Energy-adjusted DII Research Articles

The Dietary Inflammatory Index is associated with diet quality and nutrient intake during the gestational period

In pregnant women, the Energy-adjusted Dietary Inflammatory Index (E-DII) is adopted to measure the inflammatory potential of the diet, but it does not predict the quality of the diet. Our hypothesis is that a more pro-inflammatory diet during pregnancy is also a poorer quality diet. Thus, the objective of this study is to verify the association of the E-DII with the Diet Quality Index Adapted for Pregnancy (DQI-P) and the nutrient intake from the diet in terms of the second and third gestational trimesters. This is a cross-sectional study that took place in Brazil (2018-2019), with eligible adult women up to 72 hours' postpartum and in good health. Socioeconomic, gestational, anthropometric, and food consumption data were collected, enabling the calculation of E-DII, DQI-P, and nutrient intake. The sample (n = 260) had a median E-DII of 0.04 (-1.30 to 1.90) and DQI-P of 68.82 (18.82-98.22). There was no relevant difference between E-DII tertiles by sociodemographic, gestational, and anthropometric characteristics. The E-DII and the DQI-P showed agreement (55.7%) and inverse correlation (r = -0.53; P < .001). Each 1-unit increase in DQI-P, iron, iodine, magnesium, pyridoxine, and vitamin E decreased the E-DII score (P < .05). An increase of 1 unit in protein, saturated fatty acids, and vitamin C increased the E-DII score (P < .05). Thus, the results suggest that the E-DII can predict diet quality during pregnancy, with the added benefit of measuring the inflammatory potential of the diet.

Dietary inflammatory index, dietary total antioxidant capacity, and frailty among older Chinese adults

ObjectivesFrailty is an age-related syndrome associated with poor health outcomes. Studies in developed countries indicate that the dietary inflammatory index (DII) and dietary total antioxidant capacity (DTAC) are important dietary factors influencing the risk of frailty in older adults. However, few studies have explored the association between DII, DTAC, and frailty among older Chinese adults. The objective of the current study was to examine whether DII and DTAC were associated with pre-frailty or frailty among older Chinese adults. DesignA cross-sectional study. SettingCommunity-based. ParticipantsWe included 6414 participants aged ≥60 years. MeasurementsDietary intake was assessed using a validated food frequency questionnaire (FFQ). The DII and energy-adjusted DII (E-DII) were calculated using food parameters. DTAC was estimated using two widely adopted antioxidant scores: DTAC based on ferric reducing antioxidant power and dietary antioxidant quality score (DAQS) obtained from vitamins (vitamins A, C, and E) and minerals (zinc and selenium) with antioxidant functions. Frailty was assessed using the frailty index (FI) calculated from 28 health-related deficits. Individuals were classified as robust (FI ≤ 0.10), pre-frailty (FI > 0.10 to <0.25), or frailty (FI ≥ 0.25). Multiple logistic regression models were used to evaluate the associations of DII and DTAC with pre-frailty and frailty. ResultsAfter adjusting for confounding factors, individuals in the highest DII quintile (Q5) were more likely to have pre-frailty (odds ratio [OR] = 1.56; 95% confidence interval [CI]: 1.25–1.93; P for trend <0.001) than those in the lowest Q1. A similar positive association was detected for E-DII and pre-frailty. A significant association was found between DII and frailty. Compared with the lowest Q1, the highest Q5 of DTAC was negatively correlated with pre-frailty (OR = 0.66; 95% CI: 0.52–0.84; P for trend <0.001) and frailty (OR = 0.71; 95% CI: 0.50–0.1.03; P for trend <0.001). The DAQS yielded results similar to pre-frailty results (OR = 0.72; 95% CI: 0.58–0.89; P < 0.001). There was no evidence suggesting an association between DAQS and frailty. ConclusionsMore proinflammatory diets were linked to higher pre-frailty risk, whereas higher levels of dietary antioxidants were associated with lower pre-frailty and frailty risk among older Chinese adults.

The association between energy-adjusted dietary inflammatory index and physical activity with sleep quality: a cross-sectional study.

The study aimed to assess the independent and interactive association of energy-adjusted dietary inflammatory index (E-DII) and physical activity (PA) with sleep quality. A cross-sectional study was conducted on the 2466 participants (60% women). A 116-item food frequency questionnaire (FFQ) was applied to calculate E-DII, the International Physical Activity Questionnaire (IPAQ) long form for PA, and the Pittsburgh sleep quality index (PSQI) to assess sleep quality were collected via interview. Multivariate logistic regression was applied to assess independent and interactive associations of E-DII and PA with sleep quality. No significant association was observed between E-DII and sleep quality (OR: 0.96, 95% CI: 0.92_1.01). Also, there was no significant association between the levels of PA and sleep quality. Women had 70% increased odds for poor sleep quality (OR: 1.7, 95% CI: 1.39_2.09) compared with men. No interactive association was observed between E-DII and PA levels with sleep quality. No significant association was observed between E-DII and PA levels with sleep quality. The study indicates a gender difference in sleep quality. Future prospective studies are required to confirm these findings.

Gut bacterial markers involved in association of dietary inflammatory index with visceral adiposity

ObjectiveTo deepen the understanding of the influence of diet on weight gain and metabolic disturbances, we examined associations between diet-related inflammation and body composition and fecal bacteria abundances in participants of the Nutritionists’ Health Study. MethodsEarly-life, dietary and clinical data were obtained from 114 women aged ≤45 years. A validated food frequency questionnaire was used to calculate the energy-adjusted dietary inflammatory index (E-DII). Participants’ data were compared by E-DII quartiles using ANOVA or Kruskal-Wallis. Associations of DXA-determined body composition with the E-DII were tested by multiple linear regression using DAG-oriented adjustments. Fecal microbiota was analyzed targeting the V4 region of the 16S rRNA gene. Spearman correlation coefficients were used to test linear associations; differential abundance of genera across the E-DII quartiles was assessed by pair-wise comparisons. ResultsE-DII score was associated with total fat (b=1.80, p<0.001), FMI (b=0.08, p<0.001) and visceral fat (b=1.19, p=0.02), independently of maternal BMI, birth type and breastfeeding. E-DII score was directly correlated to HOMA-IR (r=0.30; p=0.004), C-reactive protein (r=0.29; p=0.003) and to the abundance of Actinomyces, and inversely correlated to the abundance of Eubacterium.xylanophilum.group. Actinomyces were significantly more abundant in the highest (most proinflammatory) E-DII quartile. ConclusionsAssociation of E-DII with markers of insulin resistance, inflammation, body adiposity and certain gut bacteria are consistent with beneficial effects of anti-inflammatory diet on body composition and metabolic profile. Bacterial markers, such as Actinomyces, could be involved in the association between the dietary inflammation with visceral adiposity. Studies designed to explore how a pro-inflammatory diet affects both central fat deposition and gut microbiota are needed.

A pro-inflammatory diet is associated with long-term depression and anxiety levels but not fatigue in people with multiple sclerosis

BackgroundMultiple sclerosis is characterised by acute and chronic inflammation in the CNS. Diet may influence inflammation, and therefore MS outcomes. ObjectiveTo determine whether the Dietary Inflammatory Index (DII®)) is associated with depression, anxiety, and fatigue in a prospective cohort of people with MS. MethodsPeople with a first clinical diagnosis of demyelination were followed over 10 years (n=223). DII and energy-adjusted DII (E-DIITM) scores were calculated from the dietary intake in the preceding 12 months measured by food frequency questionnaire. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and fatigue by the Fatigue Severity Scale. ResultsA higher E-DII score was associated with higher levels of depression and anxiety five years later (e.g., highest vs lowest E-DII quartile, HADS-D score: β=2.23, 95%CI=0.98,3.48, p<0.001; HADS-A score: β=1.90, 95%CI=0.59,3.21, p<0.001). A cumulative E-DII score was associated with depression (p<0.01) and anxiety (p=0.05) at the 10-year review. No associations were seen for fatigue. ConclusionOur findings suggest that, in people with MS, a more pro-inflammatory diet may long-term adverse impact on depression and anxiety, but not fatigue.

The association between dietary inflammatory index (DII) scores and c-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) in a general population cohort

Although there is extensive literature showing the ability of the dietary inflammation index (DII®) to predict concentrations of plasma inflammatory markers, few studies are testing the association between DII scores and nonalcoholic fatty liver disease (NAFLD). Considering the high prevalence of NAFLD and its complications, we conducted a validation study of DII scores and examined its association with NAFLD in the general adult population of Iran. This cross-sectional study was conducted on 3110 adult participants in the Amol Cohort Study (AmolCS) who underwent abdominal ultrasonography to diagnose NAFLD. DII and energy-adjusted DII (E-DII™) scores were computed using data from a valid semi-quantitative 168-item food frequency questionnaire (FFQ). Multivariable logistic regression adjusting for socio-demographic, lifestyle, and health-related factors was used to assess association. The EDII was associated with CRP inflammatory biomarker. Participants in the highest, i.e., most pro-inflammatory tertile had the highest odds of NAFLD by ultrasound in all models [fully adjusted model: OR (95% CI) tertile3vs.1:1.54 (1.05-2.05); Ptrend=0.04, and 1.63 (1.19-2.21); Ptrend=0.03 in women and men, respectively]. The highest tertile had the highest OR for NAFLD by fatty liver index (FLI) only in men [fully adjusted model OR (95% CI) tertile3vs.1: 1.77 (1.15-2.71); Ptrend=0.01]. Similar results were also obtained for NAFLD by hepatic steatosis index (HSI) in women [fully adjusted model: OR (95% CI) tertile3vs.1: 1.70 (1.12-2.58); Ptrend=0.03]. The results of the fully adjusted multivariable model of liver markers and NAFLD status, stratified by gender and abdominal obesity, revealed that the highest tertiles had the highest OR for NAFLD by ultrasound and NAFLD by FLI only in men without abdominal obesity [fully adjusted model: OR (95% CI) tertile3vs.1: 1.83 (1.17-2.84); Ptrend=0.03, and, respectively]. NAFLD by FLI tended to increase strongly with tertile E-DII scores in men without abdominal obesity in crude and three adjusted models [full-adjusted model: OR (95% CI) tertile3vs.1: 3.64 (1.56-8.46); Ptrend=0.005]. By contrast, women with abdominal obesity in the highest tertile had the highest OR for NAFLD by ultrasound in all models [full-adjusted model: OR (95% CI) tertile3vs.1: 1.67 (1.07-2.62); Ptrend=0.02]. Our results suggest that diet plays a role in regulating inflammation. Additionally, we observed an inflammatory diet predicts the risk of NAFLD in Iranian adults. However, longitudinal studies are required in order to further substantiate the utility of the DII in the development of more effective dietary interventions among populations at risk of chronic disease.

The association of dietary antioxidants and the inflammatory potential of the diet with poor physical function and disability in older Australian men: the Concord Health and Ageing in Men Project.

Our objective was to evaluate the association of antioxidant intake and the inflammatory potential of the diet with functional decline in older men. A diet history questionnaire was used to collect dietary intake data from men aged ≥ 75 years (n 794) participating in the Concord Health and Aging in Men Project cohort study. Intake of vitamins A, C, E and Zn were compared with the Australian Nutrient Reference Values to determine adequacy. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) was used to assess the inflammatory potential of the diet. Physical performance data were collected via handgrip strength and walking speed tests, and activities of daily living (ADL) and instrumental activities of daily living (IADL) questionnaires, at baseline and 3-year follow-up (n 616). Logistic regression analysis was used to identify associations between diet and incident poor physical function and disability. Both poor antioxidant intake and high E-DII scores at baseline were significantly associated with poor grip strength and ADL disability at 3-year follow-up. No significant associations with walking speed or IADL disability were observed. Individual micronutrient analysis revealed a significant association between the lowest two quartiles of vitamin C intake and poor grip strength. The lowest quartiles of intake for vitamins A, C, E and Zn were significantly associated with incident ADL disability. The study observed that poor antioxidant and anti-inflammatory food intake were associated with odds of developing disability and declining muscle strength in older men. Further interventional research is necessary to clarify the causality of these associations.

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.

The association between the dietary inflammatory index and allergic rhinitis: a case-control study.

Allergic rhinitis (AR) is a common chronic inflammatory disease that significantly impacts the quality of life of patients. However, there is limited research on the relationship between the Dietary Inflammatory Index (DII) and the risk of AR. Our study aimed to assess the association between DII and AR in a sample of adults from North China. In a case-control study, we selected 166 cases of AR and 166 age- and gender-matched controls. Dietary intake was assessed using a validated food frequency questionnaire. The energy-adjusted DII (E-DII) scores were calculated based on the quantity of diet components with inflammatory or anti-inflammatory potential. We used conditional logistic regression models to examine the association between E-DII and AR. Our findings indicate a positive correlation between E-DII and AR risk. After controlling for confounders, individuals in the highest E-DII tertile exhibited a 4.41-fold increased risk of AR compared to those in the lowest tertile (OR 4.41, 95% CI 2.31-8.41). Additionally, stratified analysis showed that E-DII was positively associated with AR subtype (seasonal vs. perennial), duration (≤6 years vs. >6 years), severity (mild vs. moderate-severe), and onset time (intermittent vs. persistent). Furthermore, individuals in the highest E-DII tertile had higher intake of total fat, SFA, PUFAs, and n-6 PUFAs. In conclusion, we realized that there is a positive association between the E-DII score and AR. The consumption of diets abundant in anti-inflammatory nutrients and low in pro-inflammatory nutrient contents is recommended as a preventative strategy against AR.

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

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. 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. 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. 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 Potential, Inflammation-Related Lifestyle Factors, and Incident Anxiety Disorders: A Prospective Cohort Study.

It is unclear whether diet-associated inflammation is related to the development of anxiety disorders. We aimed to investigate the association between energy-adjusted dietary inflammatory index (E-DII) scores and the incidence of anxiety disorders, and explore the joint effects of E-DII scores with other inflammatory lifestyles in enhancing anxiety risk. In the UK Biobank Study of 96,679 participants, baseline E-DII scores were calculated from the average intake of at least two 24 h dietary recalls. Multivariable-adjusted Cox models were used to evaluate the associations between E-DII scores and the incidence of total anxiety disorders, and primary types and subtypes; additive and multiplicative interactions of a pro-inflammatory diet and seven inflammatory lifestyles were examined. After a median follow-up of 9.4 years, 2785 incident cases of anxiety disorders occurred. Consuming a pro-inflammatory diet was significantly associated with a higher risk of total anxiety disorders (HRQ4vsQ1 = 1.12, 95% CI = 1.00-1.25), and positive associations were consistently identified for primary types and subtypes of anxiety disorders, with HRs ranging from 1.08 to 1.52, and were present in women only. Both additive and multiplicative interactions of current smoking and a proinflammatory diet on total anxiety risk were identified. A proinflammatory diet was associated with a higher incidence of anxiety disorders, and current smoking may synergize with a proinflammatory diet to promote anxiety risk, particularly among women.

Diet Quality and Mortality among Chinese Adults: Findings from the China Health and Nutrition Survey.

The association between diet quality and all-cause mortality in Chinese population is unclear. We aimed to study the associations of three a priori diet quality indices-including the Diet Quality Index-International (DQI-I), Chinese Healthy Eating Index (CHEI), and energy-adjusted Dietary Inflammatory Index (E-DII)-and their included components with all-cause mortality. We used baseline data from the 2004, 2006, 2009, and 2011 waves of the China Health and Nutrition Survey (CHNS). We used a multivariable-adjusted Cox model to examine the associations between DQI-I, CHEI, and E-DII with all-cause mortality. During a mean of 7 years of follow-up, a total of 461 deaths occurred among 12,914 participants. For DQI-I, there were significant inverse associations with mortality for the variety score (HRQ4 vs. Q1 = 0.69, 95%CI = 0.52-0.92) and overall balance score (HR>0 vs. 0 = 0.81, 95%CI = 0.66-0.91). The adequacy score of CHEI was associated with 40% less risk of all-cause mortality (HRQ4 vs. Q1 = 0.60, 95%CI = 0.43-0.84). E-DII was not associated with mortality. An estimated 20.1%, 13.9%, and 31.3% of total mortality would be averted if the DQI-I variety score, DQI-I overall balance score, and CHEI adequacy score improved from the bottom to the top quartile, respectively. Improving diet quality, especially improving diet variety and adequacy, and having a more balanced diet may reduce all-cause mortality in Chinese adults.

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.

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.

Energy-adjusted dietary inflammatory index and cognitive function in Chinese older adults: a population-based cross-sectional study

ABSTRACT Diet can regulate systemic inflammation, which may play an important role in the development and progression of cognitive impairment and dementia. To explore the relationship between the dietary inflammatory potential and cognitive ability. A total of 2307 adults aged 60 years or older were recruited from the Fujian Provincial Hospital (Fujian, China). Dietary inflammatory properties were analyzed using the energy-adjusted dietary inflammatory index (E-DII). The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Logistic regression and restricted cubic spline (RCS) were fit to assess the associations between variables. The MCI subjects with the highest E-DII scores had a higher risk of AD compared to subjects with the lowest E-DII scores (OR = 1.98, 95%CI = 1.49–2.64, P for trend < 0.001). Subjects with the highest E-DII levels were at increased risk of cognitive impairment compared to those with the lowest E-DII levels (OR = 1.56, 95%CI = 1.25–1.93, P for trend < 0.001). The link between E-DII and cognitive impairment was significant in a nonlinear dose response analysis (P for nonlinear = 0.001). Higher E-DII scores were associated with an increased risk of developing AD or cognitive impairment. These findings may contribute to the effective prevention of cognitive impairment by constructing a multidisciplinary synergistic prevention strategy and controlling dietary inflammation levels.

The role of body mass index on the association between the energy-adjusted dietary inflammatory index and hyperuricemia: a mediation analysis based on NHANES (2007-2016).

The Energy-Adjusted Dietary Inflammatory Index (E-DII) is related to both body mass index (BMI) and hyperuricemia. However, the association among BMI, hyperuricemia and DII is yet to be fully elucidated. The purpose of this study is to explore the role of BMI in the relationship between E-DII and hyperuricemia in the American population. A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016, with a sample size of 10,571 participants. The study used a weighted logistic regression model and a generalized additive model (GAM) to explore the associations among BMI, hyperuricemia and E-DII. Furthermore, mediation analysis was utilized to illustrate the mediating relationships among these variables. The results of the study indicated that a higher E-DII was related to an increased risk of hyperuricemia. The association between E-DII and hyperuricemia was partially mediated by BMI. E-DII is associated with hyperuricemia. BMI mediates the relationship between E-DII and hyperuricemia among Americans, which provides crucial information for the prevention of hyperuricemia.

Cluster analysis of maternal socioeconomic and non-modifiable factors with birth &amp; placental outcomes

Abstract Background Maternal social disadvantage adversely affects both maternal and offspring health outcomes. This study aimed to explore clustering of socioeconomic and non-modifiable factors in mothers and their association with birth and placental outcomes, which are under-researched in this context. Methods This analysis of the Lifeways Cross-Generational Cohort includes 250 mother-child pairs. Self-completed general health and food frequency questionnaires in early pregnancy provided information on diet, lifestyle, socioeconomic status (SES) and non-modifiable factors. Parity, untrimmed placental weight (PW) and birthweight (BW) were abstracted from hospital records, and the BW:PW ratio was generated. TwoStep cluster analysis clustered mothers based on age, parity, marital status, net household income, private healthcare insurance, homeowner status, and tertiary education. Differences between clusters were assessed using one-way ANOVA and chi-square tests. Results A three-cluster solution was found to be optimal with a modest average silhouette coefficient of 0.3. Clusters were classified as “Married Homeowners” (n = 140, 37.1%), “Highest Income” (n = 58, 23.2%) and “Renters” (n = 52, 20.8%) based on predictor importance. Renters were younger, more likely to smoke, have a medical card (an indicator of social disadvantage) and have poorer dietary quality and dietary inflammatory status (as indicated by lower Healthy Eating Index (HEI-2015) and higher energy-adjusted Dietary Inflammatory Index (E-DII) scores) compared to other clusters (all p &amp;lt; 0.01). Offspring of Renters were more likely to have lower BW (-259.26g, p &amp;lt; 0.01) and shorter birth length (-1.31cm, p &amp;lt; 0.01) and head circumference (-0.59cm, p = 0.02) compared to offspring of Married Homeowners. Conclusions Results suggest associations of SES (particularly housing status) with birth, but not placental, outcomes and less favourable lifestyle factors, which may have multi-behavioural and multi-sectoral policy implications. Key messages • Associations between low SES, adverse lifestyle behaviours and birth outcomes highlight the importance of a multi-sectoral public health strategy. • Placental outcomes should be examined in further studies.

Association of energy-adjusted dietary inflammatory index and frailty in older adults with nonalcoholic fatty liver disease

BackgroundEnergy-adjusted dietary inflammatory index (E-DII) can represent daily inflammatory dietary components and chronic inflammatory response is an important pathogenesis of aging, nonalcoholic fatty liver disease (NAFLD) and frailty. Therefore, the purpose of this study is to explore the association of E-DII and frailty in older adults with NAFLD. MethodsThis cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2005–2016) to investigate the association between E-DII and frailty. The NAFLD status was determined using the US Fatty Liver Index (FLI) value ≥30. The relationship between E-DII and frailty was examined through multivariate weighted logistic regression analysis and smooth curve fitting. Subgroup analyses were conducted, considering various demographic and clinical variables. ResultsOur final analysis included 1586 individuals, with an average age of 69.42 years, and 53.15 % of them were males. The overall prevalence of frailty in the study population was 39.42 %. Smooth curve fitting analysis demonstrated a nearly linear relationship between E-DII and H. pylori. Utilizing multivariate weighted logistic regression analysis, we found that the odds ratio (OR) of E-DII for frailty was 1.08 (95%CI, 1.03–1.15). Subgroup analysis further confirmed that E-DII independently increased the risk of frailty. ConclusionHigher E-DII levels were found to be associated with an increased risk of frailty in older adults with NAFLD. However, further studies are required to fully elucidate the precise mechanisms underlying the relationship between E-DII and frailty.

Dietary Inflammatory Potential and the Risk of Serrated and Adenomatous Colorectal Polyps

Studies of dietary inflammation potential and risks of colorectal cancer precursors are limited, particularly for sessile serrated lesions (SSLs). This study examines the association using the energy-adjusted dietary inflammatory index (E-DIITM), a measure of anti- and/or pro-inflammatory diet, in a large US colonoscopy-based case-control study of 3246 controls, 1530 adenoma cases, 472 hyperplastic polyp cases, and 180 SSL cases. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression models. Analyses were stratified by participant characteristics, and urinary prostaglandin E2 metabolite (PGE-M) and high-sensitivity plasma C-reactive protein (hs-CRP) levels, inflammation biomarkers. Highest E-DII™ intake was associated with significantly increased risks of colorectal adenomas (OR 1.36, 95% CI 1.11, 1.67), and hyperplastic polyps (OR 1.43, 95% CI 1.06, 1.98), compared with participants consuming the lowest E-DII™ quartile. A similar, but non-significant, increased risk was also observed for SSLs (OR 1.41, 95% CI 0.82, 2.41). The positive association was stronger in females (pinteraction <0.001), normal weight individuals (ptrend 0.01), and in individuals with lower inflammatory biomarkers (ptrend 0.02 and 0.01 for PGE-M and hs-CRP, respectively). A high E-DII™ is associated with colorectal polyp risk, therefore promoting an anti-inflammatory diet may aid in preventing colorectal polyps.

Association between Dietary Inflammatory Index and Risk of Colorectal Adenomatous Polyps in Kashgar Prefecture of Xinjiang, China.

Malignant colorectal tumors and precancerous lesions are closely associated with chronic inflammation. Specific dietary patterns can increase chronic inflammation in the body, thereby promoting the occurrence of tumors and precancerous lesions. We have conducted a case-control study in Kashgar Prefecture, Xinjiang, China, to explore the association between the energy-adjusted dietary inflammatory index (E-DII) and the risk of colorectal adenomatous polyps (CAP). A total of 52 newly diagnosed patients with CAP and 192 controls at the First People's Hospital of Kashgar Prefecture were enrolled in this study. Dietary information was collected using a food frequency questionnaire. The E-DII was calculated based on dietary data, reflecting an individual's dietary inflammatory potential. Logistic regression models were used to evaluate the relationship between the E-DII and the risk of CAP, with adjustments for potential confounding factors. The results showed that the maximum anti- and pro-inflammatory values of E-DII were -4.33 and +3.48, respectively. Higher E-DII scores were associated with an increased risk of CAP, and this association remained statistically significant after adjusting for age, sex, body mass index, smoking status, and other relevant variables. Notably, a more pro-inflammatory dietary pattern may be related to an increased risk of developing CAP in Kashgar Prefecture.