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Hajji-Louati M, Gelot A, Frenoy P, Laouali N, Guénel P, Romana Mancini F. Dietary Inflammatory Index and risk of breast cancer: evidence from a prospective cohort of 67,879 women followed for 20 years in France. Eur J Nutr 2023:10.1007/s00394-023-03108-w. [PMID: 36869910 DOI: 10.1007/s00394-023-03108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/31/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Inflammation is implicated in breast cancer development, and diet is one of the modifiable risk factors involved in the regulation of chronic inflammation. Previous studies on the association between breast cancer risk and Dietary Inflammatory Indexes (DII) derived from food frequency questionnaires and data on inflammatory potential of dietary components have reported inconsistent results. OBJECTIVE To investigate the association between the DII and the risk of breast cancer using data from a large population-based cohort study. DESIGN A total of 67,879 women from the E3N cohort were followed from 1993 to 2014. A total of 5686 breast cancer cases were diagnosed during the follow-up. The food frequency questionnaire administered at baseline in 1993 was used to calculate an adapted DII. Cox proportional hazard models using age as the time scale were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Spline regression was used to determine any dose-response relationship. We also evaluated effect modification by menopausal status, body mass index, smoking status and alcohol consumption. RESULTS The median DII score of the study population was slightly pro-inflammatory (DII = + 0.39); ranged from - 4.68 in the lowest quintile to + 4.29 in the highest quintile. The HR increased linearly with the DII (HR per 1SD = 1.04 [95% CI: 1.01, 1.07]), and reached 1.13 [95% CI: 1.04, 1.23] in the 5th quintile group as compared to the first. A positive linear dose-response relationship was also observed when modeling DII with spline functions. Slightly higher HRs were observed in non-smokers (HR for 1-SD increase 1.06 [95% CI: 1.02, 1.10]; p trend = 0.001) and in low-alcohol consumers (≤ 1 glass/day) (HR for 1-SD increase 1.05 [95% CI: 1.01, 1.08]; p trend = 0.002). CONCLUSION Our results suggest a positive association between DII and breast cancer risk. Consequently, the promotion of anti-inflammatory diet may contribute to breast cancer prevention.
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Affiliation(s)
- Mariem Hajji-Louati
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Amandine Gelot
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Pauline Frenoy
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Nasser Laouali
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Francesca Romana Mancini
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, Institut Gustave Roussy, Espace Maurice Tubiana, University Paris-Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif Cedex, France.
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Dietary inflammatory index and breast cancer risk: an updated meta-analysis of observational studies. Eur J Clin Nutr 2022; 76:1073-1087. [PMID: 34728816 DOI: 10.1038/s41430-021-01039-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022]
Abstract
This updated meta-analysis sought to determine whether the pro-inflammatory potential of diet is a risk factor for breast cancer (BrCa) development, for the first time focusing on the effects of design heterogeneity. The search was performed using Scopus, PubMed, and Embase databases. Data were extracted from twenty-one eligible studies, including eleven cohorts (336,085 participants/20,033 incidence cases), and ten case-control studies (9,833 cases/12,752controls). The random-effect was used to calculate the relative risk (RR) using STATA 16 software. The highest dietary inflammatory index (DII) vs. the lowest category showed 16% increased risk of BrCa (95% CI: 1.06-1.26; I2 = 62.8%, P (I2) < 0.001). This was notable in post-menopausal status (RR = 1.13, 95% CI: 1.04-1.22), women with body mass index (BMI) ≥ 30 kg/m2 (RR = 1.35, 95% CI: 1.07-1.63), and study populations from developing countries (RR = 1.79, 95% CI: 1.12-2.47). Methodological covariates were subject to subgroup meta-analyses and showed stronger results among case-control studies (RR = 1.50, 95% CI: 1.20-1.80), studies considered age-matched controls (RR = 1.56, 95% CI: 1.19-1.93) and hospital-based controls (RR = 2.11, 95% CI: 1.58-2.64), and cohort studies identified by prolong follow-up durations (RR = 1.13, 95% CI: 1.03-1.22). This updated meta-analysis highlighted the pro-inflammatory diet as a risk factor for BrCa, especially among women in post-menopausal status, obese groups, and developing countries. Meta-analysis in methodological subgroups could improve results, less affected by heterogeneity, and suggested subclassification with important implications for future epidemiological designs and even clinical management.
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Hammad SS, Mahmoud R, Shivappa N, Hebert JR, Marie L, Tayyem RF. Dietary inflammatory index and odds of breast cancer: A case-control study. Food Sci Nutr 2021; 9:5211-5219. [PMID: 34532029 PMCID: PMC8441294 DOI: 10.1002/fsn3.2493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022] Open
Abstract
Breast cancer (BrCA) is one of the most commonly diagnosed cancers and is the leading cause of cancer deaths in women worldwide. This study aimed to examine the association between the dietary inflammatory index (DII®) and BrCA among Jordanian women. A total of 400 adult women were enrolled into this case-control study. Cases were 200 women recently diagnosed with BrCA selected from the two hospitals that provide cancer therapy in Jordan. They were matched on age, income, and marital status with 200 BrCA-free controls. DII scores were calculated from dietary data that were collected in a face-to-face interview conducted between October 2016 and September 2017 using a validated food frequency questionnaire. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs. The study results revealed no significant associations between DII scores in relation to the odds of developing BrCA after multivariable adjustment including age, education, total energy, BMI, number of pregnancy, contraceptive use, lactation, smoking, and family history of BrCA. Stratified analyses by obesity status showed that overweight/obese participants in the highest DII tertile had a >75% increased BrCA risk (OR of 1.77 [95% CI, 1.01-3.12]) compared with participants in the lowest tertile, after adjusting for age. The results from this study showed no significant relationship between the proinflammatory potential of the diet and BrCA risk in the overall study population. However, results stratified by weight category indicated an effect of diet-associated inflammation on BrCA risk in the overweight/obese group. Results of the study are consistent with a recommendation aimed at maintaining higher diet quality, that is, adopting healthy diets characterized by low DII scores in order to reduce the risk for BrCA.
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Affiliation(s)
- Shatha S. Hammad
- Department of Nutrition and Food TechnologyFaculty of AgricultureThe University of JordanAmmanJordan
| | - Reema Mahmoud
- Department of Nutrition and Food TechnologyFaculty of AgricultureThe University of JordanAmmanJordan
| | - Nitin Shivappa
- Department of Epidemiology and BiostatisticsUniversity of South CarolinaColumbiaSCUSA
- Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaSCUSA
- Connecting Health Innovations, LLCColumbiaSCUSA
| | - James R. Hebert
- Department of Epidemiology and BiostatisticsUniversity of South CarolinaColumbiaSCUSA
- Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaSCUSA
- Connecting Health Innovations, LLCColumbiaSCUSA
| | | | - Reema F. Tayyem
- Department of Human NutritionCollege of Health SciencesQatar UniversityDohaQatar
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Heidari N, Nabie R, Jabbari M, Irannejad Niri Z, Zeinalian R, Asghari Jafarabadi M, Arefhosseini SR. The association between food diversity and serum antioxidant indices in cataract patients compared to healthy subjects. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2021; 26:59. [PMID: 34729067 PMCID: PMC8506238 DOI: 10.4103/jrms.jrms_321_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/29/2020] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cataract is a chronic disorder that is related to antioxidant-oxidant imbalance situation. We aimed to investigate the association between food diversity and serum antioxidant and oxidant indices in cataract patients compared to healthy subjects. MATERIALS AND METHODS In this case-control study, ninety volunteers (aged > 50 years) were divided into the cataract (n = 45) and healthy control (n = 45) groups. Anthropometric variables, physical activity and stress levels, food diversity score, serum total oxidant capacity (TOC), and total antioxidant capacity (TAC) measurements were done for all participants. RESULTS Serum TAC, even after adjustment for stress level, was significantly higher in healthy people compared to cataract patients (P < 0.001). In addition, serum TOC was significantly lower in healthy controls compared to cataract patients (P < 0.002). In healthy group, there was a weak significant positive association between serum TAC and meats group diversity (r = 0.149, P = 0.047). In addition, there was a moderate negative association between meats group diversity and TOC in the healthy controls (r = -0.712, P = 0.041). In the cataract group, there was a significant negative association between serum TOC and diversity score of fruits (r = -0.811, P = 0.017) and meats group (r = -0.926, P = 0.046) as well as total score of food diversity (r = -0.466, P = 0.003). CONCLUSION It seems that increase in total dietary diversity and food groups' diversity can have a beneficial effect on oxidant situation among cataract patients.
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Affiliation(s)
- Naeimeh Heidari
- Department of Biochemistry, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Nabie
- Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Jabbari
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Industry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Irannejad Niri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Zeinalian
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Seyed Rafie Arefhosseini
- Department of Biochemistry, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Hajji-Louati M, Cordina-Duverger E, Laouali N, Mancini FR, Guénel P. A case-control study in France showing that a pro-inflammatory diet is associated with a higher risk of breast cancer. Sci Rep 2021; 11:17019. [PMID: 34426601 PMCID: PMC8382695 DOI: 10.1038/s41598-021-95955-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023] Open
Abstract
Dietary regimens promoting inflammatory conditions have been implicated in breast cancer development, but studies on the association between pro-inflammatory diet and breast cancer risk have reported inconsistent results. We investigated the association between the inflammatory potential of diet and breast cancer risk in a case-control study in France including 872 breast cancer cases and 966 population controls. All women completed a food frequency questionnaire that was used to compute a Dietary Inflammatory Index (DII) based on the inflammatory weight of 33 dietary components. The DII ranged from a median of - 3.22 in the lowest quartile (anti-inflammatory) to + 2.96 in the highest quartile (pro-inflammatory). The odds ratio contrasting quartile 4 to quartile 1 was 1.31 (95% CI 1.00, 1.73; p-trend = 0.02). Slightly higher odds ratios were observed in post-menopausal women, particularly those with body mass index > 25 kg/m2 (odds ratio 1.62; 95% CI 0.92, 2.83; p-trend = 0.02), and among ever smokers (odds ratio 1.71; 95% CI 1.11, 2.65; p-trend 0.01). The analyses by breast cancer subtype showed that the DII was associated with breast tumors that expressed either the estrogen (ER) or progesterone (PR) hormone receptors or the Human Epidermal Growth Factor Receptor-2 (HER2), but no association was seen for the triple negative breast tumor subtype. Our results add further evidence that a pro-inflammatory diet is associated with breast cancer risk with possible effect variation according to tumor subtype.
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Affiliation(s)
- Mariem Hajji-Louati
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, 94800, Villejuif Cedex, France
| | - Emilie Cordina-Duverger
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, 94800, Villejuif Cedex, France
| | - Nasser Laouali
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, 94800, Villejuif Cedex, France
| | - Francesca-Romana Mancini
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, 94800, Villejuif Cedex, France
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Team Exposome and Heredity, U1018 Inserm, University Paris-Saclay, Institut Gustave Roussy, 94800, Villejuif Cedex, France.
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Chen H, Gao Y, Wei N, Du K, Jia Q. Strong association between the dietary inflammatory index(DII) and breast cancer: a systematic review and meta-analysis. Aging (Albany NY) 2021; 13:13039-13047. [PMID: 33962395 PMCID: PMC8148459 DOI: 10.18632/aging.202985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/05/2021] [Indexed: 04/12/2023]
Abstract
The association between the Dietary Inflammatory Index (DII) and breast cancer risk has been widely reported in recent years, but there is still controversy about whether a pro-inflammatory diet is a risk factor for breast cancer. We conducted a meta-analysis to investigate the relationship between the DII and breast cancer risk in pre-menopausal and post-menopausal women. We comprehensively searched PubMed, Embase and the Cochrane Library in January 2021 to identify articles reporting an association between the DII and breast cancer risk. A pooled analysis was conducted with 14 studies covering 312,885 participants. Overall, women in the most pro-inflammatory diet category were at greater risk for breast cancer than those in the most anti-inflammatory category (relative risk [RR]=1.37, 95% confidence interval [CI] 1.17-1.60, P<0.001). This association was strong in both pre-menopausal women (RR=1.87, 95% CI 1.17-2.99, P=0.001) and post-menopausal women (RR=1.23, 95% CI 1.08-1.40, P<0.001). Thus, a strong and independent association was observed between a pro-inflammatory diet (assessed using the DII score) and breast cancer risk, irrespective of menopausal status. Further studies will be required to determine the relationship between a pro-inflammatory diet and different subtypes of breast cancer.
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Affiliation(s)
- Huajian Chen
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Yuzhe Gao
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Na Wei
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Kuiying Du
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Qi Jia
- Department of Breast Surgery, Guizhou Provincial People’s Hospital, Guizhou, China
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Piyathilake CJ, Badiga S, Chappell AR, Johanning GL, Jolly PE. Racial differences in dietary choices and their relationship to inflammatory potential in childbearing age women at risk for exposure to COVID-19. Nutr Res 2021; 90:1-12. [PMID: 34049184 PMCID: PMC8143979 DOI: 10.1016/j.nutres.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
Since the ongoing coronavirus disease 2019 (COVID-19) pandemic is linked to chronic inflammation, people with initial lower inflammatory status could have better outcomes from exposure to this disease. Because dietary habits are one of the most important modifiable risk factors for inflammation, identification of dietary components associated with inflammation could play a significant role in controlling or reducing the risk of COVID-19. We investigated the inflammatory potential of diets consumed by African American (AA) and Caucasian American (CA) women of childbearing age (n = 509) who are at high risk for exposure to COVID-19 by being residents of Birmingham, Alabama, a city severely affected by this pandemic. The overall pro- and anti- inflammatory scores were calculated using dietary intake data gathered using Block food frequency questionnaire. The proinflammatory potential of diets consumed by AAs was significantly higher compared to CAs. Several anti- and proinflammatory nutrients and food groups consumed differed by race. With consumption of a greater number of antioxidants and B-vitamins, CAs switched toward an anti-inflammatory score more effectively than AAs while AAs performed better than CAs in improving the anti-inflammatory score with the consumption of a greater number of minerals and vitamin D. Effective race-specific dietary modifications or supplementation with nutrients identified will be useful to improve proinflammatory diets toward anti-inflammatory. This approach could aid in controlling the current COVID-19 pandemic and future pandemics of a similar nature in women at risk for exposure.
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Affiliation(s)
- Chandrika J Piyathilake
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Suguna Badiga
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Ashley R Chappell
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | | | - Pauline E Jolly
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Aghababayan S, Sheikhi Mobarakeh Z, Qorbani M, Tiznobeyk Z, Aminianfar A, Sotoudeh G. Higher Dietary Inflammatory Index Scores are Associated with Increased Odds of Benign Breast Diseases in a Case-Control Study. J Inflamm Res 2020; 13:61-69. [PMID: 32104043 PMCID: PMC7008174 DOI: 10.2147/jir.s232157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/14/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose Dietary inflammatory index (DII) is a new tool for assessing the inflammatory potential of diet. Since there is no study that has investigated the association of DII and benign breast diseases (BBD), the aim of our study was to compare DII scores in patients with and without BBD. Methods One hundred and eleven (111) subjects with BBD and 104 healthy women attending the Iranian Center for Breast Cancer affiliated with the Academic Center for Education, Culture and Research were enrolled in a case–control study. Dietary data collected using a 168‑item validated food frequency questionnaire (FFQ). Energy-adjusted DII was calculated based on FFQ. Socio demographic data were collected by interview. In addition, physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Weight, height and waist circumference were also measured. Results After adjustment for multiple confounding variables, participants at the highest tertile of DII had increased OR for BBD (OR=1.7, 95% CI=0.75–3.95) (P-trend =0.04). Conclusion The increased chance of BBD was suggested with a higher consumption of diets with inflammatory potential. However, this result should be interpreted with caution as OR was not statistically significant. Interventional studies are warranted to elucidate the role of inflammatory diets in the development of BBD.
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Affiliation(s)
- Sama Aghababayan
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sheikhi Mobarakeh
- Department of Cancer Quality of Life, Breast Cancer Research Center, Academic Center for Education, Culture and Research (ACECR), 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
| | - Zeinab Tiznobeyk
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Vahid F, Bourbour F, Gholamalizadeh M, Shivappa N, Hébert JR, Babakhani K, Mosavi Jarrahi A, Mirzaei Dahka S, Doaei S. A pro-inflammatory diet increases the likelihood of obesity and overweight in adolescent boys: a case-control study. Diabetol Metab Syndr 2020; 12:29. [PMID: 32292493 PMCID: PMC7140561 DOI: 10.1186/s13098-020-00536-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Obesity and Overweight at an early age can contribute with many chronic diseases such as cancers, diabetes and cardiovascular diseases. Diet-related inflammation is one of the most important underlying mechanisms that may has a key role in obesity and overweight. This paper aimed to compare the dietary inflammatory index (DII®) in normal weight and overweight adolescent boys. METHODS A total of 535 adolescent boys (214 cases were overweight and obese and 321 controls with normal weight) participated in this study from two schools in Tehran, Iran. The student's weight and body composition were measured using a Bio-Impedance Analyzer (BIA) scale. A validated semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess dietary inflammatory index. RESULTS Results obtained from modeling DII® as a continuous variable identified a positive association between DII® and obesity (OR = 1.08, CI 1.01-1.16). After multivariable adjustment, subjects with DII® > 0.02 had at 1.5 times higher odds of obesity and overweight compared to subjects with DII® ≤ 0.02 (OR = 1.52; CI 1.04-2.22). CONCLUSION Our study indicated the importance of dietary-induced inflammation in the obesity and overweight during adolescence. Therefore, advising adolescent to consume diet with lower DII® with more fruits and vegetables, rich sources of fiber, flavonoids, zinc, magnesium and selenium and avoiding the consumption of saturated fatty acids (SFA), trans-fatty acids, and cholesterol may support a healthy weight.
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Affiliation(s)
- Farhad Vahid
- Department of Nutritional Sciences, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Bourbour
- Department of Clinical Nutrition and Dietetics, Research Institute Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
| | - Khatereh Babakhani
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | | | - Saeid Doaei
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran
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The Association between Dietary Inflammatory Index (DII) and Cancer Risk in Korea: A Prospective Cohort Study within the KoGES-HEXA Study. Nutrients 2019; 11:nu11112560. [PMID: 31652856 PMCID: PMC6893737 DOI: 10.3390/nu11112560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/16/2019] [Accepted: 10/21/2019] [Indexed: 02/08/2023] Open
Abstract
Several epidemiological studies have shown that there are consistently positive associations between dietary inflammatory index (DII®) scores and cancer incidence in Western populations. However, few DII-cancer studies have been conducted in East Asian populations. In a large cohort representative of the general Korean population, we investigated whether the DII is associated with overall cancer risk. A total of 163,660 participants (56,781 males and 106,879 females) had evaluable data for analyses. This follow-up study was carried out over the course of 7.9 years. DII scores were calculated based on Semi-Quantitative Food-Frequency Questionnaire (SQ-FFQ) data for 106 food items. Cancers were self-reported based on notification by the participants’ medical doctors. Multivariable Cox proportional hazard regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). After the follow-up, 1643 incident cases of cancer (520 males and 1123 females) had developed. In a fully adjusted model, women in the highest DII quintile showed a 44% increased risk of getting cancer (HRQ5vsQ1 = 1.44; 95% CI = 1.14–1.82; p-trend = 0.0006), while men showed no apparent association (HRQ5vsQ1 = 0.80; 95% CI = 0.58–1.10). These results indicate that in Korean women, a more pro-inflammatory diet is associated with a higher risk of incident cancer.
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Dietary Inflammatory Index and Risk of Breast Cancer Based on Hormone Receptor Status: A Case-Control Study in Korea. Nutrients 2019; 11:nu11081949. [PMID: 31430979 PMCID: PMC6723443 DOI: 10.3390/nu11081949] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 12/25/2022] Open
Abstract
Breast cancer is the most common cancer in women globally, and the risk of developing breast cancer is associated with inflammation. The present study aimed to examine the association between the Dietary Inflammatory Index (DII®) and breast cancer in Korean women and investigate whether the tumor’s hormone receptor status affects this association. In this case-control study, we enrolled 364 breast cancer patients and 364 age-matched controls. DII scores were calculated from dietary intake evaluated by a 106-item food frequency questionnaire. The DII score was significantly higher in cases than in controls. After adjusting for potential confounders, the odds ratio (OR) of breast cancer was higher in the highest DII tertile (OR = 3.68, 95% confidence interval (CI): 2.34–5.80, p for trend < 0.0001) than in the lowest tertile. We found that higher DII scores were related to an increased risk of breast cancer for estrogen receptor (ER)+/progesterone receptor (PR)+ tumors regardless of menopausal status (OR = 2.59, 95% CI: 1.37–4.88 in the highest DII category, p for trend = 0.01 for premenopausal women; OR = 11.00, 95% CI: 2.93–41.30 in the highest DII category, p for trend = 0.0004 for postmenopausal women), but not for ER−/PR− status. Our results suggested that the DII scores are positively associated with breast cancer risk in Korean women and that this relationship is more robust in ER+/PR+ tumors.
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Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study). Nutrients 2019; 11:nu11061406. [PMID: 31234427 PMCID: PMC6628286 DOI: 10.3390/nu11061406] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 02/06/2023] Open
Abstract
Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60–2.32; p-trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99–1.52, p-trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26–1.74; p-trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.
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Liu ZY, Gao XP, Zhu S, Liu YH, Wang LJ, Jing CX, Zeng FF. Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies. J Gynecol Oncol 2019; 30:e23. [PMID: 30887752 PMCID: PMC6424848 DOI: 10.3802/jgo.2019.30.e23] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 10/21/2018] [Accepted: 11/09/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE There has been growing body of literatures showing that chronic inflammation might play an important role in cancer development. This meta-analysis aimed to assess the association between the dietary inflammation index (DII) score and gynecological cancers. METHODS A systematic search of PubMed, EMBASE and Web of Science up until October 20, 2018 was carried out to retrieve all related cohort and case-control studies. The summary risk assessments were pooled using random-effects models. The dose-response relationship was estimated by linear relationship model. RESULTS Twelve case-control studies (10,774 cases/15,958 controls) and six prospective cohort studies (330,363 participants/23,133 incident cases) were included in this meta-analysis. The pooled adjusted relative risk (RR) of gynecological cancers for the highest DII category compared to the lowest category was 1.38, (95% confidence intervals [CIs], 1.21-1.56, p<0.001]. A positive dose-response relationship was also noticed. Stratified by study design indicated that, the pooled RRs was significantly higher for case-control studies than cohort studies (p for interaction<0.001), for studies conducted among participants with body mass index (BMI) ≥25 kg/m² than participants with BMI <25 kg/m² (p for interaction=0.026), among participants with ovarian cancer and endometrial cancer than participants with breast cancer (p for interaction = 0.038). Meta-regression analysis further confirmed that study design significantly contributed to inter-study heterogeneity (p<0.001). CONCLUSION This meta-analysis suggests that elevated DII is independently associated with a higher risk of gynecological cancers, especially patients with ovarian cancer and endometrial cancer and among obese participants.
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Affiliation(s)
- Ze Ying Liu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Xu Ping Gao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Sui Zhu
- Department of Medical Statistics, School of Medicine, Jinan University, Guangzhou, China
| | - Yan Hua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Jun Wang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Chun Xia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Fang Fang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.
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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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