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Original Articles

Proinflammatory Dietary Intake is Associated with Increased Risk of Colorectal Cancer: Results of a Case-Control Study in Argentina Using a Multilevel Modeling Approach

, , , , &
Pages 61-68 | Received 13 Dec 2016, Accepted 06 Oct 2017, Published online: 15 Nov 2017
 

ABSTRACT

Little evidence regarding the inflammatory potential of diet and its effect on colorectal cancer exists in Latin American countries. The aim of the present study was to evaluate the association between the Dietary Inflammatory Index (DII®) and colorectal cancer (CRC) risk in Córdoba, Argentina. A frequency-matched case-control study (N = 446, including 144 (32.3%) CRC cases and 302 (67.7%) controls was conducted in Córdoba (Argentina) from 2008 through 2015. DII® scores were computed based on dietary intake assessed by a validated food frequency questionnaire (FFQ). Multilevel logistic regression models were fit to evaluate the association between DII scores and CRC, following adjustment for age, body mass index, sex, energy intake, smoking habits, socio-economic status, physical activity, and use of nonsteroidal anti-inflammatory drugs as first-level covariates and level of urbanization as the contextual variable. Odds of colorectal cancer increased linearly with increasing DII scores (ORcontinuous 1.34; 95%CI 1.07 to 1.69 and ORtertile3 vs. tertile1 1.21; 95%CI 1.01 to 1.44). The association was stronger among men than women (ORcontinuous 1.29; 95%CI 1.21 to 1.37 vs. ORcontinuous 1.05; 95%CI 0.83 to 1.33, respectively). A proinflammatory diet, reflected by higher DII scores, was positively associated with colorectal cancer occurrence, mainly in men.

Conflict of Interest

No author declares a conflict.

Declaration

JRH 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. NS is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

Acknowledgments

This work was supported by the National Science and Technology Agency (grants PICTO 2006—36035, PICT 2008—1814, and PICT 2012—1019) and the Science and Technology Secretariat of the University of Córdoba. Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors would like to thank the Córdoba Tumor Registry, the physicians who contributed to this study, and a special thanks to the people who kindly agreed to participate.

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