Anti-inflammatory Diet Research Articles

Systemic inflammation mediates the association between environmental tobacco smoke and depressive symptoms: A cross-sectional study of NHANES 2009–2018

BackgroundDepression is associated with both environmental tobacco smoke (ETS) and inflammation. However, whether systemic inflammation mediates the ETS-depression relationship is unclear. MethodsWe analyzed 19,612 participants from the 2009–2018 National Health and Nutrition Examination Survey (representing approximately 206,284,711 USA individuals), utilizing data of depressive symptoms (assessed by Patient Health Questionnaire-9), blood cotinine level (an ETS biomarker), dietary inflammatory index (DII, assessed by 24-h dietary recall) and inflammation, represented by immune-inflammation index (SII) and systemic inflammation response index (SIRI). ResultsWeighted multivariable logistic regression showed that a higher blood cotinine level is significantly associated with a higher depressive symptoms risk (OR = 1.79, 1.35–2.38). After adjusting for covariates, the effect in smokers (OR = 1.220, 95 % CI: 1.140–1.309) is larger than that in non-smokers (OR = 1.150, 95 % CI: 1.009–1.318). Compared to the lowest level, depressive symptoms risks in participants with the highest level of SII, SIRI and DII are 19 % (OR = 1.19, 1.05–1.35), 15 % (OR = 1.15, 1.01–1.31) and 88 % (OR = 1.88, 1.48–2.39) higher, respectively. Weighted linear regression demonstrated positive correlations of SII (β = 0.004, 0.001–0.006), SIRI (β = 0.009, 0.005–0.012) and DII (β = 0.213, 0.187–0.240) with blood cotinine level. Restricted cubic splines model showed a linear dose-response relationship between blood cotinine and depressive symptoms (Pnon-linear = 0.410), with decreasing risk for lower DII. And SII and SIRI respectively mediate 0.21 % and 0.1 % of the association between blood cotinine and depressive symptoms. LimitationCross-sectional design, and lack of medication data for depression. ConclusionsPositive association of ETS (blood cotinine) with depressive symptoms risk is partly mediated by systemic inflammation, and anti-inflammatory diet could be beneficial.

Association between the dietary inflammatory index and all-cause mortality in the U.S. cancer survivors: A prospective cohort study using the National Health and Nutrition Examination Survey database

BackgroundCancer remains one of the leading causes of mortality worldwide. Diet can impact inflammation and consequently affect cancer outcomes. The Dietary Inflammatory Index (DII) can serve as a tool to assess the inflammatory potential of cancer survivors' diets and further predict their survival. ObjectivesTo investigate the relationship between the DII and the survival of cancer survivors in National Health and Nutrition Examination Survey (NHANES). MethodsAn overall sample of 2359 U.S. cancer survivors from the 2005–2014 cohorts of the NHANES were studied. The DII scores were calculated using 28 dietary components and the mortality status was ascertained until December 31, 2015. Based on the multiple analyses, the relationship between DII and all-cause mortality was examined. ResultsThe weighted mean age at baseline was 65.17 ± 14.46 years, 53.16 % were female and 71.30 % were non-Hispanic white. The average DII was 1.51 ± 1.97. After accounting for multiple covariates, positive associations were observed (P < 0.01). Based on Kaplan-Meier survival curves, their significant relationship remains same and the survival probability was decreased among the groups of anti-inflammatory diets (DII < 0) versus pro-inflammatory diets (DII ≥ 0) significantly (Log rank test; P = 0.03). Further analyses were conducted on subgroups and the results are still robust. ConclusionsAn elevated DII was associated with a rising mortality rate among cancer survivors. DII might serve as a potential inflammatory predictor of cancer mortality prognosis, as well as guide nutritional care and even clinical treatment of cancer survivors.

Diet Inflammatory Index among Regularly Physically Active Young Women and Men.

Recently, special attention has been paid to the relationship between diet and inflammation in the body. A factor that influences both diet and inflammation is physical activity. The aim of this study was to assess the inflammatory potential of the diets of young people engaging in regular physical activity. The participants were physical education students (n = 141 men and n = 151 women). The measurements included basic anthropometric parameters and a 4-day nutritional history from which the dietary inflammatory index (DII) was calculated. The average DII for female students was 2.09 ± 1.52, and that for male students was 0.21 ± 1.69. Consumption of all macro- and micronutrients was significantly higher among women and men with the lowest DII value (corresponding to an anti-inflammatory diet). The female and male students consuming anti-inflammatory diets were characterized by greater lean body mass (LBM), and, for the male students, a lower body fat content, compared to those whose diets were pro-inflammatory. Young and regularly physically active people are also exposed to the pro-inflammatory nature of their diets, whose long-term effects may lead to health problems.

Impact of the anti-inflammatory diet on serum high-sensitivity C-Reactive protein and new-onset frailty in community-dwelling older adults: A 7-year follow-up of the Kashiwa cohort study.

Chronic inflammation is a pathophysiological cause of age-related diseases, including frailty. Although diet is a determinant of inflammation, few prospective studies have investigated its role in frailty onset. This study used the dietary inflammatory index to investigate whether a proinflammatory diet affects the incidence of frailty in a 7-year follow-up of older Japanese adults. We enrolled community-dwelling older adults without frailty from the 2014 Kashiwa cohort study. Energy-adjusted dietary inflammatory index (E-DII) scores were calculated using a brief self-administered diet history questionnaire. Serum high-sensitivity C-reactive protein (hsCRP) levels were measured by immunoassays. Frailty was defined as meeting three of Fried's five phenotypic criteria. Cox regression was used to analyze associations between E-DII scores and new-onset frailty after adjusting for relevant confounders. Overall, 95 (11.7%) of 811 participants (73.7 ± 4.8 years, women 47.3%) developed new-onset frailty during the 7-year follow-up. The baseline E-DII scores significantly correlated with log-hsCRP levels, even after adjustment (β = 0.075, P = 0.035). The highest tertile of E-DII scores (proinflammatory diet) showed a 2.03 times (95% confidence interval, 1.22-3.36) higher risk of new-onset frailty than that associated with the lowest tertile (P = 0.006). When E-DII was calculated on the basis of anti-inflammatory food parameters only, the highest tertile showed a 2.32 times (95% confidence interval, 1.36-3.95) higher risk than that associated with the lowest tertile (P = 0.002). E-DII scores significantly correlated with serum hsCRP levels. High E-DII scores caused by low intake of anti-inflammatory foods are associated with frailty incidence. For community-dwelling older adults, dietary interventions that lower E-DII scores (e.g., encouraging dietary fiber intake) may help prevent frailty. Geriatr Gerontol Int 2024; 24: 189-195.

The relationship between dietary inflammatory index and osteoporosis among chronic kidney disease population

Dietary inflammation index (DII) is an epidemiological survey tool to evaluate dietary inflammation potential. Osteoporosis, whose development is deeply affected by inflammation, may be also affected by dietary inflammatory patterns. However, the relationship between DII and osteoporosis is unclear for chronic kidney disease (CKD) population. Our study involved 526 CKD patients from the US National Health and Nutrition Examination Survey (NHANES). DII levels were stratified into four quantile groups. Multivariable regression models were used to examine the association between DII and osteoporosis. Restricted cubic splines and subgroup analysis were additionally adopted. Results showed that the overall prevalence of osteoporosis among CKD patients was 25.3%. After fully adjusted, OR (95% confidence interval) for Q4 group compared with Q3 (reference group) in total and female population were 2.09 (1.05, 4.23) and 2.80 (1.14, 7.08), respectively. Subgroup analysis indicated that these results had no interaction with age, gender, body mass index (BMI), renal function, urinary protein, calcium, phosphorus and total 25-hydroxyvitamin D. DII was negatively correlated with lumbar spine bone mineral density (BMD) in CKD population (P < 0.05). Therefore, in CKD patients, higher DII was associated with higher osteoporosis risk and lower BMD of lumber spine, especially in female. Anti-inflammatory diet patterns may be a protective intervention for some CKD-related osteoporosis.

Association between dietary inflammatory index and body fat percentage among newly diagnosed breast cancer patients

Background Obesity, particularly excessive body fat, is an established risk factor and substantial prognostic determinant in breast cancer. Recent studies suggested that diet-related inflammation plays a key role in obesity. This study aimed to determine the association between energy-adjusted dietary inflammatory index (E-DII) and body composition, particularly body fat percentage, among patients with newly diagnosed breast cancer. Materials and methods This cross-sectional study was conducted on 124 breast cancer outpatients within the first year of diagnosis and yet to commence oncological treatment. Body composition parameters [body weight, body mass index (BMI), body fat percentage, fat mass over fat-free mass ratio (FM/FFM), muscle mass, and visceral fat] were obtained using a bioelectrical impedance analyzer. Body fat percentage was categorized into two groups which were normal (<35%) and high (≥35%). The E-DII was calculated from the validated 165-items Food Frequency Questionnaire (FFQ) and categorized into three groups or tertiles. Multiple logistic regression analysis was used to determine the association between the E-DII and body fat percentage. Results Mean body weight, body fat percentage, FM/FFM, and visceral fat increased as E-DII increased from the lowest tertile (T1) to the most pro-inflammatory tertile (T3) (p for trend <0.05). E-DII was positively associated with body fat percentage (OR 2.952; 95% CI 1.154–7.556; p = 0.024) and remained significant after adjustment for cancer stage, age, physical activity, ethnicity, smoking history, and presence of comorbidities. Compared to T1, participants in T3 had a significantly lower consumption of fiber, vitamin A, beta-carotene, vitamin C, iron, thiamine, riboflavin, niacin, vitamin B6, folic acid, zinc, magnesium, and selenium, but a higher intake of total fat, saturated fat, and monounsaturated fatty acids. Conclusions A higher E-DII was associated with increased body fat percentage, suggesting the potential of advocating anti-inflammatory diet to combat obesity among newly diagnosed breast cancer patients.

Diet and Nutrition in Inflammatory Bowel Disease: A Review of the Literature.

Diet is thought to contribute to the development of inflammatory bowel disease (IBD) and may act as a mediator of inflammation in patients with IBD. Patients commonly associate their diet with symptoms and inquire about dietary modifications to manage their IBD. Without clinical guidelines and well-established nutritional data, healthcare providers managing patients with IBD may find it difficult to provide recommendations. Strong evidence for enteral nutrition, particularly in the pediatric population, has been established in Crohn's disease (CD) as a therapeutic option. Enteral nutrition may also serve as an adjunct to an exclusion diet. Recent studies such as the randomized trial comparing the Specific Carbohydrate Diet to a Mediterranean Diet in CD patients provide additional insights in forming dietary plans. A low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet in quiescent IBD and an anti-inflammatory diet have also been explored as adjunctive therapies. In this review, we discuss the latest evidence for the role of diet in IBD both as a therapeutic modality and as an opportunity to provide patient-centered care.

The mediating role of dietary inflammatory index on the association between eating breakfast and depression: Based on NHANES 2007–2018

BackgroundDepression is a significant, pervasive, global public health problem, associated with many factors, such as diet, social factors, and lifestyle habits. We aimed to evaluate the association between eating breakfast, dietary inflammatory index (DII) and depression, and to verify the mediating role of DII on the effect of eating breakfast on depression. Methods21,865 participants from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included in this study. Binary logistic regression and mediated effect analysis were conducted to analyze the associations between eating breakfast, DII and depression. Dietary inflammation was divided into pro-inflammatory diet and anti-inflammatory diet according to the DII. ResultsBoth pro-inflammatory diet and skipping breakfast were risk factors for depression. After adjusting for covariables, compared with participants reporting breakfast in both recalls, reporting breakfast in one recall had a higher OR 95%CI (1.54(1.20, 1.98)) of depression. These associations in stratified analysis and sensitivity analysis without cardiovascular diseases (CVD) and diabetes were robust. DII mediated the association between eating breakfast and depression, the proportion of participants who reported breakfast in one recall and no recall was 26.15 % and 26.67 %, respectively. LimitationsThis was a cross-sectional study that couldn't argue for the cause-effect relationship. Moreover, the confounding factor regarding medication use was not accounted for due to limited data. ConclusionsSkipping breakfast may increase the risk of depression by raising DII. And our study supported the essential role of regular breakfast and the anti-inflammatory diet in reducing the risk of depression.

Abstract B056: Inflammatory dietary pattern and risk of multiple myeloma in US Black women

Abstract Background: Multiple myeloma (MM) takes a disproportionate toll on Black Americans compared to non-Hispanic whites, yet factors related to these disparities remain poorly understood. In a prior analysis of two prospective cohort studies examining diet and MM, a dietary inflammatory pattern was significantly associated with MM risk. Here, we investigate the association between dietary inflammatory index (DII) score and MM incidence in a cohort of US Black women. Methods: The Black Women’s Health Study (BWHS) is a prospective cohort study that enrolled 59,000 US self-identified Black women age 21-69 at entry in 1995. Incident cases of MM, identified among BWHS participants followed by biennial questionnaires, were confirmed via medical record review or linkage with cancer registries. We analyzed food frequency questionnaire (FFQ) data collected in 1995, excluding participants with implausible or missing FFQ data. We also excluded women diagnosed with cancer (other than non-melanoma skin cancer) prior to baseline. FFQ data were used to create a dietary inflammatory index (DII) for each person. The DII score includes total fat and cholesterol as pro-inflammatory dietary contributors, and n-3 PUFAs, selenium, and vitamin D as anti-inflammatory contributors. The DII has been previously associated with six inflammatory markers (CRP, IL-1b, IL-4, IL-6, IL-10, TNF-a). We evaluated associations of DII score quintile with MM incidence using Cox proportional hazards regression, adjusted for age, body mass index (BMI), and total energy intake (kcal/day). Results: Among 55,276 BWHS participants eligible for this analysis, we confirmed 313 incident cases of MM over 26 years of follow-up. Median age at baseline was 38 years old and median BMI was 26.6 kg/m2. The multivariable hazard ratio for women in the top quintile of DII (most pro-inflammatory diet) relative to the lowest quintile (most anti-inflammatory diet) was 0.71 (95% confidence interval: 0.43, 1.16). Conclusions: Overall, DII score was not associated with MM incidence in this cohort of US Black women. Ongoing analyses of markers of dietary inflammation and specific food groups may clarify the possible role of dietary components in MM pathogenesis. Cumulative time-varying models of DII score may also offer more robust conclusions in future analyses. Citation Format: Anisha V. Patel, Julie R. Palmer, Jessica L. Petrick, Kimberly A. Bertrand. Inflammatory dietary pattern and risk of multiple myeloma in US Black women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B056.

Nutritional therapy for inflammatory bowel disease

This article presents a synthesis of publications from the relevant scientific literature, addressed to the importance of nutritional treatment in patients with inflammatory bowel diseases (IBD). Various restrictive and elimination diets are critically reviewed from the perspective of evidence-based medicine, including: exclusive enteral nutrition, low-FODMAP, specific carbohydrate, paleolithic, anti-inflammatory, CD-TREAT, and other diets. Although there are countless books and websites on „medical nutrition” in IBD, there is no conclusive evidence to support restrictive diets in IBD patients. Thus, current recommendations for these patients should rather focus on a healthy and balanced diet, based on natural, unprocessed products, rather than limiting and/or adding certain dietary components. In addition, patients with IBD should be encouraged to practice appropriate physical activity, which during the remission period should not differ from that recommended for healthy people.

The effect of an anti-inflammatory diet on cervical cancer patients

The effect of an anti-inflammatory diet on cervical cancer patients

Analysis of anti-inflammatory Diet Combined with Traditional Chinese Medicine to Prevent and Treat Malignant Tumors Based on Chronic Inflammation

Analysis of anti-inflammatory Diet Combined with Traditional Chinese Medicine to Prevent and Treat Malignant Tumors Based on Chronic Inflammation

Association between the dietary inflammatory index and gout in the National Health and Nutrition Examination Survey 2007–2018

ObjectiveThe aim of our study was to investigate whether the Dietary Inflammatory Index (DII) correlated with gout in American adults. MethodThe study used data from the 2007–2018 National Health and Nutrition Examination Survey, with 27,710 adults participating. Initially, multivariable analysis was performed, with controls for covariates, to assess the link of DII and gout. Then, restricted cubic splines (RCS) were applied to model the nonlinear relationship of DII and gout. Furthermore, propensity score matching (PSM) as a further study of potential relationships was established. Eventually, subgroup analysis was performed. ResultParticipants within the highest DII quartile would be more susceptible to increased risk of gout in the univariate regression model (Q4 vs. Q1, OR = 1.31, CI: 1.05–1.63). Additionally, a positive correlation was detected between gout risk and DII after adjusting on drinking, smoking, gender, race, age, and BMI. Based on RCS analysis, we observed that the risk of gout raised sharply as DII values increased, then flattened, and increased sharply again when the DII was greater than approximately 2.5. After performing the PSM, it was observed that DII correlated in a positive way to the presence of gout on a fully adjusted multivariable model. Subgroup analysis revealed that the link of DII and gout showed no statistical significance in females, blacks, Mexicans, nor in the population that smoked. ConclusionGreater degrees of pro-inflammation correlate with a higher risk of gout and might be a predisposing factor for gout. Hence, tactics fostering an anti-inflammatory diet for preventing and improving gout in adults should be regarded.

Association of the dietary inflammation index (DII) with the prevalence of chronic kidney disease in patients with type-2 diabetes mellitus

Chronic kidney disease (CKD) is a major complication of diabetes mellitus (DM). Inflammation is an essential component in the process of CKD progression in patients with DM. Diet is a significant determinant of systemic inflammation levels. However, the association between the dietary inflammatory index (DII) and CKD in individuals with DM remains largely unknown; therefore, the aim of this study was to explore whether the DII is linked to the prevalence of CKD in patients with DM. The research method was as follows: first, data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 were obtained. There were 7,974 participants in our study. These individuals were then classified into three groups according to DII tertiles (T1-T3), with each group consisting of 2,658 participants. Logistic regression analysis was employed to examine whether there was a connection between the DII and CKD. We observed a significant association between the DII and the prevalence of CKD in individuals with DM. After full adjustment for age, sex, ethnicity, smoking, drinking, body mass index (BMI), triglyceride (TG), total cholesterol (TC), metabolic equivalents (METs), energy intake, hypoglycemic medications, hypertension, and cardiovascular disease (CVD), the group with a higher DII had a greater frequency of CKD (T2 group: OR: 1.40; 95% CI: 1.10–1.76; p = 0.006; T3 group: OR: 1.67; 95% CI: 1.29–2.17; p < 0.001). The implementation of an anti-inflammatory diet could serve as an intervention strategy for patients with DM to prevent the onset of CKD.

The association between dietary inflammatory index and cognitive function in adults with/without chronic kidney disease

Background and aimsCognitive impairment (CI) is a prevalent condition in patients with chronic kidney disease (CKD), who face an elevated risk of developing cognitive decline. The fundamental mechanism underlying CI is linked to chronic inflammation, which can be gauged by the Dietary Inflammatory Index (DII). The DII is categorized into anti-inflammatory diets with lower scores and pro-inflammatory diets with higher scores. Specifically, pro-inflammatory diets may contribute to chronic inflammation. However, the correlation between the inflammatory potential of diet and cognitive function in patients with CKD has not been explored. This study aims to investigate the connection between the inflammatory potential of diet and cognitive function in individuals with or without chronic kidney disease.MethodsData from the 2011–2012 and 2013–2014 National Health and Nutrition Examination Survey (NHANES) were utilized. Participants under the age of 60 or lacking DII, CI, CKD, and other essential data were excluded. DII was computed based on a 24-h dietary recall interview for each participant. Cognitive performance was evaluated using three cognitive tests: the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test, the Animal Fluency Test (AFT), and the Digital Symbol Substitution Test (DSST). Logistic regression analysis and subgroup analysis were conducted to assess the independent relationship between DII score and CI in the CKD and non-CKD populations.ResultsThe study included a total of 2069 subjects, with CI prevalence ranging from 21.4 to 23.5%. Multiple regression models showed that after adjusting for all covariates of the three cognitive function tests, higher DII scores were significantly associated with increased risk of CI (CERAD OR = 1.18, 95% CI: 1.1 ~ 1.26, AFT OR = 1.15, 95% CI: 1.08 ~ 1.23, DSST OR = 1.19, 95% CI: 1.11 ~ 1.28). Subgroup analysis indicated that the effect of DII score on CI remained consistent in all subgroups (p &amp;gt; 0.05).ConclusionHigher DII scores were associated with an increased risk of cognitive impairment in people with or without CKD, suggesting that consuming a pro-inflammatory diet may contribute to the impairment of the cognitive function.

A Whole Foods Plant-Based Weight Loss Intervention Improves Quality of Life, Metabolic, Microbiome and Immune Profile in MGUS/SMM As Well As Progression Trajectory in a Subset - the Nutrivention Trial

Introduction Obesity, low adiponectin, high leptin, high insulin, and diets lacking plant-based foods are risk factors for plasma cell disorders (PCDs). Patients (pts) with monoclonal gammopathy (MGUS) and smoldering myeloma (SMM) and an elevated body mass index (BMI) are twice as likely to progress to myeloma (MM). There is evidence of microbiome dysbiosis in pts with PCDs and dietary changes can induce large microbial shifts. Therefore, there is a rationale to study a whole food plant-based dietary (WFPBD) intervention to improve modifiable biomarkers and disease trajectory. Methods This was a pilot, single-arm trial of WFPBD (self-selected prepared frozen lunch/dinner provided by Plantable with breakfast/snack guidance and no calorie restriction) for 12-weeks (w) and health coaching for 24w (by Plantable coach and a research dietitian) in pts with MGUS/SMM and BMI ≥25 (NCT04920084). The primary endpoint was feasibility (mean BMI reduction ≥5% and mean dietary adherence [kcal % unprocessed plant food intake] ≥70%) at 12w; secondary endpoints included quality of life (QoL) (EORTC QLQ C30 survey using a linear-mixed effect model), metabolic markers (plasma insulin, adiponectin leptin (AL) ratio via ELISA), gut microbiome (inverse Simpson index α-diversity and relative abundance of butyrate producers (RABP) via stool 16S sequencing), peripheral blood immune profile (leukocyte subsets via 36 color flow cytometry), secreted biomarkers (plasma via Olink inflammation panel) and change in monoclonal (M)-spike concentrations. Rate of change of M-spike/year (y) measured by slope with 95% CI was calculated for up to 20 months (m) pre-intervention and 20m post intervention start (baseline (BL)). A p-value for difference in M-spike rates was calculated. Results The study enrolled 23 pts of which 20 completed the 12w intervention and 16 completed 1y. The median age was 62y with 43% male, 43% non-White, 52% MGUS, 74% obese, and 26% prediabetic/diabetic. The study met feasibility endpoints with 90% mean and 92% median adherence during 12w intervention and 77% median at 24w. There was an 8.3% mean and 6.6% median BMI reduction at 12w and 8.6% median at 24w. There was an improvement in global health status/QoL (median increase 16.7 points, p=0.03), a reduction in dyspnea (median decrease -33.3 points, p=0.001), fatigue (median decrease -11.1 points, p=0.06), and insulin (median decrease 0.791 mU/L; p=0.01), and an increase in AL ratio (median increase 0.09; p=0.0002), α-diversity (median increase 6.18 to 8.42; p= 0.03) and RABP (median increase 0.03 to 0.08; p=0.042) at 12w. Prelim results at 12w suggest a measurable, albeit not significant change in immune subsets such as an increase in monocytes, regulatory T cells, and a decrease in dendritic cells, trends previously associated with anti-inflammatory diets, as well as increase in butyrate. A decrease in proinflammatory cytokines IL8 (p=0.065), IL12B (p=0.068), and TNFB (p=0.082) and an increase in FGF21 (p=0.043) (promoter of insulin sensitivity) was also observed. Butyrate is known to reduces pro-inflammatory cytokines and increase anti-inflammatory proteins, including FGF21. Further immune and microbiome analysis is ongoing. Of 16 pts followed for 1y, 2 with significant BMI reduction had significant improvement in M-spike trajectory: Case 1: Mayo Int Risk IgGκ/IgGλ MGUS achieved a 1y BMI reduction of 19%. Pre-intervention M-spike changed +0.28g/dL/y (6 M-spike values), and during intervention M-spike changed +0.03g/dL/y (11 M-spike values); p=0.008. BL M-spike 1.2g/dL and bone marrow plasma cells (BM PC) &amp;lt;5%; 1.5y BM PC 5-9%. Case 2: IMWG Int Risk IgGκ SMM achieved a 1y BMI reduction of 13%. Pre-intervention M-spike changed +0.11g/dL/y (8 M-spike values), and during intervention M-spike changed -0.05g/dL/y (8 M-spike values); p=0.04. BL M-spike 1.2g/dL and BM PC 20-30%; 1y BM PC 10-15%. Two pts without significant BMI reduction (-4% and -1% at 1y) had rising M-spikes. The remaining 12 pts had median 7.5% BMI reduction at 1y with stable M-spike. Conclusions This is the first dietary intervention trial in PCDs with insights into the mechanisms by which a WFPBD may delay progression. The intervention improves QoL, metabolic (BMI, insulin resistance), microbiome (α-diversity and butyrate producers) as well as immune (reduced inflammation) profile with potentially slowing progression trajectory in a subset. A larger trial is underway (NCT05640843).

11.D. Round table: Anti-inflammatory vs. sustainable dietary patterns throughout the life course

Abstract Diet is well known to affect the risk of several chronic diseases throughout the life course, potentially through modulation of the inflammatory response. Chronic inflammation, which increases with age, may contribute to the development of various chronic diseases, including cardiovascular disease, diabetes, and cancer. In parallel, the environmental impact of diet varies substantially depending on the choice of food products and the underlying production systems. Adopting sustainable diets produces co-benefits for population health, but also for the environment by limiting greenhouse gas emissions and land use. However, these patterns may be deficient in micronutrients, and are not consistently associated with lower risk of chronic conditions throughout the life course. In particular, among children and adolescents, nutritionally adequate and appealing sustainable diets are important to promote healthy growth and to develop sustainable dietary habits. Therefore, we developed this workshop with the aim to explore the overlap and synergies between sustainable and anti-inflammatory diets at different stages in life. As dietary patterns provide a more complete overview of usual diet intake, in this panel we will (1) briefly present different methods that can be used to estimate dietary patterns and as an example, we will present previous results from inflammatory dietary patterns and their association with cognitive decline. Regarding adherence to sustainable diets, we will present results from (2) studies in adults (Danish Diet, Cancer and Health study) and their association to stroke, type 2 diabetes and overall mortality and (3) studies in children (‘Children of the 90s’ ALSPAC cohort) regarding their growth curves. Regarding challenges in policy implementation, we will present (4) an example of a co-creation strategy with students and chefs to develop innovative and healthy plant-based foods for school canteens. In the discussion part of the round table, we will focus on how to combine anti-inflammatory and sustainable diets to promote health across the life course and the potential strategies for policy implementation of these dietary patterns. The objectives of this workshop are (1) to discuss within a multidisciplinary set of experts the potential synergies between two very popular “healthy” dietary patterns and (2) to evaluate what are the main challenges of implementing dietary strategies based on these diets in different generations: among children who could potentially not have their needs fulfilled and among adolescents who might not accept such dietary changes, plus potential strategies for middle-aged and older adults. The added value is to bring domain experts together in a discussion space, where new knowledge can be generated, research gaps in this field can be highlighted and future interdisciplinary collaborations be fostered. Key messages • Some dietary factors might have an impact on chronic conditions through inflammatory pathways. Yet the overlap and synergies between sustainable and anti-inflammatory patterns is still not explored. • Sustainable diets may produce health benefits throughout the life course. Implementation strategies can be challenging, however innovative strategies in schools may be successful. Speakers/Panelists Patricia Chocano-Bedoya Institute of Primary Health Care, Bern, Switzerland Christina Dahm Department of Public Health, Aarhus University, Aarhus, Denmark Jessica Laine Carmeli Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland Margarita Kokkorou European Commission Joint Research Centre, Ispra, Italy

The feasibility of an anti-inflammatory diet in endometriosis: barriers and facilitators perceived by endometriosis patients

Research questionWhat is the feasibility of an anti-inflammatory diet in women diagnosed with endometriosis? DesignQualitative study using semi-structured focus groups and individual interviews among patients with endometriosis. Transcripts of the focus groups and interviews were thematically analysed using ATLAS.ti 9. To identify and structure the ideas and views from the focus groups and interviews, two behavioural change models were used. The Capability Opportunity Motivation Behaviour (COM-B) model and domains of the Theoretical Domains Framework (TDF) helped to identify factors that make adherence to an anti-inflammatory diet more or less feasible for women with endometriosis. ResultsThe study population consisted of 23 patients with endometriosis. Numerous perceived barriers and facilitators were identified from all COM-B components and 13 out of 15 TDF domains. Knowledge and social influences were the most prominent TDF domains. Key barriers were eating with others; disbelief in a patients’ own capability regarding specific dietary guidelines; concerns about taste; lack of knowledge on how to follow the diet; lack of noticeable beneficial effect; and lack of intention to follow the diet to full extent. Key facilitators were receiving social support; general confidence in a participant's own capabilities; knowing how and why to follow the diet; noticing beneficial effect; and belief that the diet would alleviate symptoms. ConclusionProvision of knowledge, stimulating social support and enhancing self-efficacy should be emphasized. Overall, an anti-inflammatory diet in endometriosis patients, especially when identified barriers and facilitators are addressed in an intervention, is feasible.

The relationship between dietary inflammatory potential and cancer outcomes among cancer survivors: A systematic review and meta-analysis of cohort studies

Cancer remains the second leading cause of death globally. Chronic inflammatory environments promote the growth of tumors, and the intake of certain food items can increase systemic inflammation. This study examined the relationship between the inflammatory potential of diet, measured by the Dietary Inflammatory Index (DII), and recurrence, all-cause, and cancer-specific mortality among cancer survivors. Web of Science, Medline, CINHAL, and PsycINFO databases were searched in April 2022. Two independent reviewers screened all searches. Of the 1,443 studies, 13 studies involving 14,920 cancer survivors passed all the screening stages. Three studies reported cancer recurrence, 12 reported all-cause mortality, and six reported cancer-specific mortality. Seven studies calculated DII from pre-diagnosis diets, five from post-diagnosis diets, and one from both pre-and post-diagnosis diets. A random-effects model meta-analysis showed that high DII was not associated with an increased risk of recurrence (HR = 1.09, 95 % CI = 0.77, 1.54, n = 4) and all-cause (HR = 1.08, 95 % CI = 0.99, 1.19, n = 14) and cancer-specific mortality (H = 1.07, 95 % CI = 0.92, 1.25, n = 6). Analysis by the timing of dietary assessment showed that only post-diagnosis DII was associated with an increased risk of all-cause mortality (HR = 1.34, 95 % CI = 1.05, 1.72, n = 6) by 34 %; however, cancer type did not modify these associations. The quality of the study assessed using the Newcastle Ottawa Scale indicated all but one studies were good. The risk of all-cause mortality among cancer survivors could be reduced by consuming more anti-inflammatory diets after cancer diagnosis.

Anti-inflammatory diet and rheumatoid arthritis: overview on the current evidence

INTRODUCTION: Rheumatoid arthritis is a chronic autoimmune disease, with symptoms that are characterized by inflammation of the joints and requires pharmacological treatment. However, pharmacological approach is not always enough to eliminate the symptoms related to rheumatoid arthritis, and nutritional intervention is necessary as a complementary treatment to obtain a significant improvement in symptoms. Several nutritional approaches have been studied to understand which diet would provide more benefits to patients with rheumatoid arthritis, and anti-inflammatory diet described as rich in nutrients with antioxidant effect, may contribute beneficially to the control of symptoms. OBJECTIVES: The present study aimed to review the literature existent on the effect that practice an anti-inflammatory diet may have on the symptoms of rheumatoid arthritis, in order to understand its applicability, benefits, as well as limitations. METHODOLOGY: The literature review was elaborated through a bibliographic search, in the PubMed database. The search term use was: “((inflammation AND diet*) OR anti-inflammatory diet) AND (arthritis rheumatoid OR rheumatoid arthritis))”. RESULTS: Current scientific evidence has shown positive effects of the anti-inflammatory diet in rheumatoid arthritis patients, such as reduction of disease activity, reduction of tender and swollen joints and joint pain and improved physical functioning. CONCLUSIONS: The anti-inflammatory diet is a promising complementary treatment of rheumatoid arthritis, with several benefits, namely the reduction of disease activity and symptoms, as well as, in the acquisition of a more balanced food pattern.