Changes in the Dietary Inflammatory Index Over Time and Cancer Development Within Rural Post-Menopausal Women

Abstract

Objectives The objective of this study was to determine the extent to which diets with a higher inflammatory potential, as measured by the Dietary Inflammatory Index (DII), are associated with cancer development in a cohort of rural post-menopausal women. Methods This study was a secondary analysis of participants of a randomized control trial evaluating the effect of vitamin D and calcium supplementation on cancer development in rural, post-menopausal women in Nebraska. From this cohort, diets were evaluated via a 2005 Block Food Frequency Questionnaire (FFQ) at baseline and four years later (Visit 9). DII scores were calculated at both time points for each participant, including an unadjusted and energy-adjusted DII score. The relationship with DII scores and cancer development were evaluated using a chi-squared test and logistic regression, controlling for pertinent confounders. The difference in DII scores at baseline and Visit 9 for participants who developed cancer and non-cancer participants was examined via a repeated measure ANOVA test. Results There were 1977 participants with baseline and Visit 9 DII scores available for analysis. There was a significant difference in DII scores between baseline and Visit 9, with a significantly larger change in DII scores in the participants who developed cancer (p = 0.0194), shifting to higher pro-inflammatory scores at Visit 9. Cancer status was not associated with baseline DII scores, nor was DII score a predictor of cancer status, when controlling for confounders. Conclusions These findings illustrate how dietary patterns in persons diagnosed with cancer had significant changes over time, increasing inflammatory diet potential. This increase in inflammatory potential in cancer patients may impact outcomes like treatment success, overall survival, and cancer recurrence, creating a need for more research to further analyze the impact of cancer diagnoses on diet changes, and if these changes are detrimental to cancer survivor outcomes. Funding Sources None.

Change in the inflammatory potential of diet over 10 years and subsequent mortality: the Multiethnic Cohort Study

“…In the same cohort, women with dietary changes towards, or a history of, pro-inflammatory diets had a higher risk of colon cancer compared with those in the anti-inflammatory stable group, particularly for proximal colon cancer (for proinflammatory change, HR = 1•32, 95 % CI 1•01, 1•74) and among non-users of non-steroidal anti-inflammatory drugs (for proinflammatory stable, HR = 1•42, 95 % CI 1•01, 2•03) (14) . Proinflammatory change in diet has been reported in a small cohort of Australian women (aged 51-62 years at baseline, -0•60 to -0•46 over 14 years) (25) and in rural postmenopausal women (55 years or older) in Nebraska over 4 years, which was larger in participants who developed cancer than in those without cancer (26) .…”

“…The inflammatory potential of the diet, as estimated by the E-DII, has been consistently associated with disease outcomes and mortality (6)(7)(8)(9)(10)(11)(12) . However, there are only few studies that have contributed additional evidence by examining longitudinal changes in the inflammatory potential of diet (13,14,(24)(25)(26) . In the Women's Health Initiative Observational Study where FFQ were repeated among postmenopausal women (aged 50-79 years at baseline), mean E-DII score decreased modestly from -1•14 at baseline to -1•50 at Year 3 representing a transition towards an anti-inflammatory diet (24) .…”

Diet Quality Trajectories over Adulthood in a Biracial Urban Sample from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study

“…In contrast, both the Dietary Inflammatory Index (DII) and Mean Adequacy Ratio (MAR) include micronutrients, but their intakes are related to different end-points, namely the risk of effect on inflammatory markers [ 27 ] or the actual micronutrient Recommended Dietary Allowances of the individual [ 28 ], respectively. The DII has been used to assess changes in dietary quality over time [ 29 , 30 , 31 ], but no studies using the MAR were found in the current literature.…”