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Porciello G, Coluccia S, Vitale S, Palumbo E, Luongo A, Grimaldi M, Pica R, Prete M, Calabrese I, Cubisino S, Montagnese C, Falzone L, Martinuzzo V, Poletto L, Rotondo E, Di Gennaro P, De Laurentiis M, D’Aiuto M, Rinaldo M, Thomas G, Messina F, Catalano F, Ferraù F, Montesarchio V, Serraino D, Crispo A, Libra M, Celentano E, Augustin LSA. Baseline Association between Healthy Eating Index-2015 and Health-Related Quality of Life in Breast Cancer Patients Enrolled in a Randomized Trial. Cancers (Basel) 2024; 16:2576. [PMID: 39061215 PMCID: PMC11274909 DOI: 10.3390/cancers16142576] [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: 07/01/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Health-related quality of life (HRQoL) represents one of the most concerning aspects for cancer patients. The Healthy Eating Index (HEI) is an a priori diet quality index directly associated with health outcomes and HRQoL in cancer survivors in North American populations. We evaluated, in a Mediterranean population, the baseline associations between HEI-2015 and HRQoL in 492 women with breast cancer recruited in a DEDiCa lifestyle trial. Dietary data were obtained from 7-day food records; HRQoL was assessed through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) and the C30 Summary Score (SumSc). Analysis of variance and multivariable linear and log-gamma regression models were performed. Mean and standard deviation for HEI-2015 score was 68.8 ± 11.2; SumSc was 81.5 ± 12.9. Women with lower HEI-2015 score had higher BMI, were more frequently exposed to tobacco smoke and had fewer years of education. Patients with a HEI-2015 score greater than 68.7 (median value) showed a significant increase in SumSc of 4% (p = 0.02). HEI-2015 components also associated with SumSc were beans and greens (β = 1.04; p = 0.02). Weak associations were found for total vegetables and saturated fats. Higher diet quality in breast cancer survivors was associated with higher overall HRQoL in this cross-sectional analysis.
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Affiliation(s)
- Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Rosa Pica
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Melania Prete
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Ilaria Calabrese
- Healthcare Direction, “A. Cardarelli” Hospital, 80131 Naples, Italy;
| | - Serena Cubisino
- Humanitas Istituto Clinico Catanese, 95045 Misterbianco, Italy;
| | | | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinical and General Pathology Section, University of Catania, 95124 Catania, Italy;
| | - Valentina Martinuzzo
- Cancer Epidemiology Unit, National Cancer Institute, CRO, IRCCS, 33081 Aviano, Italy; (V.M.); (L.P.); (D.S.)
| | - Luigina Poletto
- Cancer Epidemiology Unit, National Cancer Institute, CRO, IRCCS, 33081 Aviano, Italy; (V.M.); (L.P.); (D.S.)
| | - Emanuela Rotondo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Piergiacomo Di Gennaro
- Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy;
| | | | | | | | | | | | | | - Vincenzo Montesarchio
- UOC Oncologia, AORN dei Colli (Monaldi-Cotugno-CTO), 80131 Naples, Italy; (V.M.); (M.L.)
| | - Diego Serraino
- Cancer Epidemiology Unit, National Cancer Institute, CRO, IRCCS, 33081 Aviano, Italy; (V.M.); (L.P.); (D.S.)
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Massimo Libra
- UOC Oncologia, AORN dei Colli (Monaldi-Cotugno-CTO), 80131 Naples, Italy; (V.M.); (M.L.)
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
| | - Livia S. A. Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (E.P.); (A.L.); (M.G.); (R.P.); (M.P.); (E.R.); (E.C.); (L.S.A.A.)
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Woolford SJ, D'Angelo S, Mancano G, Curtis EM, Ashai S, Shivappa N, Hébert JR, Crozier SR, Phillips CM, Suderman M, Relton CL, Cooper C, Harvey NC. Associations Between Late Pregnancy Dietary Inflammatory Index (DII) and Offspring Bone Mass: A Meta-Analysis of the Southampton Women's Survey (SWS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). J Bone Miner Res 2022; 37:1511-1519. [PMID: 35689423 PMCID: PMC9542867 DOI: 10.1002/jbmr.4623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 04/20/2022] [Accepted: 06/04/2022] [Indexed: 01/30/2023]
Abstract
Systemic inflammation is associated with reduced bone mineral density and may be influenced by pro-inflammatory diets. We undertook an observational analysis of associations between late pregnancy energy-adjusted dietary inflammatory index (E-DII) scores and offspring bone outcomes in childhood. E-DII scores (higher scores indicating pro-inflammatory diets) were derived from food frequency questionnaires in late pregnancy in two prospective mother-offspring cohorts: the Southampton Women's Survey (SWS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). The mean (SD) offspring age at dual-energy X-ray absorptiometry (DXA) scanning was 9.2 (0.2) years. Linear regression was used to assess associations between E-DII and bone outcomes, adjusting for offspring sex and age at DXA and maternal age at childbirth, educational level, pre-pregnancy body mass index (BMI), parity, physical activity level, and smoking in pregnancy. Associations were synthesized using fixed-effect meta-analysis. Beta coefficients represent the association per unit E-DII increment. In fully adjusted models (total n = 5910) late pregnancy E-DII was negatively associated with offspring whole body minus head bone area (BA: β = -3.68 [95% confidence interval -6.09, -1.27] cm2 /unit), bone mineral content (BMC: β = -4.16 [95% CI -6.70, -1.62] g/unit), and areal bone mineral density (aBMD: β = -0.0012 [95% CI -0.0020, -0.0004] g.cm-2 /unit), but there was only a weak association with BMC adjusted for BA (β = -0.48 [95% CI -1.11, 0.15] g/unit) at 9 years. Adjustment for child height partly or, for weight, fully attenuated the associations. Higher late pregnancy E-DII scores (representing a more pro-inflammatory diet) are negatively associated with offspring bone measures, supporting the importance of maternal and childhood diet on longitudinal offspring bone health. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Stephen J Woolford
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Shanze Ashai
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South CarolinaColumbiaSCUSA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South CarolinaColumbiaSCUSA
- Department of Nutrition, Connecting Health Innovations LLCColumbiaSCUSA
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
| | - Catherine M Phillips
- School of Public Health, Physiotherapy, and Sports ScienceUniversity College DublinBelfieldIreland
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity of OxfordOxfordUK
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