietary Inflammatory IndexTM (DII) scores were associated with increased risk of breast cancer among Chinese women. A total of 867 cases and 824 controls were recruited into the present case-control study from September 2011 to February 2016. DII scores were computed based on baseline dietary intake assessed by a validated 81-item FFQ. The OR and 95 % CI were assessed by multivariable logistic regression after adjusting for various potential confounders. DII scores in this study ranged from -5·87 (most anti-inflammatory score) to +5·71 (most proinflammatory score). A higher DII score was associated with a higher breast cancer risk (adjusted ORquartile 4 v. 1 2·28; 95 % CI 1·71, 3·03; adjusted ORcontinuous 1·40; 95 %CI 1·25, 1·39). In stratified analyses, positive associations also were observed except for underweight women or women with either oestrogen receptor+ or progesterone receptor+ status (but not both). Results from this study indicated that higher DII scores, corresponding to more proinflammatory diets, were positively associated with breast cancer risk among Chinese women.
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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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Ramirez AG, Parma DL, Muñoz E, Mendoza KD, Harb C, Holden AEC, Wargovich M. An anti-inflammatory dietary intervention to reduce breast cancer recurrence risk: Study design and baseline data. Contemp Clin Trials 2017; 57:1-7. [PMID: 28342988 PMCID: PMC6110085 DOI: 10.1016/j.cct.2017.03.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 03/10/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5-10years. Cancer recurrence risk is highest among obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)-α have been associated with cancer recurrence risk. Nutritional interventions aimed at reducing inflammation (INF) may contribute to reduced cancer recurrence risk, but studies have been limited to animal models. The goals of this one-year, culinary-based, pilot intervention were to: 1) decrease Pro-I biomarkers and increase anti-inflammatory (AI) cytokine, IL-10, by promoting AI food incorporation into BCS diets; and 2) examine intervention effects on cancer risk factors including body mass index (BMI) and circulating adipose stromal cells (ASCs). A total of 153 BCSs were recruited. Overweight and obese women aged 18 or older were randomized into Intervention (IG; n=76) and Control (CG; n=77) groups. CG received monthly nutritional brochures from the American Institute for Cancer Research. IG attended 6 monthly workshops (lectures on AI topics and chef-prepared food demonstrations), and received monthly newsletters and telephone calls incorporating Motivational Interviewing. At baseline, 6- and 12-month assessments, fasting serum was assayed for Pro-I/AI marker and ASC levels. Using R and Stata version 14 (Stata Corp, 2015), no significant differences were found between groups on baseline demographic variables. Correlations between serum cytokine levels, BMI, % body fat, ASCs, and self-reported variables are discussed.
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Affiliation(s)
- Amelie G Ramirez
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA.
| | - Dorothy Long Parma
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Edgar Muñoz
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Kristin D Mendoza
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Crystel Harb
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Alan E C Holden
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Michael Wargovich
- Department of Molecular Medicine, The University of Texas Health Science Center at San Antonio, USA
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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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Shivappa N, Hébert JR, Rosato V, Garavello W, Serraino D, La Vecchia C. Inflammatory potential of diet and risk of oral and pharyngeal cancer in a large case-control study from Italy. Int J Cancer 2017; 141:471-479. [PMID: 28340515 DOI: 10.1002/ijc.30711] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/16/2017] [Accepted: 03/20/2017] [Indexed: 12/13/2022]
Abstract
Diet and inflammation have been suggested to be important risk factors for oral and pharyngeal cancer. We examined the association between dietary inflammatory index (DII™) and oral and pharyngeal cancer in a large case-control study conducted between 1992 and 2009 in Italy. This study included 946 cases with incident, histologically confirmed oral and pharyngeal cancer, and 2,492 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a valid 78-item food frequency questionnaire and was adjusted for nonalcohol energy intake using the residual approach (E-DII™). Logistic regression models were used to estimate odds ratios (ORs), and 95% confidence intervals (CIs), adjusted for age, sex, non-alcohol energy intake, study center, year of interview, education, body mass index, tobacco smoking, and alcohol drinking. Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of oral and pharyngeal cancer, the OR being 1.80 (95% CI 1.36-2.38) for the highest versus the lowest DII quartile and 1.17 (95% CI 1.10-1.25) for a one-unit increase (8% of the DII range). When stratified by selected covariates, a stronger association was observed among women (ORquartile4 v.1 3.30, 95% CI 1.95-5.57). We also observed a stronger association for oral cancers and a strong combined effect of higher DII score and tobacco smoking or alcohol consumption on oral and pharyngeal cancer. These results indicate that the pro-inflammatory potential of the diet, as shown by higher DII scores, is associated with higher odds of oral and pharyngeal cancer.
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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.,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.,Connecting Health Innovations LLC, Columbia, SC.,Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC
| | - Valentina Rosato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - Werner Garavello
- Department of Surgery and Translational Medicine, University of Milano-Bicocca, Milan, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, (PN), Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Shivappa N, Hébert JR, Rosato V, Montella M, Serraino D, La Vecchia C. Association between the dietary inflammatory index and breast cancer in a large Italian case-control study. Mol Nutr Food Res 2017; 61:10.1002/mnfr.201600500. [PMID: 27794170 PMCID: PMC5334186 DOI: 10.1002/mnfr.201600500] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/28/2016] [Accepted: 10/24/2016] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The putative relationship between diet, including its inflammatory potential, and breast cancer has been studied extensively, but results remain inconsistent. Using data from a large Italian case-control study conducted between 1991 and 1994, we examined the association between the dietary inflammatory index (DII) and odds of breast cancer. METHODS DII scores were computed using a validated 78-item food frequency questionnaire. Subjects were 2569 women with incident, histologically confirmed breast cancer and 2588 controls admitted to hospital for acute, non-hormone-related diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) based on continuous and quintiles of DII were estimated by multiple logistic regression adjusting for age, study center, education, BMI, parity, menopausal status, family history of hormone-related cancers, and total energy intake. RESULTS Women in quintiles 2, 3, 4 and 5 had ORs of breast cancer of 1.33 (95% CI: 1.11, 1.59), 1.37 (95% CI: 1.13, 1.66), 1.41 (95% CI: 1.15, 1.73), and 1.75 (95% CI: 1.39, 2.21), respectively, compared to women in quintile 1. One-unit increase in DII increased the odds of having breast cancer by 9% (95% CI: 1.05, 1.14). CONCLUSIONS A pro-inflammatory diet is associated to increased risk of breast 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, South Carolina, 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, South Carolina, 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
| | - 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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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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Molzof HE, Wirth MD, Burch JB, Shivappa N, Hebert JR, Johnson RL, Gamble KL. The impact of meal timing on cardiometabolic syndrome indicators in shift workers. Chronobiol Int 2017; 34:337-348. [PMID: 28107043 DOI: 10.1080/07420528.2016.1259242] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aims of this study were to 1) compare the inflammatory potential of night- and day-shift nurses' diets with regard to time of day and work status and 2) explore how the timing of food intake during work and off-work is associated with cardiometabolic syndrome (CMS) risk factors between these two groups. Female nurses (N = 17; 8 day-shift and 9 night-shift) reported food intake over 9 days. On a middle day off of work, metabolic parameters were measured after an overnight fast. Energy/macronutrient intake and inflammatory potential of dietary intake (as assessed via the Dietary Inflammatory IndexTM) were calculated for nurses' workdays, work nights, off-work days, and off-work nights. Work-night total food intake (grams) accounted for a significant amount of variance in CMS risk factors for night-shift nurses only. Increased total gram consumption during night-shift nurses' work nights was associated with increased lipid levels - independent of the macronutrient composition of the food consumed. Alternatively, for night-shift nurses, work-day intake of several food parameters accounted for a significant proportion of variance in HDL cholesterol levels, with higher intake associated with higher HDL levels. For both day- and night-shift nurses, food intake during the day was more pro-inflammatory regardless of shift type or work status. Our novel approach of combining time-of-day-specific and work-day-specific analyses of dietary inflammatory factors and macronutrient composition with measurement of CMS risk factors suggests a link between meal timing and cardiometabolic health for shift-working nurses.
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Affiliation(s)
- Hylton E Molzof
- a Department of Psychology , University of Alabama , Tuscaloosa , AL , USA
| | - Michael D Wirth
- b Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,c Connecting Health Innovations , LLC , Columbia , SC , USA
| | - James B Burch
- b Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,d WJB Dorn Department of Veterans Affairs Medical Center , Columbia , SC , USA
| | - Nitin Shivappa
- b Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,c Connecting Health Innovations , LLC , Columbia , SC , USA
| | - James R Hebert
- b Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,c Connecting Health Innovations , LLC , Columbia , SC , USA
| | - Russell L Johnson
- e Department of Psychiatry and Behavioral Neurobiology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Karen L Gamble
- e Department of Psychiatry and Behavioral Neurobiology , University of Alabama at Birmingham , Birmingham , AL , 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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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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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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Alkerwi A, Baydarlioglu B, Sauvageot N, Stranges S, Lemmens P, Shivappa N, Hébert JR. Smoking status is inversely associated with overall diet quality: Findings from the ORISCAV-LUX study. Clin Nutr 2016; 36:1275-1282. [PMID: 27595637 DOI: 10.1016/j.clnu.2016.08.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 08/02/2016] [Accepted: 08/18/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS Relationships between food consumption/nutrient intake and tobacco smoking have been described in the literature. However, little is known about the association between smoking and overall diet quality. This study examined the associations between eight diet quality indices, namely, the Diet Quality Index-International (DQI-I), Recommendation Compliance Index (RCI), Dietary Approach to Stop Hypertension (DASH) score, Energy Density Score (EDS), Dietary Diversity Score (DDS), Recommended Food Score (RFS), non-Recommended Food Score (non-RFS), and Dietary Inflammatory Index (DII), and smoking status with a focus on smoking intensity. METHODS Analyses were based on a sample of 1352 participants in the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) survey, a nationwide population-based cross-sectional study of adults aged 18-69 years. Nutritional data from food frequency questionnaire (FFQ) were used to compute selected diet quality indices. Participants were classified as never smoker, former smoker (≥12 months cessation period), occasional or light smokers (≤1 cig/d), moderate smokers (≤20 cig/d) and heavy smokers (>20 cig/d). Descriptive and linear regression analyses were performed, after adjustment for several potential covariates. RESULTS Compared to the other groups, heavy smokers had significantly higher prevalence of dyslipidemia (83%), obesity (34%), and elevated glycemic biomarkers. About 50% of former smokers had hypertension. Diet quality of heavy smokers was significantly poorer than those who never smoked independent of several socioeconomic, lifestyle, and biologic confounding factors (all p < 0.001). Heavy smokers were less compliant with national or international dietary recommendations, expressed by RCI, DQI-I, and RFS. In addition, they consumed a more pro-inflammatory diet, as expressed by higher DII scores (P < 0.001) and self-reported less dietary diversity in their food choices, as expressed by DDS. CONCLUSION This study provides new evidence concerning an inverse relationship between the intensity of tobacco consumption and overall diet quality. The implication is that efforts aimed at tobacco control should target heavy smokers and intervention on smoking cessation should take into account diet quality of smokers and their nutritional habits, to increase effectiveness and relevance of public health messages.
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Affiliation(s)
- Ala'a Alkerwi
- Luxembourg Institute of Health (L.I.H.) (formerly CRP-Santé), Epidemiology and Public Health Research Unit (EPHRU), Strassen, Luxembourg.
| | - Burcu Baydarlioglu
- Luxembourg Institute of Health (L.I.H.) (formerly CRP-Santé), Epidemiology and Public Health Research Unit (EPHRU), Strassen, Luxembourg.
| | - Nicolas Sauvageot
- Luxembourg Institute of Health (L.I.H.) (formerly CRP-Santé), Epidemiology and Public Health Research Unit (EPHRU), Strassen, Luxembourg
| | - Saverio Stranges
- Luxembourg Institute of Health (L.I.H.) (formerly CRP-Santé), Epidemiology and Public Health Research Unit (EPHRU), Strassen, Luxembourg.
| | - Paul Lemmens
- University of Maastricht, Department of Health Education & Promotion, Netherlands.
| | - 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.
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