Nitin Shivappa1,2,3, James R Hébert4,5,6, Valentina Rosato7,8, Marta Rossi7, Maurizio Montella9, Diego Serraino10, Carlo La Vecchia7. 1. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA. shivappa@mailbox.sc.edu. 2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. shivappa@mailbox.sc.edu. 3. Connecting Health Innovations LLC, Columbia, SC, 29201, USA. shivappa@mailbox.sc.edu. 4. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA. 5. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. 6. Connecting Health Innovations LLC, Columbia, SC, 29201, USA. 7. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 8. Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 9. Dipartimento di Epidemiologia, 'Fondazione G. Pascale', Istituto Nazionale Tumori, Naples, Italy. 10. SOC di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, PN, Italy.
Abstract
BACKGROUND: While inflammation has been shown to play an important etiologic role in ovarian carcinogenesis, little is known about the association between inflammatory properties of diet and ovarian cancer risk. METHODS: We explored the association between the dietary inflammatory index (DII) and ovarian cancer risk in a multicentric Italian case-control study conducted between 1992 and 1999. Cases were 1,031 women with incident, histologically confirmed ovarian cancer from four areas in Italy. Controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive-tract diseases or committed to long-term modifications of diet. DII scores were computed based on 31 nutrients and food items assessed using a reproducible and validated 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake and other recognized confounding factors. RESULTS: Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of ovarian cancer compared to subjects in the lowest quartile (i.e., with an anti-inflammatory diet) (ORQuartile4vs1 1.47, 95% confidence interval, CI, 1.07, 2.01; p trend = 0.009). When analyses were carried out using continuous DII, a significant positive association with ovarian cancer was observed: the OR for one-unit increment in DII score (corresponding to approximately 8 % of its range in the current study, +6.0 to -6.20) was 1.08 (95% CI 1.02, 1.14). CONCLUSION: A pro-inflammatory diet as indicated by higher DII scores is associated with increased ovarian cancer risk.
BACKGROUND: While inflammation has been shown to play an important etiologic role in ovarian carcinogenesis, little is known about the association between inflammatory properties of diet and ovarian cancer risk. METHODS: We explored the association between the dietary inflammatory index (DII) and ovarian cancer risk in a multicentric Italian case-control study conducted between 1992 and 1999. Cases were 1,031 women with incident, histologically confirmed ovarian cancer from four areas in Italy. Controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive-tract diseases or committed to long-term modifications of diet. DII scores were computed based on 31 nutrients and food items assessed using a reproducible and validated 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake and other recognized confounding factors. RESULTS: Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of ovarian cancer compared to subjects in the lowest quartile (i.e., with an anti-inflammatory diet) (ORQuartile4vs1 1.47, 95% confidence interval, CI, 1.07, 2.01; p trend = 0.009). When analyses were carried out using continuous DII, a significant positive association with ovarian cancer was observed: the OR for one-unit increment in DII score (corresponding to approximately 8 % of its range in the current study, +6.0 to -6.20) was 1.08 (95% CI 1.02, 1.14). CONCLUSION: A pro-inflammatory diet as indicated by higher DII scores is associated with increased ovarian cancer risk.
Authors: Nitin Shivappa; Anna E Prizment; Cindy K Blair; David R Jacobs; Susan E Steck; James R Hébert Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-08-25 Impact factor: 4.254
Authors: Fred K Tabung; Susan E Steck; Jiajia Zhang; Yunsheng Ma; Angela D Liese; Ilir Agalliu; Melanie Hingle; Lifang Hou; Thomas G Hurley; Li Jiao; Lisa W Martin; Amy E Millen; Hannah L Park; Milagros C Rosal; James M Shikany; Nitin Shivappa; Judith K Ockene; James R Hebert Journal: Ann Epidemiol Date: 2015-03-19 Impact factor: 3.797
Authors: L S A Augustin; J Polesel; C Bosetti; C W C Kendall; C La Vecchia; M Parpinel; E Conti; M Montella; S Franceschi; D J A Jenkins; L Dal Maso Journal: Ann Oncol Date: 2003-01 Impact factor: 32.976
Authors: Nitin Shivappa; James R Hébert; Ernst R Rietzschel; Marc L De Buyzere; Michel Langlois; Evi Debruyne; Ascensión Marcos; Inge Huybrechts Journal: Br J Nutr Date: 2015-02-02 Impact factor: 3.718
Authors: Nitin Shivappa; Antonella Zucchetto; Maurizio Montella; Diego Serraino; Susan E Steck; Carlo La Vecchia; James R Hébert Journal: Br J Nutr Date: 2015-06-08 Impact factor: 3.718
Authors: Nitin Shivappa; Susan E Steck; Thomas G Hurley; James R Hussey; Yunsheng Ma; Ira S Ockene; Fred Tabung; James R Hébert Journal: Public Health Nutr Date: 2013-10-10 Impact factor: 4.022
Authors: Theodore M Brasky; Jingmin Liu; Emily White; Ulrike Peters; John D Potter; Roland B Walter; Christina S Baik; Dorothy S Lane; JoAnn E Manson; Mara Z Vitolins; Matthew A Allison; Jean Y Tang; Jean Wactawski-Wende Journal: Int J Cancer Date: 2014-03-20 Impact factor: 7.396
Authors: Nitin Shivappa; James R Hébert; Martina Taborelli; Maurizio Montella; Massimo Libra; Antonella Zucchetto; Anna Crispo; Maria Grimaldi; Carlo La Vecchia; Diego Serraino; Jerry Polesel Journal: Cancer Causes Control Date: 2017-05-13 Impact factor: 2.506
Authors: Lauren C Peres; James R Hebert; Bo Qin; Kristin A Guertin; Elisa V Bandera; Nitin Shivappa; Tareq F Camacho; Deanna Chyn; Anthony J Alberg; Jill S Barnholtz-Sloan; Melissa L Bondy; Michele L Cote; Ellen Funkhouser; Patricia G Moorman; Edward S Peters; Ann G Schwartz; Paul D Terry; Joellen M Schildkraut Journal: J Nutr Date: 2019-09-01 Impact factor: 4.798
Authors: Nitin Shivappa; James R Hébert; Lisa E Paddock; Lorna Rodriguez-Rodriguez; Sara H Olson; Elisa V Bandera Journal: Nutrition Date: 2017-09-23 Impact factor: 4.008
Authors: Nitin Shivappa; James R Hébert; Valentina Rosato; Maurizio Montella; Diego Serraino; Carlo La Vecchia Journal: Mol Nutr Food Res Date: 2016-11-30 Impact factor: 5.914
Authors: Nitin Shivappa; Marialaura Bonaccio; James R Hebert; Augusto Di Castelnuovo; Simona Costanzo; Emilia Ruggiero; George Pounis; Maria Benedetta Donati; Giovanni de Gaetano; Licia Iacoviello Journal: Nutrition Date: 2018-04-21 Impact factor: 4.008
Authors: Lauren C Peres; Elisa V Bandera; Bo Qin; Kristin A Guertin; Nitin Shivappa; James R Hebert; Sarah E Abbott; Anthony J Alberg; Jill Barnholtz-Sloan; Melissa Bondy; Michele L Cote; Ellen Funkhouser; Patricia G Moorman; Edward S Peters; Ann G Schwartz; Paul D Terry; Fabian Camacho; Frances Wang; Joellen M Schildkraut Journal: Int J Cancer Date: 2016-11-14 Impact factor: 7.396
Authors: Melissa Lopez-Pentecost; Tracy E Crane; David O Garcia; Lindsay N Kohler; Betsy C Wertheim; James R Hebert; Susan E Steck; Nitin Shivappa; Margarita Santiago-Torres; Marian L Neuhouser; Irene E Hatsu; Linda Snetselaar; Mridul Datta; Candyce H Kroenke; Gloria E Sarto; Cynthia A Thomson Journal: Z Gesundh Wiss Date: 2020-07-14