Association of Dietary Inflammatory Index with anthropometric indices in children and adolescents: the weight disorder survey of the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN)-IV study

Abstract

This study aimed to assess the relationship between the Dietary Inflammatory Index (DII®), a validated tool for evaluating diet-associated inflammation, and anthropometric indices in children and adolescents. This multicentre survey was conducted on 5427 school students selected via multistage cluster sampling from thirty provinces of Iran. This survey was conducted under the framework of the weight disorders survey, which is part of a national surveillance programme entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases-IV. For calculating the DII scores, twenty-five dietary factors were obtained from a validated 168-item FFQ. Height, weight, wrist circumference, neck circumference (NC), waist circumference (WC) and hip circumference (HC) were measured. BMIz-score, waist circumference:hip circumference ratio (WHR), waist circumference:height ratio (WHtR) and parental BMI were computed. Linear regression models were used to evaluate the association of DII and anthropometric indices. Significant trends were observed across quartiles of DII score for all anthropometric indices in all participants (P<0·05), except for WHR and WHtR. After adjustment for potential confounders, the multiple linear regression analysis for each anthropometric index revealed that participants in the highest DII quartile had higher BMIz-score, WC, HC and parental BMI compared with those in the first (or lowest) quartile. In summary, we found that a pro-inflammatory diet was associated with higher BMIz-score, wrist circumference, NC, WC, HC and parental BMI. The large sample size of the present study may influence the statistical significance of observed associations. Hence, the findings should be clinically interpreted with caution.

Pro-Inflammatory Diet Is Associated with Adiposity during Childhood and with Adipokines and Inflammatory Markers at 11 Years in Mexican Children

“…This study reflects the prevailing Mexican nutritional situation in that the studied population showed increasing prevalence of overweight and obesity as age increased. Likewise, our results about the association between pro-inflammatory diet and adiposity were similar to those documented by Aslani et al [34] and Ramallal et al [35], who found that children in the highest DII quartile had higher BMI z-score (p < 0.05) and higher hazard ration for obesity 1.32 (95% confidence interval 1.08-1.60) compared with children with lowest DII quartile, respectively. Moreover, Navarro et al [36] found a significant association between a pro-inflammatory C-DII and childhood obesity at 5 years (OR = 1.09, p = 0.02) and overweight/obesity at 5 and 9 years (OR = 1.06, p = 0.01 and OR = 1.12, p = 0.01, respectively).…”

Factors associated with the inflammatory potential of the Brazilian population’s diet

“…Younger individuals tend to consume more foods and nutrients with higher inflammatory potential. Aslani et al (22) identified that Iranian adolescents had a more pro-inflammatory diet due to the high consumption of fast food and sugars, such as cookies and crackers. Shivappa et al (23) observed a more pro-inflammatory diet in European adolescents that consumed more bread, chocolate, margarine, butter, animal fat, sodas, isotonics, meats, cakes, pies, cookies, sugars, honey, jam, and less vegetables, fruits, fruit juices and fish.…”

Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

“…It also is very challenging to elucidate the direction of causality between inflammation and increased adiposity, with most Mendelian randomization studies suggesting that inflammation is a consequence rather than a cause of obesity [181,182]. Since this meta-analysis, there have been a few more studies looking at this association; one was conducted in Pakistan where significant positive correlations were found between DII score and weight, BMI, waist-to-hip ratio, and body fat percentage [183] and another in Iran where a pro-inflammatory diet was associated with higher BMI z-score, wrist circumference, neck circumference, waist circumference, head circumference and parental BMI [184]. In a longitudinal study from Brazil, a pro-inflammatory diet at baseline was associated with smaller reductions in weight and body fat and poorer dietary quality (reduced consumption of fruits, vegetables, and legumes) six months after bariatric surgery [185].…”