Abstract

Background and AimsPrevious studies suggested that dietary inflammatory index (DII) was associated with a variety of adverse health conditions. However, less is known about the role of DII in prediabetes and insulin resistance (IR). Therefore, this study aimed to investigate whether DII is associated with prediabetes and IR in American adults.Method and ResultsDII scores were calculated using the average of two 24-hour dietary recalls. Linear regression models were performed to evaluate the associations of DII with markers of Type 2 diabetes (T2D) risk, and the associations of DII with prediabetes and IR were estimated using logistic regression model. The diet of the participants showed an anti-inflammatory potential, with a mean DII score of −0.14 (range: −5.83 to +5.32). After controlling for multiple potential confounders, DII scores were positively associated with fasting plasma glucose (FPG) (β: 0.009; 95%CI: 0.005 to 0.012), fasting serum insulin (FSI) (β: 0.083; 95%CI: 0.067 to 0.099) and homeostatic model assessment of insulin resistance (HOMA-IR) (β: 0.092; 95%CI: 0.075 to 0.109). Participants in the highest tertile of DII score have increased odds of prediabetes (OR: 1.40; 95%CI: 1.17 to 1.69; P for trend <0.001) and IR (OR: 1.79; 95%CI: 1.49 to 2.14; P for trend <0.001) compared with those in the first tertile of DII score.ConclusionsThis study indicates that DII was positively associated with FPG, FSI, and HOMA-IR, and a more pro-inflammatory diet was related to increased odds of insulin resistant and prediabetes.

Highlights

  • There are about 34.2 million people with diabetes in the US, and the prevalence of diabetes is expected to continue to rise in the future [1]

  • Previous studies have shown that dietary inflammatory index (DII) scores were related to a host of health conditions in the general population, namely, hypertension, cancer, and even death [14, 15]

  • The associations of continuous DII scores with FPG, FSI, and HOMA-insulin resistance (IR) were significant after adjustment for potential confounders, but the relationship between DII and HbA1c was significant only after adjustment for covariates in model 2

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Summary

Introduction

There are about 34.2 million people with diabetes in the US, and the prevalence of diabetes is expected to continue to rise in the future [1]. Findings from prior studies have demonstrated that several pro-inflammatory dietary components (e.g., fat and carbohydrate) were associated with increased risk of IR and other poor health conditions [8–10], while other anti-inflammatory nutrients (e.g., fiber) may have protective effects on health conditions [11]. It may be difficult to capture the overall effects of diet on health by studying the relationship of single nutrient with diseases. In this context, the dietary inflammatory index (DII) has been proposed to evaluate the inflammatory potential of the overall diet and link diet to inflammation which was a key driver in the progression of prediabetes and IR [12, 13]. This study aimed to investigate whether DII is associated with prediabetes and IR in American adults

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