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Wu M, Li S, Lv Y, Liu K, Wang Y, Cui Z, Wang X, Meng H. Associations between the inflammatory potential of diets with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases in Chinese adults: findings from a nation-wide prospective cohort study. Food Funct 2023; 14:9018-9034. [PMID: 37740363 DOI: 10.1039/d3fo02579a] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Aims: convincing evidence is still limited for the validation of associations between the inflammatory potential of diets, based on the dietary inflammatory index (DII), and cardiometabolic outcomes. We aimed to investigate the associations between the DII with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases (CMDs), including stroke, type 2 diabetes mellitus (T2DM) and myocardial infarction (MI). Methods: adults (N = 14 652) from the China Health and Nutrition Survey (1997-2015) were included in the current analysis. Dietary intake data were collected using a combination of 3 day consecutive 24 h dietary recalls and the food weighing method. The DII was calculated with established and validated methods. CMDs were identified using validated self-reported questionnaires. The Cox proportional hazard regression model was used for statistical analysis. Results: during a mean follow-up of 10 years, a total of 404 new-onset stroke, 1051 new-onset T2DM and 280 new-onset MI cases were identified. Lower PDI, hPDI, ERD, WISH and PHDI scores and higher uPDI scores were associated with higher DII scores (all P-trend < 0. 0001). A pro-inflammatory diet, as reflected by relatively higher DII scores, was positively associated with an increased risk of stroke (Q5 vs. Q1: HR = 1.90; 95% CI: 1.26-2.88; P-trend = 0.0006), T2DM (Q5 vs. Q1: HR = 2.08; 95% CI: 1.61-2.69; P-trend < 0.0001) and MI (Q5 vs. Q1: HR = 1.70; 95% CI: 1.04-2.76; P-trend = 0.0114) in the entire cohort. Sex and BMI significantly modified the association between the DII and the risk of T2DM, and sex significantly modified the association between the DII and the risk of MI. Conclusions: lower adherence to healthy and sustainable plant-based dietary patterns and higher adherence to unhealthy plant-based dietary patterns were associated with higher DII scores. With the use of the DII, we reported long-term positive associations between a pro-inflammatory diet and an increased risk of new-onset stroke, T2DM and MI in Chinese adults who were free from CMDs and cancer at the baseline. These findings provided evidence for the validation of associations between the DII and cardiometabolic health, and contributed to the current literature suggesting careful evaluations of whether the DII should be incorporated into dietary guidelines and utilized as an effective tool for improving the diet quality and CMD prevention in the Chinese population.
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Affiliation(s)
- Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Shun Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yiqian Lv
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaoling Wang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou, Guangdong 510080, China
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de Mello RN, de Gois BP, Kravchychyn ACP, Dâmaso AR, Horst MA, Lima GC, Corgosinho FC. Dietary inflammatory index and its relation to the pathophysiological aspects of obesity: a narrative review. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000631. [PMID: 37364142 PMCID: PMC10661000 DOI: 10.20945/2359-3997000000631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 06/28/2023]
Abstract
Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.
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Affiliation(s)
- Roseli Neves de Mello
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Saúde, Goiânia, GO, Brasil
| | - Bárbara Paixão de Gois
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Saúde, Goiânia, GO, Brasil
| | | | - Ana Raimunda Dâmaso
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pós-graduação em Nutrição, São Paulo, SP, Brasil
| | - Maria Aderuza Horst
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Saúde, Goiânia, GO, Brasil
| | - Glaucia Carielo Lima
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Saúde, Goiânia, GO, Brasil
| | - Flávia Campos Corgosinho
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Saúde, Goiânia, GO, Brasil
- Universidade Federal de Goiás, Programa de Pós-graduação e Ciências da Saúde, Goiânia, GO, Brasil,
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Motamedi A, Askari M, Mozaffari H, Homayounfrar R, Nikparast A, Ghazi ML, Nejad MM, Alizadeh S. Dietary Inflammatory Index in relation to Type 2 Diabetes: A Meta-Analysis. Int J Clin Pract 2022; 2022:9953115. [PMID: 35685508 PMCID: PMC9159166 DOI: 10.1155/2022/9953115] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/27/2022] [Indexed: 12/17/2022] Open
Abstract
Background and Aims Epidemiologic studies show a strong association between chronic inflammation and type 2 diabetes (T2D). Diet may also affect the risk of T2D by modulating inflammation. This meta-analysis aimed to assess the relation of dietary inflammatory index (DII) and risk of T2D. Methods PubMed and Scopus were systematically searched from their inception to September 2020 to identify relevant studies. Relative risks, hazard ratios, or odds ratios (OR), with their corresponding 95% confidence intervals (95% CI), were calculated and pooled using a random-effects model. Results A total of 48 different studies, with a total sample size of 1,687,424 participants, were eligible to be included in this meta-analysis. In the overall analysis, no significant association was observed between DII and risk of T2D (OR = 1.03, 95% CI: 0.91 to 1.15), with significant evidence for heterogeneity (I 2 = 96.5%, P < 0.001); however, higher DII was identified as being significantly related to increased risk of T2D in high quality studies (OR = 1.58, 95% CI: 1.15 to 2.17). In the stratified analysis by the dietary assessment tool, background disease, and sex of participants, DII showed no significant association with T2D. Conclusions Higher DII might be associated with an increased risk of T2D. Additional well-designed studies are required to confirm this finding.
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Affiliation(s)
- Amir Motamedi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Reza Homayounfrar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Nikparast
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Lafzi Ghazi
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Mofidi Nejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahab Alizadeh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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4
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Jin Q, Shi N, Aroke D, Lee DH, Joseph JJ, Donneyong M, Conwell DL, Hart PA, Zhang X, Clinton SK, Cruz-Monserrate Z, Brasky TM, Jackson R, Tinker LF, Liu S, Phillips LS, Shadyab AH, Nassir R, Bao W, Tabung FK. Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Type 2 Diabetes Risk in Postmenopausal Women. Diabetes Care 2021; 44:707-714. [PMID: 33419931 PMCID: PMC7896263 DOI: 10.2337/dc20-2216] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/30/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The empirical dietary index for hyperinsulinemia (EDIH) and empirical dietary inflammatory pattern (EDIP) scores assess the insulinemic and inflammatory potentials of habitual dietary patterns, irrespective of the macronutrient content, and are based on plasma insulin response or inflammatory biomarkers, respectively. The glycemic index (GI) and glycemic load (GL) assess postprandial glycemic potential based on dietary carbohydrate content. We tested the hypothesis that dietary patterns promoting hyperinsulinemia, chronic inflammation, or hyperglycemia may influence type 2 diabetes risk. RESEARCH DESIGN AND METHODS We calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 73,495 postmenopausal women in the Women's Health Initiative, followed through March 2019. We used multivariable-adjusted Cox regression to estimate hazard ratios (HRs) and 95% CIs for type 2 diabetes risk. We also estimated multivariable-adjusted absolute risk of type 2 diabetes. RESULTS During a median 13.3 years of follow-up, 11,009 incident cases of type 2 diabetes were diagnosed. Participants consuming the most hyperinsulinemic or proinflammatory dietary patterns experienced greater risk of type 2 diabetes; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.49 (1.32-1.68; P trend < 0.0001) and EDIP 1.45 (1.29-1.63; P trend < 0.0001). The absolute excess incidence for the same comparison was 220 (EDIH) and 271 (EDIP) cases per 100,000 person-years. GI and GL were not associated with type 2 diabetes risk: GI 0.99 (0.88-1.12; P trend = 0.46) and GL 1.01 (0.89-1.16; P trend = 0.30). CONCLUSIONS Our findings in this diverse cohort of postmenopausal women suggest that lowering the insulinemic and inflammatory potentials of the diet may be more effective in preventing type 2 diabetes than focusing on glycemic foods.
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Affiliation(s)
- Qi Jin
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, OH
| | - Ni Shi
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH
| | - Desmond Aroke
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Darwin L Conwell
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Phil A Hart
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Steven K Clinton
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, OH.,The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.,Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Zobeida Cruz-Monserrate
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, OH.,The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.,Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Theodore M Brasky
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.,Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Rebecca Jackson
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Simin Liu
- Department of Epidemiology, Brown University, Providence, RI
| | - Lawrence S Phillips
- Atlanta VA Health Care System, Decatur, GA.,Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA
| | - Rami Nassir
- Department of Pathology, School of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Fred K Tabung
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, OH .,The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
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5
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Tan QQ, Du XY, Gao CL, Xu Y. Higher Dietary Inflammatory Index Scores Increase the Risk of Diabetes Mellitus: A Meta-Analysis and Systematic Review. Front Endocrinol (Lausanne) 2021; 12:693144. [PMID: 34456864 PMCID: PMC8385131 DOI: 10.3389/fendo.2021.693144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022] Open
Abstract
The relationship between dietary inflammatory index (DII) scores and the risk of diabetes mellitus (DM) is unclear; therefore, a systematic review and meta-analysis of the current published literature was conducted. Relevant studies published online (PubMed, Embase, and Web of Science) until February 1, 2021 were identified for review. The initial search yielded 13 reports, and after perusing their titles, abstracts, and full texts, 5 studies were deemed appropriate for inclusion in the systematic review and meta-analysis. Individuals with higher DII scores (representing a more proinflammatory diet) had a higher risk of DM (pooled odds ratio 1.32, 95% confidence interval 1.01-1.72, I2 58.6%, p < 0.05). Although the current meta-analysis indicated a trend toward a positive association between DII and DM, further evidence-especially from larger prospective studies in different countries-is needed to clarify this association.
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Affiliation(s)
- Qing-Qing Tan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xin-Yi Du
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chen-Lin Gao
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Yong Xu, ; Chen-Lin Gao,
| | - Yong Xu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Yong Xu, ; Chen-Lin Gao,
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Vajdi M, Farhangi MA, Mahmoudi-Nezhad M. Dietary inflammatory index significantly affects lipids profile among adults: An updated systematic review and meta-analysis. INT J VITAM NUTR RES 2020; 92:431-447. [PMID: 33150836 DOI: 10.1024/0300-9831/a000688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The available data on the relationship between dietary inflammatory index (DII®) and serum lipids are controversial. This systematic review and meta-analysis aimed to investigate the relationship between DII® and serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) in general populations. Methods: PubMed, Web of Science, SCOPUS, and Cochrane electronic databases were systematically searched from inception to December 2019. Case-control, cohort or cross-sectional studies that evaluated the relationship between DII® and serum lipids were included. The random-effects model was applied to evaluate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Results: In total, twenty-four cross-sectional and one case-control studies with a total sample size of 129,759 were included in the meta-analysis. The pooled results showed that the highest category of DII® was associated with 5.16 mg/dl increase in TC (Pooled WMD: 5.16; 95% CI: 0.58-9.73, p = 0.02) and 3.99 mg/dl increase in LDL-C (Pooled WMD: 3.99; 95% CI: 1.16-6.81, p = 0.006). However, no significant association between DII® scores, HDL-C and TG was found. In subgroup analysis, the geographical region, gender, and dietary assessment methods were potent sources of heterogeneity. Conclusion: This study showed that a higher level of DII® was associated with higher levels of TC and LDL-C in apparently healthy populations. Since the included studies had observational designs, therefore, no conclusion of causality was possible. More studies with interventional designs are required to elucidate the causality of the observed association between DII® and the risk of abnormal lipid profile.
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Affiliation(s)
- Mahdi Vajdi
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mahsa Mahmoudi-Nezhad
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Farhangi MA, Vajdi M. The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis. INT J VITAM NUTR RES 2020; 90:535-552. [PMID: 32129728 DOI: 10.1024/0300-9831/a000648] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn't evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785-2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95-1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Vajdi
- Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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