Validation of a Dietary Inflammatory Index (DII) and Association with Risk of Gastric Cancer: a Case-Control Study

Document Type: Research Articles

Authors

1 Department of Nutritional Sciences, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.

4 Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.

5 Connecting Health Innovations LLC, Columbia, South Carolina, 29201, USA.

6 Food Safety Research Center, School of Nutrition and Food Sciences, Semnan University of Medical Sciences, Semnan, Iran.

7 Student Research Committee, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

8 Proteomics Research Center and Department of Biostatics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Gastric cancer (GC) is the fifth most common malignancy and the second leading cause of cancerrelated
deaths worldwide. Studies have shown that dietary components and inflammation are implicated in the etiology
of GC. Methods: We examined the ability of a dietary inflammatory index (DII) to predict the odds of GC in a casecontrol
study conducted from December 2014 to May 2016. The subjects were 82 cases and 95 controls who attended
specialized centers in Tabriz, Iran. DII scores were computed from a validated 168-item food frequency questionnaire.
Logistic regression models were used to estimate odds ratios (ORs) adjusted for age, sex, body mass index, education,
smoking, alcohol, H.pylori infection, physical activity, aspirin/NSAID use and total caloric intake. Results: In the fully
adjusted model, subjects with a DII score >-1.77 had nearly 3.5 times higher odds of having GC compared with subjects
with DII≤-1.77, (ORDII>-1.77≤-1.77=3.39; 95%CI=1.59, 7.22). Also, for every one-unit increase in DII, there was a
corresponding increase in hs-C-reactive protein, tumor necrosis factor-alpha, interleukin (IL)-6 and IL-1b: β=0.09, 0.16,
0.16 and 0.10, respectively; and a corresponding decrease in IL-10: β=-0.11. Conclusion: Subjects who consumed a more
pro-inflammatory diet were at increased odds of GC compared to those who consumed a more anti-inflammatory diet.

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