Dietary Inflammatory Index Is a Better Determinant of Quality of Life Compared to Obesity Status in Patients With Hemodialysis

Abstract

This study aimed to investigate the relationships among obesity, anthropometries, and the dietary inflammatory index (DII) with different aspects of quality of life (QoL) in patients undergoing hemodialysis. In 83 patients representing a range of body weights, QoL (based on short form 36), DII (extracted from dietary recalls), malnutrition-inflammation score, and anthropometric measurements were assessed. Obese patients had lower physical health score (mean difference [MD] 9.1, 95% confidence interval [CI] 0.3-17.8, P=.04), physical functioning (MD 10.5, 95% CI 0.7-20.2, P=.04), and bodily pain scores (MD 16.0, 95% CI 3.6-28.4, P=.01) than normal weight group. Patients with abdominal obesity and those with the highest body fat percentage had also lower QoL in many aspects, irrespective of body mass index. The physical (MD 13.2, 95% CI 2.05-24.3, P=.02) and mental (MD 18.4, 95% CI 7.51-29.2, P=.001) health scores, and physical functioning (MD 13.5, 95% CI 1.8-25.2, P=.02), role-physical (MD 25.8, 95% CI 3.0-48.6, P=.03), role-emotional (MD 22.1, 95% CI 5.4-52.8, P=.02), vitality (MD 18.4, 95% CI 7.6-29.3, P=.001), mental health (MD 11.7, 95% CI 3.06-20.4, P=.009), and social functioning (MD 14.2, 95% CI 1.13-27.2, P=.03) were considerably lower in patients with the highest versus the lowest DII. QoL did not differ between normal-weight and obese patients with low DII (P=.26), and between normal-weight and obese patients with high DII (P=.13). Obese patients with low DII also had better QoL than normal-weight subjects with high DII scores. A diet with higher proinflammatory potential was associated with decreased QoL, irrespective of obesity status. Adherence to a low-DII diet might protect against some obesity-associated complications, a finding that needs further investigations.