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Freitas RGBON, Vasques ACJ, da Rocha Fernandes G, Ribeiro FB, Solar I, Shivappa N, Hébert JR, de Almeida-Pititto B, Geloneze B, Ferreira SRG. Gut bacterial markers involved in association of dietary inflammatory index with visceral adiposity. Nutrition 2024; 122:112371. [PMID: 38430843 DOI: 10.1016/j.nut.2024.112371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/14/2023] [Accepted: 01/24/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To deepen the understanding of the influence of diet on weight gain and metabolic disturbances, we examined associations between diet-related inflammation and body composition and fecal bacteria abundances in participants of the Nutritionists' Health Study. METHODS Early-life, dietary and clinical data were obtained from 114 women aged ≤45 years. A validated food frequency questionnaire was used to calculate the energy-adjusted dietary inflammatory index (E-DII). Participants' data were compared by E-DII quartiles using ANOVA or Kruskal-Wallis. Associations of DXA-determined body composition with the E-DII were tested by multiple linear regression using DAG-oriented adjustments. Fecal microbiota was analyzed targeting the V4 region of the 16S rRNA gene. Spearman correlation coefficients were used to test linear associations; differential abundance of genera across the E-DII quartiles was assessed by pair-wise comparisons. RESULTS E-DII score was associated with total fat (b=1.80, p<0.001), FMI (b=0.08, p<0.001) and visceral fat (b=1.19, p=0.02), independently of maternal BMI, birth type and breastfeeding. E-DII score was directly correlated to HOMA-IR (r=0.30; p=0.004), C-reactive protein (r=0.29; p=0.003) and to the abundance of Actinomyces, and inversely correlated to the abundance of Eubacterium.xylanophilum.group. Actinomyces were significantly more abundant in the highest (most proinflammatory) E-DII quartile. CONCLUSIONS Association of E-DII with markers of insulin resistance, inflammation, body adiposity and certain gut bacteria are consistent with beneficial effects of anti-inflammatory diet on body composition and metabolic profile. Bacterial markers, such as Actinomyces, could be involved in the association between the dietary inflammation with visceral adiposity. Studies designed to explore how a pro-inflammatory diet affects both central fat deposition and gut microbiota are needed.
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Affiliation(s)
- Renata G B O N Freitas
- Department of Epidemiology, School of Public Health, University of São Paulo, Brazil; Laboratory of Investigation in Metabolism and Diabetes, School of Medical Sciences, University of Campinas, Brazil
| | - Ana Carolina J Vasques
- Laboratory of Investigation in Metabolism and Diabetes, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, São Paulo, Brazil
| | | | - Francieli B Ribeiro
- Laboratory of Investigation in Metabolism and Diabetes, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, São Paulo, Brazil
| | - Isabela Solar
- Laboratory of Investigation in Metabolism and Diabetes, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, São Paulo, Brazil
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Nutrition, Connecting Health Innovations, Columbia, SC
| | - James R Hébert
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Nutrition, Connecting Health Innovations, Columbia, SC
| | | | - Bruno Geloneze
- Laboratory of Investigation in Metabolism and Diabetes, School of Medical Sciences, University of Campinas, Brazil; Obesity and Comorbidities Research Center, University of Campinas, São Paulo, Brazil
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Wizgier D, Meng Y, Das A, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Ribeiro RV, Shivappa N, Hébert JR, Hirani V. The association of dietary antioxidants and the inflammatory potential of the diet with poor physical function and disability in older Australian men: the Concord Health and Ageing in Men Project. Br J Nutr 2024; 131:1528-1539. [PMID: 38220224 PMCID: PMC11043910 DOI: 10.1017/s0007114524000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Our objective was to evaluate the association of antioxidant intake and the inflammatory potential of the diet with functional decline in older men. A diet history questionnaire was used to collect dietary intake data from men aged ≥ 75 years (n 794) participating in the Concord Health and Aging in Men Project cohort study. Intake of vitamins A, C, E and Zn were compared with the Australian Nutrient Reference Values to determine adequacy. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) was used to assess the inflammatory potential of the diet. Physical performance data were collected via handgrip strength and walking speed tests, and activities of daily living (ADL) and instrumental activities of daily living (IADL) questionnaires, at baseline and 3-year follow-up (n 616). Logistic regression analysis was used to identify associations between diet and incident poor physical function and disability. Both poor antioxidant intake and high E-DII scores at baseline were significantly associated with poor grip strength and ADL disability at 3-year follow-up. No significant associations with walking speed or IADL disability were observed. Individual micronutrient analysis revealed a significant association between the lowest two quartiles of vitamin C intake and poor grip strength. The lowest quartiles of intake for vitamins A, C, E and Zn were significantly associated with incident ADL disability. The study observed that poor antioxidant and anti-inflammatory food intake were associated with odds of developing disability and declining muscle strength in older men. Further interventional research is necessary to clarify the causality of these associations.
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Affiliation(s)
- Daniela Wizgier
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Ying Meng
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Arpita Das
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW2006, Australia
| | - Fiona Blyth
- School of Public Health, University of Sydney, Sydney, NSW2006, Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
| | - Rosilene V. Ribeiro
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- School of Life and Environmental Science (SoLES), University of Sydney, Sydney, NSW, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - Vasant Hirani
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
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Doustmohammadian A, Amirkalali B, Esfandyari S, Motamed N, Maadi M, Shivappa N, Gholizadeh E, Hébert JR, Zamani F. The association between dietary inflammatory index (DII) scores and c-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) in a general population cohort. Clin Nutr ESPEN 2024; 60:156-164. [PMID: 38479904 DOI: 10.1016/j.clnesp.2024.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/29/2023] [Accepted: 01/16/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND AIMS Although there is extensive literature showing the ability of the dietary inflammation index (DII®) to predict concentrations of plasma inflammatory markers, few studies are testing the association between DII scores and nonalcoholic fatty liver disease (NAFLD). Considering the high prevalence of NAFLD and its complications, we conducted a validation study of DII scores and examined its association with NAFLD in the general adult population of Iran. METHODS This cross-sectional study was conducted on 3110 adult participants in the Amol Cohort Study (AmolCS) who underwent abdominal ultrasonography to diagnose NAFLD. DII and energy-adjusted DII (E-DII™) scores were computed using data from a valid semi-quantitative 168-item food frequency questionnaire (FFQ). Multivariable logistic regression adjusting for socio-demographic, lifestyle, and health-related factors was used to assess association. RESULTS The EDII was associated with CRP inflammatory biomarker. Participants in the highest, i.e., most pro-inflammatory tertile had the highest odds of NAFLD by ultrasound in all models [fully adjusted model: OR (95 % CI) tertile3vs.1:1.54 (1.05-2.05); Ptrend = 0.04, and 1.63 (1.19-2.21); Ptrend = 0.03 in women and men, respectively]. The highest tertile had the highest OR for NAFLD by fatty liver index (FLI) only in men [fully adjusted model OR (95 % CI) tertile3vs.1: 1.77 (1.15-2.71); Ptrend = 0.01]. Similar results were also obtained for NAFLD by hepatic steatosis index (HSI) in women [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.70 (1.12-2.58); Ptrend = 0.03]. The results of the fully adjusted multivariable model of liver markers and NAFLD status, stratified by gender and abdominal obesity, revealed that the highest tertiles had the highest OR for NAFLD by ultrasound and NAFLD by FLI only in men without abdominal obesity [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.83 (1.17-2.84); Ptrend = 0.03, and, respectively]. NAFLD by FLI tended to increase strongly with tertile E-DII scores in men without abdominal obesity in crude and three adjusted models [full-adjusted model: OR (95 % CI) tertile3vs.1: 3.64 (1.56-8.46); Ptrend = 0.005]. By contrast, women with abdominal obesity in the highest tertile had the highest OR for NAFLD by ultrasound in all models [full-adjusted model: OR (95 % CI) tertile3vs.1: 1.67 (1.07-2.62); Ptrend = 0.02]. CONCLUSIONS Our results suggest that diet plays a role in regulating inflammation. Additionally, we observed an inflammatory diet predicts the risk of NAFLD in Iranian adults. However, longitudinal studies are required in order to further substantiate the utility of the DII in the development of more effective dietary interventions among populations at risk of chronic disease.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Amirkalali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Esfandyari
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nitin Shivappa
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA
| | - Esmaeel Gholizadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - James R Hébert
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA; Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Saul A, Taylor BV, Blizzard L, Simpson-Yap S, Oddy WH, Shivappa N, Hebert JR, Black LJ, Ponsonby AL, Broadley SA, Lechner-Scott J, van der Mei I. A pro-inflammatory diet is associated with long-term depression and anxiety levels but not fatigue in people with multiple sclerosis. Mult Scler Relat Disord 2024; 84:105468. [PMID: 38359692 DOI: 10.1016/j.msard.2024.105468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/24/2023] [Accepted: 01/21/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Multiple sclerosis is characterised by acute and chronic inflammation in the CNS. Diet may influence inflammation, and therefore MS outcomes. OBJECTIVE To determine whether the Dietary Inflammatory Index (DII®)) is associated with depression, anxiety, and fatigue in a prospective cohort of people with MS. METHODS People with a first clinical diagnosis of demyelination were followed over 10 years (n=223). DII and energy-adjusted DII (E-DIITM) scores were calculated from the dietary intake in the preceding 12 months measured by food frequency questionnaire. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and fatigue by the Fatigue Severity Scale. RESULTS A higher E-DII score was associated with higher levels of depression and anxiety five years later (e.g., highest vs lowest E-DII quartile, HADS-D score: β=2.23, 95%CI=0.98,3.48, p<0.001; HADS-A score: β=1.90, 95%CI=0.59,3.21, p<0.001). A cumulative E-DII score was associated with depression (p<0.01) and anxiety (p=0.05) at the 10-year review. No associations were seen for fatigue. CONCLUSION Our findings suggest that, in people with MS, a more pro-inflammatory diet may long-term adverse impact on depression and anxiety, but not fatigue.
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Affiliation(s)
- A Saul
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - B V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - L Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - S Simpson-Yap
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - W H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - N Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA; Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - J R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA; Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - L J Black
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - A L Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, VIC, Australia; The Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia
| | - S A Broadley
- School of Medicine, Griffith University, Gold Coast, Australia
| | - J Lechner-Scott
- Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia; Faculty of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - I van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
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Rodgers AL, Arzoz-Fabregas M, Roca-Antonio J, Dolade-Botias M, Shivappa N, Hébert JR. Correlation research demonstrates that an inflammatory diet is a risk factor for calcium oxalate renal stone formation. Clin Nutr ESPEN 2024; 60:320-326. [PMID: 38479930 DOI: 10.1016/j.clnesp.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/11/2023] [Accepted: 02/01/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND AIMS Previous studies have demonstrated associations between the Dietary Inflammatory Index (DII®), an analytical tool which evaluates the inflammatory potential of the diet according to the pro- and anti-inflammatory properties of its components, and renal stone formation. However, these have not comprehensively addressed important parameters such as stone type, gender, DII scores in stone formers (SFs) and healthy controls (Cs) and associations of DII with urine and blood chemistries. These were adopted as the survey parameters for the present study, the purpose of which was to test whether the contributory role of an inflammatory diet on stone formation could be further confirmed. METHODS 97 calcium oxalate (CaOx) SFs and 63 Cs, matched for age and gender each completed a semi-quantitative food frequency questionnaire from which nutrient composition was computed. These data were used to calculate the DII® score. To control the effect of energy intake, energy-adjusted DII scores were calculated per 1000 kcal consumed (E-DII™). A single blood sample and two consecutive overnight (8h) urine samples were collected from a subset (n = 59 SFs and n = 54 Cs) of the overall number of particpants (n = 160). These were analysed for renal stone risk factors. Data were analysed using regression models fit in R software. RESULTS E-DII scores were found to fit the data better than DII, so they were used throughout. E-DII scores were significantly more positive (more pro-inflammatory) in SFs than in controls in the combined gender group (-0.34 vs. -1.73, p < 0.0001) and separately in males (-0.43 vs. -1.78, p = 0.01) and females (-0.26 vs. - 1.61, p = 0.05). In blood, a significant negative correlation was seen between E-DII and HDL cholesterol. In urine significant positive correlations were seen between E-DII and each of calcium (ρ = 0.25, p = 0.02), phosphate (ρ = 0.48, p < 0.001), magnesium (ρ = 0.33, p < 0.0001) and uric acid (ρ = 0.27, p = 0.004) concentrations. A significant negative correlation was seen between E-DII and urinary volume ρ = -0.27, p = 0.003). There was no correlation between E-DII scores and the relative supersaturations of urinary CaOx, calcium phosphate (brushite) and uric acid. CONCLUSIONS Our findings provide hitherto unreported quantitative evidence in support of the notion that the diet of calcium oxalate renal stone patients is significantly more pro-inflammatory than that of healthy controls.
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Affiliation(s)
| | | | | | | | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, USA; Department of Epidemiology and Biostatistics, University of South Carolina, USA; Connecting Health Innovations, Columbia, SC, USA.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, USA; Department of Epidemiology and Biostatistics, University of South Carolina, USA; Connecting Health Innovations, Columbia, SC, USA.
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da Conceição AR, da Silva A, Juvanhol LL, Marcadenti A, Bersch-Ferreira ÂC, Weber B, Shivappa N, Bressan J. The Brazilian Cardioprotective Nutritional (BALANCE) Program improves diet quality in patients with established cardiovascular disease: Results from a multicenter randomized controlled trial. Nutr Res 2024; 121:82-94. [PMID: 38056033 DOI: 10.1016/j.nutres.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/08/2023]
Abstract
Dietary modifications are essential strategies for cardiovascular disease prevention. However, studies are needed to investigate the diet quality of individuals undergoing secondary prevention in cardiology and who received dietary intervention based on cardiovascular disease management. We prospectively evaluated the diet quality in the Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial). We hypothesized that the BALANCE Program could improve patients' dietary pattern according to different indices of diet quality such as the Dietary Inflammatory Index (DII); the dietary total antioxidant capacity; overall, healthful, and unhealthful Plant-Based Diet Index (PDI, hPDI, and uPDI, respectively); and modified Alternative Healthy Eating Index (mAHEI). This multicenter randomized, controlled trial included patients aged ≥45 years randomly assigned to either the experimental or control group. Data from 2185 participants at baseline and after 12, 24, 36, and 48 months showed that the intervention group (n = 1077) had lower mean values of DII and higher dietary total antioxidant capacity, PDI, hPDI, and mAHEI than the control group. The results also showed differences between the follow-up times for DII, hPDI, and uPDI (48 months vs baseline) and for PDI and mAHEI (24 months vs baseline), regardless of group. The interaction analysis demonstrated that the intervention group showed better results than the control group at 12, 24, 36, and 48 months for the DII and at months 12, 36, and 48 for the mAHEI. Our results provide prospective evidence that the BALANCE Program improved the diet quality in those in secondary cardiovascular prevention according to different indices, with the intervention group showing better results than the control group.
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Affiliation(s)
| | - Alessandra da Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | | | - Aline Marcadenti
- Hcor Research Institute, HCor (IP-Hcor), São Paulo, SP, Brazil; Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul (IC/FUC), Porto Alegre, RS, Brazil
| | - Ângela Cristine Bersch-Ferreira
- Hcor Research Institute, HCor (IP-Hcor), São Paulo, SP, Brazil; Hospital Beneficência Portuguesa de São Paulo, PROADI-SUS Office, São Paulo, SP, Brazil
| | | | - 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
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG, Brazil
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Zheng J, Zhu T, Li F, Wu H, Jiang S, Shivappa N, Hébert JR, Li X, Li Y, Wang H. Diet Quality and Mortality among Chinese Adults: Findings from the China Health and Nutrition Survey. Nutrients 2023; 16:94. [PMID: 38201925 PMCID: PMC10780502 DOI: 10.3390/nu16010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The association between diet quality and all-cause mortality in Chinese population is unclear. We aimed to study the associations of three a priori diet quality indices-including the Diet Quality Index-International (DQI-I), Chinese Healthy Eating Index (CHEI), and energy-adjusted Dietary Inflammatory Index (E-DII)-and their included components with all-cause mortality. We used baseline data from the 2004, 2006, 2009, and 2011 waves of the China Health and Nutrition Survey (CHNS). We used a multivariable-adjusted Cox model to examine the associations between DQI-I, CHEI, and E-DII with all-cause mortality. During a mean of 7 years of follow-up, a total of 461 deaths occurred among 12,914 participants. For DQI-I, there were significant inverse associations with mortality for the variety score (HRQ4 vs. Q1 = 0.69, 95%CI = 0.52-0.92) and overall balance score (HR>0 vs. 0 = 0.81, 95%CI = 0.66-0.91). The adequacy score of CHEI was associated with 40% less risk of all-cause mortality (HRQ4 vs. Q1 = 0.60, 95%CI = 0.43-0.84). E-DII was not associated with mortality. An estimated 20.1%, 13.9%, and 31.3% of total mortality would be averted if the DQI-I variety score, DQI-I overall balance score, and CHEI adequacy score improved from the bottom to the top quartile, respectively. Improving diet quality, especially improving diet variety and adequacy, and having a more balanced diet may reduce all-cause mortality in Chinese adults.
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Affiliation(s)
- Jiali Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Tianren Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Fangyu Li
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Han Wu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China;
| | - Shuo Jiang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- 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, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Xiaoguang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
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Sung LB, Coleman HG, Shivappa N, Hébert JR, Murff HJ, Milne GL, Ness RM, Smalley WE, Zheng W, Shrubsole MJ. Dietary Inflammatory Potential and the Risk of Serrated and Adenomatous Colorectal Polyps. Nutr Cancer 2023; 75:1900-1910. [PMID: 37791878 PMCID: PMC10873098 DOI: 10.1080/01635581.2023.2261651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023]
Abstract
Studies of dietary inflammation potential and risks of colorectal cancer precursors are limited, particularly for sessile serrated lesions (SSLs). This study examines the association using the energy-adjusted dietary inflammatory index (E-DIITM), a measure of anti- and/or pro-inflammatory diet, in a large US colonoscopy-based case-control study of 3246 controls, 1530 adenoma cases, 472 hyperplastic polyp cases, and 180 SSL cases. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression models. Analyses were stratified by participant characteristics, and urinary prostaglandin E2 metabolite (PGE-M) and high-sensitivity plasma C-reactive protein (hs-CRP) levels, inflammation biomarkers. Highest E-DII™ intake was associated with significantly increased risks of colorectal adenomas (OR 1.36, 95% CI 1.11, 1.67), and hyperplastic polyps (OR 1.43, 95% CI 1.06, 1.98), compared with participants consuming the lowest E-DII™ quartile. A similar, but non-significant, increased risk was also observed for SSLs (OR 1.41, 95% CI 0.82, 2.41). The positive association was stronger in females (pinteraction <0.001), normal weight individuals (ptrend 0.01), and in individuals with lower inflammatory biomarkers (ptrend 0.02 and 0.01 for PGE-M and hs-CRP, respectively). A high E-DII™ is associated with colorectal polyp risk, therefore promoting an anti-inflammatory diet may aid in preventing colorectal polyps.
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Affiliation(s)
- L. Beth Sung
- Centre for Public Health, Queen’s University Belfast, Northern Ireland
| | - Helen G. Coleman
- Centre for Public Health, Queen’s University Belfast, Northern Ireland
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - Harvey J. Murff
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, USA
| | - Ginger L. Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Reid M. Ness
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, USA
| | - Walter E. Smalley
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, USA
| | - Wei Zheng
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, USA
| | - Martha J. Shrubsole
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, TN, USA
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9
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Wu J, Yu C, Shivappa N, Hébert JR, Xu X. Dietary inflammatory index and renal cancer risk: a prospective study. Food Funct 2023; 14:9287-9294. [PMID: 37779467 DOI: 10.1039/d3fo02158k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: High dietary inflammatory index (DII®) scores, representing pro-inflammatory diets, have been associated with increased risks for numerous cancers. However, the evidence for renal cancer is limited. In the present study, we aimed to assess the association between DII and renal cancer risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cohort. Methods: Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards model with adjustment for various potential confounders. Results: After a median 12.2 years of follow-up, this study recorded 443 renal cancer cases among 101 190 individuals. The DII score was positively associated with renal cancer risk in multivariable analyses. The HR in the highest DII tertile compared to the lowest tertile was 1.38 (95% CI 1.03-1.84). This was also true when DII was analyzed as a continuous variable. The HR of one-unit increment in DII for renal cancer risk was 1.07 (95% CI 1.01-1.12). Conclusion: In this large American cohort, pro-inflammatory diet, as estimated by higher DII scores, was significantly associated with a greater risk of renal cancer. Future large prospective studies are warranted to verify these preliminary findings.
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Affiliation(s)
- Jian Wu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chenchen Yu
- Department of Urology, Zhejiang Medical&Health Group Hangzhou Hospital, Hangzhou 310022, China
| | - 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
- Department of Nutrition, 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
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - Xin Xu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
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10
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Seva DC, Mônico-Neto M, Antunes HKM, Pino JMV, Bittencourt LRA, Galvão TD, Dâmaso AR, Oyama LM, Shivappa N, Hébert JR, Tufik S, da Silveira Campos RM. Beneficial Short-Term Effects of Bariatric Surgery on Nutritional Inflammatory Profile and Metabolic Biomarkers. Obes Surg 2023; 33:2789-2798. [PMID: 37540480 DOI: 10.1007/s11695-023-06743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Bariatric surgery (BS) has several potential metabolic benefits. However, little is known about its impact on changes in the inflammatory potential of diet and its effect on inflammatory and metabolic markers. This study aimed to assess the short-term beneficial effects of BS on dietary inflammatory potential and inflammatory and metabolic markers. MATERIALS AND METHODS Participants (n = 20) were evaluated 3 months before and after BS. Body mass, body mass index, anthropometric measurements, fat mass, fat-free mass, visceral fat, skeletal muscle mass, basal metabolic rate, serum lipids, HOMA-IR, QUICKI and inflammatory markers, including leptin, adiponectin, adiponectin/leptin ratio and plasminogen activator inhibitor-1 (PAI-1), were evaluated. Diet data were collected using a 3-day diet record and the dietary inflammatory index (DII®) and energy-adjusted dietary inflammatory index (E-DIITM) scores were computed. RESULTS There was a reduction in DII® (2.56 vs 2.13) and E-DIITM (2.18 vs 0.45) indicating an improvement in inflammatory nutritional profile. Moreover, there were increases in the adiponectin/leptin ratio (0.08 vs 0.21) and QUICKI scores (0.31 vs 0.37), and reductions in leptin (36.66 vs 11.41 ng/ml) and HOMA-IR scores (3.93 vs 1.50). There were also improvements in body composition and anthropometric parameters. CONCLUSIONS BS promotes changes in metabolic profile, inflammatory state and food intake and these modifications appeared to be associated with improvements in diet-related inflammation, an increase in the adiponectin/leptin ratio and a reduction in leptin. These results contribute to knowledge on the contribution bariatric surgery can make to the treatment of obesity and the reduction of related comorbidities.
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Affiliation(s)
- Danielle Cristina Seva
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
| | - Marcos Mônico-Neto
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil.
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
- BariMais - Medicina Integrada, São Paulo, Brazil.
| | - Hanna Karen Moreira Antunes
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Biosciences, Universidade Federal de São Paulo, Santos, Brazil
| | | | - Lia Rita Azeredo Bittencourt
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Ana R Dâmaso
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP-EPMP), São Paulo, Brazil
| | - Lila Missae Oyama
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP-EPMP), São Paulo, Brazil
- Department of Physiology Paulista Medicine School, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC, USA
| | - Sergio Tufik
- Post Graduate Program in Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Raquel Munhoz da Silveira Campos
- Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Térreo, Vila Matias, Santos, 11015020, Brazil
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11
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Rouzitalab T, Shivappa N, Daneshzad E, Izadi A, Sanoobar M, Khandouzi N, Shiri-Shahsavar MR, Khalili M. Dietary patterns and risk of multiple sclerosis: Results of a double-center case-control study in Iran. Nutr Health 2023; 29:531-539. [PMID: 35234101 DOI: 10.1177/02601060221082379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: It has been suggested that nutrition might contribute to multiple sclerosis etiology (MS). Aim: This case-control study aimed to determine the role of food habits and dietary patterns in preventing or developing MS in a multicenter study in Iran (Tehran and Shiraz). Methods: In this study, food intake of (106 patients with relapsing/remitting MS (RRMS) and 72 healthy controls in Tehran) and (75 patients with relapsing/remitting MS (RRMS) and 72 healthy controls in Shiraz) were collected using a validated semi-quantitative food frequency questionnaire. Dietary patterns were extracted using factor analysis. The association between dietary patterns and the risk of MS was analyzed by Logistic regression. Results: Two major dietary patterns were extracted: the "healthy" and the "unhealthy" patterns. After adjustment for potential confounders, in Tehran city, subjects in the highest tertile of the unhealthy dietary pattern score had greater odds of having MS, compared with those in the lowest tertile (OR: 2.16; 95% CI: [1.95-2.41]; p for trend = 0.01). In Shiraz city, subjects in the highest tertile of the unhealthy dietary pattern score had greater odds with MS than those in the lowest tertile (OR: 3.08; 95% CI: [1.27-7.38]; p for trend = 0.01). However, in both groups, no significant association was found between healthy dietary pattern and MS risk. Conclusions: Adherence to unhealthy dietary pattern may increase the risk of MS in Iran. The results can be used for developing interventions that aim to promote healthy eating for preventing MS.
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Affiliation(s)
- Tohid Rouzitalab
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - 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
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Azimeh Izadi
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Meisam Sanoobar
- Clinical Nutrition Department, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Khandouzi
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Shiri-Shahsavar
- Department of Nutrition, School of Health, Qazvin University of Medical Science, Qazvin, Iran
- Health Products Safety Research Center, Qazvin University of Medical Science, Qazvin, Iran
| | - Mohammad Khalili
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
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12
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Zuercher MD, Harvey DJ, Au LE, Shadyab AH, Santiago-Torres M, Liu S, Shivappa N, Hébert JR, Robbins JA, Garcia L. Energy-Adjusted Dietary Inflammatory Index and Diabetes Risk in Postmenopausal Hispanic Women. J Acad Nutr Diet 2023:S2212-2672(23)01310-2. [PMID: 37544374 PMCID: PMC10839112 DOI: 10.1016/j.jand.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Type 2 diabetes is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) are tools that assess dietary inflammation. Previous evidence suggests that obesity can modify the association between inflammation and disease. OBJECTIVE The aim of this study was to evaluate the association between the DII/E-DII and incident diabetes in self-identified Hispanic women from the Women's Health Initiative (WHI). The secondary aim was to evaluate whether obesity modifies the association between the DII/E-DII scores and incident diabetes. DESIGN Participants were from the WHI Observational Study and the Clinical Trial Components (except women from the treatment arm in the Dietary Modification Trial) conducted among postmenopausal women in the United States. DII/E-DII scores were calculated from a self-administered food frequency questionnaire at baseline that included 122 food items, of which 12 are representative of Hispanic eating patterns. PARTICIPANTS/SETTINGS Participants included 3,849 postmenopausal women who self-identified as Hispanic that were recruited for the WHI from 1993 to 1998 at 40 US clinical centers. MAIN OUTCOME MEASURES The outcome was incident diabetes. STATISTICAL ANALYSIS PERFORMED Cox regression models were used to assess the association between DII/E-DII and incident diabetes. Models were adjusted for age at baseline, lifestyle-related risk factors, known type 2 diabetes mellitus (T2DM) risk factors, and neighborhood socioeconomic status. Interaction was tested between the DII/E-DII scores and obesity. RESULTS The incidence of diabetes was 13.1% after a median follow-up of 13 years. Higher E-DII scores were associated with a higher risk of incident diabetes (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.04-1.14). There was no interaction between E-DII scores and obesity (P = 0.73). CONCLUSIONS Pro-inflammatory diets, as measured by higher E-DII scores, were associated with a higher risk of incident diabetes. Future research is needed for understanding how the inflammatory potential of diets can be decreased.
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Affiliation(s)
| | | | | | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
| | | | - Simin Liu
- Public Health and Medicine, Brown University, Providence, RI
| | - Nitin Shivappa
- Cancer Prevention and Control Program & Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, & Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC
| | - James R Hébert
- Cancer Prevention and Control Program & Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, & Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC
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13
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Shieh A, Karlamangla AS, Huang MH, Shivappa N, Wirth MD, Hébert JR, Greendale GA. Dietary Inflammatory Index and Fractures in Midlife Women: Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2023; 108:e594-e602. [PMID: 36780235 PMCID: PMC10348462 DOI: 10.1210/clinem/dgad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/07/2022] [Accepted: 01/25/2023] [Indexed: 02/14/2023]
Abstract
CONTEXT While evidence suggests that chronic, low-grade inflammation is a risk factor for bone loss and fractures, the potential relation between an inflammatory dietary profile and greater fracture risk is uncertain. OBJECTIVE We examined whether a more inflammatory diet, consumed during pre- and early perimenopause, is associated with more incident fractures starting in the menopause transition (MT) and continuing into postmenopause. METHODS Dietary inflammatory potential was quantified using 2 energy-adjusted dietary inflammatory index scores: one for diet only (E-DII), and one for diet plus supplements (E-DII-S). We included 1559 women from the Study of Women's Health Across the Nation, with E-DII and E-DII-S scores from the baseline visit (during pre- or early perimenopausal), and up to 20 years of follow-up. We excluded women using bone-beneficial medications at baseline; subsequent initiators were censored at first use. The associations of E-DII or E-DII-S (each tested as separate exposures) with incident fracture were examined using Cox proportional hazards regression. RESULTS Adjusted for age, BMI, cigarette use, diabetes, MT stage, race/ethnicity, prior fracture, bone-detrimental medication use, aspirin or nonsteroidal anti-inflammatory drug use, and study site, greater E-DII and E-DII-S (tested separately) were associated with more future fractures. Each SD increment in E-DII and E-DII-S predicted 28% (P = .005) and 21% (P = .02) greater fracture hazard, respectively. Associations were essentially unchanged after controlling for bone mineral density. CONCLUSION A more pro-inflammatory diet in pre- and early perimenopause is a risk factor for incident fracture. Future studies should consider whether reducing dietary inflammation in midlife diminishes fracture risk.
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Affiliation(s)
- Albert Shieh
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Arun S Karlamangla
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Mei-Hua Huang
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - 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
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Michael D Wirth
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, 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
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Gail A Greendale
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
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14
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Choi SW, Sreeja SR, Le TD, Shivappa N, Hebert JR, Kim MK. Association between inflammatory potential of diet and periodontitis disease risks: Results from a Korean population-based cohort study. J Clin Periodontol 2023; 50:952-963. [PMID: 37085969 DOI: 10.1111/jcpe.13817] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/20/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Abstract
AIM To examine the association between a pro-inflammatory diet, estimated using the energy-adjusted dietary inflammatory index (E-DII), and the risk of periodontitis. MATERIALS AND METHODS Study subjects from the Korean Genome and Epidemiology Study Health Examinee (KoGES_HEXA) cohort were included for cross-sectional analysis (n = 168,378) using multivariate logistic regression and prospective analysis (n = 160,397) using Cox proportional hazard models respectively. DII and E-DII scores were calculated based on the intake reported on a validated semi-quantitative food frequency questionnaire (SQ-FFQ). RESULTS Cox proportional hazard models revealed a significantly increased risk of incident periodontitis in individuals consuming high E-DII (more pro-inflammatory) diets in the total population (HRquartile4vs1 = 1.29; 95% CI: 1.13-1.48; ptrend <.001) and in both men (HRquartile4vs1 = 1.36; 95% CI: 1.07-1.73; ptrend = 0.02) and women (HRquartile4vs1 = 1.27; 95% CI: 1.08-1.50; ptrend = .002). The association remained significant even after excluding cases diagnosed early in the follow-up. In the cross-sectional analysis, a significant association was observed between the E-DII score and the prevalence of periodontitis among all study subjects (ORquartile4vs1 = 1.17; 95% CI: 1.03-1.34; ptrend = 0.01) and men (ORquartile4vs1 = 1.28; 95%CI: 1.01-1.63; ptrend <.001); however, the association did not reach statistical significance in women (ORquartile4vs1 = 1.13; 95% CI: 0.96-1.33; ptrend <.001). CONCLUSIONS Findings from the current study support the hypothesis that diets with high pro-inflammatory potential increase the risk of periodontitis.
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Affiliation(s)
- Sung Weon Choi
- Oral Oncology Clinic, Research Institute, and Hospital, National Cancer Center, Goyang, South Korea
| | - Sundara Raj Sreeja
- Department of Cancer Epidemiology, National Cancer Center, Goyang, South Korea
| | - Trong-Dat Le
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - 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
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hebert
- 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
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Mi Kyung Kim
- Department of Cancer Epidemiology, National Cancer Center, Goyang, South Korea
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15
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Lécuyer L, Laouali N, Viallon V, Artaud F, Hébert JR, Shivappa N, Agudo A, Tjønneland A, Mellemkjær L, Kaaks R, Katzke VA, Schulze MB, Frenoy P, Mancini FR, De Magistris MS, Macciotta A, Masala G, Agnoli C, Tumino R, Boer JMA, Verschuren WMM, Enget Jensen TM, Olsen KS, Skeie G, Chirlaque MD, Petrova D, Castro-Espin C, Quirós JR, Guevara M, Amiano P, Borné Y, Sandström M, Nilsson LM, Heath AK, Mayen AL, Huybrechts I, Weiderpass E, Boutron-Ruault MC, Dossus L, Rinaldi S, Truong T. Associations between dietary inflammatory scores and biomarkers of inflammation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Clin Nutr 2023; 42:1115-1125. [PMID: 37271707 DOI: 10.1016/j.clnu.2023.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/14/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Since the first version of the dietary inflammatory index (DII®) developed in the past decade, several other versions have been developed. However, to date no study has attempted to compare these versions with respect to their associations with biomarkers of inflammation. OBJECTIVE We aimed to investigate the relationship between four dietary inflammatory scores [DII, two energy-adjusted derivatives (E-DII and E-DIIr), and the Inflammatory Score of the Diet (ISD)], and circulating levels of several inflammatory markers and adipokines. METHODS This study included 17 637 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort with at least one marker of inflammation measured in blood. Associations between the four scores and C-reactive protein (CRP), interleukin (IL)6, IL10, IL1RA, tumor necrosis factor-α (TNFα), soluble tumor necrosis factor receptor-1 (sTNFR1), sTNFR2, leptin, soluble leptin receptor (sLeptin R), adiponectin, and High Molecular Weight (HMW) adiponectin were evaluated using multivariable linear regressions adjusted for potential confounders. RESULTS Positive associations were observed between the four dietary inflammatory scores and levels of CRP, IL6, sTNFR1, sTNFR2 and leptin. However, only the DII and the ISD were positively associated with IL1RA levels and only the DII and the E-DIIr were positively associated with TNFα levels. The proportion of variance of each biomarker explained by the scores was lower than 2%, which was equivalent to the variance explained by smoking status but much lower than that explained by body mass index. CONCLUSIONS Our results suggest that the four dietary inflammatory scores were associated with some biomarkers of inflammation and could be used to assess the inflammatory potential of diet in European adults but are not sufficient to capture the inflammatory status of an individual. These findings can help to better understand the inflammatory potential of diet, but they need to be replicated in studies with repeated dietary measurements.
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Affiliation(s)
- Lucie Lécuyer
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - Nasser Laouali
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Fanny Artaud
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Spain; Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Anne Tjønneland
- Danish Cancer Society Research Center, "Diet, Cancer and Health", Copenhagen, Denmark; University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Lene Mellemkjær
- Danish Cancer Society Research Center, "Diet, Cancer and Health", Copenhagen, Denmark
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena A Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Dept. of Molecular Epidemiology, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Pauline Frenoy
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - Francesca Romana Mancini
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | | | - Alessandra Macciotta
- Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE-ONLUS, Ragusa, Italy
| | - Jolanda M A Boer
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - Torill M Enget Jensen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Karina Standahl Olsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - María-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain; CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
| | - Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Spain; Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Spain
| | | | - Marcela Guevara
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Pilar Amiano
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain; Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - Yan Borné
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Lena Maria Nilsson
- Department of Epidemiology and Global Health/ Arcum, Arctic Centre, Umeå University, Umeå, Sweden
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ana-Lucia Mayen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Thérèse Truong
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France.
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Jandari S, Rezvani R, Yousefian S, Mosalmanzadeh N, Bagherniya M, Soleimani D, Mousavian SZ, Shivappa N, Hébert JR, Jafarzadeh Esfahani A, Akhgari A, Jarahi L, Safarian M. The effect of low dietary inflammatory index score formula on inflammatory, metabolic, and clinical outcomes in critically ill traumatic brain injury patients: A single-blind randomized controlled pilot study. Food Sci Nutr 2023; 11:3365-3375. [PMID: 37324871 PMCID: PMC10261799 DOI: 10.1002/fsn3.3326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/20/2023] [Accepted: 03/10/2023] [Indexed: 06/17/2023] Open
Abstract
In traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses are frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DII®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. This single-blind randomized controlled pilot study was conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low-DII score or standard formula at the intensive care unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. The trial groups did not differ significantly in baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in the GCS score in the low-DII score formula group compared to the standard formula group. Over 2 weeks, high sensitivity C-reactive protein (hs-CRP) values of -2.73 (95% CI: -3.67, -1.79) mg/dL in the low-DII score formula group versus 0.65 (95% CI: -0.29, 1.58) mg/dL in controls were obtained. Moreover, the length of hospital stay was longer for the standard formula group than for the low-DII score formula group. The low-DII score formula improves inflammatory factors (serum hs-CRP) and metabolic biomarkers (LDL-c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity, appear to be enhanced.
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Affiliation(s)
- Sajedeh Jandari
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Reza Rezvani
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Sajedeh Yousefian
- Department of Nutrition SciencesVarastegan Institute for Medical SciencesMashhadIran
| | - Negin Mosalmanzadeh
- Department of Nutrition SciencesVarastegan Institute for Medical SciencesMashhadIran
| | - Mohammad Bagherniya
- Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Davood Soleimani
- Department of Nutritional Sciences, School of Nutritional SciencesKermanshah University of Medical SciencesKermanshahIran
| | - Seyedeh Zeynab Mousavian
- Department of Nutritional Sciences, School of Nutritional SciencesKermanshah University of Medical SciencesKermanshahIran
| | - Nitin Shivappa
- Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaSouth CarolinaUSA
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
- Connecting Health Innovations LLCColumbiaSouth CarolinaUSA
| | - James R. Hébert
- Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaSouth CarolinaUSA
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Ali Jafarzadeh Esfahani
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Abass Akhgari
- Targeted Drug Delivery Research CenterPharmaceutical Technology Institute, Mashhad University of Medical SciencesMashhadIran
- Department of Pharmaceutics, School of PharmacyMashhad University of Medical SciencesMashhadIran
| | - Lida Jarahi
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohammad Safarian
- Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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17
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Gainfort A, Delahunt A, Killeen SL, O'Reilly SL, Hébert JR, Shivappa N, McAuliffe FM. Energy-Adjusted Dietary Inflammatory Index in pregnancy and maternal cardiometabolic health: findings from the ROLO study. AJOG Glob Rep 2023; 3:100214. [PMID: 37234814 PMCID: PMC10205536 DOI: 10.1016/j.xagr.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Background Excessive inflammation during pregnancy has been linked to adverse long-term health outcomes for both mothers and their children. One such outcome is maternal cardiometabolic dysfunction. The Energy-Adjusted Dietary Inflammatory Index is a method of scoring the overall inflammatory potential of the diet. Research on how the inflammatory potential of the maternal diet during pregnancy affects maternal cardiometabolic factors is limited. Objective We investigated if the maternal Energy-Adjusted Dietary Inflammatory Index was associated with maternal cardiometabolic factors during pregnancy. Study design This is a secondary analysis of 518 individuals who participated in the ROLO (Randomized cOntrol trial of a LOw glycemic index diet in pregnancy) study. Maternal Energy-Adjusted Dietary Inflammatory Index scores were calculated in early (12-14 weeks' gestation) and late pregnancy (34 weeks' gestation) using data collected from 3-day food diaries. Body mass index, blood pressure, fasting lipid profiles, glucose levels, and HOMA1-IR were obtained in early and late pregnancy. Multiple linear regression examined associations between early-pregnancy Energy-Adjusted Dietary Inflammatory Index and early and late maternal cardiometabolic markers. In addition, the relationship between late-pregnancy Energy-Adjusted Dietary Inflammatory Index and late cardiometabolic factors was explored. Regression models were adjusted for maternal ethnicity, maternal age at delivery, education level, smoking status, and original randomized control trial group allocation. In regression models examining late-pregnancy Energy-Adjusted Dietary Inflammatory Index with late lipids, change in lipid level from early to late pregnancy was also adjusted for. Results Women's mean (standard deviation) age at delivery was 32.8 (±4.01) years, with median (interquartile range) body mass index of 24.45 (23.34-28.20) kg/m2. Mean (standard deviation) Energy-Adjusted Dietary Inflammatory Index was 0.59 (±1.60) in early pregnancy and 0.67 (±1.59) in late pregnancy. In adjusted linear regression analysis, first-trimester maternal Energy-Adjusted Dietary Inflammatory Index was positively associated with maternal body mass index (B=0.007; 95% confidence interval, 0.003-0.011; P=.001), early-pregnancy cardiometabolic markers including total cholesterol (B=0.155; 95% confidence interval, 0.061-0.249; P=.001), triglycerides (B=0.043; 95% confidence interval, 0.005-0.080; P=.03), low-density lipoproteins (B=0.129; 95% confidence interval, 0.049-0.209; P=.002), and diastolic blood pressure (B=0.538; 95% confidence interval, 0.070-1.006; P=.02), and late-pregnancy cardiometabolic markers including total cholesterol (B=0.127; 95% confidence interval, 0.012-0.243; P=.01) and low-density lipoproteins (B=0.110; 95% confidence interval, 0.010-0.209; P=.03). In the third trimester, Energy-Adjusted Dietary Inflammatory Index was associated with late-pregnancy diastolic blood pressure (B=0.624; 95% confidence interval, 0.103-1.145; P=.02), HOMA1-IR (B=0.030; 95% confidence interval, 0.005-0.054; P=.02), and glucose (B=0.003; 95% confidence interval, 0.003-0.034; P=.03). No associations were observed between third-trimester Energy-Adjusted Dietary Inflammatory Index and late-pregnancy lipid profiles. Conclusion Maternal diets with a higher Energy-Adjusted Dietary Inflammatory Index, which were low in anti-inflammatory foods and rich in proinflammatory foods, were associated with increased levels of cardiometabolic health risk factors in pregnancy. Promoting dietary intakes that have a lower inflammatory potential may support more favorable maternal cardiometabolic profiles during pregnancy.
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Affiliation(s)
- Amy Gainfort
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland (Ms Gainfort, Delahunt, Killeen, O'Reilly, and McAuliffe)
| | - Anna Delahunt
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland (Ms Gainfort, Delahunt, Killeen, O'Reilly, and McAuliffe)
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland (Ms Gainfort, Delahunt, Killeen, O'Reilly, and McAuliffe)
| | - Sharleen L. O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland (Ms Gainfort, Delahunt, Killeen, O'Reilly, and McAuliffe)
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland (Dr O'Reilly)
| | - James R. Hébert
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina and Connecting Health Innovations LLC, Columbia, SC (Drs Hébert and Shivappa)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina and Connecting Health Innovations LLC, Columbia, SC (Drs Hébert and Shivappa)
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland (Ms Gainfort, Delahunt, Killeen, O'Reilly, and McAuliffe)
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18
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Jackson MK, Lappe J, Ma J, Timmerman M, Lyden ER, Shivappa N, Hébert JR, Travers Gustafson D, Graeff-Armas L, Hanson C. Changes in Dietary Inflammatory Index Score over Time and Cancer Development in Rural Post-Menopausal Women. Antioxidants (Basel) 2023; 12:antiox12040946. [PMID: 37107321 PMCID: PMC10135941 DOI: 10.3390/antiox12040946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Inflammation plays a key role in cancer development. As an important modulator of inflammation, the role of diet should be explored. The purpose of this study was to determine the association between diets with a higher inflammatory potential, as measured by the Dietary Inflammatory Index (DII®), and cancer development in a cohort of rural post-menopausal women. Dietary intake from a randomized controlled trial cohort of rural, post-menopausal women in Nebraska was used to compute energy-adjusted DII (E-DIITM) scores at baseline and four years later (visit 9). A linear mixed model analysis and multivariate logistic regression evaluated the association between E-DII scores (baseline, visit 9, change score) and cancer status. Of 1977 eligible participants, those who developed cancer (n = 91, 4.6%) had a significantly larger, pro-inflammatory change in E-DII scores (Non-cancer: Δ 0.19 ± 1.43 vs. Cancer: Δ 0.55 ± 1.43, p = 0.02). After adjustment, odds of cancer development were over 20% higher in those with a larger change (more pro-inflammatory) in E-DII scores than those with smaller E-DII changes (OR = 1.21, 95% CI [1.02, 1.42], p = 0.02). Shifting to a more pro-inflammatory diet pattern over four years was associated with increased odds of cancer development, but not with E-DII at baseline or visit 9 alone.
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Affiliation(s)
- Mariah Kay Jackson
- Medical Nutrition, Department of Medical Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Joan Lappe
- College of Nursing, Creighton University, Omaha, NE 68178, USA
| | - Jihyun Ma
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Megan Timmerman
- Medical Nutrition, Department of Medical Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Elizabeth R Lyden
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
| | | | - Laura Graeff-Armas
- Division of Diabetes, Endocrine & Metabolism, Department of Internal Medicine, College of Medicine, University of Nebraska Medicine, Omaha, NE 68198, USA
| | - Corrine Hanson
- Medical Nutrition, Department of Medical Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
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19
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Cohen CC, Perng W, Sauder KA, Shapiro ALB, Starling AP, Friedman C, Felix JF, Küpers LK, Moore BF, Hébert JR, Shivappa N, Scherzinger A, Sundaram SS, Shankar K, Dabelea D. Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study. J Nutr 2023; 153:1122-1132. [PMID: 36796482 PMCID: PMC10196613 DOI: 10.1016/j.tjnut.2023.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans. OBJECTIVES This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4-8 y old). METHODS Data were from 278 mother-child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1-8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake. RESULTS Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of "empty calories" were associated with higher offspring hepatic fat in early childhood. CONCLUSIONS Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.
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Affiliation(s)
- Catherine C Cohen
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Allison L B Shapiro
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P Starling
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Chloe Friedman
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Leanne K Küpers
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brianna F Moore
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, 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, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Ann Scherzinger
- Department of Radiology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Shikha S Sundaram
- Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kartik Shankar
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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20
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Lecorguillé M, Navarro P, Chen LW, Murrin C, Viljoen K, Mehegan J, Shivappa N, Hébert JR, Kelleher CC, Suderman M, Phillips CM. Maternal and Paternal Dietary Quality and Dietary Inflammation Associations with Offspring DNA Methylation and Epigenetic Biomarkers of Aging in the Lifeways Cross-Generation Study. J Nutr 2023; 153:1075-1088. [PMID: 36842935 PMCID: PMC10196589 DOI: 10.1016/j.tjnut.2023.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/21/2022] [Accepted: 01/19/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Early-life nutritional exposures may contribute to offspring epigenetic modifications. However, few studies have evaluated parental dietary quality effects on offspring DNA methylation (DNAm). OBJECTIVES We aim to fill this gap by elucidating the influence of maternal and paternal whole-diet quality and inflammatory potential on offspring DNAm in the Lifeways Cross-generation cohort. METHODS Families (n = 1124) were recruited around 16 weeks of gestation in the Republic of Ireland between 2001 and 2003. Maternal dietary intake during the first trimester and paternal diet during the 12 previous months were assessed with an FFQ. Parental dietary inflammatory potential and quality were determined using the energy-adjusted Dietary Inflammatory Index (E-DII), the Healthy Eating Index-2015 (HEI-2015), and the maternal DASH score. DNAm in the saliva of 246 children at age nine was measured using the Illumina Infinium HumanMethylationEPIC array. DNAm-derived biomarkers of aging, the Pediatric-Buccal-Epigenetic clock and DNAm estimator of telomere length, were calculated. Parental diet associations with the DNAm concentrations of 850K Cytosine-phosphate-guanine sites (CpG sites) and with DNAm-derived biomarkers of aging were examined using an epigenome-wide association study and linear regressions, respectively. RESULTS Maternal HEI-2015 scores were inversely associated with DNAm at CpG site (cg21840035) located near the PLEKHM1 gene, whose functions involve regulation of bone development (β = -0.0036, per 1 point increase in the score; P = 5.6 × 10-8). Higher paternal HEI-2015 score was related to lower methylation at CpG site (cg22431767), located near cell signaling gene LUZP1 (β = -0.0022, per 1 point increase in the score, P = 4.1 × 10-8). There were no associations with parental E-DII and DASH scores, and no evidence of major effects on biomarkers of aging. CONCLUSIONS Parental dietary quality in the prenatal period, evaluated by the HEI-2015, may influence offspring DNAm during childhood. Further research to improve our understanding of parental nutritional programming is warranted.
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Affiliation(s)
- Marion Lecorguillé
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Pilar Navarro
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Ling-Wei Chen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Karien Viljoen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - John Mehegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 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, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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21
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Bueno Ferreira L, Nunes Dos Santos T, Cosenza G, Silva do Carmo A, Linhares Bello de Araújo R, Shivappa N, R Hébert J, Dos Santos LC. The Association of the Inflammatory Index of the Maternal Diet with the Type of Delivery, Maternal Nutritional Status, and the Lipid Profile of Human Milk. Breastfeed Med 2023; 18:291-299. [PMID: 37071632 DOI: 10.1089/bfm.2022.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Objective: To evaluate the association of the dietary inflammatory index adjusted for energy (E-DII®) with the evolution of maternal body mass index and human milk lipid (HM) profile in the first 6 months postpartum. Methods: This is a cohort study with 260 Brazilian women (19-43 years old) in the postpartum period. Sociodemographic, gestational, and anthropometric data of the mother were obtained in the immediate postpartum period and in the six monthly meetings. A food frequency questionnaire was applied at baseline and used to calculate the E-DII score. Mature HM was collected, analyzed by gas chromatography coupled with mass spectrometry and the Rose Gottlib method. Generalized estimation equation models were built. Results: Women with >E-DII showed lower adherence to physical activity during pregnancy (p = 0.027), higher frequency of cesarean delivery (p = 0.024), and higher body mass index over time (p < 0.001). At the end of the 6th month, 35 women remained in the study. As for HM, 151 analyses were performed, detecting in the 3rd collection greater fat (%) among those with >E-DII (4.27 ± 1.98 vs. 3.75 ± 2.48; p = 0.003). Conclusion: Diets with >E-DII can impact the type of delivery, change the evolution of maternal nutritional status, and the stability of the lipid profile of HM.
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Affiliation(s)
- Larissa Bueno Ferreira
- Health Science - Child and Adolescent Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tamires Nunes Dos Santos
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo Cosenza
- Department of Food Sciences, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ariene Silva do Carmo
- Health Science - Child and Adolescent Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Luana Caroline Dos Santos
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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22
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Barania Adabi S, Daneghian S, Khalkhali H, Nejadrahim R, Shivappa N. The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19. Front Nutr 2023; 10:1075061. [PMID: 37063325 PMCID: PMC10103612 DOI: 10.3389/fnut.2023.1075061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/07/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundInflammation and cytokine storm have been reported to be the main cause of acute symptoms of coronavirus disease (COVID-19). Diet-induced inflammation may affect the condition of patients with COVID-19. Therefore, this study aimed to investigate the relationship between disease severity, inflammatory and immune system biomarkers, and the dietary inflammatory index (DII) in patients with COVID-19.MethodsThis cross-sectional study was conducted on 500 adult patients with COVID-19. Patients were divided into mild, moderate, and severe conditions based on clinical and laboratory evidence. A validated food frequency questionnaire (FFQ) was used to determine DII and energy-adjusted DII (E-DII) scores. The serum C-reactive protein (CRP) level and blood cell count were measured for all patients. Multiple linear regression was used to explore the association between DII and E-DII and CRP, blood cell counts, and hospitalization in patients with COVID-19.ResultsCoronavirus disease (COVID-19) patients with higher DII had higher consumption of fat and carbohydrate and lower intakes of protein, anti-inflammatory nutrients, garlic, caffeine, tea, onion, and fiber (P < 0.05). There was a positive association between DII and CRP (β = 1.024, P < 0.001), hospitalization (β = 1.062, P < 0.001), WBC count (β = 0.486, P < 0.009), neutrophil count (β = 0.565, P < 0.001), and neutrophil-to-lymphocyte ratio (β = 0.538, P < 0.001) and a negative association between DII and the lymphocyte count (β = −0.569, P < 0.001). There was a positive association between E-DII and hospitalization (β = 1.645, P < 0.001), WBC count (β = 0.417, P < 0.02), and neutrophil-to-lymphocyte ratio (β = 0.35, P < 0.03).ConclusionThere is a positive correlation between DII and inflammation, immune hyperactivation, and length of hospital stay in patients with COVID-19. Further longitudinal studies are necessary.
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Affiliation(s)
- Somayyeh Barania Adabi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Sevana Daneghian
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
- *Correspondence: Sevana Daneghian
| | | | - Rahim Nejadrahim
- Department of Infectious Diseases and Dermatology, Urmia University of Medical Sciences, Urmia, Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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23
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Vitale S, Palumbo E, Polesel J, Hebert JR, Shivappa N, Montagnese C, Porciello G, Calabrese I, Luongo A, Prete M, Pica R, Grimaldi M, Crispo A, Esindi N, Falzone L, Mattioli V, Martinuzzo V, Poletto L, Cubisino S, Dainotta P, De Laurentiis M, Pacilio C, Rinaldo M, Thomas G, D'Aiuto M, Serraino D, Massarut S, Ferraù F, Rossello R, Catalano F, Banna GL, Messina F, Gatti D, Riccardi G, Libra M, Celentano E, Jenkins DJA, Augustin LSA. One-year nutrition counselling in the context of a Mediterranean diet reduced the dietary inflammatory index in women with breast cancer: a role for the dietary glycemic index. Food Funct 2023; 14:1560-1572. [PMID: 36655860 DOI: 10.1039/d2fo02198f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: the Mediterranean diet, the low dietary glycemic index (GI) and the dietary inflammation index (DII®) have been associated with lower risk of breast cancer (BC) incidence and mortality. Objective: to investigate whether one-year nutrition counselling in the context of a Mediterranean diet, with or without low-GI carbohydrates counselling, may influence the DII in women with BC. Methods: data were obtained from participants of DEDiCa trial randomized to a Mediterranean diet (MD, n = 112) or a Mediterranean diet with low-GI carbohydrates (MDLGI, n = 111). The diet-derived DII and GI were calculated from 7-day food records while Mediterranean diet adherence from PREDIMED questionnaire. Differences between study arms were evaluated through Fisher's exact test or Mann-Whitney test and associations with multivariable regression analyses. Results: Mediterranean diet adherence significantly increased by 15% in MD and 20% in MDLGI with no difference between arms (p < 0.326). Dietary GI significantly decreased from 55.5 to 52.4 in MD and 55.1 to 47.6 in MDLGI with significant difference between arms (p < 0.001). DII significantly decreased by 28% in MD and 49% in MDLGI with no difference between arms (p < 0.360). Adjusting for energy intake (E-DII) did not change the results. Higher Mediterranean diet adherence and lower dietary GI independently contributed to DII lowering (β-coefficient -0.203, p < 0.001; 0.046, p = 0.003, respectively). Conclusions: DII and E-DII scores decreased significantly after one-year with 4 nutrition counselling sessions on the Mediterranean diet and low GI. Increased adherence to the Mediterranean diet and low GI independently contributed to the DII changes. These results are relevant given that lowering the inflammatory potential of the diet may have implications in cancer prognosis and overall survival.
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Affiliation(s)
- Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano, Italy
| | - James R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - 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.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | | | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Ilaria Calabrese
- Healtcare Direction, "A. Cardarelli" Hospital, 80131 Naples, Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Melania Prete
- Division of Radiotherapy, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", 80131, Naples, Italy
| | - Rosa Pica
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Nadia Esindi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - Veronica Mattioli
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano, Italy
| | - Valentina Martinuzzo
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano, Italy
| | - Luigina Poletto
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano, Italy
| | - Serena Cubisino
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Patrizia Dainotta
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Michelino De Laurentiis
- Division of Breast Oncology, Istituto Nazionale Tumori - IRCCS "Fondazione Giovanni Pascale", Naples, Italy
| | - Carmen Pacilio
- Division of Breast Oncology, Istituto Nazionale Tumori - IRCCS "Fondazione Giovanni Pascale", Naples, Italy
| | | | | | | | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano, Italy
| | - Samuele Massarut
- Chirurgia Oncologica del Seno - Centro di Riferimento Oncologico (CRO) IRCCS, Aviano, Italy
| | | | | | | | | | | | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
| | - David J A Jenkins
- Department of Nutritional Sciences and Medicine, Temerty, Faculty of Medicine, University of Toronto, Toronto, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Livia S A Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy.
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24
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Doherty JL, Larvie DY, Shivappa N, Hebert JR, Armah SM. Inflammatory diets are associated with lower total iron binding capacity in sera of young adults. INT J VITAM NUTR RES 2023; 93:9-17. [PMID: 33593088 DOI: 10.1024/0300-9831/a000697] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Chronic, systemic inflammation, which is associated with obesity and numerous other diseases, impairs iron status by increasing hepcidin concentration. Inflammation also decreases the concentration of transferrin, the main iron transport protein and a negative acute phase protein, which is indirectly assessed by measuring total iron binding capacity (TIBC). However, the contribution of diet-induced inflammation has not been studied. Data from two studies, namely Diet and Inflammation and Selenium and Inflammation Studies (total n=98) were used to assess the associations among Dietary Inflammatory Index (DII®) scores derived from three-day dietary records, body mass index (BMI=weight[kg]/height[m]2), inflammatory and hematological markers among young adults with normal-weight, overweight or obesity. Subjects' diets were also categorized as less inflammatory diets (LID) and inflammatory diets (ID) using cluster analysis. Independent t-test and regression analyses were used to assess associations in the data. Intakes of iron, proteins, fat, fiber, and calories were higher in the LID group compared to the ID group (p<0.05). Demographic characteristics and concentrations of C-reactive protein (CRP) and iron status biomarkers did not differ significantly between the two groups (p>0.05). Higher DII score was associated with increasing CRP (β+SE=0.23+0.07, p=0.002) and lower TIBC (β+SE=-8.46+3.44, p=0.02), independent of BMI category. The LID diet was associated with higher TIBC (β+SE=29.87+10.75, p=0.007) compared to the ID diet. In conclusion, inflammatory diets may impair iron status by reducing the iron binding capacity of transferrin.
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Affiliation(s)
- Jeanne L Doherty
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, USA
| | - Doreen Y Larvie
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, USA
| | - James R Hebert
- Cancer Prevention and Control Program and the Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, USA
| | - Seth M Armah
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, USA
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25
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Zheng J, Tabung FK, Zhang J, Caan B, Hebert JR, Kroenke CH, Ockene J, Shivappa N, Steck SE. Association between dietary inflammatory potential and mortality after cancer diagnosis in the Women's Health Initiative. Br J Cancer 2023; 128:606-617. [PMID: 36482189 PMCID: PMC9938285 DOI: 10.1038/s41416-022-02079-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic inflammation is implicated in cancer prognosis and can be modulated by diet. We examined associations between post-diagnosis dietary inflammatory potential and mortality outcomes among post-menopausal women diagnosed with cancer in the Women's Health Initiative (WHI). METHODS Energy-adjusted dietary inflammatory index scores (E-DII) were calculated from dietary and supplemental intake data collected on the first food frequency questionnaire following the diagnosis of primary invasive cancer for 3434 women in the WHI. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for risk of death from any cause, cancer, cardiovascular disease (CVD) and other causes by post-diagnosis quartiles of E-DII. Subgroup analyses by cancer stage and grade were performed. RESULTS There were 1156 deaths after a median 13 years of follow-up from the date of a cancer diagnosis. In the multivariable-adjusted analyses, a more anti-inflammatory diet plus supplements after cancer diagnosis was associated with lower all-cause mortality, cancer mortality, CVD mortality and mortality from other causes with HRsQ1vs.Q4 ranging from 0.47 to 0.68 (all P-trends < 0.05). Associations were stronger for cancers diagnosed at more distant stages or moderately differentiated grades. CONCLUSION A more anti-inflammatory diet plus supplements after a cancer diagnosis may improve survival for post-menopausal cancer survivors.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Judith Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, 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, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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26
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Afshar N, Hodge AM, Shivappa N, Hébert JR, Giles GG, English DR, Milne RL. Dietary Inflammatory Index, Alternative Healthy Eating Index-2010, Mediterranean Diet Score and the risk of pancreatic cancer. Cancer Epidemiol 2023; 82:102295. [PMID: 36395705 DOI: 10.1016/j.canep.2022.102295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies of dietary patterns and pancreatic cancer risk have been inconclusive; we aimed to investigate the association of Mediterranean Diet Score (MDS), Alternative Healthy Eating Index-2010 (AHEI-2010), and Dietary Inflammatory Index (DII®) with risk of pancreatic cancer. METHODS We used data from the Melbourne Collaborative Cohort Study including 33,690 men and women aged 40-69 years at recruitment in 1990-1994. A total of 258 incident cases of pancreatic cancer was identified over an average of 23.7 years of follow-up. Hazard ratios (HR) were estimated using Cox regression, with age as the underlying time metric, adjusting for potential confounders including sex, height, country of birth, education, socio-economic position, physical activity, energy intake, smoking status, pack-years smoking, years since quitting smoking, and alcohol intake. RESULTS A healthier diet as assessed by the AHEI-2010 was associated with a lower risk of pancreatic cancer [HRQuartile4 vs Quartile1 = 0.58; 95%CI 0.40 - 0.85; p for trend 0.003]. Weaker but consistent evidence was observed for the other indexes [DII® HRQuartile4 vs Quartile1 = 1.30; 95%CI 0.82 - 2.06; p for trend 0.1], [MDS HRCategory3 vs Category1 = 0.79; 95%CI 0.49 - 1.26; p for trend 0.06]. CONCLUSION Adherence to a healthier diet, as assessed by the AHEI-2010, may reduce the risk of pancreatic cancer.
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Affiliation(s)
- Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010, Australia.
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA; Department of Nutrition, Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA; Department of Nutrition, Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC 29201, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Rd, Clayton, VIC 3168, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC 3004, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Rd, Clayton, VIC 3168, Australia
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Choi MK, Park YMM, Shivappa N, Hong OK, Han K, Steck SE, Hebert JR, Merchant AT, Sandler DP, Lee SS. Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity. Clin Nutr 2023; 42:208-215. [PMID: 36603461 PMCID: PMC10284332 DOI: 10.1016/j.clnu.2022.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Inflammatory potential of diet may contribute to poor health outcomes in individuals with metabolic disorders. In a representative sample of the U.S. population, we investigated the association between consuming a pro-inflammatory diet and mortality risk in adults with normal range of body mass index (BMI) but with central obesity. METHODS This prospective cohort study included 3521 adults 20-90 years of age with normal BMI who participated in the National Health and Nutrition Examination Survey III, 1988-1994 and did not have a history of cardiovascular disease (CVD) or cancer and did not change their dietary intake in the year preceding baseline measurements. Mortality from all causes, CVD, and cancer was ascertained from the National Death Index. Normal-weight central obesity (NWCO, n = 1777) was defined as those with BMI 18.5 to <25 kg/m2 and waist-to-hip ratio (WHR) ≥0.85 in women and ≥0.90 in men. Severe central obesity was defined as WHR ≥0.92 in women and ≥1.00 in men. The dietary inflammatory index (DII®) was computed based on baseline dietary intake using 24-h dietary recalls, and associations with mortality were estimated using multivariable Cox proportional hazards regression. RESULTS In individuals with NWCO, DII score (i.e., more pro-inflammatory diet) was associated with increased risk of CVD mortality (HRT3 vs T1, 1.89 [95% CI, 1.01-3.53], P trend = 0.04; HR 1 SD increase 1.29 [95% CI, 1.06-1.57]). This association was stronger with more severe central obesity (HRT3 vs T1, 2.79 [95% CI, 1.10-7.03], P trend = 0.03; HR 1 SD increase 1.52 [95% CI, 1.05-2.21]). DII score was not associated with increased risk of mortality in normal-weight individuals without central obesity or with risk of cancer mortality in either group. CONCLUSION Among individuals in the normal-weight range of BMI, a pro-inflammatory diet assessed by high DII scores was associated with increased risk of CVD mortality in those with central obesity.
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Affiliation(s)
- Moon Kyung Choi
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, CA, USA
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, AR, USA; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Oak-Kee Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Susan E Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Khamoush Cheshm N, Ataie-Jafari A, Eghtesadi S, Nikravan A, Shivappa N, Hebert JR. The Association between Dietary Inflammatory and Obesity Indices in University Students in Tehran. JNFS 2023. [DOI: 10.18502/jnfs.v8i1.11766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Obesity as a major cause of low-grade chronic inflammation is a global public health issue. Inflammation arising from obesity affects organs, such as kidney and liver, and is associated with chronic diseases. The present study aims to investigate the association between the dietary inflammatory index (DII) and obesity indices in university students. Methods: This cross-sectional study included 361 college students selected using a two-stage cluster random sampling. The inclusion criteria were healthy girls and boys in the 18-35 years age group, and the exclusion criteria included the presence of chronic diseases, such as diabetes, cardiovascular diseases, taking supplements to weight loss or weight gain, and using alcohol and tobacco. DII scores were calculated from dietary data collected using a semi-quantitative food frequency questionnaire (FFQ). Anthropometric measurements were taken, and body composition was analyzed by bioelectrical impedance analysis (BIA). Results: The mean age of the students was 21.94 ± 4.04 years, 53.2% were female, and the mean DII was 1.26 ± 1.08. Among the participants, 36.8% were overweight and obese and 9.1% suffered from abdominal obesity. The DII score was not associated with body weight, body mass index (BMI), body fat, waist circumference or visceral fat (both unadjusted and after adjustment for covariates). Conclusion: The present study showed no association between the DII and obesity indices. Given the proven effects of both the DII and obesity on health indicators, it would be a good strategy to conduct studies with prospective designs to determine the exact effects of DII on obesity indicators.
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Park SY, Lozano CP, Shvetsov YB, Boushey CJ, Wirth MD, Shivappa N, Hébert JR, Haiman CA, Wilkens LR, Marchand LL. Change in the inflammatory potential of diet over 10 years and subsequent mortality: the Multiethnic Cohort Study. Br J Nutr 2023; 129:157-165. [PMID: 35392990 PMCID: PMC9547033 DOI: 10.1017/s0007114522000861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Dietary inflammatory potential assessed by the Dietary Inflammatory Index (DII®) has been associated with health outcomes. However, longitudinal changes in the DII in relation to health outcomes rarely have been studied. This study aimed to examine change in the DII score over 10 years and its association with subsequent mortality in the Multiethnic Cohort. The analysis included 56 263 African American, Japanese American, Latino, Native Hawaiian and White participants who completed baseline (45-75 years) and 10-year follow-up surveys, including a FFQ. Mean energy-adjusted DII (E-DII) decreased over 10 years in men (from -0·85 to -1·61) and women (from -1·80 to -2·47), reflecting changes towards a more anti-inflammatory diet. During an average follow-up of 13·0 years, 16 363 deaths were identified. In multivariable Cox models, compared with anti-inflammatory stable individuals, risk of all-cause mortality was increased with pro-inflammatory change in men (hazard ratio (HR) = 1·13, 95 % CI 1·03, 1·23) and women (HR = 1·22, 95 % CI 1·13, 1·32). Per one-point increase in E-DII score over time, HR was 1·02 (95 % CI 1·00, 1·03) for men and 1·06 (95 % CI 1·04, 1·07) for women (P for heterogeneity < 0·001). While no heterogeneity by race and ethnicity was observed for men, the increased risk per one-point increase among women was stronger in non-Whites than in Whites (P for heterogeneity = 0·004). Our findings suggest that a change towards a more pro-inflammatory diet is associated with an increased risk of mortality both in men and women, and that the association is stronger in women, especially non-White women, than in men.
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Affiliation(s)
- Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Chloe P. Lozano
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
- Ingestive Behavior, Weight Management & Health Promotion Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Yurii B. Shvetsov
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Carol J. Boushey
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Michael D. Wirth
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Christopher A. Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Lynne R. Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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Zuercher MD, Harvey DJ, Santiago-Torres M, Au LE, Shivappa N, Shadyab AH, Allison M, Snetselaar L, Liu B, Robbins JA, Hébert JR, Garcia L. Dietary inflammatory index and cardiovascular disease risk in Hispanic women from the Women's Health Initiative. Nutr J 2023; 22:5. [PMID: 36631866 PMCID: PMC9835220 DOI: 10.1186/s12937-023-00838-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND To evaluate the association between the dietary inflammatory index (DII®) and incident cardiovascular disease (CVD) in Hispanic women from the Women's Health Initiative (WHI), and to determine if body mass index (BMI) interacted with the DII scores. METHODS Secondary analysis of baseline dietary data and long-term CVD outcomes among 3,469 postmenopausal women who self-identified as Hispanic enrolled in WHI. DII scores were calculated from self-administered food frequency questionnaires. The CVD outcomes included coronary heart disease (CHD) and stroke. Stratified Cox regression models were used to assess the relationship between DII scores and CVD in women with and without obesity. Models were adjusted for age, lifestyle risk factors, known risk factors, and neighborhood socioeconomic status. RESULTS The incidence of CHD was 3.4 and 2.8% for stroke after a median follow-up of 12.9 years. None of the DIIs were associated with CVD risk in this sample of Hispanic women. BMI interacted with the DII (p < 0.20) and stratified models showed that the associations between the DII and CVD were only significant in women with overweight (p < 0.05). In this group, higher DII scores were associated with a higher risk of CHD (HR 1.27; 95% CI: 1.08, 1.51) and a higher risk of stroke (HR 1.32; 95% CI: 1.07, 1.64). CONCLUSION Among postmenopausal Hispanic women with overweight, greater adherence to pro-inflammatory diets was associated with higher risk of CVD. Additional research is needed to understand how to promote long-term heart-healthy dietary habits to reduce inflammation and prevent CVD in at-risk Hispanic women.
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Affiliation(s)
- Monica D. Zuercher
- grid.27860.3b0000 0004 1936 9684University of California Davis, Davis, CA USA
| | - Danielle J. Harvey
- grid.27860.3b0000 0004 1936 9684University of California Davis, Davis, CA USA
| | - Margarita Santiago-Torres
- grid.270240.30000 0001 2180 1622Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Lauren E. Au
- grid.27860.3b0000 0004 1936 9684University of California Davis, Davis, CA USA
| | - Nitin Shivappa
- grid.254567.70000 0000 9075 106XDepartment of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Aladdin H. Shadyab
- grid.266100.30000 0001 2107 4242Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA USA
| | - Matthew Allison
- grid.266100.30000 0001 2107 4242Department of Family Medicine, University of California San Diego, La Jolla, CA USA
| | - Linda Snetselaar
- grid.214572.70000 0004 1936 8294Department of Epidemiology, University of Iowa, Iowa City, IA USA
| | - Buyun Liu
- grid.214572.70000 0004 1936 8294Department of Epidemiology, University of Iowa, Iowa City, IA USA
| | - John A. Robbins
- grid.27860.3b0000 0004 1936 9684University of California Davis, Davis, CA USA
| | - James R. Hébert
- grid.254567.70000 0000 9075 106XDepartment of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Lorena Garcia
- University of California Davis, Davis, CA, USA. .,Medical Sciences 1C, UC Davis School of Medicine, Sacramento, USA.
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Clark JS, Dyer KA, Davis CR, Shivappa N, Hébert JR, Woodman R, Hodgson JM, Murphy KJ. Adherence to a Mediterranean Diet for 6 Months Improves the Dietary Inflammatory Index in a Western Population: Results from the MedLey Study. Nutrients 2023; 15:nu15020366. [PMID: 36678237 PMCID: PMC9866776 DOI: 10.3390/nu15020366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
Increasing evidence supports that a higher dietary inflammatory index (DII®) score is associated with inflammation and cardiovascular disease (CVD) risk, events, and mortality. This randomized trial sought to determine if a change to a Mediterranean diet resulted in a reduction in the DII score, and then it evaluated the relationship between the DII and cardiometabolic outcomes following the administration of a traditional Mediterranean diet in older Australian adults. A total of 152 Australian adults (mean age 71 ± 5 years) was randomly allocated either a MedDiet (n = 80) or to continue their habitual diet (HabDiet) (n = 72) for 6 months. Diet and cardiovascular outcomes were measured at baseline and 3 and 6 months of the intervention. DII and energy-adjusted DII (E-DIITM) scores were calculated from 3-day weighed food records. There was a significant reduction in the DII score at 2 and 4 months for the MedDiet group (−1.40 ± 0.20 p < 0.001 and −1.47 ± 0.20 p < 0.001, respectively), which was significantly different from the HabDiet group over time (p < 0.001). The HabDiet DII score did not change significantly at the 2 and 4 months timepoints (0.47 ± 0.21 p = 0.35 and 0.54 ± 0.21 p = 0.21, respectively). The improvement in the DII in the MedDiet group was not related to any cardiometabolic outcome. Baseline cross-sectional analyses identified a positive association between the E-DII score and average BMI, body weight, WHR, abdominal adiposity, and SBP, and a negative association with HDL-C. We demonstrate that a MedDiet intervention significantly reduced DII scores compared with a habitual Australian diet in older Australians. This could be beneficial for healthy ageing and the avoidance of chronic disease in Western populations.
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Affiliation(s)
- Jessie S. Clark
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Kathryn A. Dyer
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Courtney R. Davis
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Nitin Shivappa
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA 5001, Australia
| | - Jonathan M. Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Karen J. Murphy
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
- Correspondence: ; Tel.: +61-8-8302-2391; Fax: +61-8-8302-2389
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Monthé-Drèze C, Aris IM, Rifas-Shiman SL, Shivappa N, Hebert JR, Oken E, Sen S. The Role of Prenatal Psychosocial Stress in the Associations of a Proinflammatory Diet in Pregnancy With Child Adiposity and Growth Trajectories. JAMA Netw Open 2023; 6:e2251367. [PMID: 36662527 PMCID: PMC9860526 DOI: 10.1001/jamanetworkopen.2022.51367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/23/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Prenatal psychosocial stress and nutrition may each program offspring adiposity, an important predictor of lifelong cardiometabolic health. Although increased stress and poor nutrition have been found to co-occur in pregnancy, little is known about their combined longitudinal associations in the offspring. Objective To investigate whether the associations of the Dietary Inflammatory Index (DII) with offspring adiposity differ by prenatal stress levels and whether these associations change with age. Design, Setting, and Participants Project Viva, a prospective prebirth cohort study of mother-child dyads in Massachusetts, included singleton children of mothers enrolled between April 1999 and July 2002, with follow-up visits at early childhood, midchildhood, and early adolescence. Data analysis was performed from October 31, 2020, to October 31, 2022. Exposures Food frequency-derived DII score in pregnancy was the exposure. Effect modifiers included stress-related measures in pregnancy; depressive symptoms assessed using the Edinburgh Postnatal Depression Scale (EPDS), dichotomized at scores greater than or equal to 13 vs less than 13; and census tract-level social vulnerability (overall Social Vulnerability Index and its 4 main subindices), dichotomized at the 75th percentile. Main Outcomes and Measures Overall adiposity, comprising sex- and age-standardized body mass index (BMI z), sum of subscapular and triceps skinfolds, fat mass index (FMI), and body fat percentage estimated using bioelectrical impedance analysis (BIA) and dual x-ray absorptiometry (DXA); and central adiposity, comprising waist circumference, ratio of subscapular to triceps skinfolds, and DXA-derived trunk FMI. Results Among 1060 mother-child dyads, mean (SD) maternal age was 32.6 (4.6) years, and 811 (77%) mothers were non-Hispanic White. Mean (SD) DII score was -2.7 (1.3) units, Social Vulnerability Index level was 38th (27th) percentile, and 8% of mothers had depressive symptoms. Mean (SD) age of the children was 3.3 (0.3) years at the early childhood visit, 7.9 (0.8) years at the midchildhood visit, and 13.2 (0.9) years at the early adolescence visit. In adjusted analyses, children born to mothers in the highest (vs lowest) quartile of DII had slower decrease in BMI z scores (β, 0.03 SD units/y; 95% CI, 0.01-0.05 SD units/y), and faster adiposity gain (eg, BIA total FMI β, 0.11 kg/m2/y; 95% CI, 0.03-0.19 kg/m2/y) over time. Associations of prenatal DII quartiles with childhood adiposity were stronger (eg, BIA total FMI quartile 4 vs quartile 1 change in β, 1.40 kg/m2; 95% CI, 0.21-2.59 kg/m2) among children of mothers with high vs low EPDS scores in pregnancy, although EPDS scores did not modify the change over time. Associations of prenatal DII with adiposity change over time, however, were greater among children whose mothers lived in neighborhoods with a high (BIA percentage body fat: β, 0.55% per year; 95% CI, 0.04%-1.07% per year) vs low (β, 0.13% per year; 95% CI, -0.20 to 0.46% per year), percentage of racial and ethnic minorities, and residents with limited English-language proficiency. Conclusions and Relevance The findings of this cohort study suggest that it may be useful to simultaneously evaluate prenatal diet and psychosocial stress in women as targets for interventions intended to prevent excess childhood adiposity.
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Affiliation(s)
- Carmen Monthé-Drèze
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - James R. Hebert
- South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Sarbattama Sen
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Alhaj OA, Trabelsi K, Younes AM, Shivappa N, Bragazzi NL, Hebert JR, Jahrami HA. Diet-related inflammation increases the odds of multiple sclerosis: Results from a large population-based prevalent case-control study in Jordan. Front Nutr 2023; 10:1098883. [PMID: 37090771 PMCID: PMC10113660 DOI: 10.3389/fnut.2023.1098883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background Multiple sclerosis, a chronic inflammatory disease in young and middle-aged adults, is one of the leading causes of non-traumatic disability in adults. Diet is known to have an important role in the modulating inflammatory processes and influencing molecular pathways. Purpose This study aims to examine the association of the inflammatory capacity of diet measured by DII with MS in Jordan. Methods This prevalent case-control study included participants of both sexes, aged between 20 and 60 years. The cases (n = 541) had a confirmed diagnosis of prevalent Multiple Sclerosis (MS) in the previous 3 years, and controls (n = 607) were apparently healthy individuals matched on sex and age (42 ± 4 years). A validated Arabic food frequency questionnaire (FFQ) was utilized to obtain estimated dietary intake. Dietary data from the FFQ were analyzed using ESHA's Food Processor® nutrition analysis software, and the results were used to calculate the DII scores. Logistic regression analyses, controlling for covariates such as age, sex, body mass index, and smoking status, were used to measure the association between DII score and MS outcomes. Results Cases represent a mixed sample of MS phenotypes and controls were comparable on age and sex. However, controls tended to be taller, lighter, had a lower BMI, and had a lower smoking rate. After controlling for age, BMI, sex, and smoking status, there was a consistent increase in MS risk according to DII score, with a 10-fold increase in odds in quartile 4 vs. quartile 1 [ORquartile 4vs1 = 10.17 (95% CI: 6.88; 15.04)]. For each point increase in DII score, there was nearly a doubling of odds [OR1 = 1.75 (95% CI: 1.59; 1.92)]. Individual nutrients and food values aligned according to their contribution to the DII score calculations. Conclusion The findings of this study, obtained in MS patients with varied illness duration over the previous 3 years, are consistent with an association between the overall inflammatory potential of diet and MS odds. Our findings among MS participants showed a significantly more pro-inflammatory DII scores than age- and sex-matched controls. Our results also suggest that MS group had a diet rich in pro-inflammatory foods and nutrients.
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Affiliation(s)
- Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, United States
| | - Nicola L. Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Statistics, York University, Toronto, ON, Canada
- Human Nutrition Unit, Department of Food and Drugs, University of Parma Medical School, Parma, Italy
- Nicola L. Bragazzi,
| | - James R. Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, United States
| | - Haitham A. Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Ministry of Health, Government Hospitals, Manama, Bahrain
- *Correspondence: Haitham A. Jahrami,
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Soares MM, Juvanhol LL, Ribeiro SAV, Franceschini SDCC, Shivappa N, Hebert JR, Araújo RMA. Proinflammatory maternal diet and early weaning are associated with the inflammatory diet index of Brazilian children (6-12 mo): A pathway analysis. Nutrition 2023; 105:111845. [PMID: 36323148 DOI: 10.1016/j.nut.2022.111845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess the dietary inflammatory index (DII) and its association with maternal factors and excess body weight in Brazilian children aged <2 y during complementary feeding. METHODS This was a cross-sectional study (2016-2019), conducted with 231 mothers and children ages 6 to 24 mo. The food consumption of the mother-child dyad was obtained through the mean of three 24-h recalls, as well as information on the consumption of breast milk. The DII was used to verify the quality of the diet. Children's weight and length were measured, and the weight/height index was calculated. Path analysis was used to assess the interrelationships between variables. Multiple linear regression was conducted to identify the components of the child's DII (C-DII) that contributed the most to explaining its variation. RESULTS The children had an anti-inflammatory diet (C-DII -0.37 ± 0.91) whereas the mothers had a proinflammatory diet (M-DII +0.24 ± 0.86). Fiber was the nutrient that contributed most to the variations in the C-DII. Approximately 28% of children were overweight. In the pathway analysis, we verified a direct negative effect of education on excess body weight (standardized coefficients [SC], -0.180; P = 0.034) and C-DII (SC, -0.167; P = 0.002); negative direct effect of breastfeeding on the C-DII (SC, -0.294; P < 0.001); and positive direct effect of M-DII on C-DII (SC, 0.119; P = 0.021). CONCLUSION Children's proinflammatory diet during the period of complementary feeding was associated with maternal proinflammatory diets, lower education, and absence of breastfeeding practice.
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Affiliation(s)
- Marcela Martins Soares
- Department of Nutrition and Health of the Federal University of Viçosa, Minas Gerais, Brazil.
| | | | | | | | - Nitin Shivappa
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, Columbia, South Carolina, USA
| | - James R Hebert
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, Columbia, South Carolina, USA
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Corrêa CR, da Costa BGG, Silva KS, Shivappa N, Wirth MD, Hébert JR, Nunes EA. A higher energy-adjusted Dietary Inflammatory Index is positively associated with total and visceral body fat in young male adults. J Hum Nutr Diet 2022; 35:1136-1150. [PMID: 35377488 DOI: 10.1111/jhn.13012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/18/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The energy-adjusted Dietary Inflammatory Index (E-DII™) has been associated with a high body mass index and markers of chronic diseases. Also, pro-inflammatory diets with a high E-DII have been positively associated with metabolic disturbances such as glucose intolerance and type II diabetes mellitus. However, it is unclear whether E-DII scores are positively associated with body fat percentage and visceral fat per se. This cross-sectional study aimed to evaluate whether the E-DII is associated with body fat content and metabolic health indicators in lean and obese young men. METHODS The present study was conducted on 59 participants, without comorbidities, not using tobacco, medication and nutritional supplements. Dietary data were obtained by 3-day food records to calculate E-DII scores based on 28 food parameters. Body composition was assessed by dual X-ray absorptiometry (DXA). Blood samples were taken to measure fasting glucose, insulin, triacylglycerols, total cholesterol, and low- and high-density lipoprotein cholesterol. An oral glucose tolerance test also was performed. Associations were determined by mixed-effects linear regression. RESULTS E-DII scores ranged from -3.48 to +3.10. Energy intake was similar across E-DII tertiles. After adjusting for covariates, the highest E-DII tertile was associated with increased body fat, visceral adipose tissue and waist circumference. There was no association between E-DII scores and glycaemic parameters. CONCLUSIONS In young participants, a dietary pattern with a higher E-DII (i.e., pro-inflammatory) score was associated with high body fat and markers of central adiposity assessed by DXA, regardless of body mass.
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Affiliation(s)
- Cinthia R Corrêa
- Health Sciences Center, Nutrition Graduate Program, Federal University of Santa Catarina, Florianópolis, SC, Brazil.,Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Bruno G G da Costa
- Sports Center, Physical Education Graduate Program, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Kelly S Silva
- Sports Center, Physical Education Graduate Program, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Everson A Nunes
- Health Sciences Center, Nutrition Graduate Program, Federal University of Santa Catarina, Florianópolis, SC, Brazil.,Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Bavi Behbahani H, Bazyar H, Aghamohammadi V, Ahangarpour A, Shivappa N, R Hebert J, Alipour M, Shokouhi Nasab M, Moradi F, Hay Bar H. The Dietary Inflammatory Index is positively associated with cardiometabolic risk parameters in atherosclerosis patients. Nutr Res 2022; 107:26-36. [PMID: 36162276 DOI: 10.1016/j.nutres.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 12/27/2022]
Abstract
Inflammation is implicated in the development and progression of a variety of cardiovascular diseases. We hypothesized that the Dietary Inflammatory Index (DII) is associated with anthropometric indices and metabolic parameters in Iranian atherosclerosis patients. The present cross-sectional study was conducted on 320 Iranian atherosclerosis patients. The DII was estimated using a valid and reliable 168-item food frequency questionnaire. Odds ratios and 95% confidence intervals were evaluated for anthropometric indices and metabolic parameters according to the DII score. Linear regression was used to estimate the relationship between DII scores with atherosclerosis-related dependent variables. According to the continuous score of DII, there was no significant association between DII and odds of obesity, total cholesterol/high-density lipoprotein cholesterol ratio, and aspartate aminotransferase/alanine aminotransferase ratio in all 3 models (P ≥ .05). In linear regression analysis, we found a significant association between DII score and fasting blood sugar, lipid profile (except for high-density lipoprotein cholesterol), liver enzymes (except for alkaline phosphatase), and serum sodium in adjusted models (P < .05). In this study, patients with atherosclerosis consuming a pro-inflammatory diet was positively associated with fasting blood sugar, lipid, and liver enzymes measures. Future studies with prospective and interventional designs are required to clarify the association between this dietary index and cardiovascular disease risk factors among patients with atherosclerosis.
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Affiliation(s)
- Hossein Bavi Behbahani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hadi Bazyar
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Sirjan School of Medical Sciences, Sirjan, Iran.
| | | | - Akram Ahangarpour
- Health Research Institute, Diabetes Research Center, Department of Physiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - 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; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - 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; Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | | | - Mashhad Shokouhi Nasab
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fateme Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Habib Hay Bar
- Cardiovascular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Sood S, Feehan J, Itsiopoulos C, Wilson K, Plebanski M, Scott D, Hebert JR, Shivappa N, Mousa A, George ES, de Courten B. Higher Adherence to a Mediterranean Diet Is Associated with Improved Insulin Sensitivity and Selected Markers of Inflammation in Individuals Who Are Overweight and Obese without Diabetes. Nutrients 2022; 14:nu14204437. [PMID: 36297122 PMCID: PMC9608711 DOI: 10.3390/nu14204437] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0-45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with higher scores indicating a pro-inflammatory diet. IR was assessed using hyperinsulinemic euglycemic clamps, insulin secretion by intravenous glucose tolerance test, adiposity by dual-energy X-ray absorptiometry, and circulating cytokine and adipokine concentrations by multiplex assays. Higher MDS was associated with greater insulin sensitivity (β = 0.179; 95%CI: 0.39, 0.318) after adjusting for age, sex and % body fat, and lower NF-κB, higher adiponectin and adipsin in unadjusted and adjusted models. Higher E-DII score was associated with increased total cholesterol (β = 0.364; 95%CI: 0.066, 0.390) and LDL-cholesterol (β = 0.305; 95%CI: 0.019, 0.287) but not with adiposity, glucose metabolism, cytokines or adipokines. Greater MDS appears to be associated with decreased IR and inflammatory markers in overweight/obese adults.
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Affiliation(s)
- Surbhi Sood
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Footscray, VIC 3011, Australia
| | - Catherine Itsiopoulos
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Kirsty Wilson
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Magdalena Plebanski
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
| | - James R. Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - 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
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Barbora de Courten
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
- Correspondence: ; Tel.: +61-3-9925-6474
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38
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McDiarmid KP, Wood LG, Upham JW, MacDonald-Wicks LK, Shivappa N, Hebert JR, Scott HA. The Impact of Meal Dietary Inflammatory Index on Exercise-Induced Changes in Airway Inflammation in Adults with Asthma. Nutrients 2022; 14:nu14204392. [PMID: 36297076 PMCID: PMC9610037 DOI: 10.3390/nu14204392] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 11/23/2022] Open
Abstract
Research suggests exercise may reduce eosinophilic airway inflammation in adults with asthma. The Dietary Inflammatory Index (DII®) quantifies the inflammatory potential of the diet and has been associated with asthma outcomes. This study aimed to determine whether the DII of a meal consumed either before or after exercise influences exercise-induced changes in airway inflammation. A total of 56 adults with asthma were randomised to (1) 30–45 min moderate–vigorous exercise, or (2) a control group. Participants consumed self-selected meals, two hours pre- and two hours post-intervention. Energy-adjusted DII (E-DIITM) was determined for each meal, with meals then characterised as “anti-inflammatory” or “pro-inflammatory” according to median DII. Induced sputum cell counts were measured pre- and four hours post-intervention. Participants consuming an anti-inflammatory meal two hours post-exercise had a decrease in sputum %eosinophils (−0.5 (−2.0, 0.3)%) compared with participants who consumed a pro-inflammatory meal two hours post-exercise (0.5 (0, 3.0)%, p = 0.009). There was a positive correlation between the E-DII score of the post-exercise meal and change in sputum %eosinophils (rs = 0.478, p = 0.008). The E-DII score of the meal consumed two hours pre-exercise had no effect on sputum %eosinophils (p = 0.523). This study suggests an anti-inflammatory meal two hours post-exercise augments exercise-induced improvements in eosinophilic airway inflammation in adults with asthma.
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Affiliation(s)
- Katrina P. McDiarmid
- Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Lisa G. Wood
- Immune Health Research Program, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - John W. Upham
- Lung and Allergy Research Centre, Diamantina Institute, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Lesley K. MacDonald-Wicks
- Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hebert
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Hayley A. Scott
- Immune Health Research Program, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Lung and Allergy Research Centre, Diamantina Institute, The University of Queensland, Brisbane, QLD 4102, Australia
- Correspondence: ; Tel.: +61-2-4042-0113
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39
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Lécuyer L, Laouali N, Dossus L, Shivappa N, Hébert JR, Agudo A, Tjonneland A, Halkjaer J, Overvad K, Katzke VA, Le Cornet C, Schulze MB, Jannasch F, Palli D, Agnoli C, Tumino R, Dragna L, Iannuzzo G, Jensen TE, Brustad M, Skeie G, Zamora-Ros R, Rodriguez-Barranco M, Amiano P, Chirlaque MD, Ardanaz E, Almquist M, Sonestedt E, Sandström M, Nilsson LM, Weiderpass E, Huybrechts I, Rinaldi S, Boutron-Ruault MC, Truong T. Inflammatory potential of the diet and association with risk of differentiated thyroid cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Eur J Nutr 2022; 61:3625-3635. [PMID: 35635567 DOI: 10.1007/s00394-022-02897-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Chronic inflammation is thought to initiate or promote differentiated thyroid cancer (DTC) and previous studies have shown that diet can modulate this inflammatory process. We aimed to evaluate the association of several dietary scores reflecting the inflammatory potential of the diet with DTC risk. METHODS Within the EPIC cohort, 450,063 participants were followed during a mean period of 14 years, and 712 newly incident DTC cases were identified. Associations between four dietary inflammatory scores [the dietary inflammatory index (DII®) and two energy-adjusted derivatives (the E-DIIr and the E-DIId), and the Inflammatory Score of the Diet (ISD)] and DTC risk were evaluated in the EPIC cohort using multivariable Cox regression models. RESULTS Positive associations were observed between DTC risk and the DIIs (HR for 1 SD increase in DII: 1.11, 95%CI: 1.01, 1.23, similar results for its derivatives), but not with the ISD (HR for 1 SD increase: 1.04, 95% CI 0.93, 1.16). CONCLUSION Diet-associated inflammation, as estimated by the DII and its derivatives, was weakly positively associated with DTC risk in a European adult population. These results suggesting that diet-associated inflammation acts in the etiology of DTC need to be validated in independent studies.
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Affiliation(s)
- Lucie Lécuyer
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
| | - Nasser Laouali
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Laure Dossus
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Anne Tjonneland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Danish Cancer Society Research Center, Institute of Cancer Epidemiology, Copenhagen, Denmark
| | - Jytte Halkjaer
- Danish Cancer Society Research Center, Institute of Cancer Epidemiology, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Charlotte Le Cornet
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, A.I.R.E.-O.N.L.U.S., Ragusa, Italy
| | - Luca Dragna
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, 10126, Turin, Italy
| | - Gabriella Iannuzzo
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Torill Enget Jensen
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Magritt Brustad
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
- The Public Dental Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain
- Epidemiology of Chronic and Communicable Diseases Group, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - María-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Martin Almquist
- Department of Clinical Sciences Lund, Skåne University Hospital, Lund University, Lund, Sweden
- Department of Surgery Section of Endocrine and Sarcoma Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Lena Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Inge Huybrechts
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France
| | - Sabina Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research On Cancer, 150, Cours Albert Thomas, 69008, Lyon, France
| | | | - Thérèse Truong
- Paris-Saclay University, UVSQ, Gustave Roussy, Inserm, CESP, Team "Exposome and Heredity", 94807, Villejuif, France.
- Team Exposome and Heredity, Inserm U1018, CESP, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
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40
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Trakman GL, Lin WYY, Hamilton AL, Wilson-O’Brien AL, Stanley A, Ching JY, Yu J, Mak JWY, Sun Y, Niu J, Miao Y, Lin X, Feng R, Chen M, Shivappa N, Hebert JR, Morrison M, Ng SC, Kamm MA. Processed Food as a Risk Factor for the Development and Perpetuation of Crohn's Disease-The ENIGMA Study. Nutrients 2022; 14:nu14173627. [PMID: 36079885 PMCID: PMC9460819 DOI: 10.3390/nu14173627] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Developing countries have experienced a rapid recent rise in Inflammatory Bowel Disease (IBD) incidence and emerging evidence suggests processed foods and food additives may predispose one to the development and perpetuation of Crohn’s disease (CD). The aim of this study was to evaluate processed food and food additive intake in CD patients and controls, in Australia (high CD incidence), Hong Kong (intermediate incidence) and mainland China (emerging incidence). (2) Methods: In 274 CD patients (CD), 82 first-degree relatives (FDR), 83 household members (HM) and 92 healthy unrelated controls (HC) from Australia (n = 180), Hong Kong (HK) (n = 160) and mainland China (n = 191) we estimated early life (0–18 years), recent (12 months), and current processed and food additive intake, using validated questionnaires and a 3-day-food diary. (3) Results: Early life processed food intake: Combining all regions, CD were more likely to have consumed soft drinks and fast foods than HM, more likely to have consumed processed fruit and snacks than their FDR, and more likely to have consumed a range of processed foods than HC. HK and China CD patients were more likely to have consumed a range of processed foods than HC. Recent food-additive intake (12-months): Combining all regions, CD patients had significantly higher intakes of aspartame and sucralose, and polysorbate-80, than HC, and more total emulsifiers, artificial sweeteners, and titanium dioxide than FDR and HC. HK and China CD patients had a higher intake of almost all food additives than all controls. Current additive intake (3-days): Australian and HK CD patients had higher total food-additive intake than FDR, and HK CD patients had a higher intake of total food-additives and emulsifiers than HM. (4) Conclusions: CD patients have been exposed to more processed food and food additives than control groups, which may predispose them to CD development and ongoing inflammation.
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Affiliation(s)
- Gina L. Trakman
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne 3065, Australia
- Department of Medicine, The University of Melbourne, Melbourne 3065, Australia
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne 3086, Australia
| | - Winnie Y. Y. Lin
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Hong Kong, China
| | - Amy L. Hamilton
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne 3065, Australia
- Department of Medicine, The University of Melbourne, Melbourne 3065, Australia
| | - Amy L. Wilson-O’Brien
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne 3065, Australia
- Department of Medicine, The University of Melbourne, Melbourne 3065, Australia
| | - Annalise Stanley
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne 3065, Australia
| | - Jessica Y. Ching
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Jun Yu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Joyce W. Y. Mak
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Yang Sun
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming 650032, China
| | - Junkun Niu
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming 650032, China
| | - Yinglei Miao
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming 650032, China
| | - Xiaoqing Lin
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510060, China
| | - Rui Feng
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510060, China
| | - Minhu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510060, China
| | - Nitin Shivappa
- The Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Norman J Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hebert
- The Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Norman J Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Mark Morrison
- The University of Queensland Diamantina Institute, Faculty of Medicine, Translational Research Institute, Brisbane 4102, Australia
| | - Siew C. Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Hong Kong, China
- Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael A Kamm
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne 3065, Australia
- Department of Medicine, The University of Melbourne, Melbourne 3065, Australia
- Correspondence: ; Tel.: +61-3 9417-5064
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41
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Aubert AM, Chen LW, Shivappa N, Cooper C, Crozier SR, Duijts L, Forhan A, Hanke W, Harvey NC, Jankowska A, Kelleher CC, de Lauzon-Guillain B, McAuliffe FM, Mensink-Bout SM, Polanska K, Relton CL, Suderman M, Hebert JR, Phillips CM, Bernard JY, Heude B. Predictors of maternal dietary quality and dietary inflammation during pregnancy: An individual participant data meta-analysis of seven European cohorts from the ALPHABET consortium. Clin Nutr 2022; 41:1991-2002. [PMID: 35964423 DOI: 10.1016/j.clnu.2022.06.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Maternal diet during pregnancy is a modifiable behaviour which plays an important role in maternal, neonatal and child health outcomes. Thus, knowledge of predictors of dietary quality and dietary inflammatory potential in European countries may contribute to developing maternal diet-related public health policies that target specific at-risk populations in Europe. METHODS We used harmonised data from >26,000 pregnant women enrolled in the ALSPAC, EDEN, Generation R, Lifeways, REPRO_PL, ROLO and SWS cohorts, as part of the ALPHABET consortium. Maternal dietary quality and inflammatory potential were assessed using the Dietary Approaches to Stop Hypertension (DASH) and the energy-adjusted Dietary Inflammatory Index (E-DII). We conducted an individual participant data meta-analysis to investigate the maternal sociodemographic, health and behavioural predictors of maternal diet before and during pregnancy. RESULTS DASH and E-DII scores were moderately correlated: from -0.63 (95% CI: -0.66, -0.59) to -0.48 (95% CI: -0.49, -0.47) across cohorts. Higher maternal age, education, household income, and physical activity during pregnancy were associated with a better dietary quality and a more anti-inflammatory diet. Conversely, multiparity and smoking during pregnancy were associated with a poorer dietary quality and a more proinflammatory diet. Women with obesity had a poorer pregnancy dietary quality than women with a normal body mass index range. CONCLUSIONS The results will help identify population subgroups who may benefit from targeted public health strategies and interventions aimed at improving women's dietary quality during pregnancy.
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Affiliation(s)
- Adrien M Aubert
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Ling-Wei Chen
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford OX1 2JD, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton SO16 7NP, UK.
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Anne Forhan
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Agnieszka Jankowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Blandine de Lauzon-Guillain
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Kinga Polanska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Caroline L Relton
- 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.
| | - 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 29208, USA.
| | - Catherine M Phillips
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
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Dehghan P, Nejati M, Vahid F, Almasi-Hashiani A, Saleh-Ghadimi S, Parsi R, Jafari-Vayghan H, Shivappa N, R Hébert J. The association between dietary inflammatory index, dietary antioxidant index, and mental health in adolescent girls: an analytical study. BMC Public Health 2022; 22:1513. [PMID: 35945535 PMCID: PMC9361696 DOI: 10.1186/s12889-022-13879-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 07/26/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Diet is considered as one of the modifiable factors that appears to exert a vital role in psychological status. In this way, we designed this study to examine the association between dietary inflammatory index (DII), dietary antioxidant index (DAI), and mental health in female adolescents. METHODS This cross-sectional study included 364 female adolescents selected from high schools in the five regions of Tabriz, Iran. A 3-day food record was used to extract the dietary data and calculate DII/DAI scores. DII and DAI were estimated to assess the odds of depression, anxiety, and stress based on the Depression Anxiety Stress Scales-21. Adjusted relationships of the DII and DAI with depression, anxiety, and stress were determined using multiple regression after adjusting for age, energy intake, BMI, family income and mother and father education. Overweight was defined as body mass index (BMI)-for-age > + 1 z-score relative to world health organization standards. RESULTS Depression, anxiety, and stress were observed in 21.4%, 26.6%, and 25.7% of subjects, respectively. The percentage of overweight among adolescents was 19.4%. The association between DII and score of mental health profile was positive among subjects in the third tertile of DII compared to subjects in the first tertile. However, this association was not statistically significant after adjusting for confounding variables. Moreover, there was a significant inverse association between DAI and depression and anxiety; and a statistically insignificant association between DAI and stress after adjusting for confounders. CONCLUSIONS Our results highlighted the importance of a healthy and anti-inflammatory diet on mental health in female adolescents. Therefore, modifying unhealthy dietary habits are likely to be effective in the management of psychosocial disorders.
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Affiliation(s)
- Parvin Dehghan
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Marzieh Nejati
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Vahid
- Population Health Department, Nutrition and Health Group, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sevda Saleh-Ghadimi
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Parsi
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Jafari-Vayghan
- Department of Nutrition, School of Health, Arak University of Medical Sciences, Arak, Iran.
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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43
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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44
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Millar CL, Dufour AB, Hebert JR, Shivappa N, Okereke OI, Kiel DP, Hannan MT, Sahni S. Association of Proinflammatory Diet With Frailty Onset Among Adults With and Without Depressive Symptoms: Results From the Framingham Offspring Study. J Gerontol A Biol Sci Med Sci 2022; 78:250-257. [PMID: 35830506 PMCID: PMC9951064 DOI: 10.1093/gerona/glac140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset because they typically have higher levels of inflammation. The study objective was to determine the association between a proinflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. METHODS This prospective study included 1 701 nonfrail individuals with self-reported baseline (1998-2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM; calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria (i.e., slow gait, weak grip strength, unintentional weightloss, low physical activity, and self-reported exhaustion). Results are presented by baseline CES-D scores <16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders. RESULTS In all study participants, mean (SD) age was 58(8) years and E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more proinflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, 1-unit higher E-DII score was associated with 14% increased odds (95% CI: 1.05-1.24) of frailty. In those with depressive symptoms, 1-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13-2.13). CONCLUSIONS The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.
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Affiliation(s)
- Courtney L Millar
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Alyssa B Dufour
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Shivani Sahni
- Address correspondence to: Shivani Sahni, PhD, Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA. E-mail:
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Chen L, Ming J, Chen T, Hébert JR, Sun P, Zhang L, Wang H, Wu Q, Zhang C, Shivappa N, Ban B. Association between dietary inflammatory index score and muscle mass and strength in older adults: a study from National Health and Nutrition Examination Survey (NHANES) 1999-2002. Eur J Nutr 2022; 61:4077-4089. [PMID: 35809101 PMCID: PMC9596556 DOI: 10.1007/s00394-022-02941-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 06/15/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE Chronic low-grade systemic inflammation affects muscle protein metabolism. The dietary inflammatory index (DII®) is a tool designed to assess the inflammatory potential of the diet. The available data on the association between DII and sarcopenia are limited. We aimed to investigate the association of the DII with components of sarcopenia in individuals over 50 years of age. METHODS This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999-2002 dataset. Body composition was measured, and isokinetic strength of the knee extensors (peak force) was evaluated. Low muscle mass and strength were defined using sex-specific thresholds. Energy-adjusted DII (E-DII™) scores were calculated using 24-h dietary recall data. Regression models were fit to evaluate the association between E-DII scores and low muscle mass and low muscle strength, alone and combined. RESULTS Mean age of study participants was 62.1 ± 9.5 years, and 138 participants (7.4%) belonged to the combination group of low muscle mass and low muscle strength. In multivariable-adjusted regression models, higher E-DII score was associated with lower appendicular skeletal muscle index (ASMI) (β = - 0.03, P < 0.001, P trend <0.001), and lower peak force (β = -2.15, P = 0.04, P trend = 0.01) and higher likelihood for these components combined (OR = 1.12, 95% CI 1.01-1.25, P = 0.03). CONCLUSION Higher E-DII score is associated with lower muscle mass and muscle strength, and increased likelihood for the combination of low muscle mass and low muscle strength in older adults. This has important implications for healthy aging.
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Affiliation(s)
- Lingzhi Chen
- Department of Clinical Nutrition, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, China.
| | - Jingjing Ming
- Department of Emergency Trauma Surgery, Jining No. 1 People's Hospital, Jining, 272029, Shandong, China.,School of Nursing, Shandong First Medical University, Shandong Academy of Medical Sciences, Tai'an, 271000, Shandong, China
| | - Tianyi Chen
- Department of Biochemistry and Molecular Biology, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 400, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC, 29201, USA
| | - Peng Sun
- Department of Clinical Nutrition, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, China
| | - Li Zhang
- Department of Clinical Nutrition, Yan Tai Yu Huang Ding Hospital, Yantai, 264000, Shandong, China
| | - Hongya Wang
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, China
| | - Qingkuo Wu
- Department of Clinical Nutrition, Tumor Hospital of Jining, Jining, 272029, Shandong, China
| | - Cancan Zhang
- Department of Clinical Nutrition, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, China
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 400, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC, 29201, USA
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, China. .,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China.
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46
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Li Z, Wang K, Shivappa N, Hébert JR, Chen H, Liu H, Jiang X. Inflammatory potential of diet and colorectal carcinogenesis: a prospective longitudinal cohort. Br J Cancer 2022; 126:1735-1743. [PMID: 35136208 PMCID: PMC9174157 DOI: 10.1038/s41416-022-01731-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 12/31/2021] [Accepted: 01/28/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Acknowledging the role of inflammation in colorectal carcinogenesis, this study aimed to evaluate the associations between diet-associated inflammation, as measured by the energy-adjusted dietary inflammatory index (E-DIITM), and distinct stages of colorectal carcinogenesis. METHODS The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial enrolled participants without a colorectal cancer history, who were asked to complete baseline questionnaires and food frequency questionnaires. To estimate the associations between the E-DII and risks of newly incident colorectal adenoma, recurrent adenoma, and colorectal cancer, multivariable-adjusted Cox proportional hazards regression models were employed. RESULTS Among 101,680 participants, with an average age of 65 years, a total of 1177 incident colorectal adenoma cases, 895 recurrent adenoma cases and 1100 colorectal cancer cases were identified. Higher E-DII scores from food and supplement (HRQ5 vs Q1: 0.86 [0.69-1.06], Ptrend: 0.27) or from food only (HRQ5 vs Q1: 0.82 [0.64-1.05], Ptrend: 0.06) were not associated with higher risks of incident adenoma. However, the elevated risk of recurrent adenoma was found in the highest category of E-DII from food plus supplement (HRQ5 vs Q1: 1.63 [1.28-2.03], Ptrend: < 0.001) when compared with the lowest category. A significant association between colorectal cancer risk and E-DII from food plus supplement (HRQ5 vs Q1: 1.34 [1.09-1.65], Ptrend: 0.009) was found, where this association was only pronounced in distal colorectal cancer. CONCLUSION Higher E-DII scores from diet plus supplement but not from diet only were associated with a higher risk of recurrent adenoma and distal colorectal cancer. The role of nutrient supplements on cancer risk, especially when combined with diet, needs to be elucidated in future studies.
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Affiliation(s)
- Zhuyue Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Kang Wang
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 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, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Hui Liu
- West China Second Hospital, Sichuan University, Chengdu, China
| | - Xiaolian Jiang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China.
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47
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Burns JL, Mirotta JA, Duncan AM, Darlington G, Haines J, Shivappa N, Hebert JR, Ma DWL. Intakes of PUFA are Low in Preschool-aged Children in the Guelph Family Health Study Pilot Cohort. Appl Physiol Nutr Metab 2022; 47:973-978. [PMID: 35649282 DOI: 10.1139/apnm-2021-0618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated intakes of total, n-3, and n-6 polyunsaturated fatty acids (PUFA) in 109 preschool-aged children who participated in the Guelph Family Health Study pilot. Intakes of total, n-3, and n-6 PUFA did not meet recommendations. This study highlights the need for additional monitoring and potential interventions to improve PUFA intake in preschool-aged children. Clinical trial #NCT02223234. Novelty: Canadian preschool-aged children are not consuming enough n-3 and n-6 polyunsaturated fatty acids.
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Affiliation(s)
- Jessie L Burns
- University of Guelph, 3653, Human Heath and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Julia A Mirotta
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Alison M Duncan
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Gerarda Darlington
- University of Guelph, 3653, Mathematics and Statistics, Guelph, Ontario, Canada;
| | - Jess Haines
- University of Guelph, 3653, Family Relations and Applied Nutrition , Guelph, Ontario, Canada;
| | - Nitin Shivappa
- University of South Carolina, 2629, Epidemiology and Biostatistics, Columbia, South Carolina, United States;
| | - James R Hebert
- University of South Carolina, 2629, Epidemiology and Biostatistics, Columbia, South Carolina, United States;
| | - David W L Ma
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
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48
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Liu YH, Zheng L, Cheng C, Li SN, Shivappa N, Hebert JR, Fu WJ, Zhao XL, Cao Y, Dou WF, Chen HN, Duan DD, Lyu QJ, Zeng FF. Dietary inflammatory index, inflammation biomarkers and preeclampsia risk: a hospital-based case-control study. Br J Nutr 2022; 129:1-9. [PMID: 35581673 DOI: 10.1017/s0007114522001489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study evaluated the association between inflammatory diets as measured by the Dietary Inflammatory index (DII), inflammation biomarkers and the development of preeclampsia among the Chinese population. We followed the reporting guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology statement for observational studies. A total of 466 preeclampsia cases aged over 18 years were recruited between March 2016 and June 2019, and 466 healthy controls were 1:1 ratio matched by age (±3 years), week of gestation (±1 week) and gestational diabetes mellitus. The energy-adjusted DII (E-DII) was computed based on dietary intake assessed using a seventy-nine item semiquantitative FFQ. Inflammatory biomarkers were analysed by ELISA kits. The mean E-DII scores were -0·65 ± 1·58 for cases and -1·19 ± 1·47 for controls (P value < 0·001). E-DII scores positively correlated with interferon-γ (r s = 0·194, P value = 0·001) and IL-4 (r s = 0·135, P value = 0·021). After multivariable adjustment, E-DII scores were positively related to preeclampsia risk (Ptrend < 0·001). The highest tertile of E-DII was 2·18 times the lowest tertiles (95 % CI = 1·52, 3·13). The odds of preeclampsia increased by 30 % (95 % CI = 18 %, 43 %, P value < 0·001) for each E-DII score increase. The preeclampsia risk was positively associated with IL-2 (OR = 1·07, 95 % CI = 1·03, 1·11), IL-4 (OR = 1·26, 95 % CI = 1·03, 1·54) and transforming growth factor beta (TGF-β) (OR = 1·17, 95 % CI = 1·06, 1·29). Therefore, proinflammatory diets, corresponding to higher IL-2, IL-4 and TGF-β levels, were associated with increased preeclampsia risk.
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Affiliation(s)
- Yan-Hua Liu
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People's Republic of China
| | - Lu Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou510632, Guangdong, People's Republic of China
| | - Chen Cheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou510632, Guangdong, People's Republic of China
| | - Shu-Na Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou510632, Guangdong, People's Republic of China
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA; Connecting Health Innovations LLC, Columbia, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA; Connecting Health Innovations LLC, Columbia, USA
| | - Wen-Jun Fu
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People's Republic of China
| | - Xian-Lan Zhao
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People's Republic of China
| | - Yuan Cao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People's Republic of China
| | - Wei-Feng Dou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou450000, Henan, People's Republic of China
| | - Hua-Nan Chen
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou450000, Henan, People's Republic of China
| | - Dan-Dan Duan
- Department of Clinical Nutrition, Luoyang New Area People's Hospital, Luoyang471023, Henan, People's Republic of China
| | - Quan-Jun Lyu
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, Henan, People's Republic of China
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou450000, Henan, People's Republic of China
| | - Fang-Fang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou510632, Guangdong, People's Republic of China
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Suhett LG, Juvanhol LL, Silva MA, Ribeiro SAV, Hermsdorff HHM, Shivappa N, Hébert JR, de Novaes JF. Interaction effect between breakfast skipping and sedentary behavior in the dietary inflammatory potential in Brazilian schoolchildren. Nutrition 2022; 102:111749. [DOI: 10.1016/j.nut.2022.111749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/04/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
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Schütte O, Bachmann L, Shivappa N, Hebert JR, Felix JF, Röder S, Sack U, Borte M, Kiess W, Zenclussen AC, Stangl GI, Herberth G, Junge KM. Pro-inflammatory Diet Pictured in Children With Atopic Dermatitis or Food Allergy: Nutritional Data of the LiNA Cohort. Front Nutr 2022; 9:868872. [PMID: 35464023 PMCID: PMC9024336 DOI: 10.3389/fnut.2022.868872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. Methods In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DII™) scores were calculated. Information about atopic manifestations during the first 10 years of life and confounding factors were obtained from standardized questionnaires during pregnancy and annually thereafter. Results Analyses from confounder-adjusted logistic regression models (n = 211) revealed that having atopic outcomes was associated with having a pro-inflammatory pattern at the age of 10 years: OR = 2.22 (95% CI: 1.14–4.31) for children with atopic dermatitis and OR = 3.82 (95% CI: 1.47–9.93) for children with food allergy in the first 10 years of life. Conclusion A pro-inflammatory dietary pattern might worsen the atopic outcome and reduce the buffering capacity of the individual against harmful environmental exposures or triggers. For pediatricians it is recommended to test for the individual tolerance of allergenic foods and to increase the nutrient density of tolerable food items to avoid undesirable effects of eating a pro-inflammatory diet.
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Affiliation(s)
- Olivia Schütte
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Larissa Bachmann
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - 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.,Department of Nutrition, Connecting Health Innovations LLC, 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.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, United States
| | - Janine F Felix
- The Generation R Study Group (Na-2918), Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Stefan Röder
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Ulrich Sack
- Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Michael Borte
- Children's Hospital, Municipal Hospital "St. Georg," Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research Leipzig, Medical Faculty, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Ana C Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.,Perinatal Immunology, Medical Faculty, Saxonian Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany
| | - Gabriele I Stangl
- Institute for Agricultural and Nutritional Science, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Kristin M Junge
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.,Institute for Agricultural and Nutritional Science, Martin Luther University Halle-Wittenberg, Halle, Germany
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