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Appl Physiol Nutr Metab. 2017 Apr;42(4):399-404. doi: 10.1139/apnm-2016-0395. Epub 2016 Dec 15.

Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study.

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a Department of Nutritional Sciences, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
b Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
c Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
d Connecting Health Innovations LLC, Columbia, SC 29201, USA.
e Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
f Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran.
g Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DIIT3VS1: b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DIIT3VS1: b = 8.76; 95% CI 1.78, 15.73), HbA1c (DIIT3VS1: b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DIIT3VS1: b = 16.37; 95% CI 11.04, 21.69), triglyceride (DIIT3VS1: b = 21.01; 95% CI 8.61, 33.42) and body fat (DIIT3VS1: b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DIIT3VS1: b = -3.39; 95% CI -5.94, -0.84) and lean body mass (DIIT3VS1: b = -3.11; 95% CI -4.83, -1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DIIT3VS1: OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DIIcontinuous: OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.


diet; inflammation; metabolic syndrome; régime alimentaire; syndrome métabolique

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