Nitin Shivappa1,2,3, James R Hébert4,5,6, Martina Taborelli7, Maurizio Montella8, Massimo Libra9, Antonella Zucchetto7, Anna Crispo8, Maria Grimaldi8, Carlo La Vecchia10, Diego Serraino7, Jerry Polesel7. 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. Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, PN, Italy. 8. Dipartimento di Epidemiologia, 'Fondazione G. Pascale' Istituto Nazionale Tumori, Naples, Italy. 9. Department of Biomedical and Biotechnological Sciences (Biometec), University of Catania, Catania, Italy. 10. Italy Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Abstract
BACKGROUND: While dietary factors have been shown to play an important etiologic role in non-Hodgkin lymphoma (NHL), little is known about the association between inflammatory properties of diet and NHL risk. METHODS: We explored the association between the dietary inflammatory index (DII) and NHL risk in a multicenter Italian case-control study conducted between 1999 and 2014. Cases were 536 subjects with incident, histologically confirmed NHL from three areas in Italy. Controls were 984 subjects admitted to the same network of hospitals as the cases for acute, nonmalignant conditions, unrelated to diet. DII scores were computed based on 30 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 NHL compared with subjects in the lowest quartile (i.e., with the most anti-inflammatory diets) (ORQuartile4vs1 1.61, 95% confidence interval CI 1.07-2.43; p-trend = 0.01). Stratified analyses produced stronger associations between DII and NHL among males (ORQuartile4vs1 2.14; 95% CI 1.25-3.67) with significant heterogeneity (p value = 0.02); when analyzed by histologic subtype, a significant association was observed with diffuse large B-cell lymphoma (ORQuartile4vs1 1.84; 95% CI 1.09-3.10). CONCLUSION: A pro-inflammatory diet, as indicated by higher DII scores, is associated with elevated odds of NHL, especially among males.
BACKGROUND: While dietary factors have been shown to play an important etiologic role in non-Hodgkin lymphoma (NHL), little is known about the association between inflammatory properties of diet and NHL risk. METHODS: We explored the association between the dietary inflammatory index (DII) and NHL risk in a multicenter Italian case-control study conducted between 1999 and 2014. Cases were 536 subjects with incident, histologically confirmed NHL from three areas in Italy. Controls were 984 subjects admitted to the same network of hospitals as the cases for acute, nonmalignant conditions, unrelated to diet. DII scores were computed based on 30 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 NHL compared with subjects in the lowest quartile (i.e., with the most anti-inflammatory diets) (ORQuartile4vs1 1.61, 95% confidence interval CI 1.07-2.43; p-trend = 0.01). Stratified analyses produced stronger associations between DII and NHL among males (ORQuartile4vs1 2.14; 95% CI 1.25-3.67) with significant heterogeneity (p value = 0.02); when analyzed by histologic subtype, a significant association was observed with diffuse large B-cell lymphoma (ORQuartile4vs1 1.84; 95% CI 1.09-3.10). CONCLUSION: A pro-inflammatory diet, as indicated by higher DII scores, is associated with elevated odds of NHL, especially among males.
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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: 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: Catherine M Phillips; Ling-Wei Chen; Barbara Heude; Jonathan Y Bernard; Nicholas C Harvey; Liesbeth Duijts; Sara M Mensink-Bout; Kinga Polanska; Giulia Mancano; Matthew Suderman; Nitin Shivappa; James R Hébert Journal: Nutrients Date: 2019-08-12 Impact factor: 5.717
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