Diet and inflammation have been suggested to be important risk factors for oral and pharyngeal cancer. We examined the association between dietary inflammatory index (DII™) and oral and pharyngeal ...cancer in a large case‐control study conducted between 1992 and 2009 in Italy. This study included 946 cases with incident, histologically confirmed oral and pharyngeal cancer, and 2,492 controls hospitalized for acute non‐neoplastic diseases. The DII was computed based on dietary intake assessed by a valid 78‐item food frequency questionnaire and was adjusted for nonalcohol energy intake using the residual approach (E‐DII™). Logistic regression models were used to estimate odds ratios (ORs), and 95% confidence intervals (CIs), adjusted for age, sex, non‐alcohol energy intake, study center, year of interview, education, body mass index, tobacco smoking, and alcohol drinking. Subjects with higher DII scores (i.e., with a more pro‐inflammatory diet) had a higher risk of oral and pharyngeal cancer, the OR being 1.80 (95% CI 1.36–2.38) for the highest versus the lowest DII quartile and 1.17 (95% CI 1.10–1.25) for a one‐unit increase (8% of the DII range). When stratified by selected covariates, a stronger association was observed among women (ORquartile4 v.1 3.30, 95% CI 1.95–5.57). We also observed a stronger association for oral cancers and a strong combined effect of higher DII score and tobacco smoking or alcohol consumption on oral and pharyngeal cancer. These results indicate that the pro‐inflammatory potential of the diet, as shown by higher DII scores, is associated with higher odds of oral and pharyngeal cancer.
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Oral and pharyngeal cancer is strongly associated with alcohol and tobacco use. However, certain dietary components, namely those with high inflammatory potential, may also play an etiological role. In this case‐control study in Italy, oral and pharyngeal cancer risk was investigated for associations with dietary inflammatory index (DII), a population‐based assessment of the inflammatory character of an individual's diet. High DII scores, indicative of a relatively pro‐inflammatory diet, were linked to elevated oral and pharyngeal cancer risk. The findings suggest that efforts to improve DII scores via public health recommendations could potentially help reduce oral and pharyngeal cancer risk.
OBJECTIVES:To determine whether the dietary inflammatory index (DII) is associated with inflammatory or metabolic biomarkers and metabolic syndrome (MetSyn) among police officers.
...METHODS:Cross-sectional data from the Buffalo Cardio-Metabolic Occupational Police Stress study were derived from saliva and fasting blood samples, anthropometric measurements, long-term shiftwork histories, and demographic, stress/depression, and food frequency questionnaires (FFQs). Metabolic syndrome was defined using standard criteria.
RESULTS:Officers in DII quartiles 2 to 4 were more likely to exceed a threshold of 3.0 mg/L for C-reactive protein (odds ratio OR = 1.88; 95% confidence interval 95% CI = 1.02 to 3.45; OR = 2.17; 95% CI = 1.19 to 3.95; OR = 1.57; 95% CI = 0.85 to 2.88, respectively) compared with quartile 1. The glucose intolerance component of MetSyn was more prevalent among officers in DII quartile 4 than among those in quartile 1 (OR = 2.03; 95% CI = 1.08 to 3.82).
CONCLUSIONS:A pro-inflammatory diet was associated with elevated CRP and with the glucose intolerance component of MetSyn.
Abstract Purpose Many dietary factors have either proinflammatory or anti-inflammatory properties. We previously developed a dietary inflammatory index (DII) to assess the inflammatory potential of ...diet. In this study, we conducted a construct validation of the DII based on data from a food frequency questionnaire and three inflammatory biomarkers in a subsample of 2567 postmenopausal women in the Women's Health Initiative Observational Study. Methods We used multiple linear and logistic regression models, controlling for potential confounders, to test whether baseline DII predicted concentrations of interleukin-6, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha receptor 2, or an overall biomarker score combining all three inflammatory biomarkers. Results The DII was associated with the four biomarkers with beta estimates (95% confidence interval) comparing the highest with lowest DII quintiles as follows: interleukin-6: 1.26 (1.15–1.38), Ptrend < .0001; tumor necrosis factor alpha receptor 2: 81.43 (19.15–143.71), Ptrend = .004; dichotomized hs-CRP (odds ratio for higher vs. lower hs-CRP): 1.30 (0.97–1.67), Ptrend = .34; and the combined inflammatory biomarker score: 0.26 (0.12–0.40), Ptrend = .0001. Conclusions The DII was significantly associated with inflammatory biomarkers. Construct validity of the DII indicates its utility for assessing the inflammatory potential of diet and for expanding its use to include associations with common chronic diseases in future studies.
Abstract Objective A 22-week federally qualified health center (FQHC)-based farmers' market (FM) and personal financial incentive intervention designed to improve access to and consumption of fruits ...and vegetables (FVs) among low-income diabetics in rural South Carolina was evaluated. Methods A mixed methods, one-group, repeated-measures design was used. Data were collected in 2011 before (May/June), during (August), and after (November) the intervention with 41 diabetes patients from the FQHC. FV consumption was assessed using a validated National Cancer Institute FV screener modified to include FV sold at the FM. Sales receipts were recorded for all FM transactions. A mixed-model, repeated measures analysis of variance was used to assess intervention effects on FV consumption. Predictors of changes in FV consumption were examined using logistic regression. Results A marginally significant (p = 0.07) average increase of 1.6 servings of total FV consumption per day occurred. The odds of achieving significant improvements in FV consumption increased for diabetics using financial incentives for payment at the FM (OR: 38.8, 95% CI: 3.4–449.6) and for those frequenting the FM more often (OR: 2.1, 95% CI: 1.1–4.0). Conclusions Results reveal a dose–response relationship between the intervention and FV improvements and emphasize the importance of addressing economic barriers to food access.
Inflammation is considered a key mechanism leading to obesity. Dietary patterns and certain food items influence inflammation. Few studies have investigated the contribution of major dietary patterns ...to biological measures of inflammation. Therefore, the present study aimed to examine the associations of different dietary patterns with dietary inflammatory index (DII), systemic inflammation, and insulin resistance (IR) in the apparently healthy obese. In this cross-sectional study, 151 abdominally obese subjects were recruited from the Northwest of Iran. Dietary intake, demographic data, anthropometric indices, and physical activity (PA) was assessed. DII scores were calculated based on a validated 168-item food frequency questionnaire (FFQ). Three dietary patterns were identified, using principal component analysis. Basal blood samples were collected to determine biochemical parameters. Linear regression test with adjusted beta estimates was applied for data analysis. Three dietary patterns were extracted as Healthy, Western, and Traditional. Body mass index (BMI) (p < 0.01) and fat mass (p < 0.001) were directly associated with the Western dietary pattern. Conversely, serum lipopolysaccharide-binding protein (LBP) (b = - 0.1, p < 0.04) was negatively associated with Healthy dietary pattern, after controlling for confounders. The Traditional pattern was found to be inversely related to DII (b = - 0.3, p < 0.001). The association was also reveresed between Traditional pattern and IR (Odds Ratio: 0.3 (95% Confidence Interval 0.1-0.9)). The results suggested that the Western dietary pattern was related to higher BMI and fat mass. In addition, the Healthy pattern was associated with decreased levels of LBP. Adherence to the Traditional dietary pattern was inversely related to DII as well as IR.
Relationships between socio-environmental factors and obesity are poorly understood due to a dearth of longitudinal population-level research. The objective of this analysis was to examine 45-year ...trends in time-use, household management (HM) and energy expenditure in women.
Using national time-use data from women 19-64 years of age, we quantified time allocation and household management energy expenditure (HMEE) from 1965 to 2010. HM was defined as the sum of time spent in food preparation, post-meal cleaning activities (e.g., dish-washing), clothing maintenance (e.g., laundry), and general housework. HMEE was calculated using body weights from national surveys and metabolic equivalents.
The time allocated to HM by women (19-64 yrs) decreased from 25.7 hr/week in 1965 to 13.3 hr/week in 2010 (P<0.001), with non-employed women decreasing by 16.6 hr/week and employed women by 6.7 hr/week (P<0.001). HMEE for non-employed women decreased 42% from 25.1 Mj/week (6004 kilocalories per week) in 1965 to 14.6 Mj/week (3486 kcal/week) in 2010, a decrement of 10.5 Mj/week or 1.5 Mj/day (2518 kcal/week; 360 kcal/day) (P<0.001), whereas employed women demonstrated a 30% decrement of 3.9 Mj/week, 0.55 Mj/day (923 kcal/week, 132 kcal/day) (P<0.001). The time women spent in screen-based media use increased from 8.3 hr/week in 1965 to 16.5 hr/week in 2010 (P<0.001), with non-employed women increasing 9.6 hr/week and employed women 7.5 hr/week (P<0.001).
From 1965 to 2010, there was a large and significant decrease in the time allocated to HM. By 2010, women allocated 25% more time to screen-based media use than HM (i.e., cooking, cleaning, and laundry combined). The reallocation of time from active pursuits (i.e., housework) to sedentary pastimes (e.g., watching TV) has important health consequences. These results suggest that the decrement in HMEE may have contributed to the increasing prevalence of obesity in women during the last five decades.
Adverse birth outcomes are major causes of morbidity and mortality during childhood and associate with a higher risk of noncommunicable diseases in adult life. Maternal periconception and antenatal ...nutrition, mostly focusing on single nutrients or foods, has been shown to influence infant birth outcomes. However, evidence on whole diet that considers complex nutrient and food interaction is rare and conflicting. We aim to elucidate the influence of whole-diet maternal dietary inflammatory potential and quality during periconceptional and antenatal periods on birth outcomes.
We harmonized and pooled individual participant data (IPD) from up to 24,861 mother-child pairs in 7 European mother-offspring cohorts cohort name, country (recruitment dates): ALSPAC, UK (1 April 1991 to 31 December 1992); EDEN, France (27 January 2003 to 6 March 2006); Generation R, the Netherlands (1 April 2002 to 31 January 2006); Lifeways, Ireland (2 October 2001 to 4 April 2003); REPRO_PL, Poland (18 September 2007 to 16 December 2011); ROLO, Ireland (1 January 2007 to 1 January 2011); SWS, United Kingdom (6 April 1998 to 17 December 2002). Maternal diets were assessed preconceptionally (n = 2 cohorts) and antenatally (n = 7 cohorts). Maternal dietary inflammatory potential and quality were ranked using the energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) index, respectively. Primary outcomes were birth weight and gestational age at birth. Adverse birth outcomes, i.e., low birth weight (LBW), macrosomia, small-for-gestational-age (SGA), large-for-gestational-age (LGA), preterm and postterm births were defined according to standard clinical cutoffs. Associations of maternal E-DII and DASH scores with infant birth outcomes were assessed using cohort-specific multivariable regression analyses (adjusted for confounders including maternal education, ethnicity, prepregnancy body mass index (BMI), maternal height, parity, cigarettes smoking, and alcohol consumption), with subsequent random-effects meta-analyses. Overall, the study mothers had a mean ± SD age of 29.5 ± 4.9 y at delivery and a mean BMI of 23.3 ± 4.2 kg/m2. Higher pregnancy DASH score (higher dietary quality) was associated with higher birth weight β(95% CI) = 18.5(5.7, 31.3) g per 1-SD higher DASH score; P value = 0.005 and head circumference 0.03(0.01, 0.06) cm; P value = 0.004, longer birth length 0.05(0.01, 0.10) cm; P value = 0.010, and lower risk of delivering LBW odds ratio (OR) (95% CI) = 0.89(0.82, 0.95); P value = 0.001 and SGA 0.87(0.82, 0.94); P value < 0.001 infants. Higher maternal prepregnancy E-DII score (more pro-inflammatory diet) was associated with lower birth weight β(95% CI) = -18.7(-34.8, -2.6) g per 1-SD higher E-DII score; P value = 0.023 and shorter birth length -0.07(-0.14, -0.01) cm; P value = 0.031, whereas higher pregnancy E-DII score was associated with a shorter birth length -0.06(-0.10, -0.01) cm; P value = 0.026 and higher risk of SGA OR(95% CI) = 1.18(1.11, 1.26); P value < 0.001. In male, but not female, infants higher maternal prepregnancy E-DII was associated with lower birth weight and head circumference, shorter birth length, and higher risk of SGA (P-for-sex-interaction = 0.029, 0.059, 0.104, and 0.075, respectively). No consistent associations were observed for maternal E-DII and DASH scores with gestational age, preterm and postterm birth, or macrosomia and LGA. Limitations of this study were that self-reported dietary data might have increased nondifferential measurement error and that causality cannot be claimed definitely with observational design.
In this cohort study, we observed that maternal diet that is of low quality and high inflammatory potential is associated with lower offspring birth size and higher risk of offspring being born SGA in this multicenter meta-analysis using harmonized IPD. Improving overall maternal dietary pattern based on predefined criteria may optimize fetal growth and avert substantial healthcare burden associated with adverse birth outcomes.
Abstract Recently, there has been an influx of research interest regarding the anti-inflammatory role that diet has in chronic and metabolic diseases. A literature-based dietary inflammatory index ...(DII) that can be used to characterize the inflammation-modulating capacity of individuals' diets has even been developed and validated in an American population. We hypothesized that the DII could predict levels of high-sensitivity C-reactive protein (CRP), which is an important inflammatory marker, as well as metabolic measures that include the metabolic syndrome and its components in European adults. This hypothesis was tested according to data from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg study, a nationwide, cross-sectional survey based in Luxembourg. Statistical methods consisted of descriptive and multivariable logistic regression analyses. The DII ranged from a minimum of −4.02 (most anti-inflammatory) to a maximum of 4.00 points, with a mean value of −0.41. Participants with higher DII score were significantly younger and had lower body mass index, waist circumferences, and systolic blood pressure levels. Other cardiovascular biomarkers including diastolic blood pressure, CRP, lipids, and glycemic biomarkers did not vary significantly across DII tertiles. Participants with proinflammatory (>1) DII scores had increased adjusted odds (odds ratio, 1.46; 95% confidence interval, 1.00-2.13) of having a low high-density lipoprotein cholesterol, compared with those with anti-inflammatory scores (DII ≤1). There were no significant relationships between high-sensitivity CRP and the DII. This study, which tested the inflammatory capacity of the DII outside the United States, did not detect a significant independent relationship with cardiometabolic biomarkers, by using Food Frequency Questionnaire–collected data. These results are informative and representative of a relevant step in directing future research for nutrition and diet quality.
The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast ...cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20–65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and
post hoc
multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice.
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