1
|
Zhuo S, Zhang B, Zhang J, Yang M, Yu Z. Effects of dietary inflammatory index, blood lead levels, and flavonoid intake on stroke risk in older Americans: A cross-sectional study. J Stroke Cerebrovasc Dis 2023; 32:107336. [PMID: 37677899 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES We aimed to investigate the relationship between dietary flavonoids, the dietary inflammatory index (DII), blood lead levels, and stroke and evaluate how these factors interact with one another in relation to stroke. MATERIALS AND METHODS We analyzed data from 3675 older American adults aged ≥60 years, obtained from the National Health and Nutrition Examination Survey. Since this database does not specifically differentiate between hemorrhagic and ischemic strokes, our data include both types. We utilized the DII to assess the inflammatory potential of the diet, calculated using 24 h dietary recalls. To determine the association between dietary flavonoids, blood lead levels, DII, and stroke, we performed multivariate logistic regression, subgroup analysis, and restricted cubic splines. We modeled additive interactions to assess the relationship between blood lead levels and DII. RESULTS A high intake of flavonols, flavan-3-ols, and total flavonoids correlated negatively with stroke risk, whereas blood lead levels had a positive association. After adjusting for confounders, stroke risk was found to increase with higher DII. Restricted cubic splines analysis revealed that flavan-3-ols, total flavonoids, blood lead levels, and DII were linearly related to stroke, while the relationships with flavonoids and flavonols were nonlinear. Additionally, a significant interaction was detected between high DII and elevated blood lead levels in relation to stroke risk. CONCLUSIONS Intake of flavan-3-ol, flavanols, and total flavonoids is negatively associated with stroke risk, while higher blood lead levels and DII are positively related to it. High DII and elevated blood lead levels interact synergistically to influence stroke risk.
Collapse
Affiliation(s)
- Shitu Zhuo
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Biyue Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Jingying Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Meili Yang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Zheng Yu
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China.
| |
Collapse
|
2
|
Wu M, Li S, Lv Y, Liu K, Wang Y, Cui Z, Wang X, Meng H. Associations between the inflammatory potential of diets with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases in Chinese adults: findings from a nation-wide prospective cohort study. Food Funct 2023; 14:9018-9034. [PMID: 37740363 DOI: 10.1039/d3fo02579a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Aims: convincing evidence is still limited for the validation of associations between the inflammatory potential of diets, based on the dietary inflammatory index (DII), and cardiometabolic outcomes. We aimed to investigate the associations between the DII with adherence to plant-based dietary patterns and the risk of new-onset cardiometabolic diseases (CMDs), including stroke, type 2 diabetes mellitus (T2DM) and myocardial infarction (MI). Methods: adults (N = 14 652) from the China Health and Nutrition Survey (1997-2015) were included in the current analysis. Dietary intake data were collected using a combination of 3 day consecutive 24 h dietary recalls and the food weighing method. The DII was calculated with established and validated methods. CMDs were identified using validated self-reported questionnaires. The Cox proportional hazard regression model was used for statistical analysis. Results: during a mean follow-up of 10 years, a total of 404 new-onset stroke, 1051 new-onset T2DM and 280 new-onset MI cases were identified. Lower PDI, hPDI, ERD, WISH and PHDI scores and higher uPDI scores were associated with higher DII scores (all P-trend < 0. 0001). A pro-inflammatory diet, as reflected by relatively higher DII scores, was positively associated with an increased risk of stroke (Q5 vs. Q1: HR = 1.90; 95% CI: 1.26-2.88; P-trend = 0.0006), T2DM (Q5 vs. Q1: HR = 2.08; 95% CI: 1.61-2.69; P-trend < 0.0001) and MI (Q5 vs. Q1: HR = 1.70; 95% CI: 1.04-2.76; P-trend = 0.0114) in the entire cohort. Sex and BMI significantly modified the association between the DII and the risk of T2DM, and sex significantly modified the association between the DII and the risk of MI. Conclusions: lower adherence to healthy and sustainable plant-based dietary patterns and higher adherence to unhealthy plant-based dietary patterns were associated with higher DII scores. With the use of the DII, we reported long-term positive associations between a pro-inflammatory diet and an increased risk of new-onset stroke, T2DM and MI in Chinese adults who were free from CMDs and cancer at the baseline. These findings provided evidence for the validation of associations between the DII and cardiometabolic health, and contributed to the current literature suggesting careful evaluations of whether the DII should be incorporated into dietary guidelines and utilized as an effective tool for improving the diet quality and CMD prevention in the Chinese population.
Collapse
Affiliation(s)
- Man Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Shun Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yiqian Lv
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Ke Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Yin Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaoling Wang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong 510080, China
- Guangdong Province Engineering Laboratory for Nutrition Translation, Guangzhou, Guangdong 510080, China
| |
Collapse
|
3
|
Mohammadi S, Hosseinikia M, Ghaffarian‐Bahraman A, Clark CCT, Davies IG, Yousefi Rad E, Saboori S. Dietary inflammatory index and elevated serum C-reactive protein: A systematic review and meta-analysis. Food Sci Nutr 2023; 11:5786-5798. [PMID: 37823095 PMCID: PMC10563751 DOI: 10.1002/fsn3.3553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 10/13/2023] Open
Abstract
Diet can affect the inflammatory state of the body. Accordingly, the dietary inflammatory index (DII) has been developed to quantify the inflammatory properties of food items. This study sought to investigate the association between dietary inflammation index (DII) and the odds ratio of elevated CRP (E-CRP) through a systematic review and meta-analysis study. The International electronic databases of PubMed, Web of Science (ISI), and Scopus were searched until May 2023 to find related articles. From 719 studies found in the initial search, 14 studies, with a total sample size of 59,941 individuals, were included in the meta-analysis. The calculated pooled odds ratio (OR) of E-CRP in the highest DII category was 1.39 (95% CI: 1.06, 1.14, test for heterogeneity: p = .63, and I 2 = .0%) in comparison with the lowest DII category. Also, the results of this study showed that each unit increase in DII as a continuous variable generally elicited a 10% increase in the odds of E-CRP (OR 1.10, 95% CI 1.06, 1.14, test for heterogeneity: p = .63, and I 2 = .0%). Subgroup meta-analyses showed that there is a higher E-CRP odds ratio for the articles that reported energy-adjusted DII (E-DII) instead of DII, the studies that measured CRP instead of hs-CRP, and the studies that used 24-h recall instead of FFQ as the instrument of dietary intake data collection. Individuals with a higher DII were estimated to have higher chances of developing elevated serum CRP. This value was influenced by factors such as the participants' nationality, instruments of data collection, methods used to measure inflammatory biomarkers, study design, and data adjustments. However, future well-designed studies can help provide a more comprehensive understanding of the inflammatory properties of diet and inflammatory serum biomarkers.
Collapse
Affiliation(s)
- Salman Mohammadi
- Nutritional Health Research CenterLorestan University of Medical SciencesKhorramabadIran
| | - Mahboobe Hosseinikia
- Department of Nutrition and Food SciencesYasuj University of Medical SciencesYasujIran
| | - Ali Ghaffarian‐Bahraman
- Occupational Environment Research CenterRafsanjan University of Medical SciencesRafsanjanIran
| | | | - Ian G Davies
- Research Institute of Sport and Exercise ScienceLiverpool John Moores UniversityLiverpoolUK
| | - Esmaeil Yousefi Rad
- Oxford Brookes Centre for Nutrition and Health (OxBCNH)Department of Sport, Health Sciences and Social Work, Faculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Somayeh Saboori
- Nutritional Health Research CenterLorestan University of Medical SciencesKhorramabadIran
- Oxford Brookes Centre for Nutrition and Health (OxBCNH)Department of Sport, Health Sciences and Social Work, Faculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| |
Collapse
|
4
|
Gao Y, Wang Y, Zhang D, Wu T, Li Q. The Relationship Between Dietary Inflammatory Index and All-Cause, Cardiovascular Disease-Related, and Cancer-Related Mortality. J Multidiscip Healthc 2023; 16:2543-2556. [PMID: 37667797 PMCID: PMC10475282 DOI: 10.2147/jmdh.s423558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023] Open
Abstract
Background In the general population of the United States (U.S.), the relationship between dietary inflammatory index (DII) and mortality (all-cause, cardiovascular disease (CVD)-related, and cancer-related) is still unclear. Therefore, in this research, we examined the association of DII with mortality caused by all-cause, CVD-related, and cancer-related causes. Methods Data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2018 was used for exploring the link between DII and all-cause, CVD-related, and cancer-related mortality through the use of Cox proportional hazard models and restricted cubic spline model. In addition, subgroup analyses were further performed. Results The study included 29,013 individuals from the NHANES from 1999 to 2018. The DII scores were nominated as low (T1: -5.281-0.724), medium (T2: 0.725-2.513), and high-grade inflammation (T3: 2.514-5.795), with T1 serving as the reference group. The linear positive correlation between DII and all-cause and CVD-related mortality was studied using Cox regression analysis. In the full-adjusted model, as compared with the individuals with T1 DII scores, adjusted odds ratios with 95% confidence intervals for all-cause and CVD-related mortality were 1.149 (1.059, 1.247), and 1.186 (1.084, 1.297), as well as 1.197 (1.032, 1.387), and 1.198 (1.019, 1.409), respectively. However, there was no statistical significance between DII and cancer-related mortality. The RCS plot also showed a significant increase in all-cause and CVD-related mortality with increased DII. Nevertheless, as DII scores increased, cancer-related mortality first increased and then decreased. Conclusion All-cause and CVD-related mortality are linked independently to high DII scores, independently. Further study of the association of DII scores with mortality caused by all-cause, CVD-related, and cancer-related causes is necessary to explore.
Collapse
Affiliation(s)
- Yonghong Gao
- Department of Cardiology, Shanghai Jinshan District Tinglin Hospital, Shanghai, 201505, People’s Republic of China
| | - Yan Wang
- Department of Cardiology, Shanghai Jinshan District Tinglin Hospital, Shanghai, 201505, People’s Republic of China
| | - Dandan Zhang
- Department of General Practice, Shanghai Jinshan District Tinglin Hospital, Shanghai, 201505, People’s Republic of China
| | - Tingting Wu
- Department of Cardiology, Shanghai Jinshan District Tinglin Hospital, Shanghai, 201505, People’s Republic of China
| | - Qingwei Li
- Department of Cardiology, Shanghai Jinshan District Tinglin Hospital, Shanghai, 201505, People’s Republic of China
| |
Collapse
|
5
|
Li Y, Peng X, Wang X, Lin R, Liu X, Meng F, Liu X, Li L, Bai R, Wen S, Ruan Y, Tang R, Liu N. Association of shift work and dietary inflammatory potential with all-cause death among us hypertensive population: national health and nutrition examination study, 2005-2010. BMC Public Health 2023; 23:1094. [PMID: 37280597 DOI: 10.1186/s12889-023-15740-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/23/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND & AIMS The individual effect of working schedule on survival in the hypertensive population has not been adequately studied. Shiftworkers are also prone to unhealthy lifestyles like pro-inflammatory diet. Therefore, we assessed the effect of shift work and its joint association with dietary inflammatory potential on mortality risk among the large US nationally representative sample of adult hypertensive population. METHODS Data were from a nationally representative prospective cohort among US hypertensive population (n = 3680; weighted population, 54,192,988). The participants were linked to the 2019 public-access linked mortality archives. The working schedule were self-reported using the Occupation Questionnaire Section. Dietary inflammatory index (DII) scores were equally calculated using the 24-hour dietary recall (24 h) interviews. Multivariable Cox proportional hazards regression models were used to estimate hazard ratio and 95% confidence intervals (95%CI) for survival of hypertension individuals by work schedule and dietary inflammatory potential. The joint effect of work schedule and dietary inflammatory potential was then examined. RESULTS Among the 3680 hypertension individuals (39.89% female [n = 1479] and 71.42% white [n = 1707]; weighted mean [SE] age, 47.35 [0.32] years), 592 individuals reported shift work status. 474 (10.76%) reported shift work status with pro-inflammatory dietary pattern (DII scores > 0). 118 (3.06%) reported shift work status with anti-inflammatory dietary pattern (DII scores < 0). 646 (19.64%) reported a non-shift working schedule with anti-inflammatory dietary pattern, while 2442 (66.54%) reported non-shift working schedule with pro-inflammatory dietary pattern. After a median follow-up of 11.67 years (140 months), 317 deaths (cardiovascular diseases (CVD), 65; cancer, 104) were registered. Cox regression analysis showed that shift work was associated with higher risk of all-cause mortality (hazard ratio [HR], 1.48; 95% CI, 1.07-2.06) compared with non-shift workers. In the joint analysis, shift work status combined with pro-inflammatory dietary pattern was associated with the highest all-cause mortality risk. Moreover, adopting the anti-inflammatory diet significantly attenuates the deleterious effect of shift work on mortality risk. CONCLUSIONS In this large representative sample of adults with hypertension in the U.S., the combination of shift work status with pro-inflammatory dietary pattern was highly prevalent and was associated with the highest risks of death from all causes.
Collapse
Affiliation(s)
- Yukun Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xiaodong Peng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xuesi Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Rong Lin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- North China Medical & Health Group XingTai Genernal Hospital, Xingtai, 054000, China
| | - Xinmeng Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Fanchao Meng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Xiaoying Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Linling Li
- Department of Cardiology, Bejing Chuiyangliu Hospital, Beijing, 100012, China
| | - Rong Bai
- Banner University Medical Center Phoenix, College of Medicine University of Arizona Phoenix, Arizona, 85123, USA
| | - Songnan Wen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Yanfei Ruan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China
| | - Ribo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China.
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China.
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100012, China.
- National Clinical Research Center for Cardiovascular Diseases, Beijing, 100012, China.
| |
Collapse
|
6
|
Zhang J, Jia J, Lai R, Wang X, Chen X, Tian W, Liu Q, Li J, Ju J, Xu H. Association between dietary inflammatory index and atherosclerosis cardiovascular disease in U.S. adults. Front Nutr 2023; 9:1044329. [PMID: 36687707 PMCID: PMC9849765 DOI: 10.3389/fnut.2022.1044329] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Objective To evaluate the association between dietary inflammatory index (DII) and Atherosclerotic cardiovascular disease (ASCVD) among U.S. adults. Methods We collected data from National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Adults who reported complete information to diagnose ASCVD and calculate DII were included. We used three models to differentially adjust the covariates, including age, sex, race or ethnicity, education level, smoking status, poverty, insurance, body mass index, hyperlipemia, hypertension, and diabetes. Logistic regression was used to estimate the Odds Ratio (OR) and 95% confidence interval (95% CI) for ASCVD grouped by DII deciles. We additionally conducted spline smoothing with the generalized additive model (GAM) and the log-likelihood ratio to examine the non-linear relationship between DII and ASCVD. If exists, the segmented linear regression will be used to detect the cutoff point. The subgroup analyses were stratified by various atherosclerotic cardiovascular diseases (i.e., CHD, angina, heart attack, and stroke) and sex. Results A total of 48,733 participants (mean age, 47.13 ± 0.19 years) with 51.91% women were enrolled, of which 5,011 were diagnosed with ASCVD. In the crude model, participants in the five highest deciles (D6, 7, 8, 9, and 10) of DII score had a significantly higher risk of having ASCVD compared to those in the first decile. In the fully adjusted model, those in the tenth decile [OR = 1.47, 95% CI = (1.18,1.84)] of DII had a significantly increased risk of ASCVD compared to the first decile. Notably, when DII is above 3, the ASCVD risk increased by 41% for each one increase in DII [OR = 1.41, 95% CI = (1.15,1.73)]. This relationship was more pronounced in females. Conclusion Our study revealed a positive and non-linearly association between DII and ASCVD in U.S. adults. This relationship was more pronounced in females. The findings provide a reference for future research and diet recommendations.
Collapse
Affiliation(s)
- Jie Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jundi Jia
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Runmin Lai
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinyi Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuanye Chen
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Wende Tian
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiyu Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingen Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Jingen Li,
| | - Jianqing Ju
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Jianqing Ju,
| | - Hao Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Hao Xu,
| |
Collapse
|
7
|
Racial Distribution of Neighborhood-Level Social Deprivation in a Retrospective Cohort of Prostate Cancer Survivors. Diseases 2022; 10:diseases10040075. [PMID: 36278574 PMCID: PMC9589959 DOI: 10.3390/diseases10040075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background: A better understanding of neighborhood-level factors’ contribution is needed in order to increase the precision of cancer control interventions that target geographic determinants of cancer health disparities. This study characterized the distribution of neighborhood deprivation in a racially diverse cohort of prostate cancer survivors. Methods: A retrospective cohort of 253 prostate cancer patients who were treated with radical prostatectomy from 2011 to 2019 was established at the Medical University of South Carolina. Individual-level data on clinical variables (e.g., stage, grade) and race were abstracted. Social Deprivation Index (SDI) and Healthcare Professional Shortage (HPS) status was obtained from the Robert Graham Center and assigned to participants based on their residential census tract. Data were analyzed with descriptive statistics and multivariable logistic regression. Results: The cohort of 253 men consisted of 168 white, 81 African American, 1 Hispanic and 3 multiracial men. Approximately 49% of 249 men lived in areas with high SDI (e.g., SDI score of 48 to 98). The mean for SDI was 44.5 (+27.4), and the range was 97 (1−98) for all study participants. African American men had a significantly greater likelihood of living in a socially deprived neighborhood compared to white men (OR = 3.7, 95% C.I. 2.1−6.7, p < 0.01), while men who lived in areas with higher HPS shortage status were significantly more likely to live in a neighborhood that had high SDI compared to men who lived in areas with lower HPS shortages (OR = 4.7, 95% C.I. = 2.1−10.7, p < 0.01). African Americans had a higher likelihood of developing biochemical reoccurrence (OR = 3.7, 95% C.I. = 1.7−8.0) compared with white men. There were no significant association between SDI and clinical characteristics of prostate cancer. Conclusions: This study demonstrates that SDI varies considerably by race among men with prostate cancer treated with radical prostatectomy. Using SDI to understand the social environment could be -particularly useful as part of precision medicine and precision public health approaches and could be used by cancer centers, public health providers, and other health care specialists to inform operational decisions about how to target health promotion and disease prevention efforts in catchment areas and patient populations.
Collapse
|
8
|
Yan LJ, Zhang FR, Ma CS, Zheng Y. Higher dietary inflammatory index is associated with increased all-cause mortality in adults with chronic kidney disease. Front Nutr 2022; 9:883838. [PMID: 35938119 PMCID: PMC9355393 DOI: 10.3389/fnut.2022.883838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/28/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diet property grounded on inflammatory potential, evaluated by the dietary inflammatory index (DII), has been proven to be connected with mortality, while studies of adults with chronic kidney disease (CKD) are scarce. OBJECTIVE The purpose of this research was to evaluate the interrelationships between DII and all-cause mortality among adults with CKD. METHODS In the National Health and Nutrition Examination Survey (NHANES) 2001-2006, we identified and evaluated data of 4,554 adults with CKD. DII scores were calculated from 24 h of dietary consumption at baseline. Vital status was followed through 31 December 2015. The association of all-cause mortality with DII score was assessed using the Kaplan-Meier curve and the Cox regression analysis. RESULTS After an average follow-up of 132.103 months, a total of 1,246 (27.36%) deaths were recorded. The death rates in the DII tertile categories were 24.04, 26.81, and 31.23%, respectively. The Kaplan-Meier curve showed increased death risks for the high DII tertile as compared with the low DII tertile. After we adjusted for a broad range of possible confounders, the estimation between extreme tertiles of DII scores presented a positive and significant association with all-cause mortality [hazard ratio (HR): 1.21, 95% CI: 1.05-1.39]. CONCLUSION Our results confirm the hypothesis that proinflammatory diets contribute to the increased all-cause mortality in adults with CKD.
Collapse
Affiliation(s)
- Li-Jun Yan
- Department of Hemodialysis, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Fei-Ran Zhang
- Department of Gastroenterology Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chan-Shan Ma
- Department of Gastroenterology Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yang Zheng
- Department of Gastroenterology Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| |
Collapse
|
9
|
Kuhail M, Shab-Bidar S, Yaseri M, Djafarian K. Major Dietary Patterns Relationship with Severity of Coronary Artery Disease in Gaza-Strip, Palestine: A Cross-Sectional Study. Ethiop J Health Sci 2021; 31:599-610. [PMID: 34483617 PMCID: PMC8365497 DOI: 10.4314/ejhs.v31i3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background The association of dietary patterns (DPs) linked to the severity of coronary artery disease (CAD) is little known. Therefore, this study aims to explore the relationship between major DPs and the severity of CAD. Methods This cross-sectional study was conducted among423 newly discovered CAD patients (both genders, aged 35–65 years), who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested using a semi-quantitative food frequency questionnaire and other related data through face-to-face interviews. Factor analysis and logistic regression were applied by using SPSS version-24. Results By principal component analysis, two major DPs were identified: “Unhealthy” DP that characterized mainly by high intakes of sugar and sweets, soft drinks, salts, cooking oils, and processed meats, and “Healthy” DP that consisting high intakes of fruits, fish, poultry, vegetables, whole grains. After adjustment for confounding variables, the odds of severe CAD was significantly higher in the third (T3) and second (T2) tertile of the unhealthy pattern by 4.79 and 2.48 times more compared to the first tertile (T1) (OR 4.79; 95%CI 2.60, 8.83; P<0.001) and (OR 2.48; 95%CI 1.40, 4.39; P=0.002), respectively. However, the odds of CAD severity in the T3 and T2 of the healthy pattern was lowered by 0.24 and 0.38 times less compared to the T1 (OR 0.24; 95%CI 0.12, 0.47; P=0.002) and (OR 0.38; 95%CI 0.20, 0.73; P=0.006), respectively. Conclusion The severity of CAD was significantly increased by the unhealthy dietary pattern, while decreased by adherence to the healthy pattern.
Collapse
Affiliation(s)
- Mohamed Kuhail
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, International-Campus. Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional, School of Nutritional Sciences and Dietetics, International College, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, International-Campus. Tehran, Iran
| |
Collapse
|
10
|
Liu Z, Liu H, Deng Q, Sun C, He W, Zheng W, Tang R, Li W, Xie Q. Association Between Dietary Inflammatory Index and Heart Failure: Results From NHANES (1999-2018). Front Cardiovasc Med 2021; 8:702489. [PMID: 34307508 PMCID: PMC8292138 DOI: 10.3389/fcvm.2021.702489] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022] Open
Abstract
Objective: To explore the relationship between dietary inflammatory index (DII) and heart failure (HF) in participants with cardiovascular and cerebrovascular diseases. Methods: NHANES (1998–2018) data were collected and used to assess the association of HF with DII. Twenty-four-hour dietary consumptions were used to calculate the scores of DII. Demographic characteristics and physical and laboratory examinations were collected for the comparison between HF and non-HF groups. Logistic regression analysis and random forest analysis were performed to calculate the odds rate and determine the potential beneficial dietary components in HF. Results: A total of 19,067 cardiac-cerebral vascular disease participants were categorized as HF (n = 1,382; 7.25%) and non-HF (n = 17,685; 92.75%) groups. Heart failure participants had higher levels of DII score compared with those in the non-HF group (0.239 ± 1.702 vs. −0.145 ± 1.704, p < 0.001). Compared with individuals with T1 (DII: −3.884 to −0.570) of DII, those in T3 (DII: 1.019 to 4.598) had a higher level of total cholesterol (4.49 ± 1.16 vs. 4.75 ± 1.28 mmol/L, p < 0.01), globulin (29.92 ± 5.37 vs. 31.29 ± 5.84 g/L, p < 0.001), and pulse rate (69.90 ± 12.22 vs. 72.22 ± 12.77, p < 0.001) and lower levels of albumin (40.76 ± 3.52 vs. 39.86 ± 3.83 g/L, p < 0.001), hemoglobin (13.76 ± 1.65 vs. 13.46 ± 1.77 g/dl, p < 0.05), and hematocrit (40.83 ± 4.69 vs. 40.17 ± 5.01%, p < 0.05). The odds rates of HF for DII from the logistic regression were 1.140, 1.158, and 1.110 in models 1, 2, and 3, respectively. In addition, from the results of random forest analysis, dietary magnesium, fiber, and beta carotene may be essential in HF. Conclusion: Dietary inflammatory index was positively associated with HF in US adults, and dietary intervention might be a promising method in the therapy of HF.
Collapse
Affiliation(s)
- Zuheng Liu
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Haiyue Liu
- Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Xiamen Key Laboratory of Genetic Testing, Xiamen, China
| | - Qinsheng Deng
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Changqing Sun
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wangwei He
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wuyang Zheng
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Rong Tang
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Weihua Li
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Qiang Xie
- Department of Cardiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| |
Collapse
|
11
|
Kuhail M, Djafarian K, Shab-Bidar S, Yaseri M. Major dietary patterns and metabolic syndrome associated with severity of coronary artery disease: A structural equation modeling. Nutr Health 2021; 28:277-287. [PMID: 34151612 DOI: 10.1177/02601060211020655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known. AIM This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM). METHODS In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35-65 years, who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested by using a semi-quantitative food frequency questionnaire, international physical activity questionnaire, perceived stress scale, lipid profile, fasting blood glucose, and anthropometric and blood pressure measurements. Statistical analysis was performed using SPSS and AMOS version 24. RESULTS Two dietary patterns (DPs) were identified by principal components analysis and labeled as "unhealthy DP" and "healthy DP". The results of SEM analysis showed that the unhealthy DP has a significant positive direct association with the severity of CAD (β=0.304, p<0.001), which is indirectly mediated by the presence of metabolic syndrome (β=0.021, p=0.021), adjusted for age and perceived stress scale. However, healthy DP has a significant negative direct association with the Gensini score (β=-0.213, p<0.001), and an indirect association through negative metabolic syndrome (β=-0.019, p=0.022), controlled for gender, physical activity, and perceived stress scale. CONCLUSIONS The severity of CAD was directly associated with the unhealthy DP and indirectly mediated by the presence of the metabolic syndrome, while a healthy DP had a direct inverse association with CAD severity and indirectly mediated by the absence of metabolic syndrome.
Collapse
Affiliation(s)
- Mohamed Kuhail
- 48439Tehran University of Medical Sciences, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Iran
| | - Kurosh Djafarian
- 48439Tehran University of Medical Sciences, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Iran
| | - Sakineh Shab-Bidar
- 48439Tehran University of Medical Sciences, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International College, Iran
| | - Mehdi Yaseri
- 48439Tehran University of Medical Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Iran
| |
Collapse
|
12
|
Moludi J, Shivappa N, Alisgharzadeh S, Hébert JR, Alizadeh M. Dietary Inflammatory Index Is Related to Heart Failure Risk and Cardiac Function: A Case-Control Study in Heart Failure Patients. Front Nutr 2021; 8:605396. [PMID: 33889592 PMCID: PMC8056025 DOI: 10.3389/fnut.2021.605396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/22/2021] [Indexed: 12/30/2022] Open
Abstract
Aims: Previous studies suggest that diet and inflammation are important risk factors for heart failure (HF); however, the associations remain unclear. The Dietary Inflammatory Index (DII®) was established to measure the inflammatory capacity of individuals' diet. This study aimed to explore the DII in HF subjects compared with controls. Methods and Results: We conducted a case-control (116 cases and 113 controls) study that recruited in the similar clinics. DII scores were calculated based on dietary intakes. N-Terminal pro-brain natriuretic peptide (NT-proBNP) levels and ejection fraction (EF) were assessed in both groups. In order to analyze DII scores with HF as the outcome, we used conditional logistic regression. A linear regression was applied to explore the associations between the DII and left ventricular EF (LVEF). There was statistically significant difference in DII scores in cases vs. controls (-0.16 ± 1.37 vs. -0.33 ± 1.67; p = 0.040). Conditional logistic regression has shown that subjects with higher DII scores had higher risk of HF. For every one-point rise in DII score, the odds of having HF increased by 30% (OR: 1.30; CI: 1.03, 1.69; p = 0.047). The EF was inversely associated with saturated fatty acid (β = -0.34, 95% CI: -0.61, -0.07; p = 0.012). Subjects with higher DII scores had higher NT-proBNP levels and had lower EF. Conclusion: The DII score was associated with high probability of HF. It appears that consumption of anti-inflammatory diet may lead to the prevention of HF and therefore suggests that dietary modification with the goal of reducing DII scores could be a valuable strategy for improving clinical outcomes in these patients.
Collapse
Affiliation(s)
- Jalal Moludi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - 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.,Connecting Health Innovations LLC, Columbia, SC, United States
| | | | - James R Hébert
- 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.,Connecting Health Innovations LLC, Columbia, SC, United States
| | - Mohammad Alizadeh
- Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
13
|
Pro-inflammatory diet is associated with a high number of cardiovascular events and ultra-processed foods consumption in patients in secondary care. Public Health Nutr 2020; 24:3331-3340. [DOI: 10.1017/s136898002000378x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjective:To evaluate the association of dietary inflammatory index (DII®) with the occurrence of cardiovascular events, cardiometabolic risk factors and with the consumption of processed, ultra-processed, unprocessed or minimally processed foods and culinary ingredients.Design:This was a cross-sectional study that analysed the baseline data from 2359 cardiac patients. Data on socio-demographic, anthropometric, clinical and food consumption were collected. Energy-adjusted food intake data were used to calculate DII, and the foods were classified according to the NOVA classification. Furthermore, the patients were grouped according to the number (1, 2 or ≥ 3) of manifested cardiovascular events. The data were analysed using linear and multinomial logistic regression.Settings:Multicentre study from Brazil.Participants:Patients with established cardiovascular events from the Brazilian Cardioprotective Nutritional Program Trial evaluated at baseline.Results:Most of the patients were male (58·8 %), older adults (64·2 %) and were overweight (68·8 %). Patients in the third tertile of DII (DII > 0·91) had were more likely to have 2 (OR 1·27, 95 % CI: 1·01–1·61) and ≥ 3 (OR 1·39, 95 % CI: 1·07–1·79) cardiovascular events, with poor cardiometabolic profile. They also were more likely to consume a higher percentage of processed, ultra-processed and culinary ingredients foods consumption compared with the patients in the first DII tertile (DII ≤ 0·91).Conclusion:A more pro-inflammatory diet is associated with a greater chance of having 2 and ≥ 3 cardiovascular events and cardiometabolic risk factors and were more likely to consume processed, ultra-processed and culinary ingredients compared to those with a more anti-inflammatory diet.
Collapse
|
14
|
Vitale M, Calabrese I, Massimino E, Shivappa N, Hebert JR, Auciello S, Grioni S, Krogh V, Sartore G, Signorini S, Rivellese AA, Riccardi G, Vaccaro O, Masulli M. Dietary inflammatory index score, glucose control and cardiovascular risk factors profile in people with type 2 diabetes. Int J Food Sci Nutr 2020; 72:529-536. [PMID: 33045863 DOI: 10.1080/09637486.2020.1832054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We examined the relationships between the dietary inflammatory index (DII®), dietary habits and cardiovascular risk factor profiles in people with type 2 diabetes mellitus (T2DM). Energy-adjusted DII (E-DII™) scores were calculated from a Food Frequency Questionnaire in 2568 T2DM patients from different parts of Italy. Analyses were conducted according to quartiles of sex-specific E-DII scores. Higher, more pro-inflammatory, (quartile 4) E-DII scores were associated with overall poor quality of the diet characterised by higher content of refined carbohydrates, added sugars, saturated fat and cholesterol and lower unsaturated fat, fibre and polyphenols compared to quartile 1. Higher E-DII scores also were associated with higher waist circumference (105.4 vs. 103.5 cm; p = 0.002), triglycerides (154.6 vs. 146.1 mg/dL; p = 0.005), diastolic blood pressure (80.05 vs. 78.6 mmHg; p = 0.04) and lower HDL-cholesterol (45.3 vs. 47.4 mg/dL; p = 0.04). In conclusion, E-DII is a potent marker of overall quality of the diet and is associated with an unfavourable cardiovascular risk factor profile.
Collapse
Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Elena Massimino
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - 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.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Stefania Auciello
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Sara Grioni
- Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy
| | - Vittorio Krogh
- Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy
| | | | | | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Olga Vaccaro
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| |
Collapse
|
15
|
Wang K, Sun JZ, Wu QX, Li ZY, Li DX, Xiong YF, Zhong GC, Shi Y, Li Q, Zheng J, Shivappa N, Hébert JR, Foukakis T, Zhang X, Li HY, Xiang TX, Ren GS. Long-term anti-inflammatory diet in relation to improved breast cancer prognosis: a prospective cohort study. NPJ Breast Cancer 2020; 6:36. [PMID: 32821804 PMCID: PMC7426822 DOI: 10.1038/s41523-020-00179-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
Inflammation-modulating nutrients and inflammatory markers are established cancer risk factors, however, evidence regarding the association between post-diagnosis diet-associated inflammation and breast cancer survival is relatively sparse. We aimed to examine the association between post-diagnosis dietary inflammatory index (DII®) and risks of all-cause and breast cancer-specific mortality. A total of 1064 female breast cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial prospective cohort, were included in this analysis if they had completed the diet history questionnaire (DHQ). Energy-adjusted DII (E-DIITM) scores were calculated based on food and supplement intake. Cox regression and competing risk models were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by E-DII tertile (T) for all-cause and breast cancer-specific mortality. With median follow-up of 14.6 years, there were 296 (27.8%) deaths from all causes and 100 (9.4%) breast cancer-specific death. The E-DII was associated with all-cause mortality (HR T3 vs T1, 1.34; 95% CI, 1.01-1.81; P trend, 0.049, Table 2) and breast cancer mortality (HR T3 vs T1, 1.47; 95% CI, 0.89-2.43; P trend, 0.13; multivariable-adjusted HR for 1-unit increment: 1.10; 95% CI: 1.00-1.22). Non-linear positive dose-response associations with mortality from all causes were identified for E-DII scores (P non-linearity < 0.05). The post-diagnosis E-DII was statistically significantly associated with mortality risk among breast cancer survivors. Long-term anti-inflammatory diet might be a means of improving survival of breast cancer survivors.
Collapse
Affiliation(s)
- Kang Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia-Zheng Sun
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian-Xue Wu
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Zhu-Yue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Da-Xue Li
- Department of Breast Surgery, Chongqing Health Center for Women and Children, Chongqing, 400000 China
| | - Yong-Fu Xiong
- The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637007 China
| | - Guo-Chao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Shi
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA USA
| | - Qing Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
| | - 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, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 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, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 USA
| | - Theodoros Foukakis
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
- Breast Center, Theme Cancer, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Xiang Zhang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Hong-Yuan Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Ting-Xiu Xiang
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guo-Sheng Ren
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
16
|
Dietary inflammatory index potentially increases blood pressure and markers of glucose homeostasis among adults: findings from an updated systematic review and meta-analysis. Public Health Nutr 2020; 23:1362-1380. [PMID: 31708005 DOI: 10.1017/s1368980019003070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In the current meta-analysis, we aimed to systematically review and summarize eligible studies for the association between dietary inflammatory index (DII) and blood pressure, hypertension (HTN) and glucose homeostasis biomarkers. DESIGN/SETTING In a systematic search of PubMed, Scopus and Google Scholar electronic databases up to February 2019, relevant studies were included in the literature review. Observational studies evaluating the association between DII and HTN, hyperglycaemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and glycated Hb (HbA1c) were included. PARTICIPANTS Not applicable. RESULTS Total numbers of studies were as follows: OR for DII and HTN (n 12), OR for DII and hyperglycaemia (n 9), HTN prevalence (n 9), mean (sd) of SBP and DII (n 12), mean (sd) of DBP and DII (n 10), mean (sd) of FBS and DII (n 13), mean (sd) of HbA1c and DII (n 3), mean (sd) of insulin and DII (n 6), mean (sd) of HOMA-IR and DII (n 7). Higher DII scores were associated with higher odds of HTN (OR = 1·13; 95 % CI 1·01, 1·27; P < 0·001), SBP (weighted mean difference (WMD) = 1·230; 95 % CI 0·283, 2·177; P = 0·011), FBS (WMD = 1·083; 95 % CI 0·099, 2·068; P = 0·031), insulin (WMD = 0·829; 95 % CI 0·172, 1·486; P = 0·013), HbA1c (WMD = 0·615; 95 % CI 0·268, 0·961; P = 0·001) and HOMA-IR (WMD = 0·192; 95 % CI 0·023, 0·361; P = 0·026) values compared with lowest DII categories. CONCLUSIONS Lower inflammatory content of diets for prevention of cardiovascular risk factors is recommended.
Collapse
|
17
|
Puddu PE, Shivappa N, Menotti A, Hébert JR, Tolonen H, Kafatos A, Adachi H. Energy-adjusted Dietary Inflammatory Index scores predict long-term cardiovascular disease mortality and other causes of death in an ecological analysis of the Seven Countries Study. Eur J Prev Cardiol 2020; 28:1342-1350. [PMID: 33611375 DOI: 10.1177/2047487320903866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/13/2020] [Indexed: 11/17/2022]
Abstract
Abstract
Using data from the Seven Countries Study of Cardiovascular Diseases, the first study to conduct international comparisons of men in different European, USA, and Japanese cohorts, we examined the effect of diet-associated inflammation on prediction of coronary heart disease-, other major cardiovascular disease- and all-cause mortality after 50-years of follow-up. The energy-adjusted Dietary Inflammatory Index was used to quantify the effect of diet on systemic inflammation. Positive linear correlations were observed between the cohort-average energy-adjusted Dietary Inflammatory Index score and both overall death rates (R = 0.61, p = 0.0114) and major cardiovascular disease mortality rates (R = 0.51, p = 0.0337) but not cancer. Correlations for all-cause mortality were higher when the Belgrade outlier cohort was omitted (R = 0.72, p = 0.0024) or when analyses were adjusted for socioeconomic status (R = 0.67, p = 0.0065). There was also a significant reverse correlation between energy-adjusted Dietary Inflammatory Index score and age at death (R = –0.50 to –0.68, p = 0.0480 to 0.0012). Adjusting for systolic blood pressure, cholesterol, and smoking habits did not modify these correlations that were still significant. With control for these covariates a significant correlation emerged for coronary heart disease. Results obtained using a 25-year follow-up to allow unprojected data from all cohorts were similar. Results from this long-term follow-up study are consistent with a recommendation to increase consuming an anti-inflammatory diet characterized by high concentrations of fruits and vegetables and low consumption of simple carbohydrates and fats.
Collapse
Affiliation(s)
- Paolo E Puddu
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Italy
- Signalisation, Électrophysiologie et Imagerie des Lésions d’Ischémie Reperfusion Myocardique, UNICAEN, France
- Association for Cardiac Research, Italy
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, USA
- Department of Epidemiology and Biostatistics, University of South Carolina, USA
| | | | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, USA
- Department of Epidemiology and Biostatistics, University of South Carolina, USA
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare, Finland
| | | | - Hisashi Adachi
- Department of Internal Medicine, Kurume University, Japan
| |
Collapse
|
18
|
Kaluza J, Levitan EB, Michaëlsson K, Wolk A. Anti‐inflammatory diet and risk of heart failure: two prospective cohort studies. Eur J Heart Fail 2020; 22:676-682. [DOI: 10.1002/ejhf.1746] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/18/2019] [Accepted: 12/30/2019] [Indexed: 01/22/2023] Open
Affiliation(s)
- Joanna Kaluza
- Unit of Cardiovascular and Nutritional Epidemiology Institute of Environmental Medicine, Karolinska Institutet Stockholm Sweden
- Department of Human Nutrition Warsaw University of Life Sciences – SGGW Warsaw Poland
- Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Emily B. Levitan
- Department of Epidemiology University of Alabama at Birmingham Birmingham AL USA
| | - Karl Michaëlsson
- Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology Institute of Environmental Medicine, Karolinska Institutet Stockholm Sweden
- Department of Surgical Sciences Uppsala University Uppsala Sweden
| |
Collapse
|
19
|
Aslani Z, Sadeghi O, Heidari-Beni M, Zahedi H, Baygi F, Shivappa N, Hébert JR, Moradi S, Sotoudeh G, Asayesh H, Djalalinia S, Qorbani M. Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose-response meta-analysis of observational studies. Diabetol Metab Syndr 2020; 12:86. [PMID: 33117453 PMCID: PMC7590706 DOI: 10.1186/s13098-020-00592-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
CONTEXT The association of dietary inflammatory index (DII®), as an index of inflammatory quality of diet, with cardiometabolic diseases (CMDs) and risk factors (CMRFs) has been inconsistent in previous studies. OBJECTIVE The current systematic review and dose-response meta-analysis was performed to investigate the association of the DII score with CMDs and CMRFs. DATA SOURCES All published observational studies (cohort, case-control and cross-sectional) using PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar databases were retrieved from inception through November 2019. DATA EXTRACTION Two reviewers independently extracted the data from included studies. DATA ANALYSIS Pooled hazard ratio (HR) or odds ratio (OR) were calculated by using a random-effects model. RESULTS Ten prospective cohort studies (total n = 291,968) with 31,069 CMDs-specific mortality, six prospective cohort studies (total n = 43,340) with 1311 CMDs-specific morbidity, two case-control studies with 2140 cases and 6246 controls and one cross-sectional study (total n = 15,613) with 1734 CMDs-specific morbidity were identified for CMDs. Meta-analyses of published observational studies demonstrated that the highest DII score category versus the lowest DII score category was associated with 29% increased risk of CMDs mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41). Moreover, there was a significant association between the DII score and risk of CMDs in cohort studies (HR = 1.35; 95% CI 1.13, 1.61) and non-cohort study (HR = 1.36; 95% CI 1.18, 1.57). We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension. None-linear dose response meta-analysis showed that there was a significant association between the DII score and risk of CMDs mortality (Pnonlinearity < 0.001). Moreover, evidence of none-linear association between the DII score and risk of CMDs was not observed (p-value = 0.1). CONCLUSIONS Adherence to pro-inflammatory diet was associated with increased risk of CMDs, mortality and MetS.
Collapse
Affiliation(s)
- Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hoda Zahedi
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations LLC, Columbia, SC 29201 USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations LLC, Columbia, SC 29201 USA
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
20
|
Brandhorst S, Longo VD. Dietary Restrictions and Nutrition in the Prevention and Treatment of Cardiovascular Disease. Circ Res 2019; 124:952-965. [PMID: 30870119 DOI: 10.1161/circresaha.118.313352] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in many developed countries and remains one of the major diseases strongly affected by the diet. Nutrition can affect CVD directly by contributing to the accumulation of vascular plaques and also indirectly by regulating the rate of aging. This review summarizes research on nutrition and CVD incidence based on a multipillar system that includes basic research focused on aging, epidemiological studies, clinical studies, and studies of centenarians. The relevant research linking nutrition and CVD with focus on macronutrients and aging will be highlighted. We will review some of the most relevant studies on nutrition and CVD treatment, also focusing on interventions known to delay aging. We will discuss both everyday dietary compositions, as well as intermittent and periodic fasting interventions with the potential to prevent and treat CVD.
Collapse
Affiliation(s)
- Sebastian Brandhorst
- From the Longevity Institute, Davis School of Gerontology, University of Southern California, Los Angeles (S.B., V.D.L.)
| | - Valter D Longo
- From the Longevity Institute, Davis School of Gerontology, University of Southern California, Los Angeles (S.B., V.D.L.).,Institute of Molecular Oncology, Italian Foundation for Cancer Research, Milan (V.D.L.)
| |
Collapse
|
21
|
Pocovi-Gerardino G, Correa-Rodríguez M, Callejas-Rubio JL, Ríos-Fernández R, Martín-Amada M, Cruz-Caparros MG, Rueda-Medina B, Ortego-Centeno N. Dietary Inflammatory Index Score and Cardiovascular Disease Risk Markers in Women with Systemic Lupus Erythematosus. J Acad Nutr Diet 2019; 120:280-287. [PMID: 31492654 DOI: 10.1016/j.jand.2019.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/17/2019] [Accepted: 06/07/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patients with systemic lupus erythematosus (SLE), a chronic inflammatory autoimmune disease, have an increased risk of developing cardiovascular diseases. Environmental factors like diet and nutrition are known to play a key role in modulating inflammation and the prognosis of cardiovascular diseases. OBJECTIVE To investigate the relationship between Dietary Inflammatory Index score and cardiovascular disease risk markers in a population of women with SLE. DESIGN A cross-sectional study was conducted in women with SLE recruited from 2016 through 2017. PARTICIPANTS/SETTINGS Clinically stable women with SLE were enrolled from three public hospitals in the Andalusian region of Spain. Participants with chronic renal failure, active infections, recent trauma, pregnancy, and/or other autoimmune diseases were excluded. MAIN OUTCOME MEASURES A 24-hour diet recall was used to estimate Dietary Inflammatory Index score and physical activity was assessed through the International Physical Activity Questionnaires. Cardiovascular disease risk markers included blood lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels), high-sensitivity C-reactive protein levels, and homocysteine levels, along with diagnosis of obesity, diabetes mellitus, hypertension, dyslipidemia, and ankle-brachial index measurement. STATISTICAL ANALYSIS Comparisons of cardiovascular disease risk markers across Dietary Inflammatory Index score tertiles were analyzed through a one-way analysis of variance and linear regressions adjusting for age, physical activity level, and medical treatment. RESULTS A total of 105 women (aged 45.4±12.8 years) were included. Linear regression analysis revealed that Dietary Inflammatory Index score was significantly associated with total cholesterol levels (β=.26, 95% CI 1.66 to 14.28; P=0.014) after adjusting for age, physical activity, and the use of medical treatment. No significant associations were observed between Dietary Inflammatory Index score and the other cardiovascular markers considered. CONCLUSIONS Higher inflammatory potential of the diet was positively associated with higher total cholesterol levels in women with SLE. These findings suggest that the inflammatory potential of a person's diet may play a role in lipid profiles in this population. Future intervention studies are needed to build on these results and explore the effect of anti-inflammatory diets on health outcomes in individuals with SLE.
Collapse
|
22
|
Teixeira GP, Barreto ADCF, Mota MC, Crispim CA. Caloric midpoint is associated with total calorie and macronutrient intake and body mass index in undergraduate students. Chronobiol Int 2019; 36:1418-1428. [DOI: 10.1080/07420528.2019.1652830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | | | - Maria Carliana Mota
- Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil
| | | |
Collapse
|
23
|
Wirth MD, Robinson C, Murphy EA, Shivappa N, Hébert JR. The dietary inflammatory index is associated with gastrointestinal infection symptoms in the national health and nutrition examination survey. Int J Food Sci Nutr 2019; 71:106-115. [PMID: 31106619 DOI: 10.1080/09637486.2019.1614539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Inflammation influences many aspects of health including gastrointestinal illnesses. Associations between the Dietary Inflammatory Index (DII®) and gastrointestinal symptoms were examined using cross-sectional data from the National Health and Nutrition Examination Survey (years 2005-2014, n = 25,553). Outcomes included self-reported presence of mucus or liquid in bowel leakage and stomach illness in the past month, diarrhoea in the past year and number of weekly bowel movements. Energy-adjusted DII (E-DII) scores were estimated from one 24-h dietary recall. Analyses included survey design-appropriate logistic and linear regression. Compared to E-DII quartile 1 (anti-inflammatory), E-DII quartile 4 (pro-inflammatory) had elevated odds of mucus in leakage: 71% (95% confidence interval [95%CI] = 1.01-1.20); liquid in leakage: 74% (95%CI = 1.30-2.33); stomach illness: 43% (95%CI = 1.18-1.72); and diarrhoea: 65% (95%CI = 1.21-2.26). Those with more anti-inflammatory diets had more bowel movements. Future questions should address whether anti-inflammatory diets provide protective effects against gastrointestinal infections and if these relationships are modified by other health behaviours.
Collapse
Affiliation(s)
- Michael D Wirth
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,College of Nursing, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Cory Robinson
- Department of Microbiology, Immunology, and Cell Biology, University of West Virginia School of Medicine, Morgantown, WV, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| |
Collapse
|
24
|
Abstract
PURPOSE OF REVIEW There is a growing body of evidence that nutritional factors influence the incidence of heart failure (HF). The current manuscript aims to collate evidence relating to nutritional intervention in the treatment of HF as well as to provide context regarding challenges and opportunities in the field. RECENT FINDINGS Despite the accepted importance of nutritional factors relating to cardiovascular disease severity, there is surprisingly little human intervention research regarding dietary intake and HF. Further, existing nutritional interventions in HF were mostly pilot studies with small samples and short follow-up. There is consistent evidence that nutritional factors majorly influence HF. Despite limited research, there is evidence that nutritional modification can rapidly and profoundly influence multiple aspects of HF. There is an urgent need for well-conducted research to ascertain if nutritional modification can alter the long-term course of HF.
Collapse
|
25
|
Secular trends in Dietary Inflammatory Index among adults in the United States, 1999-2014. Eur J Clin Nutr 2018; 73:1343-1351. [PMID: 30542148 DOI: 10.1038/s41430-018-0378-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate secular trends in Dietary Inflammatory Index (DII) scores in the United States between 1999 and 2014. METHODS Data from adults over 19 years from the 1999 to 2014 National Health and Nutrition Examination Survey (N = 39,191) were used. DII scores, at each 2-year cycle, were evaluated from a 24-h recall, including 26 food parameters for DII calculation. Analyses were conducted in 2018. RESULTS For the entire sample, there was a quadratic trend (Ptrend < 0.001), with the DII scores peaking in 2003-2004, and then decreasing during the cycles from 2005 to 2014. Similar quadratic trends (Ptrend < 0.001) were observed by age, gender, race-ethnicity, and education. CONCLUSION Males, non-Hispanic Blacks, younger adults, and those with less education adults had the highest DII scores (i.e., indicating the greatest inflammatory potential). The overall DII scores of the US population showed a quadratic trend from 1999 to 2014. Continued monitoring of DII changes is needed to better understand changes in the inflammatory potential of diet of American adults, and how they relate to changes in the risk of chronic disease.
Collapse
|
26
|
Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies. Nutr Res Rev 2018; 32:1-27. [DOI: 10.1017/s0954422418000148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractGrowing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.
Collapse
|
27
|
Interactions between dietary inflammatory index, nutritional state and Multiple Sclerosis clinical condition. Clin Nutr ESPEN 2018; 26:35-41. [DOI: 10.1016/j.clnesp.2018.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 04/30/2018] [Indexed: 12/20/2022]
|
28
|
Kord Varkaneh H, Fatahi S, Tajik S, Rahmani J, Zarezadeh M, Shab-Bidar S. Dietary inflammatory index in relation to obesity and body mass index: a meta-analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.1108/nfs-09-2017-0203] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose
Studies investigating the association between dietary inflammatory index (DII) and body mass index (BMI) have led to inconsistent findings. Therefore, to decisively conclude, this paper aims to clarify the relationship between DII and obesity by performing meta-analysis.
Design/methodology/approach
PubMed, Scopus and Google Scholar were searched up to July 2017 using key words selected from Medical Subject Headings and other related keywords to identify all relevant articles. In total, 22 articles were entered into the meta-analysis; 22 studies compared the mean of BMI among subjects with highest versus the lowest DII and 4 studies had data on the hazard risk (HR) or odds ratio (OR) for obesity.
Findings
A meta-analysis on included studies indicated a significant association on either mean differences (MD) in BMI (MD = 0.811; 95 per cent CI: 0.365-1.256; p: 0.0001) or obesity OR (OR: 1.310; 95 per cent CI: 1.144-1.500; p = 0.000) by comparing the highest and lowest DII categories. Between-study heterogeneity was high (Cochrane Q test, p < 0.001, I2 = 98.1 per cent, df = 21, τ2 = 0.9273), and only dietary assessment methods could explain the source of heterogeneity in which 24-h dietary recalls were homogeny (I2 = 8.4 per cent, df = 2, p = 0.335).
Originality/value
The results of the present meta-analysis suggest that adherence to high DII score increased BMI and obesity. More prospective studies in different populations are needed to better clarify this relation.
Collapse
|
29
|
Ren Z, Zhao A, Wang Y, Meng L, Szeto IMY, Li T, Gong H, Tian Z, Zhang Y, Wang P. Association between Dietary Inflammatory Index, C-Reactive Protein and Metabolic Syndrome: A Cross-Sectional Study. Nutrients 2018; 10:nu10070831. [PMID: 29954070 PMCID: PMC6073906 DOI: 10.3390/nu10070831] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 01/17/2023] Open
Abstract
Increased prevalence of metabolic syndrome (MetS) has become a global major public health problem. Chronic low-grade inflammation associated with diet was found to play an import role in the development of MetS, although further studies are needed. The main purpose of this study was to explore the association between the dietary inflammatory index (DII), C-reactive protein (CRP) as a sign of inflammation status, and MetS. A total of 1712 participants from eight cities in China were included. Sociodemographic and health-related information was collected by a self-administrated questionnaire. Anthropometric information and fasting blood samples were collected for identification of MetS. DII scores were computed based on one time 24-h dietary recall. No significant association between MetS and DII was observed except for the blood pressure component of MetS (OR T3 versus T1 = 1.40; 95% CI: 1.03 to 1.89). A significant increased prevalence for MetS was observed for higher CRP (OR = 1.66; 95% CI: 1.26 to 2.18), as well as four out of five of MetS components. In stratified analyses by sex, the associations between DII/CRP and MetS among women, but not men, are comparable to the whole sample. In addition, Both the 2nd and 3rd tertile of the DII had a higher CRP level (β-Coefficients T2 versus T1 = 0.086, 95% CI: 0.004 to 0.167; β-Coefficients T3 versus T1 = 0.145, 95% CI: 0.045 to 0.245) among subjects with MetS. Participants with higher DII scores reported a higher degree of “Shanghuo” (p = 0.007), which is a traditional concept characterized by “redness, swelling, fever and pain” in Chinese Medicine. This study suggested a close association between CRP and MetS, while the association between the DII and MetS was limited. DII was only specifically associated with CRP at a higher level among participants with MetS.
Collapse
Affiliation(s)
- Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Ai Zhao
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Yan Wang
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot 010110, China.
- Yili Innovation Center, Inner Mongolia Yili Industrial Group Co. Ltd., Hohhot 010110, China.
| | - Liping Meng
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot 010110, China.
- Yili Innovation Center, Inner Mongolia Yili Industrial Group Co. Ltd., Hohhot 010110, China.
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot 010110, China.
- Yili Innovation Center, Inner Mongolia Yili Industrial Group Co. Ltd., Hohhot 010110, China.
| | - Ting Li
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot 010110, China.
- Yili Innovation Center, Inner Mongolia Yili Industrial Group Co. Ltd., Hohhot 010110, China.
| | - Huiting Gong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Zixing Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| |
Collapse
|
30
|
Han YY, Forno E, Shivappa N, Wirth MD, Hébert JR, Celedón JC. The Dietary Inflammatory Index and Current Wheeze Among Children and Adults in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:834-841.e2. [PMID: 29426751 PMCID: PMC5948124 DOI: 10.1016/j.jaip.2017.12.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/30/2017] [Accepted: 12/30/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND A proinflammatory diet may increase allergic airway inflammation by affecting innate and adaptive immune responses. OBJECTIVE In this study, we examine the relation between the diet's inflammatory potential, measured by the Dietary Inflammatory Index (DII), and current asthma, current wheeze, and lung function in U.S. children and adults. METHODS We analyzed data from 8,175 children (aged 6-17 years) and 22,294 adults (aged 18-79 years) who participated in the 2007-2012 National Health and Nutrition Examination Survey. The DII was calculated by nutrient intake based on 24-hour dietary recalls, and normalized as per 1,000 calories of food consumed to account for total energy intake. Multivariable regression models were used for the analysis of the DII and current asthma, current wheeze, and lung function measures. RESULTS Higher DII (a proinflammatory diet) was associated with current wheeze among adults (eg, odds ratio [OR] for quartile 4 vs 1, OR = 1.41, 95% confidence interval [CI] = 1.17-1.70; Ptrend < .01) and among children with high fractional exhaled nitric oxide (a marker of eosinophilic airway inflammation; OR = 2.38, 95% CI = 1.13-5.02; Ptrend = .05). The DII also was associated with decreased forced expiratory volume in 1 second and forced vital capacity in adults without asthma or wheezing. The DII was not associated with lung function in children or current asthma in either age group. CONCLUSIONS Our findings suggest that a proinflammatory diet, assessed by the DII, increases the odds of current wheeze in adults and children with allergic (atopic) wheeze. These results further support testing dietary interventions as part of the management of asthma.
Collapse
Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC; College of Nursing, University of South Carolina, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC; Connecting Health Innovations, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
| |
Collapse
|
31
|
Shivappa N, Wirth MD, Murphy EA, Hurley TG, Hébert JR. Association between the Dietary Inflammatory Index (DII) and urinary enterolignans and C-reactive protein from the National Health and Nutrition Examination Survey-2003-2008. Eur J Nutr 2018; 58:797-805. [PMID: 29675557 DOI: 10.1007/s00394-018-1690-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/13/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Enterolignans are important biomarkers of microbiota diversity, with higher levels indicating greater diversity. Diet and inflammation have been shown to play a role in maintaining microbiota diversity. This study examined whether inflammatory potential of diet, as measured by the Dietary Inflammatory Index (DII®) has an impact on levels of urinary enterolignans in the National Health and Nutrition Examination Survey (NHANES) 2003-2008. We also carried out construct validation of the DII with C-reactive protein (CRP). METHODS Data came from NHANES 2003-2008. Enterolignans [enterodiol (END) and enterolactone (ENL)] and CRP were assayed from urine and serum specimens, respectively. Energy-adjusted DII (E-DII) scores were calculated from food intakes assessed using 24-h dietary recalls and expressed per 1000 calories consumed. Associations were examined using survey-based multivariable linear and logistic regression for enterolignans, and logistic regression for CRP. RESULTS After multivariable adjustment, higher E-DII scores (i.e., indicating a relatively more pro-inflammatory diet) were associated with lower levels of creatinine-normalized END [beta coefficient (b)DIIquartile4vs1 = - 1.22; 95% CI = - 0.69, - 1.74; Ptrend ≤ 0.001] and ENL (bDIIquartile4vs1 = - 7.80; 95% CI = - 5.33, - 10.26; Ptrend ≤ 0.001). A positive association was also observed when enterolignans were dichotomized based on the cut-off of the 75th percentile value. In this same sample, the E-DII also was associated with CRP ≥ 3 mg/l (ORDIIcontinuous = 1.12; 95% CI 1.05, 1.19). CONCLUSION In these NHANES data, there was an association between E-DII score and enterolignans. This study also provided construct validation of the E-DII using CRP in a nationally representative sample. The results indicate that dietary inflammatory potential is associated with urinary enterolignans, a potential marker for microbiota diversity. However, studies are required to understand the direct association between DII and microbiota.
Collapse
Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA. .,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA. .,College of Nursing, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,College of Nursing, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC, 29201, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, 29209, USA
| | - Thomas G Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Suite 200, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC, 29208, USA.,Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC, 29201, USA
| |
Collapse
|
32
|
Wirth MD, Sevoyan M, Hofseth L, Shivappa N, Hurley TG, Hébert JR. The Dietary Inflammatory Index is associated with elevated white blood cell counts in the National Health and Nutrition Examination Survey. Brain Behav Immun 2018; 69:296-303. [PMID: 29217263 PMCID: PMC5857420 DOI: 10.1016/j.bbi.2017.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/28/2017] [Accepted: 12/02/2017] [Indexed: 11/29/2022] Open
Abstract
White blood cells (WBCs) are considered a reliable biomarker of inflammation. Elevations in both WBCs and pro-inflammatory cytokines are associated with several chronic conditions. Diet is a strong moderator of inflammation and WBCs. The purpose of this study was to examine the association between the Dietary Inflammatory Index (DII®) and WBCs using data from the United States National Health and Nutrition Examination Survey (NHANES). NHANES is a cross-sectional study that occurs in two-year cycles. Respondents from five cycles (n = 26,046) with available data on diet (collected through a single 24-h dietary recall [24HR]) and WBCs (derived using the Coulter method) were included. The DII (theoretical range is about -8 to +8) was derived from the micro and macronutrients calculated from the 24HR. Linear regression models, using survey design procedures, were used to estimate adjusted mean WBC (i.e., total, lymphocytes, monocytes, and neutrophils) counts and percentages by DII quartiles. Among all participants no statistically significant difference in WBCs were observed when comparing DII quartile 4 (most pro-inflammatory) to quartile 1 (most anti-inflammatory). However, a one-unit increase in the DII was associated with a 0.028 (1000 per µL) increase in total WBCs (p = .01). Additionally, a 0.024 increase in neutrophils (p < .01) was observed for a one-unit increase in the DII. In the group of participants with normal body mass index (BMI, 18.5-24.9 kg/m2), those in DII quartile 4 had higher levels of total WBCs compared to subjects with normal BMI in DII quartile 1 (7.12 vs. 6.88, p = .01). Similar comparisons were observed for monocytes and neutrophils. However, these relationships were not observed for participants who were overweight or obese, which are pro-inflammatory conditions. Normal-weight individuals consuming more pro-inflammatory diets were more likely to have elevated WBCs. Because of its cross-sectional design, NHANES cannot inform directly on temporal relations, thus limiting causal inference. Future research is needed to examine the impact of anti-inflammatory diet adoption on lowering levels of WBCs, in addition to other inflammatory mediators.
Collapse
Affiliation(s)
- Michael D. Wirth
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Maria Sevoyan
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Lorne Hofseth
- University of South Carolina, South Carolina College of Pharmacy, 715 Sumter Street, CLS 513B, Columbia, SC 29208
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Thomas G. Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
| |
Collapse
|
33
|
Assmann KE, Adjibade M, Shivappa N, Hébert JR, Wirth MD, Touvier M, Akbaraly T, Hercberg S, Galan P, Julia C, Kesse-Guyot E. The Inflammatory Potential of the Diet at Midlife Is Associated with Later Healthy Aging in French Adults. J Nutr 2018; 148:437-444. [PMID: 29546305 PMCID: PMC6251567 DOI: 10.1093/jn/nxx061] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/04/2017] [Indexed: 12/14/2022] Open
Abstract
Background While low-grade chronic inflammation has been suggested as a major modulator of healthy aging (HA), no study has yet investigated the link between the inflammatory potential of the diet and multidimensional concepts of HA. Objective We aimed to evaluate the association between the inflammatory potential of the diet at midlife, as measured by the Dietary Inflammatory Index (DII), and HA assessed 13 y later. Methods We analyzed data from 2796 participants in the French Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study aged 45-60 y at baseline (1994-1995) and initially free of diabetes, cardiovascular disease, and cancer. During the trial phase of the study (1994-2002), participants received either a placebo or a daily nutritional dose of antioxidant supplement (120 mg vitamin C, 6 mg β-carotene, 30 mg vitamin E, 100 μg Se, 20 mg Zn). HA was assessed in 2007-2009, and defined as having no major chronic disease, good physical and cognitive functioning, independence in daily activities, no depressive symptoms, good social health, good overall self-perceived health, and no function-limiting pain. The DII was calculated based on repeated baseline 24-h dietary records. Its association with HA was assessed by robust-error-variance Poisson regression, providing RR estimates. Results After adjustment for potential confounders, higher DII scores (reflecting a more proinflammatory diet), were associated with a decreased likelihood of HA: RRtertile 3/tertile 1 = 0.85 (95% CI: 0.74, 0.99); P-trend = 0.03. Secondary analyses revealed that this association was only significant among participants who had been in the placebo group during the trial phase: RRtertile 3/tertile 1 = 0.80 (95% CI: 0.64, 1.00); P-trend = 0.04. Conclusions This study suggests that a proinflammatory diet may lower the probability of overall HA. The SU.VI.MAX trial was registered at www.clinicaltrials.gov as NCT00272428.
Collapse
Affiliation(s)
- Karen E Assmann
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France,Address correspondence to KEA (e-mail: )
| | - Moufidath Adjibade
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France
| | - Nitin Shivappa
- Cancer Prevention and Control Program, and Department of Epidemiology and
Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia,
SC,Connecting Health Innovations LLC, Columbia, SC
| | - James R Hébert
- Cancer Prevention and Control Program, and Department of Epidemiology and
Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia,
SC,Connecting Health Innovations LLC, Columbia, SC
| | - 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,Connecting Health Innovations LLC, Columbia, SC
| | - Mathilde Touvier
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France
| | - Tasnime Akbaraly
- MMDN, Univ. Montpellier, EPHE, INSERM, U1198, Montpellier, France,University College London, Department of Epidemiology and Public Health,
London, United Kingdom
| | - Serge Hercberg
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France,Department of Public Health, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Pilar Galan
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France
| | - Chantal Julia
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France,Department of Public Health, Hôpital Avicenne (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13 University, Nutritional Epidemiology Research Team (EREN),
Epidemiology and Statistics Research Center, U1153 National Institute of Health and Medical
Research (INSERM), U1125 National Institute for Agricultural Research (INRA), National
Conservatory of Arts and Crafts (CNAM), Sorbonne Paris Cité COMUE, Bobigny, France
| |
Collapse
|
34
|
Bergmans RS, Palta M, Robert SA, Berger LM, Ehrenthal DB, Malecki KM. Associations between Food Security Status and Dietary Inflammatory Potential within Lower-Income Adults from the United States National Health and Nutrition Examination Survey, Cycles 2007 to 2014. J Acad Nutr Diet 2018; 118:994-1005. [PMID: 29452975 DOI: 10.1016/j.jand.2017.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/11/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Evidence suggests both that chronic inflammation mediates the association of food insecurity with adverse health outcomes and that diet may be a significant source of inflammation among food insecure individuals. OBJECTIVE To examine whether food security status is associated with dietary inflammatory potential. DESIGN AND PARTICIPANTS Cross-sectional data came from the National Health and Nutrition Examination Survey (NHANES), cycles 2007 to 2014 (n=10,630). The analysis sample is representative of noninstitutionalized US adults with an income-to-poverty ratio ≤3.00. MAIN OUTCOME Dietary Inflammatory Index (DII) score, calculated using the average of two 24-hour dietary recalls, was the main outcome measure. STATISTICAL ANALYSIS Type III F tests or χ2 tests compared population characteristics by food security status, defined using the US Food Security Survey Module. Multivariable linear regression was used to estimate the association between food security status and the DII score and moderation by demographic factors. Survey weighting procedures accounted for the effects of stratification and clustering used in the NHANES study design. RESULTS When accounting for socioeconomic status, demographic factors, and health status, DII score was higher at greater levels of food insecurity (P=0.0033). Those with very low food security had a 0.31 (95% CI=0.12 to 0.49) higher DII score than those with high food security. Age moderated the association between food security status and DII score (interaction P=0.0103), where the magnitude of the association between DII score and severity of food insecurity was higher for those >65 years than for younger age groups. CONCLUSION Food security status may be associated with dietary inflammatory potential, which is hypothesized to play a role in multiple chronic health conditions. Further research is needed to determine the causal nature of this relationship and evaluate how best to implement programs designed to address health disparities within food insecure populations.
Collapse
|
35
|
Shivappa N, Godos J, Hébert JR, Wirth MD, Piuri G, Speciani AF, Grosso G. Dietary Inflammatory Index and Cardiovascular Risk and Mortality-A Meta-Analysis. Nutrients 2018; 10:nu10020200. [PMID: 29439509 PMCID: PMC5852776 DOI: 10.3390/nu10020200] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/29/2018] [Accepted: 02/09/2018] [Indexed: 01/25/2023] Open
Abstract
Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and CVD. Individuals in the highest versus the lowest (reference) DII category showed a 36% increased risk of CVD incidence and mortality, with moderate evidence of heterogeneity (relative risk (RR) = 1.36, 95% confidence interval (CI): 1.19, 1.57; heterogeneity index I2 = 69%, p < 0.001). When analyzed as a continuous variable, results showed an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score. Results remained unchanged when analyses were restricted to the prospective studies. Results of our meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality. In conclusion, a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality. These results further substantiate the utility of DII as tool to characterize the inflammatory potential of diet and to predict CVD incidence and mortality.
Collapse
Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - Justyna Godos
- NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge CB4 0WS, UK.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA.
| | - Gabriele Piuri
- Inflammation Society, 18 Woodlands Park, Bexley DA52EL, UK.
| | | | - Giuseppe Grosso
- NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge CB4 0WS, UK.
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, 95123 Catania, Italy.
| |
Collapse
|
36
|
Zheng J, Tabung FK, Zhang J, Liese AD, Shivappa N, Ockene JK, Caan B, Kroenke CH, Hébert JR, Steck SE. Association between Post-Cancer Diagnosis Dietary Inflammatory Potential and Mortality among Invasive Breast Cancer Survivors in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2018; 27:454-463. [PMID: 29358225 DOI: 10.1158/1055-9965.epi-17-0569] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/10/2017] [Accepted: 01/09/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Inflammation is important in chronic disease and can be modulated by dietary exposures. Our aim was to examine whether the inflammatory potential of diet after cancer diagnosis, assessed using the dietary inflammatory index (DII), is associated with all-cause and cause-specific mortality among women diagnosed with invasive breast cancer in the Women's Health Initiative (WHI).Methods: Our analytic cohort included 2,150 postmenopausal women, ages 50 to 79 years at baseline, who developed invasive breast cancer during follow-up and completed a food frequency questionnaire (FFQ) on average 1.5 years after diagnosis. Women were followed from breast cancer diagnosis until death or the end of follow-up by October 2014. Energy-adjusted DII (E-DII) scores were calculated from food plus supplements using a nutrient-density approach. Cox proportional hazards models were fit to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, breast cancer-specific, and cardiovascular disease (CVD) mortality.Results: After a median 13.3 years of follow-up, 580 deaths from any cause occurred, including 212 breast cancer deaths and 103 CVD deaths. Lower (i.e., more anti-inflammatory) E-DII scores were associated with a lower risk of CVD mortality (HRQ1VSQ4 = 0.44; 95% CI, 0.24-0.82; Ptrend = 0.005), but not with breast cancer-specific mortality (HRQ1VSQ4 = 0.96; 95% CI, 0.62-1.49; Ptrend = 0.96) or all-cause mortality (HRQ1VSQ4 = 0.82; 95% CI, 0.63-1.05; Ptrend = 0.17).Conclusions: Consuming a more anti-inflammatory diet after breast cancer diagnosis may be a means for reducing risk of death from CVD.Impact: Survival after invasive breast cancer diagnosis may be improved by consumption of an anti-inflammatory diet. Cancer Epidemiol Biomarkers Prev; 27(4); 454-63. ©2018 AACR.
Collapse
Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Fred K Tabung
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina.,Connecting Health Innovations, LLC, Columbia, South Carolina
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Bette Caan
- Kaiser Permanente Northern California, Division of Research, Oakland, California
| | - Candyce H Kroenke
- Kaiser Permanente Northern California, Division of Research, Oakland, California
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina.,Connecting Health Innovations, LLC, Columbia, South Carolina
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. .,Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
37
|
Utilizing Dietary Micronutrient Ratios in Nutritional Research May be More Informative than Focusing on Single Nutrients. Nutrients 2018; 10:nu10010107. [PMID: 29351249 PMCID: PMC5793335 DOI: 10.3390/nu10010107] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/13/2018] [Accepted: 01/16/2018] [Indexed: 12/17/2022] Open
Abstract
The 2015 US dietary guidelines advise the importance of good dietary patterns for health, which includes all nutrients. Micronutrients are rarely, if ever, consumed separately, they are not tissue specific in their actions and at the molecular level they are multitaskers. Metabolism functions within a seemingly random cellular milieu however ratios are important, for example, the ratio of adenosine triphosphate to adenosine monophosphate, or oxidized to reduced glutathione. Health status is determined by simple ratios, such as the waist hip ratio, or ratio of fat mass to lean mass. Some nutrient ratios exist and remain controversial such as the omega-6/omega-3 fatty acid ratio and the sodium/potassium ratio. Therefore, examining ratios of micronutrients may convey more information about how diet and health outcomes are related. Summarized micronutrient intake data, from food only, from the National Health and Nutrition Examination Survey, were used to generate initial ratios. Overall, in this preliminary analysis dietary ratios of micronutrients showed some differences between intakes and recommendations. Principles outlined here could be used in nutritional epidemiology and in basic nutritional research, rather than focusing on individual nutrient intakes. This paper presents the concept of micronutrient ratios to encourage change in the way nutrients are regarded.
Collapse
|
38
|
Abstract
Evidence supporting the role of nutrition in heart failure (HF) incidence and severity is growing. A comprehensive search of online databases was conducted using relevant keywords to identify human studies including diet and HF. Several plant-based diets have consistently been associated with decreased HF incidence and severity, notably the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets. Several other plant-based dietary patterns, including low-fat diets and the rice diet, also show promise. Higher dietary quality, as assessed using different scores, seems to provide protective qualities. Fruit, vegetables, legumes and wholegrains appear to be beneficial, whereas red/processed meats, eggs and refined carbohydrates appear harmful. Some evidence suggests detrimental effects of dairy products and poultry, but more research is needed. There is observational and interventional evidence that a plant-based diet high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans fats may decrease the incidence and severity of HF. Potential mechanisms for this include decreased oxidative stress, homocysteine and inflammation levels, as well as higher antioxidant defence and nitric oxide bioavailability with gut microbiome modulation. Well-designed randomised, controlled nutrition intervention trials specific to HF are urgently required.
Collapse
Affiliation(s)
- Conor P Kerley
- Chronic Cardiovascular Disease Management Unit and Heart Failure Unit, St Vincent's Healthcare Group/St Michael's Hospital Dublin, Ireland
| |
Collapse
|
39
|
Camargo-Ramos CM, Correa-Bautista JE, Correa-Rodríguez M, Ramírez-Vélez R. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1104. [PMID: 28984835 PMCID: PMC5664605 DOI: 10.3390/ijerph14101104] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 09/15/2017] [Accepted: 09/21/2017] [Indexed: 01/22/2023]
Abstract
Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore (p < 0.05). A lower DII score was inversely correlated with plasma triglyceride levels (r = -0.354, p < 0.05), glucose (r = -0.422, p < 0.05), MetScore (r = -0.228, p < 0.05), and PWV (r = -0.437, p < 0.05), and positively with FMD (r = 0.261, p < 0.05). In contrast, a higher DII score (pro-inflammatory diet) showed a positive relationship with MetScore (r = 0.410, p < 0.05) and a negative relationship with FMD (r = -0.233, p < 0.05). An increased inflammatory potential of diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD.
Collapse
Affiliation(s)
- Claudia Marcela Camargo-Ramos
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - María Correa-Rodríguez
- Departamento de Enfermería, Facultad de Ciencias de la Salud Avda, De la Ilustración, s/n, (18016), Universidad de Granada, Granada 18071, Spain.
| | - Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| |
Collapse
|
40
|
Zhong X, Guo L, Zhang L, Li Y, He R, Cheng G. Inflammatory potential of diet and risk of cardiovascular disease or mortality: A meta-analysis. Sci Rep 2017; 7:6367. [PMID: 28744020 PMCID: PMC5527022 DOI: 10.1038/s41598-017-06455-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/12/2017] [Indexed: 12/16/2022] Open
Abstract
Inconsistent findings have reported on the inflammatory potential of diet and cardiovascular disease (CVD) and mortality risk. The aim of this meta-analysis was to investigate the association between the inflammatory potential of diet as estimated by the dietary inflammatory index (DII) score and CVD or mortality risk in the general population. A comprehensive literature search was conducted in PubMed and Embase databases through February 2017. All prospective observational studies assessing the association of inflammatory potential of diet as estimated by the DII score with CVD and all-cause, cancer-related, cardiovascular mortality risk were included. Nine prospective studies enrolling 134,067 subjects were identified. Meta-analyses showed that individuals with the highest category of DII (maximal pro-inflammatory) was associated with increased risk of all-cause mortality (hazard risk [HR] 1.22; 95% confidence interval [CI] 1.06-1.41), cardiovascular mortality (RR 1.24; 95% CI 1.01-1.51), cancer-related mortality (RR 1.28; 95% CI 1.04-1.58), and CVD (RR 1.32; 95% CI 1.09-1.60) than the lowest DII score. More pro-inflammatory diets, as estimated by the higher DII score are independently associated with an increased risk of all-cause, cardiovascular, cancer-related mortality, and CVD in the general population, highlighting low inflammatory potential diet may reduce mortality and CVD risk.
Collapse
Affiliation(s)
- Xiaoming Zhong
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Lin Guo
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Lei Zhang
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Yanming Li
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Ruili He
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Guanchang Cheng
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China.
| |
Collapse
|
41
|
Babatunde OA, Adams SA, Wirth MD, Eberth JM, Sofge J, Choi SK, Harmon BE, Davis L, Drayton R, Hurley TG, Brandt HM, Armstead CA, Hébert JR. Predictors of Retention among African Americans in a Randomized Controlled Trial to Test the Healthy Eating and Active Living in the Spirit (HEALS) Intervention. Ethn Dis 2017; 27:265-272. [PMID: 28811738 DOI: 10.18865/ed.27.3.265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Retention of racial/ethnic minority groups into research trials is necessary to fully understand and address health disparities. This study was conducted to identify participants' characteristics associated with retention of African Americans (AAs) in a randomized controlled trial (RCT) of a behavioral intervention. METHODS Using data from an RCT conducted from 2009 to 2012 among AAs, participant-level factors were examined for associations with retention between three measurement points (ie, baseline, 3-month, and 12-month). Chi-square tests and logistic regression analyses were conducted to compare retained participants to those who were not retained in order to identify important predictors of retention. RESULTS About 57% of participants (n=238) were retained at 12 months. Baseline characteristics that showed a statistically significant association with retention status were age, marital status, body mass index (BMI), intervention group, enrollment of a partner in the study, and perceived stress score (PSS). Multivariable logistic regression that adjusted for age, BMI, and PSS showed the odds of being retained among participants who enrolled with a partner was 2.95 (95% CI: 1.87-4.65) compared with participants who had no study partner enrolled. The odds of being retained among participants who were obese and morbidly obese were .32 and .27 (95% CI: .14-.74 and .11-.69), respectively, compared with participants who had normal weight. CONCLUSION Having a partner enrolled in behavioral interventions may improve retention of study participants. Researchers also need to be cognizant of participants' obesity status and potentially target retention efforts toward these individuals.
Collapse
Affiliation(s)
- Oluwole A Babatunde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Swann Arp Adams
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,College of Nursing, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Jameson Sofge
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Seul Ki Choi
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Brook E Harmon
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN
| | - Lisa Davis
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Ruby Drayton
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Thomas G Hurley
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Heather M Brandt
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Cheryl A Armstead
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC.,Department of Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC
| |
Collapse
|
42
|
Vissers LET, Waller M, van der Schouw YT, Hébert JR, Shivappa N, Schoenaker DAJM, Mishra GD. A pro-inflammatory diet is associated with increased risk of developing hypertension among middle-aged women. Nutr Metab Cardiovasc Dis 2017; 27:564-570. [PMID: 28446366 DOI: 10.1016/j.numecd.2017.03.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS A pro-inflammatory diet is thought to lead to hypertension through oxidative stress and vessel wall inflammation. We therefore investigated the association between the dietary inflammatory index (DII) and developing hypertension in a population-based cohort of middle-aged women. METHODS AND RESULTS The Australian Longitudinal Study on Women's Health included 7169 Australian women, aged 52 years (SD 1 year) at baseline in 2001, who were followed up through 4 surveys until 2013. The DII, a literature-derived dietary index that has been validated against several inflammatory markers, was calculated based on data collected via a validated food-frequency questionnaire administered at baseline. Hypertension was defined as new onset of doctor-diagnosed hypertension, ascertained through self-report between 2001 and 2013. Generalised Estimating Equation analyses were used to investigate the association between the DII and incident hypertension. The analyses were adjusted for demographic and hypertension risk factors. During 12-years follow-up we identified 1680 incident cases of hypertension. A more pro-inflammatory diet was associated with higher risk of hypertension in dichotomised analyses with an ORfully adjusted of 1.24, 95% CI: 1.06-1.45. CONCLUSION A pro-inflammatory diet might lead to a higher risk of developing hypertension. These results need to be replicated in other studies.
Collapse
Affiliation(s)
- L E T Vissers
- The University of Queensland, School of Public Health, Brisbane, Australia; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Waller
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations, LLC, Columbia, SC 29201, USA
| | - N Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations, LLC, Columbia, SC 29201, USA
| | - D A J M Schoenaker
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - G D Mishra
- The University of Queensland, School of Public Health, Brisbane, Australia.
| |
Collapse
|
43
|
Wirth MD, Shivappa N, Burch JB, Hurley TG, Hébert JR. The Dietary Inflammatory Index, shift work, and depression: Results from NHANES. Health Psychol 2017; 36:760-769. [PMID: 28557499 DOI: 10.1037/hea0000514] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Abnormal physiology (e.g., inflammation), brought on by environmental exposures (e.g., diet or shift work [SW]), can affect numerous bodily systems, including the brain, and may be associated with depressive symptomatology. The study examined the associations between SW and depressive symptoms and diet-related inflammation (estimated by the Dietary Inflammatory Index [DII]) and depressive symptoms. Additionally, diet was examined as a mediator between SW and depressive symptoms. METHOD Data were obtained from the U.S. National Health and Nutrition Examination Survey (Centers for Disease Control and Prevention, 2013). SW data were based on self-report. Dietary data were collected using 24-hr dietary recalls for DII calculation. Depressive symptoms were defined using a cut-point of 10 (moderate) on the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to estimate odds ratios and 95% confidence intervals (95% CI) for depressive symptoms by SW and DII quartiles. RESULTS DII scores were associated with depressive symptoms among women. Women in DII quartile 4 were 30% more likely to report depressive symptoms than women in quartile 1 (95% CI [1.00-1.68]). There was no association between symptoms and SW when using a PHQ-9 cut-point of 10. When using a cut-point of 5 (mild depressive symptoms), those working any form of SW were more likely to suffer from mild symptoms than day workers (odds ratio = 1.22; 95% CI [1.04-1.43]). There was some evidence for mediation by the DII between SW and depressive symptoms. CONCLUSIONS Future longitudinal studies should examine effects of reductions in inflammation through diet on depressive symptoms, especially among shift workers, to elucidate the role of diet on depression among these groups. (PsycINFO Database Record
Collapse
Affiliation(s)
- Michael D Wirth
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina
| | - James B Burch
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina
| | - Thomas G Hurley
- Cancer Prevention and Control Program, University of South Carolina
| | - James R Hébert
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina
| |
Collapse
|
44
|
Harmon BE, Wirth MD, Boushey CJ, Wilkens LR, Draluck E, Shivappa N, Steck SE, Hofseth L, Haiman CA, Le Marchand L, Hébert JR. The Dietary Inflammatory Index Is Associated with Colorectal Cancer Risk in the Multiethnic Cohort. J Nutr 2017; 147:430-438. [PMID: 28179489 DOI: 10.3945/jn.116.242529] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/03/2016] [Accepted: 01/09/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Diet is known to influence systemic inflammation, a recognized risk factor for colorectal cancer (CRC). Studies in ethnically diverse populations that examine the association between dietary inflammatory potential and CRC incidence are limited.Objectives: We used the Dietary Inflammatory Index to clarify the relation between the inflammatory potential of diet and CRC incidence across racial/ethnic groups. We hypothesized that proinflammatory diets would be associated with an increased risk of CRC, and that these associations may differ across racial/ethnic groups.Methods: The Multiethnic Cohort (MEC) follows a prospective study design. It includes 190,963 white, African-American, native Hawaiian, Japanese-American, and Latino men and women aged 45-75 y at recruitment and followed over 20 y. Participants completed a food frequency questionnaire from which energy-adjusted Dietary Inflammatory Index (E-DII) scores were computed and categorized into quartiles. CRC incidence was documented through linkage to cancer registry programs. Cox proportional hazards regression was used to estimate HRs and 95% CIs, adjusting for known or expected CRC risk factors.Results: Among all participants, more-proinflammatory diets (highest quartile compared with lowest quartile) were associated with an increased risk of CRC (HR: 1.21; 95% CI: 1.11, 1.32). However, the effect size was larger for men (HR: 1.28; 95% CI: 1.13, 1.45) than for women (HR: 1.16; 95% CI: 1.02, 1.33), although the interaction term for sex was not statistically significant (P-interaction = 0.17). When stratified by race/ethnicity, the association was significantly different between groups for men (P-interaction = 0.01), although not for women (P-interaction = 0.20). Significant associations with HRs ranging from 2.33 to 1.04 were observed in white, Japanese-American, and Latino men, and native Hawaiian women.Conclusions: Overall, more-proinflammatory diets, as identified by the E-DII, were associated with increased CRC risk in MEC participants across racial/ethnic groups. This study adds to the evidence suggesting that diets with high proinflammatory potential may increase CRC risk.
Collapse
Affiliation(s)
- Brook E Harmon
- School of Public Health, University of Memphis, Memphis, TN;
| | - Michael D Wirth
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | | | - Emma Draluck
- School of Public Health, University of Memphis, Memphis, TN
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Susan E Steck
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Lorne Hofseth
- South Carolina College of Pharmacy, University of South Carolina, Columbia, SC; and
| | - Christopher A Haiman
- Cancer Center, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| | | | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC
| |
Collapse
|
45
|
Gambardella J, Santulli G. Integrating diet and inflammation to calculate cardiovascular risk. Atherosclerosis 2016; 253:258-261. [PMID: 27594541 DOI: 10.1016/j.atherosclerosis.2016.08.041] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 08/26/2016] [Indexed: 10/21/2022]
|
46
|
Ruiz-Canela M, Bes-Rastrollo M, Martínez-González MA. The Role of Dietary Inflammatory Index in Cardiovascular Disease, Metabolic Syndrome and Mortality. Int J Mol Sci 2016; 17:E1265. [PMID: 27527152 PMCID: PMC5000663 DOI: 10.3390/ijms17081265] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/15/2016] [Accepted: 07/28/2016] [Indexed: 02/06/2023] Open
Abstract
Inflammation is an underlying pathophysiological process in chronic diseases, such as obesity, type 2 diabetes mellitus and cardiovascular disease. In fact, a number of systematic reviews have shown the association between inflammatory biomarkers, such as CRP, IL-1β, IL-6, TNF-α, IL-4, or IL-10, and cardio-metabolic diseases. Diet is one of the main lifestyle-related factors which modulates the inflammatory process. Different individual foods and dietary patterns can have a beneficial health effect associated with their anti-inflammatory properties. The dietary inflammatory index (DII) was recently developed to estimate the inflammatory potential of overall diet. The aim of this review is to examine the findings of recent papers that have investigated the association between the DII, cardio-metabolic risk factors and cardiovascular disease. The relevance of the DII score in the association between inflammation and cardio-metabolic diseases is critically appraised, as well as its role in the context of healthy dietary patterns. We conclude that the DII score seems to be a useful tool to appraise the inflammatory capacity of the diet and to better understand the relationships between diet, inflammation, and cardio-metabolic diseases.
Collapse
Affiliation(s)
- Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona 31008, Spain.
- IDISNA (Navarra Health Research Institute), Pamplona 31008, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona 31008, Spain.
- IDISNA (Navarra Health Research Institute), Pamplona 31008, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona 31008, Spain.
- IDISNA (Navarra Health Research Institute), Pamplona 31008, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid 28029, Spain.
| |
Collapse
|