Dietary Inflammatory Potential and the Risk of Serrated and Adenomatous Colorectal Polyps

Abstract

Studies of dietary inflammation potential and risks of colorectal cancer precursors are limited, particularly for sessile serrated lesions (SSLs). This study examines the association using the energy-adjusted dietary inflammatory index (E-DII^TM), a measure of anti- and/or pro-inflammatory diet, in a large US colonoscopy-based case-control study of 3246 controls, 1530 adenoma cases, 472 hyperplastic polyp cases, and 180 SSL cases. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression models. Analyses were stratified by participant characteristics, and urinary prostaglandin E2 metabolite (PGE-M) and high-sensitivity plasma C-reactive protein (hs-CRP) levels, inflammation biomarkers. Highest E-DII™ intake was associated with significantly increased risks of colorectal adenomas (OR 1.36, 95% CI 1.11, 1.67), and hyperplastic polyps (OR 1.43, 95% CI 1.06, 1.98), compared with participants consuming the lowest E-DII™ quartile. A similar, but non-significant, increased risk was also observed for SSLs (OR 1.41, 95% CI 0.82, 2.41). The positive association was stronger in females (p_interaction <0.001), normal weight individuals (p_trend 0.01), and in individuals with lower inflammatory biomarkers (p_trend 0.02 and 0.01 for PGE-M and hs-CRP, respectively). A high E-DII™ is associated with colorectal polyp risk, therefore promoting an anti-inflammatory diet may aid in preventing colorectal polyps.

Author Contributions

MJS and HGC conceived and designed the analysis; MJS, GLM, RMN, WES, HJM, and WZ collected the data; NS and JRH contributed data; MJS and LBS performed the analysis; All authors wrote or edited the manuscript:

Disclosure Statement

Getty LB, Coleman HG, Murff HJ, Milne G, Ness RM, Smalley WE, Zheng W, and Shrubsole MJ have no conflicts to report. Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed 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. 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.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, MJS, upon reasonable request and when consistent with the informed consent of study participants and institutional policies of the participating sites.

Additional information

Funding

This study was supported by grants [P50CA950103] (WZ), [R01CA97386] (WZ), and [K07CA122451] (MJS). Surveys and sample collection and processing for this study were conducted by the Survey and Biospecimen Shared Resource, which is supported in part by [P30CA68485]. hs-CRP values were stored in Research Electronic Data Capture (REDCap) which is supported in part by the Vanderbilt Institute for Clinical and Translational Research [UL1TR000445]. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. A portion of the participants were studied as the result of resources and the use of facilities at the VA Tennessee Valley Healthcare System.