A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein

Improvement of chronic metabolic inflammation and regulation of gut homeostasis: Tea as a potential therapy

Chronic metabolic inflammation is a common mechanism linked to the development of metabolic disorders such as obesity, diabetes, and cardiovascular disease (CVD). Chronic metabolic inflammation often related to alterations in gut homeostasis, and pathological processes involve the activation of endotoxin receptors, metabolic reprogramming, mitochondrial dysfunction, and disruption of intestinal nuclear receptor activity. Recent investigations into homeostasis and chronic metabolic inflammation have revealed a novel mechanism which is characterized by a timing interaction involving multiple components and targets. This article explores the positive impact of tea consumption on metabolic health of populations, with a special focus on the improvement of inflammatory indicators and the regulation of gut microbiota. Studies showed that tea consumption is related to the enrichment of gut microbiota. The relative proportion of Firmicutes/Bacteroidetes (F/B) is altered, while the abundance of Lactobacillus, Bifidobacterium, and A. muciniphila increased significantly in most of the studies. Thus, tea consumption could provide potential protection from the development of chronic diseases by improving gut homeostasis and reducing chronic metabolic inflammation. The direct impact of tea on intestinal homeostasis primarily targets lipopolysaccharide (LPS)-related pathways. This includes reducing the synthesis of intestinal LPS, inhibiting LPS translocation, and preventing the binding of LPS to TLR4 receptors to block downstream inflammatory pathways. The TLR4/MyD88/NF-κB p65 pathway is crucial for anti-metaflammatory responses. The antioxidant properties of tea are linked to enhancing mitochondrial function and mitigating mitochondria-related inflammation by eliminating free radicals, inhibiting NLRP3 inflammasomes, and modulating Nrf2/ARE activity. Tea also contributes to safeguarding the intestinal barrier through various mechanisms, such as promoting the synthesis of short-chain fatty acids in the intestine, activating intestinal aryl hydrocarbon receptor (AhR) and farnesoid X receptor (FXR), and improving enteritis. Functional components that improve chronic metabolic inflammation include tea polyphenols, tea pigments, TPS, etc. Tea metabolites such as 4-Hydroxyphenylacetic acid and 3,4-Dihydroxyflavan derivatives, etc., also contribute to anti-chronic metabolic inflammation effects of tea consumption. The raw materials and processing technologies affect the functional component compositions of tea; therefore, consuming different types of tea may result in varying action characteristics and mechanisms. However, there is currently limited elaboration on this aspect. Future research should conduct in-depth studies on the mechanism of tea and its functional components in improving chronic metabolic inflammation. Researchers should pay attention to whether there are interactions between tea and other foods or drugs, explore safe and effective usage and dosage, and investigate whether there are individual differences in the tea-drinking population leading to different effects of tea intervention. Ultimately, the application of tea drinking could be a universal therapy for regulating intestinal homeostasis, anti-chronic metabolic inflammatory responses, and promoting metabolic health.

Dietary Relationships between Obesity and Inflammatory Bowel Diseases: A Narrative Review of Diets Which May Promote Both Diseases

PURPOSE OF REVIEW

The pandemic of obesity preceded global spread of Inflammatory Bowel diseases by almost 2 decades. A pathogenic relationship has been described between obesity and inflammatory bowel diseases, but Crohn`s disease may be selectively impacted. The role of diet in pathogenesis has also gained significant support in the last few decades. This review explores dietary relationships to account for epidemiological observations. Quantifiable indices for diets have been described including a glycemic index, inflammatory indices and levels of food processing. Meta-analyses have been published which examine each for effects on obesity and co-morbidities as well as Crohn's disease and ulcerative colitis. This review suggests that ultra-processed foods provide the best link between obesity and Crohn's disease explaining epidemiological observations. However, the other 2 types of dietary indices likely contribute to ulcerative colitis as well as to co-morbidities related to both obesity and inflammatory bowel diseases. The term ultra-processed foods cover a large number of additives and extensive work is needed to define individual or combined harmful effects. Furthermore, the interactions among the 3 main indices need clarification in order to precisely apply therapeutic diets to both diseases (obesity and inflammatory bowel disease).

Exploring the association between dietary inflammatory index (DII) and different types of skin cancer: a cross-sectional study from NHANES 1999-2018

BACKGROUND

The potential role of diet-related inflammatory responses in skin carcinogenesis is gaining increasing recognition. This study investigated the association between the Dietary Inflammatory Index (DII) and different types of skin cancer in the United States general population.

METHODS

The study analyzed cross-sectional data on 45,409 participants in the 1999-2018 National Health and Nutrition Examination Survey (NHANES). The association between the DII and different types of skin cancer was estimated using weighted multivariable logistic regression, and its non-linearity was examined using restricted cubic spline (RCS) regression. Subgroup analyses were stratified by age, sex, race, body mass index, hypertension status, diabetes status, and frequency of skin-protecting behaviors.

RESULTS

The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for melanoma were 1.54 (1.02-2.35), 1.67 (1.02-2.73), and 1.55 (0.86-2.80) for the second, third, and fourth DII quartiles, respectively, compared with the first quartile. The adjusted ORs with 95% CIs for non-melanoma skin cancer (NMSC) were 0.90 (0.68-1.19), 0.96 (0.69-1.35), and 1.01 (0.70-1.45) for the second, third, and fourth DII quartiles, respectively, compared with the first quartile. The RCS curves showed no overall or non-linear significant association between DII and melanoma prevalence (P = 0.240, Pnon-linearity = 0.144) or NMSC (P = 0.068, Pnon-linearity = 0.410).

CONCLUSION

This study suggests that Compared with participants in DII quartile 1, those in DII quartiles 2 and 3 had a significantly increased risk of melanoma, whereas those in quartile 4 did not. These findings underscore the potential role of dietary inflammation in melanoma etiology and highlight the importance of further research to better understand and mitigate this risk factor.

Predictive role of the dietary inflammatory index on stroke risk among hypertensive patients

This study aims to evaluate the association between the dietary inflammatory index (DII) and stroke risk in hypertensive patients. Data were sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2020, including 23,712 hypertensive patients. DII scores were calculated based on dietary intake data, and stroke diagnoses were determined through self-reported physician diagnoses. The relationship between DII and stroke risk was assessed using multivariable logistic regression models. Dose-response relationships and subgroup differences were explored through stratified analysis and restricted cubic spline (RCS) methods. Key dietary factors associated with stroke were identified using least absolute shrinkage and selection operator (LASSO) regression and incorporated into a risk prediction nomogram model. The model's discriminatory ability for stroke was evaluated using receiver operating characteristic (ROC) curves. After adjusting for confounding factors, the highest DII quartile was associated with an adjusted odds ratio (OR) of 1.44 (95% CI 1.19, 1.74) for stroke compared to the lowest quartile, and each unit increase in DII was associated with an OR of 1.08 (95% CI 1.04-1.13) for stroke prevalence. The RCS curve demonstrated a nonlinear relationship between DII and stroke, with a turning point at 0.29. The nomogram model based on key dietary factors identified by LASSO regression had an area under the curve (AUC) of 70.93% (95% CI 69.81%-72.06%). There is a nonlinear relationship between DII and stroke risk in hypertensive patients. Given the inherent limitations of a cross-sectional study design, further research is needed to establish causality.

Association of Dietary Inflammatory Potential with Inflammatory Biomarkers in Brazilian Children: The Role of Obesity Status in the South American Youth/Child Cardiovascular and Environmental (SAYCARE) Study

Background: The objective of this study was to test the association of Pro-Inflammatory/Anti-Inflammatory Food Intake Score (PAIFIS) and inflammatory biomarkers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 levels in a sample of Brazilian children. Methods: This cross-sectional study included children aged 5-8 years. Levels of inflammatory biomarkers and habitual food intake were measured using a quantitative food frequency questionnaire (FFQ) to estimate PAIFIS and anthropometric and socioeconomic data. The Mann-Whitney test, Spearman's correlation test, and nonparametric regression models with Kernel effects were used for analysis. Results: PAIFIS showed an association with increased TNF-α in the univariate analysis [β = 0.53, 95% confidence interval (CI) 0.05-1.15] and the multivariate analysis adjusted for the sum of skinfolds (ΣSF) and income (β = 0.31, 95% CI 0.00-1.11). ΣSF was associated with an increase in TNF-α (β = 15.0, 95% CI 3.16-36.1) and CRP (β = 0.013, 95% CI 0.004-0.022). Conclusions: The PAIFIS shows a positive association with TNF-α. Adiposity was also identified as an important risk factor for inflammation.

Effects of the Energy-Adjusted Dietary Inflammation Index During Pregnancy on Prenatal Depression: The Mediating Effect of Sleep Quality

(1) Background: Prenatal depression is prevalent and can adversely affect maternal and infant health. This study aimed to analyze the relationship between the energy-adjusted dietary inflammatory index (E-DII) and prenatal depression, as well as to explore the mediating effect of sleep quality. (2) Methods: In this cross-sectional study, a total of 749 pregnant women were enrolled. The E-DII scores were evaluated using semi-quantitative Food Frequency Questionnaires (FFQ); the Edinburgh Postpartum Depression Scale (EPDS) was used to measure depression levels; and the Pittsburgh Sleep Quality Index (PSQI) to evaluate the sleep quality of pregnant women. Binary logistic regression analysis was employed to analyze the relationships of E-DII with prenatal depression, of E-DII with sleep quality, and of sleep quality with prenatal depression. The bootstrap approach was employed to investigate the mediating effect of sleep quality. (3) Results: Findings indicated that a higher E-DII score was significantly associated with an increased risk of prenatal depression compared to the lowest score, and this association still existed after adjusting for sleep quality. In addition, the lowest E-DII score was also associated with a lower risk of poor sleep quality. Sleep quality played a partial mediating role in the association between E-DII and prenatal depression, and the proportion of the mediation effect relative to the total effect was 34.30%. (4) Conclusions: Sleep quality partially mediated the association between E-DII and prenatal depression. Close monitoring and proactive improvement of sleep quality among pregnant women following a pro-inflammatory diet may help reduce the risk of developing prenatal depression.

The relationship between dietary inflammatory index in adults and coronary heart disease: from NHANES 1999-2018

Background

Previous studies have shown that pro-inflammatory diets increase the risk of coronary heart disease (CHD) and all-cause mortality. The dietary inflammatory index (DII) is a quantitative measure of dietary inflammation, and its accuracy has been validated by several studies.

Methods

This study included 43,842 participants aged ≥18 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The data of CHD was obtained through a questionnaire survey, and the DII was calculated using 24-h dietary recall data. Generalized linear models and logistic regression were used to determine the mediation factors, and subgroup analyses were conducted to evaluate the interaction between DII and CHD. Mean decrease in Gini (MDG) was used to determine the importance of individual dietary components.

Results

The age of the participants was 49.81 ± 18.10 years, with 20,793 (47.4%) being male. A total of 1,892 (4.3%) participants were diagnosed with CHD, and the median DII score was 1.33 (0.11, 2.40). After adjusting for potential confounders, logistic regression analysis revealed that DII independently associated with CHD [OR: 1.049 (1.012-1.087), p = 0.008]. Triglyceride-glucose index, visceral adiposity index, body mass index, waist-to-height ratio, high-density lipoprotein, and glomerular filtration rate (all p < 0.05) may mediate the relationship between DII and CHD. Subgroup analyses showed that DII was more sensitive in participants aged <75 years (p < 0.001), females (p = 0.028), those with low cholesterol levels (p = 0.004), and individuals with low Framingham risk scores (p = 0.005). MDG analysis indicated that carbohydrate, vitamin C and iron intake have the greatest impact on CHD.

Conclusion

This study suggests that various metabolic and lipid indicators play a mediating role in the relationship between DII and CHD. DII may have a greater adverse impact on traditional low-risk CHD populations.

Associations of dietary inflammatory indices (DII and E-DII) with sperm parameters

OBJECTIVE

This study aimed to explore the ambiguous link between dietary inflammatory indices and sperm parameters. Specifically, it investigated the associations between the dietary inflammatory index (DII) and the energy-adjusted dietary inflammatory index (E-DII) with sperm motility, morphology, and count in men undergoing routine semen analysis.

METHODS

A cross-sectional study was conducted with 144 men enrolled, where semen samples were collected and evaluated according to the 2010 World Health Organization guidelines. Dietary data were gathered using a 147-item semi-quantitative food frequency questionnaire developed by the researchers. Pearson correlation analysis was employed to assess the relationships of the DII and E-DII with sperm parameters.

RESULTS

The mean DII and E-DII scores were 1.23±1.1 and 0.49±0.43, respectively. The mean values for sperm motility, morphology, and count were 43.08%±19.30%, 78.03%±26.99%, and 48.12±44.41 million, respectively. Both motility (r=-0.353) and count (r=-0.348) were found to be inversely and significantly correlated with DII. Similarly, Pearson correlation tests revealed strong and significant inverse correlations of motility (r=-0.389) and count (r=-0.372) with E-DII.

CONCLUSION

The findings suggest that a diet with a higher anti-inflammatory potential may be associated with increased sperm count and motility, but not with changes in morphology. Further research is necessary to confirm these findings, elucidate the underlying mechanisms, and identify dietary modifications that could improve male fertility.

Dietary inflammatory index predicts cancer mortality in male patients but not female patients: Results from NHANES 1999 to 2014

This study explored sex differences between dietary inflammatory index (DII) and cancer prognosis and their mechanisms. We hypothesized that association between dietary inflammatory index and cancer prognosis differs by sex. The study included 2874 adults with cancer from the National Health and Nutrition Examination Survey covering 1999 to 2014. Mortality status was linked to National Death Index mortality data through 31 December 2019. Cox proportional hazards regression models were applied to calculate hazard risk and 95% confidence intervals (Cis) in male patients and female patients. Sex-specific cancer and nonsex-specific cancer subgroup analyses were performed, and the role of C-reactive protein in sex differences was analyzed. The Cancer Genome Atlas pan-cancer transcriptome data were combined to explore the biological mechanisms of the sex differences. Multivariate Cox regression showed higher DII in male patients correlated with increased all-cause mortality (hazard risk highest vs lowest quartile = 1.57 [95% confidence intervals 1.24-1.98]; P for trend <.01), but not in female patients (P = .44). For sex-specific cancers, higher DII potentially correlated with increased mortality in prostate cancer (unadjusted P for trend = .04), but not in breast (P = .83), ovarian (P = .49), or cervical cancers (P = .91). In melanoma and colon cancer, higher DII correlated with increased mortality in male patients but not female patients. Serum C-reactive protein, interleukin-1 binding, interleukin-35 pathway, and programmed cell death protein 1 pathway may contribute to these sex differences. In conclusion, sex differences exist between DII and mortality risk in cancer patients.

The relationship between red blood cell distribution width and long-term prognosis of asthma: a population-based study

Statistically, 30% of asthma deaths occur among asthmatics with insignificant symptoms, which creates a social burden. We aimed to analyze the role of erythrocyte distribution width (RDW) in the prognosis of asthma, especially in patients with insignificant symptoms. We included 3039 adult (≥ 20 years) asthma patients from the National Health and Nutrition Examination Survey (NHANES). Cox regression was used to assess the association between RDW and long-term mortality. We adjusted three models to reduce potential bias. Subgroup analysis is used to evaluate specific populations. In addition, receiver operating characteristic (ROC) curves were used to analyze the predictive effect of RDW on asthma mortality. After a mean follow-up of 130 months, we found a positive correlation between RDW and long-term mortality. After aliquoting RDW into thirds, the high RDW (RDW ≥ 13.0%) group had higher all-cause mortality (HR 1.66, 95% CI 1.18-2.34) and respiratory mortality (HR 8.69, 95% CI 2.03-37.3). There was a significant interaction of RDW in the male and wheezing subgroups for respiratory mortality. Combining RDW and wheezing, we found that patients with high RDW and wheezing had the most increased respiratory mortality, and patients with high RDW but no wheezing also had higher mortality. Furthermore, the area under the curve of the RDW in predicting respiratory death in asthmatics was greater than 80%. Our study showed an association between high RDW and poor prognosis in asthma patients. In combination with wheezing symptoms, RDW is expected to be a biomarker for asthma management.

The association between dietary inflammatory index and anemia in individuals with diabetes mellitus

Background

Diabetes mellitus (DM) has emerged as a significant component of the global health crisis, closely linked with anemia. Studies have demonstrated a connection between anemia and inflammation. The Dietary Inflammatory Index (DII) is a novel metric for evaluating the overall inflammatory or anti-inflammatory impact of dietary intake. While risk factors for DM are linked to an unhealthy diet, there is currently insufficient research regarding the correlation between DII and anemia among individuals with DM. This study aims to investigate the correlation between DII and anemia among American individuals with DM.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) database, encompassing 4,435 participants recorded between 2007 and 2016. We conducted a weighted multivariable logistic regression analysis to investigate the correlation between the DII and anemia of individuals with DM. Furthermore, we explored their relationship through subgroup analysis and smooth curve fitting techniques.

Results

This study comprised 726 participants with DM who were anemic and 3,709 who were non-anemic; notably, anemic participants exhibited elevated DII scores (2.05 ± 1.50 vs. 1.70 ± 1.59). In the fully adjusted model, we noted a positive correlation between the DII and anemia (Odds Ratio [OR] = 1.09, 95% Confidence Interval [CI] =1.03 to 1.16, p = 0.004). Participants in the fully adjusted model had a 9% higher prevalence of anemia for each unit increase in DII. The significant association between anemia and DII persisted even after subgroup analysis. Smooth curve fitting analysis revealed a positive correlation between DII and anemia.

Conclusion

There is a positive correlation between DII and anemia in individuals with DM in the United States. It provides important insights into dietary management strategies for diabetic patients with anemia.

Association between dietary inflammation index and herpes simplex virus I and II: A cross-sectional study

INTRODUCTION

We aimed to fill the research gap between DII and herpes simplex virus infection among adults in the US by analyzing the association between dietary inflammatory index and herpes simplex virus and to provide new ideas for herpes simplex virus prevention and treatment.

METHOD

We used data from 8636 participants in NHANES 2007-2016, which were statistically analyzed by participant baseline study, one-way analysis of variance, multiple regression equations, smoothed curve fitting, and stratified analysis.

RESULT

In the fully adjusted model, the DII high concentration group was positively associated with the prevalence of herpes simplex (1.15 (0.89, 1.48), p = 0.0027), and the results of the stratified analyses indicated that the positive association between DII and herpes simplex virus type II was stable in the population.

CONCLUSION

This study demonstrates a positive association between DII and herpes simplex virus II in US adults, suggesting that a proinflammatory diet may be an independent risk factor for herpes simplex virus II.

The role of dietary inflammation in the risk of osteoporosis in Iranian postmenopausal women: a case-control study

Chronic inflammation is known to play a critical role in the development of various diseases, such as osteoporosis. The inflammatory potential of a diet can be evaluated using a well-established scale known as the Dietary Inflammatory Index (DII). This study aimed to investigate the relationship between the DII score and the odds of osteoporosis in Iranian women. The study conducted was a case-control study involving 131 postmenopausal healthy women, as well as 131 women with osteoporosis and osteopenia aged 45-65. Osteoporosis was diagnosed through dual-energy X-ray absorptiometry, which measures bone mineral density (BMD) in the femoral neck bone and lumbar spine. To assess the DII score, a validated semi-quantitative food frequency questionnaire was applied. In comparison to the first tertile of DII score, higher and significant odds of osteoporosis/osteopenia were seen in the last tertile (fully adjusted model (body mass index, age, income, education, physical activity, calcium and vitamin D supplements): odds ratio (OR) = 2.43, 95% confidence interval (CI): 1.19-4.95, Ptrend = 0.023). Also, individuals in the highest DII tertile had higher odds of abnormalities in femoral neck and lumbar spine BMD (fully adjusted model: OR = 2.85, 95% CI: 1.37-5.89, Ptrend = 0.007 and OR = 2.59, 95% CI: 1.29-5.19, Ptrend = 0.009, respectively). Based on our findings, it appears that there may be a connection between following pro-inflammatory diets and the odds of osteoporosis in postmenopausal women.

Rice bran peptides target lectin-like oxidized low-density lipoprotein receptor-1 to ameliorate atherosclerosis

Food-derived multifunctional peptides offer numerous health benefits through different biochemical pathways. However, their impact on aging-related atherosclerotic cardiovascular disease (ASCVD), especially atherosclerosis, remains underexplored despite cardiovascular disease (CVD) being the leading cause of death globally. In this study, NHANES data and Mendelian randomization were used to analyze the association between lipid metabolism disorders, systemic immune responses, dietary inflammatory index, and ASCVD. The results showed that they were all positively correlated with ASCVD. A dietary intervention was used to induce a mouse model of atherosclerosis through a high-fat diet (HFD). Our findings demonstrate that rice bran peptide could mitigate the typical pathological features of atherosclerosis. Molecular docking analysis further predicted that lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is a key target of rice bran peptide. This prediction was validated through a two-cell model of endothelial cells and lox-1-interfered macrophages. Therefore, targeting LOX-1 with rice bran peptide inhibits the excessive uptake of oxidized LDL (ox-LDL) by macrophages, thereby hindering the mass production of foam cells, which is crucial in preventing the early onset of atherosclerosis.

The association between the dietary inflammatory index during pregnancy and risk of gestational diabetes: a prospective cohort study and a meta-analysis

INTRODUCTION

To examine the association between dietary inflammatory index (DII) and risk of gestational diabetes mellitus (GDM).

METHODS

A prospective birth cohort study was conducted in Iran. During the first trimester of pregnancy, food intake was measured using a food frequency questionnaire. Each participant's DII score was calculated, and then, the Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% CI of GDM across the quartiles of DII. We systematically searched the literature to conduct a meta-analysis of observational studies (PROSPERO: CRD42022331703). To estimate the summary relative risk for the highest versus lowest category of DII, a random-effects meta-analysis was performed. The certainty of evidence was assessed using the GRADE approach.

RESULTS

In the prospective cohort study (n = 635 pregnant mothers), the multivariable HRs of GDM for the third and fourth quartiles of DII were 2.98 (95%CI: 1.98, 6.46) and 2.72 (95%CI: 1.11, 6.63), respectively. Based on a meta-analysis of six prospective cohorts and a case-control study (1014 cases of GDM in 7027 pregnant mothers), being in the highest category of the DII was associated with a 27% higher risk of GDM (relative risk: 1.27, 95%CI: 1.01, 1.59; I2 = 50%; low certainty of evidence). A dose-response meta-analysis suggested a positive monotonic association between DII and GDM risk.

CONCLUSIONS

Our prospective cohort demonstrated a positive correlation between GDM risk and the inflammatory potential of diet in the first trimester of pregnancy. The results need to be confirmed by larger cohort studies.

CLINICAL TRIAL NUMBER

Not applicable.

Dietary quality, perceived health, and psychological status as key risk factors for newly developed metabolic dysfunction-associated steatotic liver disease in a longitudinal study

OBJECTIVES

This study investigated biomarkers in individuals with newly developed metabolic dysfunction-associated steatotic liver disease (ND-MASLD) and examined the interplay between genetic predisposition and environmental factors using a machine learning approach in a large longitudinal study.

METHODS

Participants were classified into four groups based on metabolic dysfunction-associated steatotic liver disease (MASLD) status between the first and second measurements with an approximate 5-y gap. A model was developed to identify early-stage biomarkers of ND-MASLD (n = 1603). Nutrient intake, dietary patterns, genetic variants, and psychosocial factors were compared among the no MASLD (n = 60 081), recovered MASLD (n = 3181), persistent MASLD (n = 670), and ND-MASLD (n = 1603) groups. Their association with ND-MASLD was also predicted using a machine learning approach.

RESULTS

The model incorporating ND-MASLD status, age, sex, dietary inflammatory index, and metabolic syndrome (MetS), especially low high-density lipoprotein cholesterol and hypertriglyceridemia, at the second measurement demonstrated an optimal fit. High carbohydrate intake with a high glycemic index was associated with elevated ND-MADSLD risk. Fatty liver index was lower in persistent MASLD followed by ND-MASLD, recovered MASLD, and no MASLD. Participants in the ND-MASLD group had lower vitamin D and total isoflavonoid intake and a lower modified healthy eating index, indicating unhealthy diets. The XGBoost and deep neural network models identified age, sex, MetS components, dietary antioxidants, self-rated health, psychological well-being indexes, and serum liver enzyme levels at the second measurement as significant predictors of ND-MASLD. However, polygenic risk scores were not included.

CONCLUSIONS

Early-stage biomarkers of ND-MASLD were closely linked to MetS incidence. Dietary quality, perceived health status, and psychological stress emerged as potential targets for MASLD prevention strategies, with lifestyle modifications potentially overriding genetic predispositions. The results indicate that preventive strategies about lifestyle modification should be developed for MASLD.

Diet quality patterns and chronic kidney disease incidence: a UK Biobank cohort study

BACKGROUND

Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults.

OBJECTIVE

To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults.

METHODS

A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders.

RESULTS

After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses.

CONCLUSIONS

In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk.

Exploring the link between dietary inflammatory index, inflammatory biomarkers, and sleep quality in adults with obesity: a pilot investigation

OBJECTIVE

Obesity is known to be associated with inflammation and impaired sleep quality. In addition, the anti-inflammatory properties of the daily diet provide positive effects on health. The aim of this study was to investigate the relationship between the inflammatory index of the diet consumed by people with obesity and inflammatory biomarkers and sleep quality.

METHOD

This study included 124 people with obesity (F: 75; M: 49) with a mean age of 42.20 ± 11.00 years, who presented to a dietary outpatient clinic in Malatya between November 2021 and May 2022. Three-day dietary intake records were collected to calculate Dietary Inflammatory Index (DII) scores, which were then compared with inflammatory biomarkers, anthropometric measurements, and sleep quality measures.

RESULTS

Among the biochemical parameters, C-reactive protein (CRP) was found to be significantly higher in the groups with higher DII score (p = 0.006), and CRP (r = 0.258; p = 0.004) and total cholesterol (r = -0.243; p = 0.007) increased significantly with increasing inflammatory score of the diet. As the inflammatory burden of the diet consumed by the participants increased, their Body Mass Index (BMI) also increased (p = 0.009). No significant correlation was found between DII and sleep quality (p = 0.348).

CONCLUSION

These findings suggest that an anti-inflammatory diet can effectively reduce inflammation and BMI in people with obesity, but has a limited effect on sleep quality. Therefore, it is recommended that dietitians integrate anti-inflammatory dietary strategies for people with obesity into their clinical practice.

The Dietary Inflammatory Index and Sarcopenia in Older Adults in Four Chinese Provinces: A Cross-Sectional Study

Background: Sarcopenia associated with aging severely affects the quality of life of the elderly; diets have been shown to elicit an inflammatory response in the body, and diets that promote inflammation may lead to damage to muscles. The Dietary Inflammatory Index (DII) has been developed to quantify the inflammatory potential of individual diets. Therefore, this study aimed to investigate the association between the DII, sarcopenia and its components in elderly Chinese people. Methods: In this study, data were obtained from the China Nutrition Improvement Strategies and Applications for the Elderly Research Programme. An assessment of sarcopenia was carried out according to the Asian Working Group on Sarcopenia's (AWGS2019) criteria. The DII was calculated using food intake data obtained using the FFQ method, and then the quartile method was used to categorize the subjects into four groups. Multifactor logistic regression was conducted to examine the associations between DII, sarcopenia and its components. Results: This study included 993 subjects over the age of 65, and the prevalence of sarcopenia was 20.2%. The mean DII score of the study population was 0.99 ± 0.1. After adjusting for the confounders age, gender, marital status, and educational level, the risk of sarcopenia was 1.66 times higher in group Q4 than in group Q1 (p-trend < 0.05). However, this relationship is not statistically significant when other more confounding factors are added. Nevertheless, when further analyzing the relationship between DII and sarcopenia components, it was found that after adjusting the model, a higher DII was associated with a risk of muscle strength loss (OR = 1.65, p-trend < 0.05). Conclusions: Higher DII scores increase the risk of muscle strength loss in older adults. By guiding older adults to adopt a more anti-inflammatory diet, muscle health can be improved in terms of increased muscle strength. Further cohort or interventional studies are necessary to validate our findings.

Association between the dietary inflammatory index and depressive symptoms in adults with metabolic syndrome: a cross-sectional study from the NHANES database

Objective

The comorbidity of metabolic syndrome (MS) and depressive symptoms has emerged as a growing public health concern, contributing to a substantial global economic burden. The pathogenesis of this comorbidity is thought to be closely linked to inflammation. However, research examining the impact of the Dietary Inflammatory Index (DII) on depressive symptoms in adults with MS remains limited. This study aims to investigate the association between the DII and depressive symptoms in adults with MS, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study included 7,553 participants aged 20 and older MS from six cycles of the NHANES (2007-2018). Depressive symptoms were assessed using the Patient Health Questionnaire scores, and dietary information was gathered to calculate the Dietary Inflammatory Index (DII). The association between DII scores and depressive symptoms in individuals with MS was evaluated through multivariable logistic regression analysis, adjusting for relevant covariates. Subgroup analyses and restricted cubic splines (RCS) were performed to explore this relationship further.

Results

Among the participants, 907 individuals (12.0%) were identified as having depressive symptoms. After adjusting for all covariates, a positive correlation was observed (OR = 1.09, 95% CI: 1.04-1.14). After adjusting for all covariates, a positive association was observed between DII scores and depressive symptoms (OR = 1.09, 95% CI: 1.04-1.14). Individuals in the highest tertile of DII scores had significantly higher odds of depressive symptoms compared to those in the lowest tertile (OR = 1.36, 95% CI: 1.13-1.65). Subgroup analyses revealed that men were more likely to experience depressive symptoms among adults with MS. The RCS model revealed a nonlinear positive association between DII scores and depressive symptoms in these participants.

Conclusion

Our study indicates that the DII is positively correlated with an increased likelihood of depressive symptoms among adults with MS in the United States. These findings align with existing research and necessitate further validation through prospective cohort studies.

Association of dietary quality and mortality in the non-alcoholic fatty liver disease and advanced fibrosis populations: NHANES 2005-2018

Background

Nonalcoholic fatty liver disease (NAFLD) has emerged as a significant global health concern, with advanced fibrosis increasing mortality risks. Despite the abundance of dietary guidelines for managing NAFLD, the precise impact of diet quality on mortality among individuals with advanced fibrosis remains elusive. This study aims to explore the influence of five dietary quality indexes on mortality among NAFLD patients and advanced fibrosis patients.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018 to assess dietary quality based on the Alternate Mediterranean Diet (aMED), Healthy Eating Index-2020 (HEI-2020), Dietary Approach to Stop Hypertension (DASH), Alternate Healthy Eating Index (AHEI), and Dietary Inflammatory Index (DII). Weighted Cox proportional hazard regression models along with restricted cubic splines and subgroup analyses were employed in this study.

Results

The analysis encompassed 3,634 NAFLD patients. After a median follow-up of 89 months, it was found that higher scores on the aMED (HR 0.814, 95% CI 0.681-0.972), HEI-2020 (HR 0.984, 95% CI 0.972-0.997), DASH (HR 0.930, 95% CI 0.883-0.979), and AHEI (HR 0.980, 95% CI 0.966-0.995) were associated with lower mortality risks, while DII scores (HR 1.280, 95% CI 1.098-1.493) indicated an increased risk of mortality. Additionally, a nonlinear relationship was identified solely between AHEI scores and all-cause mortality in NAFLD patients. Notably, among patients with advanced fibrosis, HEI-2020 as a categorical variable (T3: HR 0.519, 95% CI 0.280-0.964), DASH as a continuous variable (continuous: HR 0.921, 95% CI 0.849-0.999), AHEI (continuous: HR 0.971, 95% CI 0.945-0.997; T2: HR 0.545, 95% CI 0.310-0.960; T3: HR 0.444, 95% CI 0.245-0.804), and DII (continuous: HR 1.311, 95% CI 1.121-1.534; T3: HR 2.772, 95% CI 1.477-5.202) exhibited significant associations with all-cause mortality. Subgroup analyses revealed an interaction between AHEI scores and sex among NAFLD patients, where higher AHEI scores correlated with lower all-cause mortality in females, but no such association was observed in males. For other dietary quality, subgroup analyses indicated that their relationships with mortality were robust.

Conclusion

Our study suggests that a high-quality diet could potentially mitigate mortality risk in both NAFLD and advanced fibrosis patients.

The relationship between dietary inflammatory index and all-cause and cardiovascular disease-related mortality in adults with metabolic syndrome: a cohort study of NHANES

Objective

This study aims to investigate the correlation between dietary inflammatory index (DII) and mortality resulting from all-cause and cardiovascular diseases (CVD) in adults affected by metabolic syndrome (MetS).

Methods

The focus of this study was to analyze the information of 13,751 adults who had been diagnosed with MetS. DII scores were computed based on a 24-hour dietary intake at the start of the study. By implementing both the Cox regression analysis and restricted cubic spline(RCS) analysis, we examined the correlation between DII score and mortality.

Results

After a mean follow-up duration of 114 months, a total of 2,343 individuals (representing 13.45% of the sample) died, with 639 fatalities attributed to CVD. The degrees of dietary inflammation were classified into three groups based on DII scores: low, medium, and high-grade. The mortality rates for each tertile of DII were 11.55%, 13.96%, and 15.05%, respectively. In comparison to participants with T1, the multivariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for participants with T3 were 1.16 (95% CI: 1.01-1.34) regarding mortality caused by any reason, and 1.26 (95% CI: 0.95-1.68) for mortality related to CVD. Through the use of the Kaplan-Meier survival curve and RCS, it was observed that individuals in the high DII tertile had an increased likelihood of death compared to those in the low DII tertile.

Conclusion

Our findings provide validation of the theory that diets high in inflammatory substances contribute to elevated mortality rates for all causes and CVD-related deaths in individuals diagnosed with MetS.

The relationship between kidney function and cardiometabolic risk factors, anthropometric indices, and dietary inflammatory index in the Iranian general population: a cross-sectional study

BACKGROUND

The prevalence of chronic kidney disease (CKD) is estimated to be about 13.4% worldwide. Studies have shown that CKD accounts for up to 2% of the health cost burden. Various factors, such as genetic polymorphisms, metabolic disorders, and unhealthy lifestyles, can contribute to the occurrence of CKD. Therefore, the present study aimed to investigate the relationship between renal function and cardiometabolic risk factors, anthropometric characteristics, and the dietary inflammatory index (DII) in an Iranian population.

METHODS

This study was conducted on 2472 male and female employees of Shiraz University of Medical Sciences (SUMS), selected through census between 2018 and 2019. In this cross-sectional study, renal function was evaluated using serum creatinine (sCr), blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR). Biochemical indices including sCr, BUN, fasting blood sugar (FBS), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were measured using standard laboratory methods. eGFR was calculated using the Modification of Diet in Renal Disease formula. Systolic (SBP) and diastolic (DBP) blood pressure as well as anthropometric indices such as height (Ht), weight (Wt), hip circumference (HC), waist circumference (WC), body mass index (BMI), conicity index (C-Index), visceral adiposity index (VAI), abdominal volume index (AVI), body adiposity index (BAI), and body shape index (ABSI) were measured and calculated using standard methods and formulas. Diet was evaluated through a 113-item food frequency questionnaire, and the DII was calculated according to its specific instructions. To predict the factors influencing renal function and to remove the impact of confounders, multivariable linear regression was employed using the backward elimination method.

RESULTS

There was a significant direct relationship between sCr and FBS, TG, HDL, DBP, Wt, and BAI as well as between BUN and age, TG, HDL, and BAI. In addition, there was a significant inverse relationship between eGFR and SBP, Wt, BAI, and VAI. In women compared to men, sCr and BUN values were significantly lower, while eGFR levels were significantly higher.

CONCLUSIONS

It seems that age, gender, lipid profile, glycemic status, BP, BAI, VAI, and Wt can be considered factors associated with renal function.

Meta-analysis of the association between the dietary inflammatory index and risk of chronic kidney disease

To explore the relationship between Dietary Inflammatory Index (DII) and chronic kidney disease (CKD) risk, we obtained 6 studies (3 prospective studies and 3 cross-sectional studies) from PubMed, CBM, Cochrane Library, and Embase, as of March 6, 2023. Our results revealed a positive link between the CKD risk and rising DII that signified a pro-inflammatory diet. With medium heterogeneity (Overall RR = 1.44, 95%CI: 1.22, 1.71; I2 = 64.7%, P = 0.015), individuals in the highest DII exposure category had a 44% greater overall risk of developing CKD than those in the lowest DII exposure category. According to risk estimations from cross-sectional studies, individuals in the highest DII exposure category had a 64% higher risk of developing CKD than those in the lowest DII exposure category, with significant heterogeneity (RR = 1.64, 95%CI: 1.18, 2.29; I2 = 70.9%, P = 0.032). The risk estimates in cohort studies revealed individuals in the highest DII exposure category had a 28% higher risk of CKD than those in the lowest DII exposure category, with a low heterogeneity (RR = 1.28, 95%CI: 1.14, 1.44; I2 = 17.2%, P = 0.015). Cross-sectional studies showed a nonlinear dose-response relationship between DII and CKD risk, while cohort studies indicated a linear dose-response relationship. Meta-regression results showed publication year, study design, and country had no significant correlation with the meta-analysis. The subgroup analysis results remained consistent. Results support the significance and importance of adopting a better anti-inflammatory diet in preventing CKD. These findings further confirm DII as a tool of the inflammatory potential of the diet to prevent and delay the onset and progression of CKD.

Association between dietary inflammatory index and visual impairment among adults in the NHANES 2005-2008

The association between the dietary inflammatory index (DII) and visual impairment remains unclear. This study aimed to investigate the relationship between the DII and non-refractive visual impairment among US populations. A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2008, including dietary information and visual impairment assessment. Participants with presenting visual impairment, defined as presenting visual acuity in the better-seeing eye worse than 20/40, were included. Participants whose visual acuity in the better-seeing eye could be corrected to 20/40 or better through automated refraction, were classified as having uncorrected refractive error, while others were considered to have non-refractive visual impairment. Logistic regression models, restricted cubic spline (RCS) analysis, subgroup analyses, and propensity score matching (PSM) were performed to assess the association between DII and the prevalence of non-refractive visual impairment. After adjusting for potential confounding factors, a positive association was observed between DII scores and the prevalence of non-refractive visual impairment (odds ratio [OR] = 1.277, 95% confidence interval [CI] = 1.017-1.603, P < 0.05). RCS analysis demonstrated that there was no nonlinear relationship between them (P for nonlinear > 0.05). Furthermore, sensitivity analysis by PSM indicated the robustness of this positive association. This study revealed a positive correlation between the DII and the prevalence of non-refractive visual impairment among those with presenting visual impairment in the United States. Further prospective studies are warranted to confirm a causal relationship and elucidate the underlying mechanisms involved.

The Role of Inflammatory and Nutritional Indices in Postmenopausal Osteoporosis: A Retrospective Study

Background: Postmenopausal osteoporosis is characterized by impaired bone metabolism, inflammation, and nutritional deficiencies. This study aimed to evaluate the potential of inflammatory and nutritional markers in identifying decreased bone mineral density (BMD) in postmenopausal women. Methods: This cross-sectional study retrospectively analyzed postmenopausal women from January 2018 and December 2023. A total of 368 women were divided into three groups based on T-scores: 61 women with osteoporosis (T-score ≤ -2.5), 153 women with osteopenia (-1 > T-score > -2.5), and 154 women with normal BMD (T-score > -1). Inflammatory and nutritional biomarkers included the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune inflammation value (PIV), geriatric nutritional risk index (GNRI), triglycerides, total cholesterol, and body weight index (TCBI), prognosis nutritional index (PNI), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, 25-OH Vitamin D level, Na, K, Ca, Mg, and their ratios. Results: The GNRI was significantly lower in the osteoporosis group compared to the control group. The NLR, PLR, SII, SIRI, PIV, TCBI, PNI, and HALP were similar between the groups. The GNRI and TCBI showed a positive correlation with T-scores. The Mg level was lower in the osteoporosis group than in the control group and osteopenia group, and the Na/Mg ratio was higher. Additionally, the Ca/Mg ratio was lower in the osteoporosis group than in the control group. The T-score was positively correlated with Mg and Ca/Mg, while the Na/Mg ratio showed a significant negative correlation. Vitamin D, other minerals, and their ratios did not show significant differences between the groups. Conclusions: Our findings suggest that the GNRI could serve as a useful indicator for assessing bone health and the risk of osteoporosis. Furthermore, maintaining appropriate levels of Mg and balanced Na/Mg and Ca/Mg ratios appears crucial for BMD.

Higher Dietary Inflammatory Index Score Is Associated With a Greater Risk of High Allostatic Load in US Adults: National Health and Nutrition Examination Survey, 2017-2020

BACKGROUND

Allostatic load (AL) is a comprehensive indicator of chronic stress. Foods with pro-inflammatory properties can increase the risk of elevated AL levels. However, no studies have explored the association between AL and dietary inflammation.

OBJECTIVE

The aim of this study was to investigate the relationship between Dietary Inflammatory Index (DII) scores and AL.

DESIGN

This cross-sectional study examined dietary data from 24-hour dietary recalls and biomarkers associated with AL in adult participants 18 years and older from the National Health and Nutrition Examination Survey (2017-2020).

PARTICIPANTS/SETTING

The National Health and Nutrition Examination Survey examines a nationally representative sample of approximately 5000 individuals each year. A total of 15 560 participants were surveyed during the 2017-2020 period, and 1577 participants were ultimately included in this study.

MAIN OUTCOME MEASURES

Twenty-six dietary components were selected to calculate the DII, and 10 biomarkers representing the cardiovascular, metabolic, and immune systems were chosen to calculate the AL.

STATISTICAL ANALYSES PERFORMED

Logistic regression and linear regression analyses were used to investigate the relationship between DII and AL and between each biomarker. Subgroup analyses were conducted based on sociodemographic variables, including age, sex, race and ethnicity, and BMI.

RESULTS

The risk of high AL was 1.53 times higher in those with DII scores in the highest quartile than in those with DII scores in the lowest quartile (odds ratio [OR] 1.53; 95% CI 1.00 to 2.36; Ptrend = .04). For each unit increase in DII, the probability of having high AL increased by 11% (OR 1.11; 95% CI 1.01 to 1.21; Ptrend = .03). Higher DII scores were significantly associated with higher systolic blood pressure, diastolic blood pressure, pulse, waist-to-hip ratio, and high-sensitivity C-reactive protein levels. Higher DII scores were also significantly associated with lower total cholesterol and high-density lipoprotein cholesterol levels (P < .05). The association between DII score and AL was more pronounced in women (ORQuartile3vs1 2.04; 95% CI 1.15 to 3.61; ORQuartile4vs1 2.07; 95% CI 1.18 to 3.62; Ptrend = .01) and in those with a BMI < 24.9 (ORQuartile3vs1 4.74; 95% CI 1.21 to 18.05; Ptrend = .03).

CONCLUSIONS

This study found that higher DII scores were associated with greater risk of high AL. Further research with more rigorous study designs is needed to build on these results and evaluate the effect of diets with low inflammatory potential (low DII scores) on AL.

Association between dietary inflammation index with anemia in Americans: a cross-sectional study with U.S. National health and nutrition examination survey

OBJECTIVES

Dietary inflammatory index (DII) is utilized to determine the inflammatory effects of nutrients and foods on various diseases. Inflammation is a potential risk factor for anemia. We hypothesize that pro-inflammatory diets boost the incidence of anemia, as indicated by high DII.

METHODS

41, 360 Americans were included in this study from the U.S. National Health and Nutrition Survey (NHANES) from 2003-2018. Multivariable logistic regression models were employed to examine the association between DII and anemia.

RESULTS

After adjustment for all the covariates, the odds ratios (ORs) (95% CI) between the risk of anemia and DII across tertile 3 were 1.2556 (95% CI 1.0621, 1.4843; P = 0.0077), and the trend test was statistically significant (P for trend = 0.009). Furthermore, in the subgroup analysis stratified by gender. The ORs (95% CI) between the risk of anemia and DII across tertile 2 and 3 were 1.8071 (95% CI 1.1754, 2.7783; P = 0.0070) and 2.1591 (95% CI 1.4009, 3.3278; P = 0.0005) in men after multivariable adjustment. However, in women, this association was only significantly different (P < 0.05) across tertile 3 in the crude model. In the subgroup analysis stratified by race, this association was significant (P < 0.05) between the risk of anemia and DII for Non-Hispanic Whites/Blacks after adjustment.

DISCUSSION

Together, anemia was significantly associated with DII using logistic regression. In stratified analyses, higher DII scores were linked to an increased incidence of anemia in men, while no association was found in women after adjustment. Additionally, anemia may be associated with greater pro-inflammatory diets in Non-Hispanic Whites/Blacks.

CONCLUSION

In the present study, we evaluate the potential relationship between DII and anemia using data from NHANES. This cross-sectional study confirmed the hypothesis that the higher DII was significantly associated with a higher risk of anemia in the U.S. population.

Determination of the relationship between dietary inflammatory index and depression status in female students

Background: The relationship between diet, inflammation and mental health has been receiving increasing interest. However, limited data are available on the inflammatory role of diet in university students, among whom depression is commonly observed. Aim: The aim of our study is to investigate the relationship between dietary inflammatory index (DII) and depression among female students of nutrition and dietetics department, whom we assume to be conscious about health. Methods: DII scores were determined by averaging the 3-day dietary records. Depression status of the students was determined by using Beck Depression Inventory (BDI). Results: Our study was conducted with 122 female university students. The mean total BDI score of the students in the first tertile (more anti-inflammatory effect) was found significantly lower than those of the students in the second and third tertiles (p = 0.001). In addition, there were no significant difference between the depression scores of the students and their grade level (p = 0.114) and place of residence (p = 0.866). We found a positive association between DII and depressive symptoms (Model 1, B = 0.512, %95 CI: 0.236-0.789, p = 0.000). This relationship was also found when adjusting for age, weight, body mass index, smoking status, and presence of chronic disease (Model 2, B = 0.496, %95 CI: 0.217-0.776, p = 0.006; Model 3, B = 0.493, %95 CI: 0.210-0.777, p = 0.024. Conclusion: Supporting that the inflammatory burden of diet is associated with mental health, our findings are of significance for the development of anti-inflammatory nutritional approaches among students who are prone to depression.

Dietary inflammatory index is not associated with bone mineral density in functionally able community-dwelling older adults

BACKGROUND

Osteoporosis poses a significant health and quality-of-life burden on older adults, particularly with associated fractures after a fall. A notable increase in pro-inflammatory cytokines associated with aging contributes to a decline in bone mineral density (BMD). Certain food components have been shown to influence an individual's inflammatory state and may contribute to optimal bone health as a modifiable risk factor, particularly later in life. This study aims to explore the relationship between the dietary inflammatory index (DII) and dietary intake with BMD in community-dwelling older adults.

METHODS

Heathy community-dwelling older adults aged 65-85 years. DII scores were calculated using 24-h dietary recalls, and lumbar spine (L1-L4) and femoral neck (ward's triangle) BMD was assessed via dual-energy x-ray absorptiometry.

RESULTS

A total of 94 participants were recruited (72.9 ± 4.9 years, 76.6% female) with 61.7% identified having an anti-inflammatory diet (average DII = - 0.50 ± 1.6), 88.3% were physically active, 47.8% were osteopenic and 27.7% osteoporotic. There was no significant difference between DII scores, nutrient or food group intake in groups stratified by BMD T-Score except for lean meats and alternatives food group (p = 0.027). Multiple regression analysis found no associations between DII and lumbar spine (unadjusted model β = 0.020, p = 0.155) or femoral neck BMD (unadjusted model β = - 0.001, p = 0.866).

CONCLUSION

Most of this cohort of functionally able community-dwelling older adults followed an anti-inflammatory diet. DII and dietary intake were not associated with BMD. This research underlines the complex interplay between modifiable and non-modifiable risk factors on the BMD of older, physically active adults.

Ultra-processed Food Intake During Pregnancy and its Impact on Maternal Diet Quality and Weight Change: A Systematic Review of Observational Studies

PURPOSE OF REVIEW

Adequate and balanced nutrition during pregnancy is essential for both the mother's and fetus's health. The increased dietary intake of ultra-processed foods (UPFs) and their significant share in the diet negatively affects diet quality and gestational weight gain during pregnancy. The aim of this systematic review was to examine the association of UPFs consumption with diet quality and gestational weight change among healthy pregnant women, using data from observational studies (PROSPERO Identifier: CRD42023468269) from the last 10 years.

RECENT FINDINGS

A search was performed in Pubmed, Wiley, Scopus, and Web of Science, and studies published in english language were selected. Study selection and data extraction were made by determining the exclusion and eligible inclusion criterias according to the PECOS framework. Of the 12 studies included, 5 were longitudinal cohort studies and 7 were cross-sectional studies. On average, half of the energy in the participants' daily diets came from UPFs in 3 studies, but the energy share of UPFs was about 20-30% in the remainder studies. UPFs-enriched maternal diet was associated with less dietary intake of legumes, vegetables, fruits and protein sources (seafood and plant protein, total protein) and greater consumption of refined grains compared to those who consume less UPFs. In parallel, UPFs consumption was negatively associated with Healthy Eating Index. UPF intake during pregnancy has a negative impact on diet quality and gestational weight gain. Increasing awareness of UPFs during this period may reduce potential complications during pregnancy and fetal growth.

DII modulates the relationship between SVD3 and NAFLD prevalence, rather than liver fibrosis severity, in hospitalized T2DM population

Type 2 diabetes (T2DM) patients are at high risk for non-alcoholic fatty liver disease (NAFLD). Studies show SVD3 and dietary inflammatory index (DII) are associated with NAFLD. It's unknown if they interact in T2DM patients with NAFLD. We collected data from 110 hospitalized T2DM patients, measured physiological and biochemical indicators, conducted dietary surveys, and converted data into DII and NFS, FIB-4, and BARD indices. We used logistic regression, mediation effect analysis, and moderation effect analysis to explore the relationship between DII and SVD3 with NAFLD and liver fibrosis in T2DM patients. DII was not significant in either NAFLD incidence in T2DM patients or liver fibrosis in NAFLD patients. SVD3 was positively correlated with NAFLD incidence in T2DM patients, but this correlation became insignificant as DII increased towards pro-inflammation. SVD3 is positively correlated with NAFLD incidence in T2DM patients, but this correlation becomes less significant as DII increases towards pro-inflammation.

The role of dietary inflammatory index in metabolic diseases: the associations, mechanisms, and treatments

In recent years, the prevalence of metabolic diseases has increased significantly, posing a serious threat to global health. Chronic low-grade inflammation is implicated in the development of most metabolic diseases, such as type 2 diabetes mellitus (T2DM), obesity, dyslipidemia, and cardiovascular disease, serving as a link between diet and these conditions. Increasing attention has been directly toward dietary inflammatory patterns that may prevent or ameliorate metabolic diseases. The Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of dietary intake. Consequently, a growing body of research has examined the associations between the DII and the risk of several metabolic diseases. In this review, we explore the current scientific literature on the relationships between the DII, T2DM, obesity, and dyslipidemia. It summarizes recent findings and explore potential underlying mechanisms from two aspects: the interaction between diet and inflammation, and the link between inflammation and metabolic diseases. Furthermore, this review discusses the therapeutic strategies, including dietary modifications, prebiotics, and probiotics, and discusses the application of the DII in metabolic diseases, as well as future research directions.

Demographic risk factors of pro-inflammatory diet: a narrative review

While inflammation is a known beneficial mechanism, pro-inflammatory nutrients can lead to chronic inflammation. The energy-adjusted dietary inflammatory index (E-DII) has revealed positive associations with chronic inflammatory diseases. However, more evidence about the demographic risk factors for high E-DII is needed. Therefore, the present study reviewed the high-risk groups of people for high E-DII scores. Men had higher E-DII than women worldwide, which could be explained by the craving for energy induced by stress and higher physical activity. However, in some societies, women had higher consumption of a pro-inflammatory diet, which could be induced by compulsive eating and craving for more sweets and carbohydrates during menstruation and also can be seen among women with premenopausal syndrome. The pro-inflammatory diets were more common among elders in southern America, East Asia, and Arab countries, while some other studies had contradictory results. The proliferation of unhealthy foods, such as fast food and Western dietary patterns enriched with a pro-inflammatory diet, increased youth's E-DII and decreased the healthy eating index among older people. Also, smokers and alcoholics tended to consume a diet with a higher E-DII, which should be investigated in further studies. Black people consumed the most pro-inflammatory diets compared with White people, especially in pregnant women. Education had a negative association with E-DII, while socioeconomic status was positively associated with a pro-inflammatory diet. Therefore, E-DII consumption had no association with access to healthy foods but is more associated with knowledge and cultural dietary habits. Moreover, further nutritional interventions are required to educate the vulnerable populations and also provide better availability of healthy food enriched with anti-inflammatory nutrients in the future.

Overview of anti-inflammatory diets and their promising effects on non-communicable diseases

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

Association between dietary inflammatory index and all-cause mortality risk in adults with coronary heart disease in the United States

Diet and inflammation are crucial in the incidence and progression of coronary heart disease (CHD). This study aimed to investigate the correlation between the Dietary inflammatory index (DII) and all-cause mortality in CHD patients. A total of 1,303 CHD patients from the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2018 were included. Multivariate Cox regression was used to explore the correlation between the DII and the risk of all-cause mortality in these patients. Restricted cubic spline (RCS) analysis was also utilized to examine the relationship between the DII and all-cause mortality risk in CHD patients. Additionally, subgroup analyses were conducted to determine how the correlation between the DII and all-cause mortality varied across different demographics. During a median follow-up period of 77 months among 1,303 CHD patients, 536 died from all causes. The DII scores were significantly higher in deceased patients compared to survivors. After adjusting for confounding factors, the multivariate Cox regression analysis indicated a strong positive correlation between the DII and all-cause mortality in CHD patients. RCS analysis suggested a non-linear relationship between the DII and all-cause mortality among CHD patients. Additionally, an increase in DII was more pronounced in its impact on female patients. The DII is strongly correlated with the risk of all-cause mortality among CHD patients, particularly among females. Thus, managing dietary inflammation is vital for the prevention and treatment of CHD, especially in female patients.

The effect of diets with different inflammatory scores on inflammation and sleep in obese subjects: a randomized controlled trial

OBJECTIVE

The aim of this study was to investigate the effect of different dietary inflammatory index diets on inflammatory markers, anthropometric measurements, and sleep quality in obese subjects.

METHODS

This study was conducted in a public hospital in Turkey between November 2021 and May 2022. Participants with pro-inflammatory dietary habits were included in the study. Randomly divided into two groups of 33 participants, they were subjected to an anti-inflammatory diet or a control diet for 8 weeks. The study evaluated the anthropometric parameters, inflammatory biomarkers, and sleep quality indices of the diet groups.

RESULTS

Significant reductions in body mass index were observed in both groups, more marked in the anti-inflammatory diet cohort. C-reactive protein levels, indicative of inflammation, also decreased substantially in both groups, with a more marked reduction in the anti-inflammatory diet cohort. Despite the improvement in sleep quality in both groups, the variation was not statistically significant.

CONCLUSION

This study demonstrates the importance of anti-inflammatory diets in nutritional strategies for obesity by reducing body mass index and inflammation.

Dietary Inflammatory Index and female infertility: findings from NHANES survey

Background and objectives

Infertility is a pressing public health concern on a national scale and has been linked to inflammatory conditions. However, limited research has been conducted on the impact of the Dietary Inflammatory Index (DII) on female infertility. This study sought to investigate the association between DII and infertility utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study included a cohort of 3,071 women aged 20-44 years from three NHANES cycles (2013-2018). Dietary information was collected to calculate the Dietary Inflammatory Index (DII), while infertility status was determined through positive responses to specific questions in a questionnaire. The association between DII scores and infertility was assessed using adjusted multivariate logistic regression analyses. Subgroup analysis and restricted cubic spline (RCS) was conducted for further investigation.

Results

Among the participants, 354 women (11.53%) were identified as experiencing infertility. Upon adjusting for all covariates, a positive correlation was observed (OR = 1.61, 95% CI: 1.12-2.31). Individuals with DII scores in the highest quartile exhibited significantly greater odds of infertility compared to those in the lowest quartile (OR = 1.71, 95% CI = 1.17-2.51). The relationship between DII and infertility in the RCS models demonstrated an S-shaped curve. When using the median DII as a reference point, a higher DII was associated with an increased prevalence of infertility. Additionally, obesity was found to be a significant factor.

Conclusions

Our research indicated that the DII was positively correlated with an increased likelihood of infertility in American women among the ages of 20 and 44. These results contribute to the existing literature and underscore the need for further validation through larger prospective cohort studies.

Association between dietary inflammatory index and disease activity in patients with ulcerative colitis

Considering the influence of dietary factors on inflammatory markers that may affect the disease course in patients with ulcerative colitis (UC), this study aimed to assess the association between dietary inflammatory index (DII) score and disease activity in patients with ulcerative colitis. This cross-sectional study included 158 patients with UC. The Mayo Clinic score was used to determine the disease severity. A food frequency questionnaire was applied to gather the dietary information, then the Shivappa et al. method was used for the calculation of DII. An association between disease severity (dependent factor) and DII score quartiles (independent factors) was conducted by a logistic regression adjusted to different covariates. In this study, 53.8% of participants were in remission or had mild disease activity. The mean DII score was - 0.24 ± 0.66. The mean DII score was significantly lower in patients with remission (-0.34 ± 0.71) compared with patients who were in the active phase (-0.1 ± 0.57) of UC (P = 0.02). The results of the logistic regression analysis showed that after adjusting for confounding factors, the odds of severe disease were 3.33 times higher among patients who had a more pro-inflammatory diet compared with patients who had an anti-inflammatory diet [OR: 3.33 (95%CI: 1.13, 9.76), p = 0.02]. In conclusion, there was a significant association between higher intake of a pro-inflammatory diet and UC severity. So, from a clinical point of view, there is a need to apply an anti-inflammatory diet to decrease disease severity in patients with ulcerative colitis.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and chronic obstructive pulmonary disease: the mediating role of dietary inflammatory index

Background

Numerous studies have indicated a potential correlation between COPD, lipid metabolism, and dietary inflammation. However, the exact mechanisms by which dietary inflammation regulates the pathological processes of COPD related to lipid metabolism remain unclear. NHHR is a novel composite index of atherosclerotic lipid profiles, while the Dietary Inflammatory Index (DII) measures diet-induced inflammation. This study explores the relationship between NHHR and COPD and evaluates whether DII mediates this association.

Methods

We employed multivariable logistic regression, smooth curve fitting, threshold effect analysis, and subgroup analysis to explore the relationship between NHHR and the incidence of COPD. Additionally, we conducted a mediation analysis to explore the potential relationship between dietary inflammatory index (DII) levels and the relationship between NHHR and COPD.

Results

This analysis encompassed 13,452 participants, with 2,332 reporting incidents of COPD. Following adjustment for all covariates using multivariable logistic regression, each unit increase in NHHR level and DII level was associated with a 10% (OR = 1.10, 95% CI: 1.05, 1.16) and 8% (OR = 1.08, 95% CI: 1.04, 1.13) increase, respectively, in the incidence rate of COPD. Furthermore, compared to the lowest quartile, the highest quartile of NHHR level and DII level was associated with a 47% (p < 0.001) and 50% (p < 0.001) increase, respectively, in the incidence rate of COPD. Smooth curve fitting and threshold effect analysis revealed a nonlinear relationship between NHHR and the risk of COPD, with a breakpoint at 2.60. Mediation analysis indicated that DII mediated 7.24% of the association between NHHR and COPD (p = 0.004).

Conclusion

Higher NHHR levels are associated with an increased prevalence of COPD. Moreover, this association is mediated by DII, suggesting that an anti-inflammatory diet may be beneficial.

Impact of dietary inflammatory index on gestational diabetes mellitus in normal and overweight women: a systematic review and meta-analysis of observational studies

BACKGROUND AND OBJECTIVES

To systematically investigate the association between the dietary inflammatory index (DII) and gestational diabetes mellitus (GDM), with a focus on the role of BMI in this relationship.

METHODS AND STUDY DESIGN

A comprehensive search was conducted in PubMed, Embase, Web of Science, The Cochrane Library, Medline, CINAHL Complete, Chinese Periodical Full-text Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and China Wanfang Database for rele-vant observational studies published up to August 2023. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled effect size was calculated using a random-effects model. Sub-group and meta-regression analyses were performed to explore potential sources of heterogeneity.

RESULTS

The study included 54,058 participants from 10 studies. Pregnant women with a higher DII, indicating a pro-inflammatory diet, had a significantly increased risk of GDM compared to those with a lower DII, indicating an anti-inflammatory diet (pooled OR: 1.17, 95% CI: 1.01-1.36; I²=70%, p <0.001). Subgroup analyses revealed a stronger association in normal weight stratification (OR: 1.25, 95%CI: 1.04-1.51), case-control studies (OR: 1.45, 95%CI: 1.03-2.05), Asia (OR: 1.26, 95%CI: 1.10-1.43), Europe (OR: 1.27, 95%CI: 1.09-1.48), 3-day dietary record as a dietary assessment tool (OR: 1.30, 95%CI: 1.16-1.46), physical activity adjustment (OR: 1.28, 95%CI: 1.13-1.46), and energy intake adjustment (OR: 1.33, 95%CI: 1.19-1.48). Meta-regression analysis confirmed that geographical region significantly influenced heterogeneity between studies (p <0.05).

CONCLUSIONS

An elevated DII is independently linked to a higher risk of GDM, especially in women of normal weight.

Association between dietary inflammatory index and all-cause mortality in patients with osteopenia or osteoporosis: A retrospective cohort study from the NHANES 2007-2018

Objective

Osteoporosis is an inflammatory disease that causes a large disease burden worldwide. Dietary inflammation index (DII), a comprehensive assessment index that reflects the pro-inflammatory/anti-inflammatory level of diet was related to multiple inflammatory diseases. This study aimed to explore the association between DII and all-cause mortality in patients with osteoporosis or osteopenia.

Methods

In this retrospective cohort study, data of patients aged ≥ 45 years diagnosed as osteopenia or osteoporosis and had complete dietary intake information were extracted from the National Health and Nutrition Examination Survey (NHANES 2007-2010, 2013-2014, 2017-2018). Dietary intake information was obtained from 24-h dietary recall interviews and was used to calculate the DII score. Weighted univariate and multivariate Cox proportional hazard models were utilized to explore the association between DII and all-cause mortality in patients with osteoporosis or osteopenia, with hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup analyses based on different age, gender and complications were further assessed this association.

Results

A total of 5,381 patients were included. Until December 31, 2019, 1,286 all-cause deaths occurred. After adjusting all covariates, high DII was associated with the high odds of all-cause mortality among patients with osteoporosis or osteopenia (HR=1.28, 95 %CI: 1.10-1.48), especially in the male (HR=1.38, 95 %CI: 1.06-1.78), aged < 65 years (HR=1.49, 95 %CI: 1.09-2.02), and without the history the cardiovascular disease (HR=1.30, 95 %CI: 1.03-1.65), diabetes mellitus (HR=1.27, 95 %CI: 1.06-1.52) and chronic kidney disease (HR=1.28, 95 %CI: 1.03-1.58).

Conclusion

A pro-inflammatory diet may have an adverse effect on the prognosis of osteoporosis patients.

Nutritional Epigenomics: Bioactive Dietary Compounds in the Epigenetic Regulation of Osteoarthritis

Nutritional epigenomics is exceptionally important because it describes the complex interactions among food compounds and epigenome modifications. Phytonutrients or bioactive compounds, which are secondary metabolites of plants, can protect against osteoarthritis by suppressing the expression of inflammatory and catabolic mediators, modulating epigenetic changes in DNA methylation, and the histone or chromatin remodelling of key inflammatory genes and noncoding RNAs. The combination of natural epigenetic modulators is crucial because of their additive and synergistic effects, safety and therapeutic efficacy, and lower adverse effects than conventional pharmacology in the treatment of osteoarthritis. In this review, we have summarized the chondroprotective properties of bioactive compounds used for the management, treatment, or prevention of osteoarthritis in both human and animal studies. However, further research is needed into bioactive compounds used as epigenetic modulators in osteoarthritis, in order to determine their potential value for future clinical applications in osteoarthritic patients as well as their relation with the genomic and nutritional environment, in order to personalize food and nutrition together with disease prevention.

Androgenic alopecia is associated with higher dietary inflammatory index and lower antioxidant index scores

Background

Androgenic alopecia (AGA), the most prevalent hair loss type, causes major psychological distress and reduced quality of life. A definite and safe cure/prevention for this condition is still lacking. The role of oxidative stress and inflammation in AGA pathogenesis prompted us to investigate the association between dietary antioxidant index (DAI) and energy-adjusted dietary inflammatory index (E-DII) with AGA.

Methods

The investigation was designed based on data from 10,138 participants from the Fasa Adult Cohort Study (FACS). DAI and energy-adjusted DII (E-DII) were calculated utilizing a validated 125-item food frequency questionnaire (FFQ). A physician diagnosed AGA. Logistic regression models were utilized to evaluate the association of DAI and E-DII with AGA.

Results

After exclusion, 9,647 participants (44.0% men, mean age: 48.6 ± 9.5 years) consisting of 7,348 participants with AGA entered the analyses. Higher DAI was associated with 10% lower AGA odds, while higher E-DII showed 4% higher AGA odds after adjusting for various confounding variables. However, significant associations were found only among women, and adjusting for metabolic syndrome (MetS) made the E-DII-AGA association insignificant.

Conclusion

Antioxidant-rich diets protect against AGA, while pro-inflammatory diets increase the risk, likely through developing MetS. Patient nutrition is frequently overlooked in clinical practice, yet it plays a crucial role, especially for women genetically predisposed to androgenetic alopecia. Dietary changes, such as reducing pro-inflammatory foods (like trans and saturated fats) and increasing anti-inflammatory options (fruits and vegetables), can help prevent hair loss and mitigate its psychological impacts, ultimately lowering future treatment costs.

Dietary inflammatory index and type 2 diabetes in US women: a cross-sectional analysis of the National Health and Nutrition Examination Survey, 2007-2018

Objective

Type 2 diabetes (T2D) is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) is a useful tool for assessing dietary inflammation. Although much research links the DII to diabetes, little is known about the relationship in adult women with a reproductive history in the United States. We aimed to investigate how the relationship between the DII and T2D varies among different subgroups of American women.

Methods

Secondary data from the National Health and Nutrition Examination Survey from 2007 to 2018 were analyzed. Cross-sectional analysis of 8,394 American women aged 20 years or older who had at least one live birth. The main outcome was the diagnosis of T2D. Multivariate survey-weighted regression was used to determine the odds ratio (OR) and 95% confidence interval (95%CI) for the association between DII and T2D. A weighted restricted cubic spline (RCS) model was constructed to establish OR curves at three knots to examine the dose-response association between DII and T2D. Additionally, a weighted subgroup analysis was performed in a fully adjusted model to verify that the association was robust.

Results

The study main found a significant association between the DII and T2D (OR = 1.19, 95%CI: 1.12, 1.26, p < 0.001). Participants in the highest third of DII scores had a 56% increased risk of T2D (OR = 1.56, 95%CI: 1.16, 2.10; p for trend = 0.003) compared with those in the lowest third of DII scores, after adjusting for all covariates. The multivariable RCS demonstrated a linear association between DII and T2D (p = 0.892). The subsidiary found that subgroup analyses revealed a significant variation in the association between DII and T2D according to obesity, oral health, and poverty-income ratio (PIR) status. Among non-obese women, the OR was 1.22 (95%CI: 1.08, 1.37); among women with good oral health, the OR was 1.17 (95%CI: 1.07, 1.28); among women with low PIR, the OR was 1.17 (95%CI: 1.05, 1.30); and among women with high PIR, the OR was 1.26 (95% CI: 1.07, 1.48).

Conclusion

Our findings suggest that there is a significant association between DII and T2D and that oral health, obesity, and PIR status may influence the relationship between DII and T2D risk. Further studies are warranted to validate our results and evaluate whether the results are similar in other populations.

The association between energy-adjusted dietary inflammatory index and metabolic syndrome and its mediatory role for cardiometabolic diseases: a prospective cohort study

Background

Metabolic syndrome (MetS) is a collection of medical conditions that elevate the chance of cardiovascular disease. An unhealthy diet is a major risk factors for MetS through different mechanisms, especially systemic chronic inflammation.

Objective

This study aimed to investigate the effect of dietary inflammatory potential on MetS incidence and the role of MetS in the association between Energy-adjusted dietary inflammatory index (E-DII) and cardiometabolic diseases.

Methods

In this prospective cohort study, 10,138 participants were recruited. All participants were divided into MetS or non-MetS groups based on the Adult Treatment Panel III criteria. The E-DII was used to assess the inflammatory potential of diet. After excluding the participants with MetS at baseline, 2252 individuals were followed for 5 years (longitudinal phase), and the effect of E-DII on MetS incidence was investigated using logistic regression models (p-value <0.05).

Results

The cohort's mean age (45.1% men) was 48.6 ± 10.0 years. E-DII ranged from -6.5 to 5.6 (mean: -0.278 ± 2.07). Higher E-DII score had a 29% (95%CI: 1.22-1.36) increased risk for incidence of MetS and its components during five-year follow-up. Also, E-DII was significantly associated with the prevalence of MetS (OR = 1.55, 95%CI: 1.51-1.59). Among MetS components, E-DII had the strongest association with waist circumference in the cross-sectional study (OR = 2.17, 95%CI: 2.08-2.25) and triglyceride in the longitudinal study (OR = 1.19, 95%CI: 1.13-1.25). The association between E-DII and MetS was consistent in both obese (OR = 1.13, 95%CI:1.05-1.21) and non-obese (OR = 1.42, 95%CI: 1.27-1.60) individuals and stronger among non-obese participants. Additionally, MetS mediated the association between E-DII and hypertension, diabetes, and myocardial infarction.

Conclusion

In conclusion, a pro-inflammatory diet consumption is associated with a higher risk of MetS and its components. Furthermore, a pro-inflammatory diet increases the risk of cardiometabolic diseases. The higher E-DII had a stronger association with MetS, even among normal-weight individuals.

Dietary inflammatory potential and arterial stiffness in a French cohort: Insights from the STANISLAS study

BACKGROUND AND AIMS

Chronic inflammation plays a key role in arterial stiffness pathogenesis. Dietary components can display anti- or pro-inflammatory properties. Nonetheless, the association between the diet's overall inflammatory potential and arterial stiffness is unclear. This study aimed to assess the association between the diet's overall inflammatory potential and arterial stiffness assessed by carotid-femoral pulse wave velocity (cfPWV).

METHODS AND RESULTS

This cross-sectional study included 1307 participants from the STANISLAS family cohort study. Dietary data were collected using a validated food frequency questionnaire. The adapted dietary inflammatory index (ADII) score was calculated to assess the inflammatory potential of the participants' diet. The association of ADII score quartile with cfPWV was assessed using IPW-weighted linear mixed models with random family effect. The median (Q1-Q3) ADII score was 0.45 (-1.57, 2.04). Participants exhibiting higher ADII scores demonstrated elevated energy intake, dietary saturated fat, and ultra-processed foods. Conversely, individuals with lower ADII scores exhibited higher vitamins and omega intakes, and a higher diet quality, as assessed by the DASH score. Despite these observations from the descriptive analyses, ADII score quartiles were not significantly associated with cfPWV (β(95% CI) were 0.01 (-0.02,0.04) for Q2, 0.02 (-0.01,0.05) for Q3, and 0.02 (-0.01,0.05) for Q4 compared to Q1).

CONCLUSION

In this cross-sectional study, participants had a relatively modest consumption of pro-inflammatory foods, no substantial associations were observed between the diet inflammatory potential and arterial stiffness. Further longitudinal studies in larger cohorts are needed to better understand the link between inflammatory diet and arterial stiffness.

The association between energy-adjusted dietary inflammatory index and 10-year cardiovascular risk: Fasa adult cohort study

A healthy diet is dominant in cardiovascular disease (CVD) prevention. Inflammation is pivotal for CVD development. This study aimed to evaluate the association between the pro-inflammatory diet and the CVD risk. This cross-sectional study involved 10,138 Fasa adult cohort study participants. After excluding participants with missing data, the Energy-Adjusted Dietary Inflammatory Index (E-DII) was calculated to assess the inflammatory potential of diet using the recorded Food Frequency Questionnaire. Framingham risk score (FRS) was used to predict the 10-year risk of CVD. The association between E-DII and high risk for CVD was investigated using multinominal regression. After exclusion, the mean age of studied individuals (n = 10,030) was 48.6 ± 9.6 years, including 4522 men. Most participants were low risk (FRS <10%) for CVD (87.6%), while 2.7% of them were high risk (FRS ≥20%). The median FRS was 2.80 (1.70, 6.30). The E-DII ranged from -4.22 to 4.49 (mean E-DII = 0.880 ± 1.127). E-DII was significantly associated with FRS. This result persisted after adjusting for confounding factors and in both genders. This study revealed that the pro-inflammatory diet significantly increases the CVD risk. Consequently, reducing the inflammatory potential of diet should be considered an effective dietary intervention in CVD prevention.

Is There a Relationship Between the Dietary Inflammatory Index and Clinical Attachment Loss in Patients with Periodontitis?

OBJECTIVE

The pathogenesis of periodontal diseases is partially driven by oxidative stress. However, studies on the relationship between periodontitis and the inflammatory load of diet are still insufficient. Therefore, this study aimed to examine the relationship between the diet's inflammatory load and periodontitis and clinical attachment loss (CAL).

METHODS

This cross-sectional study included 119 participants diagnosed with periodontitis according to the 1999 classification. The dietary inflammatory index (DII) was calculated using three-day food consumption records and divided into quartiles (Q1, Q2, and Q3). Body mass index (BMI) was calculated as weight and height (kg/m2). Clinical attachment loss (CAL) score was determined, and the patients were grouped with those CAL scores as 7 < CAL and ≥7 CAL.

RESULTS

Of the 119 patients with periodontitis, aged 46.24 ± 12.84 years, 45.3% were found to have an anti-inflammatory diet profile (n = 54). When the daily energy and nutrient intake of individuals were examined, it was found that the intake of omega-3 fatty acids (p = 0.004), black tea (p = 0.021), and green pepper (p = 0.029) was higher in those with CAL < 7 compared to those with CAL ≥ 7. There was no relationship between the patients' DII and CAL values. Daily energy, protein, fiber, vitamin A, vitamin E, folic acid, Fe, Zn, and Mg intake in patients with an anti-inflammatory diet in Q1 were higher than in Q2 and Q3 (p < 0.001).

CONCLUSION

This study found no relationship between DII levels and CAL scores. However, it was observed that periodontitis patients following an anti-inflammatory diet had higher intakes of omega-3 fatty acids, vitamins A, E, and C, as well as zinc and magnesium which are nutrients known to be effective against inflammation. These patients also had CAL scores below 7. Therefore, reducing the inflammatory load of the diet may prevent the development of periodontitis, and further research in this regard would be beneficial.

Associations of dietary inflammatory index scores and serum inflammatory factors with the risk of osteoporosis: a cross-sectional study from Xinjiang, China

BACKGROUND

Previous studies have shown that the inflammatory potential of the diet is associated with a variety of chronic noncommunicable diseases characterized by a chronic low-grade inflammatory response. However, the relationships between dietary inflammatory potential and organismal inflammatory status and osteoporosis have been less studied. This study aimed to investigate the relationships among inflammatory diet, inflammatory state and osteoporosis in the Xinjiang multiethnic population.

METHODS

The participants consisted of 4452 adults aged 35 to 74 years from Xinjiang, China. The dietary inflammatory index (DII) was calculated using dietary data collected with a semiquantitative food frequency questionnaire, and information about osteoporosis was derived from quantitative ultrasound measurements. The relationships of the DII score and inflammatory factors with the risk of osteoporosis were analysed using multivariate logistic regression, and the nonlinear associations between DII and osteoporosis were further analysed using restricted cubic splines.

RESULTS

The results showed that proinflammatory diets were associated with a greater risk of osteoporosis (T3 vs. T1: OR = 1.87; 95% CI = 1.44, 2.45) and that there was no nonlinear relationship between the DII and the risk of osteoporosis. Increased concentrations of the inflammatory factors IL-6, IL-10, IL-12p70, IL-17, and IL-23 were associated with a greater risk of osteoporosis.

CONCLUSIONS

The risk of osteoporosis can be reduced by increasing the consumption of an appropriate anti-inflammatory diet.