Cancer remains one of the most prevalent diseases in the United States and a leading cause of death. Large prospective studies have found significant correlations between dietary intake and cancer. Chronic inflammation promotes pro-cancer inflammatory environments promoting the formation and growth of tumors while preventing effective anti-tumor responses. Nutrition can impact inflammation, with the intake of certain food items increasing biomarkers for systemic inflammation thus, the objective of this research was to explore the relationship between inflammatory diet score measured by the Dietary Inflammatory index and all-cause mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. Web of Science, Medline, CINHAL, and PsycINFO databases were searched to collect potentially eligible sources that focus on dietary inflammation and cancer outcomes. All sources were uploaded to Covidence software and screened by two independent blinded reviewers. The quality of the sources was assessed using the Newcastle Ottawa scale and relevant data was extracted and transferred to the Comprehensive Meta Analysis software and a random effects model was used to perform meta-analysis. Of the 1444 studies imported into the Covidence software, 13 passed all the screening stages and were included in the final analysis. Eight studies reported on pre-diagnosis diet while five others reported on post-diagnosis diet. Five studies reported on colorectal cancer, four on breast cancer, two on ovarian cancer, one on endometrial cancer and one on prostate cancer. Meta-analysis of the studies found that being in the highest postdiagnosis DII score indicating pro-inflammatory diet significantly increased the risk of all-cause death among cancer survivors by 33.5% (HR = 1.335, 95% CI = 1.049, 1.698, n = 6). Analysis did not show a statistically significant association between DII score and cancer mortality or recurrence (HR = 1.097, 95% CI = 0.939, 1.281, n = 6). Analysis by cancer subtype found a significant correlation between postdiagnosis DII score and all-cause mortality among the breast cancer survivors (HR = 1.335, 95% CI = 1.041, 1.711, n = 3) though there were no significant associations between DII and the outcomes of interest from the other cancer types. The meta-analysis concludes that being in the highest postdiagnosis DII score group significantly increased the risk of all-cause death among cancer survivors. This suggests that risk of all-cause mortality could be reduced for cancer survivors by consuming more anti-inflammatory food components and reducing consumption of pro-inflammatory foods. These findings also warrant more research in this field to clarify the relationship between dietary inflammation as measured by the DII and cancer outcomes, particularly cancer-specific mortality.

Submitted by Maria Aparecida (cidazen@gmail.com) on 2017-12-04T15:19:39Z No. of bitstreams: 1 Carolina Abreu de Carvalho.pdf: 1818066 bytes, checksum: 5d7b157435ace852cabbfd08eaba9af0 (MD5) / Made available in DSpace on 2017-12-04T15:19:39Z (GMT). No. of bitstreams: 1 Carolina Abreu de Carvalho.pdf: 1818066 bytes, checksum: 5d7b157435ace852cabbfd08eaba9af0 (MD5) Previous issue date: 2017-10-17 / Introduction: Several studies have documented the association between inflammation and metabolic outcomes. The Dietary Inflammatory Index (DII) is a tool to evaluate the inflammatory potential of the diet. Studies associating the DII with the metabolic syndrome or insulin resistance still controversial. Purpose: to assess the association of the DII with insulin resistance (IR) or metabolic syndrome (MS). Methods: A cross-sectional study was conducted on 2017 adults aged 23 to 25 years in Ribeirão Preto, Brazil. Food consumption was assessed using a validated Food Frequency Questionnaire. The DII was calculated from 35 available food parameters. IR was determined from the classification of HOMA-IR values (≥2.7uU mL-1). MS was diagnosed based on the Joint Interim Statement (JIS) criterion. The association of DII score with IR or MS was determined by Poisson regression analysis with robust estimation of variance. The variables included in the multivariable model were selected from Directed Acyclic Graphs (DAG). Results: The diet of the young adults studied showed a high inflammatory potential, with a mean DII of 1.10 (range: -4.69 to +5.28). The prevalence of MS was 12.2% and of IR was 12.3%, both greater in males. In adjusted analysis, the DII was not associated with IR or MS in either sex. Conclusions: Although this association was not detected in this sample of young adults, the study demonstrated that their diet had a high inflammatory potential, a fact that may increase the risk for the development of non-communicable diseases in the future. / Introdução: Diversos estudos têm documentado a associação entre inflamação e desfechos metabólicos. O Índice Inflamatório da Dieta (IID) é uma ferramenta para avaliação do potencial inflamatório da dieta. Trabalhos associando o IID à síndrome metabólica ou resistência insulínica ainda controversos. Objetivo: avaliar a associação do IID com resistência insulínica (RI) ou síndrome metabólica (SM). Materiais e Métodos: Trata-se de um estudo transversal, realizado com 2017 adultos de 23 a 25 anos, em Ribeirão Preto, Brasil. O consumo alimentar foi avaliado a partir de um Questionário de Frequência Alimentar validado. O IID foi calculado a partir de 35 parâmetros alimentares. A RI foi avaliada a partir da classificação de valores de HOMA-IR (≥2,7 uU mL-1). Para diagnosticar SM foi considerado o critério do Joint Interim Statement (JIS). A associação do IID com RI ou SM foi avaliada por análise de regressão de Poisson com estimativa robusta da variância. As variáveis incluídas no modelo multivariado foram selecionadas a partir de gráficos acíclicos direcionados (Directed Acyclic Graph – DAG). Resultados: A dieta dos adultos jovens estudados apresentou elevado potencial inflamatório, com média de IID de 1,10, variando de -4,69 a +5,28. A prevalência de SM foi de 12,2% e de RI 12,3%, ambas maiores no sexo masculino. Na análise ajustada, o IID não se associou com RI ou SM em ambos os sexos. Conclusão: Apesar da associação não ter sido encontrada nesta amostra de adultos jovens, o estudo evidencia que a dieta dos jovens estudados tem um elevado potencial inflamatório, o que pode aumentar o risco para o desenvolvimento de doenças e agravos não-transmissíveis no futuro.

BACKGROUND: The effects of pro-inflammatory diets, as measured by the Dietary Inflammatory Index (DII), on periodontal disease among Americans have not been evaluated. OBJECTIVE: This study examines whether the DII is associated with periodontitis in U.S. adults participating in the National Health and Nutrition Examination Surveys (NHANES) 2009-2014. In particular, it evaluates whether an anti-inflammatory dietary pattern is associated with lower prevalence of periodontitis in NHANES and lower severity of periodontitis. METHODS: Dietary Inflammatory Index score was derived from taking the mean of two 24-hour dietary recall interviews. The sample population included 7,480 subjects (3,628 men and 3,852 women), who were 30-80 years old from all racial/ethnic groups. The exclusion criteria were incomplete or missing data regarding clinical periodontal and dental examinations. In addition, participants were also excluded who had diabetes, cancer, pregnancy or breastfeeding status, unreliable dietary information, or elevated alcohol intake. The DII score was classified as Low DII/anti-inflammatory (DII: -5.16≤DII≤0.54) and High DII/pro-inflammatory (DII: 0.54<DII≤4.82). Outcome was measured using case definitions of periodontitis and classified as mild, moderate, severe, and total periodontitis. The prevalence for each was calculated in the overall sample population and sex-specific subgroups. Logistic regression models were used to calculate crude ORs (and 95% CI) for the presence of total periodontitis. Multivariate regression analysis was used to adjust for age, sex, alcohol consumption, and smoking. Chi-square test was used to calculate the ORs for mild, moderate, and severe periodontitis. RESULTS: The prevalence of total periodontitis among subjects with Low DII is 42% and the prevalence of total periodontitis among subjects with High DII is 47.5%. The prevalence of total periodontitis among men with Low DII is 49.8%, while the prevalence of total periodontitis among men with High DII is 57.7%. The prevalence is 32.1% and 41.4% for women with Low DII and High DII, respectively. Based on adjusted logistic regression models, consuming a diet that scores High DII results in 35% increased risk of total periodontitis; for men the risk is 25% and for women 44%. Based on the subtype analysis, consuming a diet that scores High DII results in a statistically significant 21% increased risk of moderated periodontitis and 48% increased risk of severe periodontitis. CONCLUSIONS: Pro-inflammatory diet (High DII) is associated with higher prevalence of moderate, severe, and total periodontitis in both men and women. The prevalence of mild periodontitis is higher among women adhering to High DII, but not among men. The overall cohort has increased odds of having moderate, severe, and total periodontitis when consuming pro-inflammatory foods and nutrients, with women being at greater risk for total periodontitis. Subjects whose diet was pro-inflammatory had statistically-significant increased risk of having moderate or severe periodontitis, but not mild.