Meta-analysis of the association between the dietary inflammatory index (DII) and breast cancer risk

Wang, Lu; Liu, Cun; Zhou, Chao; Zhuang, Jing; Tang, Shifeng; Yu, Jin‐Tai; Tian, Jinhui; Feng, Fubin; Liu, Lijuan; Zhang, Tingting; Sun, Changgang

doi:10.1038/s41430-018-0196-9

Cited by 50 publications

(30 citation statements)

References 42 publications

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“…With 33,907 gynecological cancers cases, our results reinforced and complemented the findings in several previous studies [30313233], which indicated that the elevated DII certainly linked with higher risk of gynecological cancers. Compared with those previous meta analyses, our studies included 6 new eligible studies [163435363738], and more studies enable us to explore the potential source of heterogeneity such as stratified analyses according to study design, and different age and BMI strata.…”

Section: Discussionsupporting

confidence: 90%

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies

et al. 2019

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ObjectiveThere has been growing body of literatures showing that chronic inflammation might play an important role in cancer development. This meta-analysis aimed to assess the association between the dietary inflammation index (DII) score and gynecological cancers.MethodsA systematic search of PubMed, EMBASE and Web of Science up until October 20, 2018 was carried out to retrieve all related cohort and case-control studies. The summary risk assessments were pooled using random-effects models. The dose-response relationship was estimated by linear relationship model.ResultsTwelve case-control studies (10,774 cases/15,958 controls) and six prospective cohort studies (330,363 participants/23,133 incident cases) were included in this meta-analysis. The pooled adjusted relative risk (RR) of gynecological cancers for the highest DII category compared to the lowest category was 1.38, (95% confidence intervals [CIs], 1.21–1.56, p<0.001]. A positive dose-response relationship was also noticed. Stratified by study design indicated that, the pooled RRs was significantly higher for case-control studies than cohort studies (p for interaction<0.001), for studies conducted among participants with body mass index (BMI) ≥25 kg/m2 than participants with BMI <25 kg/m2 (p for interaction=0.026), among participants with ovarian cancer and endometrial cancer than participants with breast cancer (p for interaction = 0.038). Meta-regression analysis further confirmed that study design significantly contributed to inter-study heterogeneity (p<0.001).ConclusionThis meta-analysis suggests that elevated DII is independently associated with a higher risk of gynecological cancers, especially patients with ovarian cancer and endometrial cancer and among obese participants.

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Section: Discussionsupporting

confidence: 90%

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies

et al. 2019

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“…The development and progression of BC has been linked, among other parameters, to inflammation [55]. The evidence regarding the association between DII and overall BC risk is still inconclusive despite being evaluated in several prospective cohorts [31,32,56,57,58], case-control studies [59,60,61,62,63], and cancer-specific and general meta-analyses [30,64,65,66]. Although our estimates suggested increased relative risks for the association between E-DII and overall BC, the 95% CIs included the null value.…”

Section: Discussionmentioning

confidence: 99%

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study)

et al. 2019

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Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60–2.32; p-trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99–1.52, p-trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26–1.74; p-trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.

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“…Several dietary indexes have been developed and used to assess diet quality, but only the DII focuses on diet’s effects on inflammation [7]. DII scores have been linked to risk of disease and mortality [8,9,10,11,12,13]. In a recent meta-analysis, a higher DII score, indicating a pro-inflammatory diet, was associated with an increased risk of all-cause mortality [11].…”

Section: Introductionmentioning

confidence: 99%

The Dietary Inflammatory Index and All-Cause, Cardiovascular Disease, and Cancer Mortality in the Multiethnic Cohort Study

et al. 2018

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Diet quality based on inflammatory potential, assessed by the Dietary Inflammatory Index (DII®), has been related to mortality, but studies from racially/ethnically diverse populations are scarce. Using data from the Multiethnic Cohort Study in Hawaii and California, we investigated the association of the DII with all-cause, cardiovascular disease (CVD) and cancer mortality, both overall and by race/ethnicity. The analysis included 150,405 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 47,436 deaths during an average follow-up of 18.2 ± 4.9 years. In multivariable-adjusted Cox models, the hazard ratios (95% confidence intervals) for the highest vs. lowest quintile of the DII in men and women were 1.15 (1.09–1.21) and 1.22 (1.14–1.28) for all-cause, 1.13 (1.03–1.23) and 1.29 (1.17–1.42) for CVD, and 1.10 (1.00–1.21) and 1.13 (1.02–1.26) for cancer mortality. In men, an increased risk of all-cause mortality with higher DII scores was found in all racial/ethnic groups except for Native Hawaiians (P for heterogeneity < 0.001). Similarly, in women, an increased risk of CVD mortality was found in the four racial/ethnic groups, but not in Native Hawaiians. These findings support the association of a pro-inflammatory diet with a higher risk of mortality and suggest the association may vary by race/ethnicity.

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Meta-analysis of the association between the dietary inflammatory index (DII) and breast cancer risk

Abstract: This meta-analysis suggested that more pro-inflammatory diets (higher DII scores) are associated with increased breast cancer incidence. However, the research is not about significant associations but about moderate effect sizes.

Cited by 50 publications

References 42 publications

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study)

The Dietary Inflammatory Index and All-Cause, Cardiovascular Disease, and Cancer Mortality in the Multiethnic Cohort Study

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