Inflammatory potential of diet and risk of colorectal cancer: a case–control study from Italy

Diet and inflammation have been suggested to be important risk factors for colorectal cancer (CRC). In the present study, we examined the association between the dietary inflammatory index (DII) and the risk of CRC in a multi-centre case–control study conducted between 1992 and 1996 in Italy. The study included 1225 incident colon cancer cases, 728 incident rectal cancer cases and 4154 controls hospitalised for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed using a validated seventy-eight-item FFQ that included assessment of alcohol intake. Logistic regression models were used to estimate the OR adjusted for age, sex, study centre, education, BMI, alcohol drinking, physical activity and family history of CRC. Energy intake was adjusted using the residual method. Subjects with higher DII scores (i.e. with a more pro-inflammatory diet) had a higher risk of CRC, with the DII being used both as a continuous variable (ORcontinuous 1·13, 95 % CI 1·09, 1·18) and as a categorical variable (ORquintile 5 v. 1 1·55, 95 % CI 1·29, 1·85; P for trend < 0·0001). Similar results were observed when the analyses were carried out separately for colon and rectal cancer cases. These results indicate that a pro-inflammatory diet is associated with an increased risk of CRC.

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Inflammatory Potential of Diet is Associated with Increased Odds of Cataract in a Case-Control Study from Iran

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000420 ◽

2017 ◽

Vol 87 (1-2) ◽

pp. 17-24 ◽

Cited By ~ 4

Author(s):

Nitin Shivappa ◽

James R. Hébert ◽

Bahram Rashidkhani ◽

Matin Ghanavati

Keyword(s):

Case Control Study ◽

Continuous Variable ◽

Case Control ◽

Control Group ◽

Case Group ◽

Logistic Regression Models ◽

Inflammatory Index ◽

Increased Risk ◽

Unit Increase ◽

Control Study

Abstract.Background: In previous studies, diet has been shown to be associated with cataract. However, no study to date has focused on the association between inflammatory potential of diet and cataract. Objectives: In this case-control study conducted in Iran, we examined the association of the dietary inflammatory index (DII®) and cataract. Methods: This case-control study included 97 cataract cases and 198 healthy controls hospitalized for acute non-neoplastic diseases with the control group matched according to age (with a five-year interval) and sex with the case group. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Multivariable logistic regression models were used to estimate odds ratios (ORs), with the DII analyzed as both continuous and as tertiles. Energy was adjusted using the residual method. Results: Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher odds of cataract, with the DII being used as both a continuous variable (ORcontinuous 1.51, 95% confidence interval, CI, 1.13 – 2.03; one unit increase corresponding to ≈18% of its range in the current study) and as tertiles (ORtertile3vs1 2.67, 95%CI 1.32 – 5.48, Ptrend = 0.002). Conclusions: These results indicate that a pro-inflammatory diet is associated with increased risk of cataract. Additional studies should be conducted to further explore this association.

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Dietary Inflammatory Index and Risk of Multiple Sclerosis in a Case-Control Study from Iran

Neuroepidemiology ◽

10.1159/000445874 ◽

2016 ◽

Vol 47 (1) ◽

pp. 26-31 ◽

Cited By ~ 12

Author(s):

Nitin Shivappa ◽

James R. Hebert ◽

Maryam Behrooz ◽

Bahram Rashidkhani

Keyword(s):

Multiple Sclerosis ◽

Case Control Study ◽

Continuous Variable ◽

Case Control ◽

Dietary Inflammatory Index ◽

Logistic Regression Models ◽

Inflammatory Index ◽

Increased Risk ◽

History Of ◽

Control Study

Background: Diet and inflammation have been suggested to be important risk factors for multiple sclerosis (MS). Objectives: In this study, we examined the ability of the dietary inflammatory index (DII) to predict MS in a case-control study conducted in Iran. Methods: This study included 68 MS cases and 140 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Logistic regression models were used to estimate ORs adjusted for age, energy, sex, body mass index, season of birth, rubella history, history of routine exercise before MS, smoking and history of consumption of cow's milk in the first 2 years of life. Results: Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of MS, with the DII being used both as a continuous variable (ORcontinuous 1.66; 95% CI 1.19-2.31; 1 unit increase corresponding to ≈15% of its range in the current study) and a categorical variable (ORDII (>1.43 vs.≤1.43) 2.68; 95% CI 1.15-6.26). Conclusions: These results indicate that a pro-inflammatory diet is associated with increased risk of MS.

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Dietary inflammatory index and odds of colorectal cancer in a case-control study from Jordan

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2017-0035 ◽

2017 ◽

Vol 42 (7) ◽

pp. 744-749 ◽

Cited By ~ 13

Author(s):

Nitin Shivappa ◽

James R. Hébert ◽

Susan E. Steck ◽

Lorne J. Hofseth ◽

Ihab Shehadah ◽

...

Keyword(s):

Colorectal Cancer ◽

Sex Education ◽

Case Control Study ◽

Middle Eastern ◽

Continuous Variable ◽

Case Control ◽

Dietary Inflammatory Index ◽

Logistic Regression Models ◽

Inflammatory Index ◽

Control Study

Dietary components that promote inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet and CRC has been investigated in several developed or Western countries. Despite the fact that dietary choices in the Middle East differ markedly from those in the West, results have not been reported from any study conducted in a Middle-Eastern population. We examined the association between dietary inflammatory index (DII) scores and CRC in a case-control study conducted in Jordan. This study included 153 histopathologically confirmed CRC cases and 202 disease-free control subjects’ frequency matched on age, sex, and occupation. Data were collected between January 2010 and December 2012, using interviewer-administered questionnaires. DII scores were computed from dietary data reported using a food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, sex, education, physical activity, body mass index, smoking, and family history of CRC. Subjects with higher DII scores were at increased odds of CRC, with the DII being used both as a continuous variable (ORcontinuous = 1.45, 95% CI: 1.13–1.85; 1-unit increase corresponding to ≈20% of its range in the current study) and as a categorical variable (ORtertile 3 vs tertile 1 = 2.13, 95%CI: 1.23–3.72). Our results, based on a Jordanian population, add to the growing literature indicating that a pro-inflammatory diet is associated with increased odds of CRC.

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Inflammatory potential of diet and risk for hepatocellular cancer in a case–control study from Italy

British Journal Of Nutrition ◽

10.1017/s0007114515004419 ◽

2015 ◽

Vol 115 (2) ◽

pp. 324-331 ◽

Cited By ~ 35

Author(s):

Nitin Shivappa ◽

James R. Hébert ◽

Jerry Polesel ◽

Antonella Zucchetto ◽

Anna Crispo ◽

...

Keyword(s):

Hepatitis B ◽

Case Control Study ◽

Hepatocellular Cancer ◽

Serum Markers ◽

Case Control ◽

Logistic Regression Models ◽

Inflammatory Index ◽

Increased Risk ◽

History Of ◽

Control Study

AbstractInflammation and diet have been suggested to be important risk factors for hepatocellular cancer (HCC). This Italian multicentre hospital-based case–control study conducted between 1999 and 2002 and including 185 cases with incident, histologically confirmed HCC, and 404 controls hospitalised for acute non-neoplastic diseases provided an opportunity to investigate the association between HCC and the dietary inflammatory index (DII). The DII was computed on the basis of dietary intake assessed 2 years before the date of interview by a validated sixty-three-item FFQ. Logistic regression models were used to estimate OR adjusted for age, sex, study centre, education, BMI, smoking, physical activity, serum markers of hepatitis B and C infection and energy intake. Energy adjustment for DII was performed using the residual method. Participants in the highest tertile of DII scores (i.e. with a more pro-inflammatory diet) had a higher risk for HCC (ORtertile 3 v, 1 2·43; 95 % CI 1·27, 4·68; Ptrend=0·03). When stratified by the presence or absence of hepatitis B/C infection and sex, DII was strongly associated with HCC in hepatitis B- and C-negative participants (ORtertile 3 v. 1 4·18; 95 % CI 1·53, 11·39; Ptrend=0·02) and among males (ORtertile 3 v. 1 3·60; 95 % CI 1·65, 7·87; Ptrend=0·001). These results indicate that a pro-inflammatory diet is associated with increased risk for HCC, in those without a history of hepatitis B/C infection and among males.

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Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0395 ◽

2017 ◽

Vol 42 (4) ◽

pp. 399-404 ◽

Cited By ~ 26

Author(s):

Farhad Vahid ◽

Nitin Shivappa ◽

Mohsen Karamati ◽

Alireza Jafari Naeini ◽

James R. Hebert ◽

...

Keyword(s):

Case Control Study ◽

Density Lipoprotein ◽

Continuous Variable ◽

Case Control ◽

Oral Glucose ◽

Dietary Inflammatory Index ◽

Inflammatory Index ◽

Increased Risk ◽

Incident Cases ◽

Control Study

The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DIIT3VS1: b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DIIT3VS1: b = 8.76; 95% CI 1.78, 15.73), HbA1c (DIIT3VS1: b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DIIT3VS1: b = 16.37; 95% CI 11.04, 21.69), triglyceride (DIIT3VS1: b = 21.01; 95% CI 8.61, 33.42) and body fat (DIIT3VS1: b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DIIT3VS1: b = −3.39; 95% CI −5.94, −0.84) and lean body mass (DIIT3VS1: b = −3.11; 95% CI −4.83, −1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DIIT3VS1: OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DIIcontinuous: OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.

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Association between Maternal Dietary Inflammatory Index (DII) and abortion in Iranian women and validation of DII with serum concentration of inflammatory factors: case-control study

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0274 ◽

2017 ◽

Vol 42 (5) ◽

pp. 511-516 ◽

Cited By ~ 35

Author(s):

Farhad Vahid ◽

Nitin Shivappa ◽

Azita Hekmatdoost ◽

James R. Hebert ◽

Sayed Hossein Davoodi ◽

...

Keyword(s):

Case Control Study ◽

Continuous Variable ◽

Case Control ◽

Diet Group ◽

Inflammatory Factors ◽

Dietary Inflammatory Index ◽

Logistic Regression Models ◽

Inflammatory Index ◽

Incident Cases ◽

Control Study

Previous studies have shown that some dietary components may be implicated in the etiology of spontaneous abortion. However, the possible relationship between diet-related inflammation and the risk of abortion has not yet been investigated. We examined the ability of the literature-derived Dietary Inflammatory Index (DII) to predict the abortion incidence in women suffering from recurrent abortion in a case-control study conducted from April 2010 to March 2011. This included 67 incident cases and 68 controls (frequency matched to cases by age) who attended infertility and miscarriage specialized centers in Tehran, Iran. The DII was computed based on dietary intake assessed using a validated and reproducible 168 item food-frequency questionnaire. Logistic regression models were used to estimate multivariable ORs adjusted for age, education, occupation, and body mass index. Subjects with higher DII scores (i.e., a more pro-inflammatory diet) had higher odds of abortion, with the DII being used as a continuous variable (ORcontinuous = 2.12, 95% CI: 1.02–4.43). When analysis was carried out with DII expressed as a dichotomous variable, women in the pro-inflammatory diet group (DII > 1.24) were at 2.12 times higher odds of having abortion compared with women in the referent group (DII ≤ 1.24) (ORDII>1.24/≤1.24 = 2.12; 95% CI: 1.02–4.43). In the same study, for every 1-unit increase in DII, there was a corresponding increase in interleukin-6 by 0.15 pg/mL, 95% CI (<0.01, 0.28). In conclusion, subjects who consumed a more pro-inflammatory diet were at increased odds of abortion compared with those who consumed a more anti-inflammatory diet.

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High consumption of vegetable and fruit colour groups is inversely associated with the risk of colorectal cancer: a case–control study

British Journal Of Nutrition ◽

10.1017/s0007114515000331 ◽

2015 ◽

Vol 113 (7) ◽

pp. 1129-1138 ◽

Cited By ~ 17

Author(s):

Wei-Ping Luo ◽

Yu-Jing Fang ◽

Min-Shan Lu ◽

Xiao Zhong ◽

Yu-Ming Chen ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Case Control Study ◽

Vegetable Intake ◽

Case Control ◽

Colorectal Cancer Risk ◽

Fruit Colour ◽

Logistic Regression Models ◽

Orange Yellow ◽

Control Study

The colour of the edible portion of vegetables and fruit reflects the presence of specific micronutrients and phytochemicals. No existing studies have examined the relationship between the intake of vegetable and fruit colour groups and the risk of colorectal cancer. The present study, therefore, aimed to investigate these associations in a Chinese population. A case–control study was conducted between July 2010 and July 2014 in Guangzhou, China, in which 1057 consecutively recruited cases of colorectal cancer were frequency-matched to 1057 controls by age (5-year interval), sex and residence (rural/urban). A validated FFQ was used to collect dietary information during face-to-face interviews. Vegetables and fruit were classified into four groups according to the colour of their primarily edible parts: green; orange/yellow; red/purple; white. Unconditional logistic regression models were used to estimate the OR and 95 % CI. A higher consumption of orange/yellow, red/purple and white vegetables and fruit was inversely associated with the risk of colorectal cancer, with adjusted OR of 0·16 (95 % CI 0·12, 0·22) for orange/yellow, 0·23 (95 % CI 0·17, 0·31) for red/purple and 0·53 (95 % CI 0·40, 0·70) for white vegetables and fruit when the highest and lowest quartiles were compared. Total vegetable intake and total fruit intake have also been found to be inversely associated with colorectal cancer risk. However, the intake of green vegetable and fruit was not associated with colorectal cancer risk. The results of the present study, therefore, suggest that a greater intake of orange/yellow, red/purple and white vegetables and fruit is inversely associated with the risk of colorectal cancer.

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Association between shiftwork and the risk of colorectal cancer in females: a population-based case–control study

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104657 ◽

2018 ◽

Vol 75 (5) ◽

pp. 344-350 ◽

Cited By ~ 11

Author(s):

Wa Mwenga Walasa ◽

Renee N Carey ◽

Si Si ◽

Lin Fritschi ◽

Jane S Heyworth ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Case Control Study ◽

Early Morning ◽

Population Based ◽

Case Control ◽

Colorectal Cancer Risk ◽

Adverse Health Outcomes ◽

Increased Risk ◽

Control Study

ObjectiveResearch indicates that shiftwork may be associated with increased risks of adverse health outcomes, including some cancers. However, the evidence of an association between shiftwork and colorectal cancer risk is limited and inconclusive. Further, while several possible pathways through which shiftwork might result in cancer have been proposed, few studies have taken these factors into account. We investigated the association between two types of shiftwork (graveyard shiftwork and early-morning shiftwork) and six mechanistic shiftwork variables (including light at night and phase shift) and the risk of colorectal cancer among females in an Australian population-based case–control study. Graveyard shiftwork was the primary exposure of interest.MethodsParticipants (350 cases and 410 controls) completed a lifetime occupational history, and exposure to each of the eight shiftwork variables was assigned to participants through a job exposure matrix. We used logistic regression to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for the association between different shiftwork variables and the risk of colorectal cancer, adjusting for potential demographic, lifestyle and medical confounders.ResultsWorking in an occupation involving long-term exposure (>7.5 years) to graveyard shiftwork was not associated with colorectal cancer risk (adjusted OR 0.95, 95% CI 0.57 to 1.58). Similarly, no increased risks of colorectal cancer were seen for any of the other seven shiftwork variables examined.ConclusionsNo evidence of an increased risk of colorectal cancer among females who had worked in occupations involving shiftwork was observed in this study.

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Association of the glycaemic index and glycaemic load with colorectal cancer in the population of Córdoba (Argentina): results of a case–control study using a multilevel modelling approach

British Journal Of Nutrition ◽

10.1017/s0007114519000035 ◽

2019 ◽

Vol 122 (5) ◽

pp. 575-582 ◽

Cited By ~ 1

Author(s):

Eugenia Haluszka ◽

Valentina Luciana Dávila ◽

Laura Rosana Aballay ◽

Maria del Pilar Diaz ◽

Alberto Rubén Osella ◽

...

Keyword(s):

Colorectal Cancer ◽

Case Control Study ◽

Multilevel Modelling ◽

Glycaemic Index ◽

Case Control ◽

Logistic Regression Models ◽

Weekly Intake ◽

Glycaemic Load ◽

Control Study

AbstractThe glycaemic index (GI) and glycaemic load (GL) are involved in the aetiology of different diseases, and they could be related to the development of colorectal cancer (CRC). The aim of this study was to evaluate the association between the quality and quantity indicators of carbohydrates consumed by the population of Córdoba (Argentina) and the odds of developing CRC in 2008–2016 period. A case–control study was conducted with 492 participants (161/331 cases/controls), interviewed through a validated FFQ. Multilevel logistic regression models were used to assess the effect of GI, GL and the quantity or weekly intake of high-GI foods on CRC occurrence, following adjustment for individual/first-level covariates, and using level of urbanisation as the contextual variable. The models were stratified by sex. Participants in the highest v. lowest tertile of dietary GL and weekly intake of high-GI foods had increased odds of CRC presence in the entire sample (OR 1·64, 95 % CI 1·16, 2·34 and OR 1·11, 95 % CI 1·09, 1·14, respectively) and in women (OR 1·98, 95 % CI 1·24, 3·18 and OR 1·41, 95 % CI 1·09, 1·83, respectively). In men, the second tertile of GL and weekly intake of high-GI foods were associated with CRC (OR 1·44, 95 % CI 1·04, 1·99 and OR 1·48, 95 % CI 1·32, 1·65, respectively). Also, GI was associated with CRC in women (highest v. lowest tertile OR 2·12, 95 % CI 1·38, 3·27). In addition to the quantity and quality of carbohydrates intake, it is important to consider the frequency of consumption of high-GI foods in CRC prevention.

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