TY - JOUR
T1 - The Dietary Inflammatory Index and its associations with biomarkers of nutrients with antioxidant potential, a biomarker of inflammation and multiple long-term conditions
AU - Mulligan, Angela A.
AU - Lentjes, Marleen A. H.
AU - Skinner, Jane
AU - Welch, Ailsa A.
N1 - Data Availability Statement: The authors will make the dataset available under a Data Transfer Agreement to any bona fide researcher who wishes to obtain the dataset in order to undertake a replication analysis. Although the dataset is anonymised, the breadth of the data included and the multiplicity of variables that are included in this analysis file as primary variables or confounding factors means that provision of the dataset to other researchers without a Data Transfer Agreement would constitute a risk. Requests for data sharing/access should be submitted to the EPIC Management Committee ([email protected]).
Funding information: The EPIC-Norfolk study (DOI: 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (G9502233, MR/N003284/1, MC-UU_12015/1 and MC_UU_00006/1) and Cancer Research UK (C864/A14136).
PY - 2024/8/8
Y1 - 2024/8/8
N2 - We aimed to validate the Dietary Inflammatory Index (DII®) and assess the cross-sectional associations between the DII® and multiple long-term conditions (MLTCs) and biomarker concentrations and MLTCs using data from the European Prospective Investigation into Cancer (EPIC-Norfolk) study (11,113 men and 13,408 women). The development of MLTCs is associated with low-grade chronic inflammation, and ten self-reported conditions were selected for our MLTC score. Data from a validated FFQ were used to calculate energy-adjusted DII® scores. High-sensitivity C-reactive protein (hs-CRP) and circulating vitamins A, C, E, β-carotene and magnesium were available. Micronutrient biomarker concentrations were significantly lower as the diet became more pro-inflammatory (p-trend < 0.001), and hs-CRP concentrations were significantly higher in men (p-trend = 0.006). A lower DII® (anti-inflammatory) score was associated with 12–40% higher odds of MLTCs. Lower concentrations of vitamin C and higher concentrations of hs-CRP were associated with higher odds of MLTCs. The majority of the associations in our study between MLTCs, nutritional biomarkers, hs-CRP and the DII® were as expected, indicating that the DII® score has criterion validity. Despite this, a more anti-inflammatory diet was associated with higher odds of MLTCs, which was unexpected. Future studies are required to better understand the associations between MLTCs and the DII®.
AB - We aimed to validate the Dietary Inflammatory Index (DII®) and assess the cross-sectional associations between the DII® and multiple long-term conditions (MLTCs) and biomarker concentrations and MLTCs using data from the European Prospective Investigation into Cancer (EPIC-Norfolk) study (11,113 men and 13,408 women). The development of MLTCs is associated with low-grade chronic inflammation, and ten self-reported conditions were selected for our MLTC score. Data from a validated FFQ were used to calculate energy-adjusted DII® scores. High-sensitivity C-reactive protein (hs-CRP) and circulating vitamins A, C, E, β-carotene and magnesium were available. Micronutrient biomarker concentrations were significantly lower as the diet became more pro-inflammatory (p-trend < 0.001), and hs-CRP concentrations were significantly higher in men (p-trend = 0.006). A lower DII® (anti-inflammatory) score was associated with 12–40% higher odds of MLTCs. Lower concentrations of vitamin C and higher concentrations of hs-CRP were associated with higher odds of MLTCs. The majority of the associations in our study between MLTCs, nutritional biomarkers, hs-CRP and the DII® were as expected, indicating that the DII® score has criterion validity. Despite this, a more anti-inflammatory diet was associated with higher odds of MLTCs, which was unexpected. Future studies are required to better understand the associations between MLTCs and the DII®.
KW - antioxidant
KW - biomarker
KW - dietary inflammatory index
KW - MLTCs
KW - MM
KW - multi-morbidity
KW - multiple long-term conditions
KW - validation
UR - http://www.scopus.com/inward/record.url?scp=85202528658&partnerID=8YFLogxK
U2 - 10.3390/antiox13080962
DO - 10.3390/antiox13080962
M3 - Article
VL - 13
JO - Antioxidants
JF - Antioxidants
SN - 2076-3921
IS - 8
M1 - 962
ER -
