Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Abstract

Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures. Results: A total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ± 1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects. Conclusion: Our findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.

Dietary Inflammatory Index in relation to Type 2 Diabetes: A Meta-Analysis

“…Among the included studies, there were 8 high quality studies reporting the adjusted risk estimate for T2D associated with DII as the primary outcome [ 32 , 33 , 39 , 50 – 52 , 59 , 63 ], while for other studies [ 23 – 31 , 34 – 38 , 40 – 49 , 53 – 58 , 60 – 62 , 64 – 70 ], T2D was a secondary outcome and the crude odds ratio for T2D was calculated based on the frequency of subjects with T2D in the highest category of DII, compared with subjects in the lowest category. DII was calculated with the use of 7-day dietary record in 3 studies [ 31 , 44 , 50 ], 24-hour dietary recall in 11 studies [ 35 , 37 , 46 , 51 , 54 , 55 , 62 – 64 , 68 , 70 ], dietary history questionnaire in 2 studies [ 45 , 52 ], and food frequency questionnaire (FFQ) in the remaining studies. Moreover, data for men was reported in 7 studies [ 28 , 36 , 44 , 50 , 53 , 54 , 64 ] and for women was reported in 10 studies [ 24 , 28 , 34 , 36 , 38 , 49 , 52 , 54 , 64 , 67 ], and other studies reported results for a combination of both sexes.…”

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

“…Not all studies have reported positive associations between DII and bone health. The Brazilian Osteoporosis Study (n = 2269 adults ≥ 40 years old) failed to identify any link between DII scores and low-impact fractures [283]. In further work the relationship between DII scores and muscle mass and strength were examined in Chinese children (n = 466, age six–nine years).…”

Association between the dietary inflammatory index and bone markers in postmenopausal women

“…In addition, in the study of the elderly population, pro-inflammatory foods were confirmed to increase the risk of fracture [ 46 ]. However in the Brazilian osteoporosis study, females had a higher DII score than males, but there was no association between DII score and fracture risk of vulnerability [ 47 ]. In our study, there was no association between DII and BMD.…”