The dietary inflammatory index and human health: An umbrella review of meta-analyses of observational studies

Author Identifier

Lauren Blekkenhorst

ORCID : 0000-0003-1561-9052

Document Type

Journal Article

Publication Title

Advances in Nutrition

Volume

12

Issue

5

First Page

1681

Last Page

1690

Publisher

Oxford University Press

School

School of Medical and Health Sciences

RAS ID

42741

Funders

National Health and Medical Research Council Funding information : https://doi.org/10.1093/advances/nmab037

Grant Number

NHMRC Number : APP1156909, GNT1171313, 1172987

Comments

Marx, W., Veronese, N., Kelly, J. T., Smith, L., Hockey, M., Collins, S., . . . Jacka, F. (2021). The dietary inflammatory index and human health: An umbrella review of meta-analyses of observational studies. Advances in Nutrition, 12(5), 1681-1690. https://doi.org/10.1093/advances/nmab037

Abstract

Numerous observational studies have investigated the role of the Dietary Inflammatory Index (DII®) in chronic disease risk. The aims of this umbrella review and integrated meta-analyses were to systematically synthesize the observational evidence reporting on the associations between the DII and health outcomes based on meta-analyses, and to assess the quality and strength of the evidence for each associated outcome. This umbrella review with integrated meta-analyses investigated the association between the DII and a range of health outcomes based on meta-analyses of observational data. A credibility assessment was conducted for each outcome using the following criteria: Statistical heterogeneity, 95% prediction intervals, evidence for small-study effect and/or excess significance bias, as well as effect sizes and P values using calculated random effects meta-analyses. In total, 15 meta-analyses reporting on 38 chronic disease-related outcomes were included, incorporating a total population of 4,360,111 subjects. Outcomes (n = 38) were examined through various study designs including case-control (n = 8), cross-sectional (n = 5), prospective (n = 5), and combination (n = 20) study designs. Adherence to a pro-inflammatory dietary pattern had a significant positive association with 27 (71%) of the included health outcomes (P value < 0.05). Using the credibility assessment, Class I (Convincing) evidence was identified for myocardial infarction only, Class II (Highly suggestive) evidence was identified for increased risk of all-cause mortality, overall risk of incident cancer, and risk of incident site-specific cancers (colorectal, pancreatic, respiratory, and oral cancers) with increasing (more pro-inflammatory) DII score. Most outcomes (n = 31) presented Class III (Suggestive) or lower evidence (Weak or No association). Pro-inflammatory dietary patterns were nominally associated with an increased risk of many chronic disease outcomes. However, the strength of evidence for most outcomes was limited. Further prospective studies are required to improve the precision of the effect size.

DOI

10.1093/advances/nmab037

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