Association between Dietary Inflammatory Index and Gastric Cancer Risk in an Italian Case-Control Study

ABSTRACT

Background: In this study, we explored the association between the dietary inflammatory index (DII) and gastric cancer risk in an Italian case-control study. Materials and Methods: Cases were 230 patients with incident, histologically confirmed cases of gastric cancer from the Greater Milan area, Northern Italy. Controls were 547 frequency-matched subjects admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The DII was computed using a reproducible and valid 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models conditioned on age and sex and adjusted for recognized confounding factors, including total energy intake. Results: Subjects with the most pro-inflammatory diet had a higher risk of gastric cancer compared to subjects with the most anti-inflammatory diet (OR_Quartile4vs1 = 2.35, 95% confidence interval, 1.32, 4.20; P-trend = 0.004). Conclusion: These results indicate that a pro-inflammatory diet, as indicated by higher DII score, was associated with increased risk of gastric cancer.

Acknowledgments

This study was supported by the Italian Foundation for Research on Cancer (FIRC) and by the Italian Ministry of Health, General Directorate of European and International Relation. Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases.

Disclosure

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI.