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Nutrients. 2019 Jun 21;11(6). pii: E1406. doi: 10.3390/nu11061406.

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, and Colorectal and Breast Cancer Risk (MCC-Spain Study).

Obón-Santacana M1,2,3, Romaguera D4,5,6, Gracia-Lavedan E7,8,9, Molinuevo A10, Molina-Montes E11,12, Shivappa N13,14,15, Hebert JR16,17,18, Tardón A19,20, Castaño-Vinyals G21,22,23,24, Moratalla F25,26,27,28, Guinó E29,30,31, Marcos-Gragera R32,33, Azpiri M34,35, Gil L36,37, Olmedo-Requena R38,39,40, Lozano-Lorca M41, Alguacil J42,43, Fernández-Villa T44,45, Martín V46,47,48, Molina AJ49,50, Ederra M51,52,53, Moreno-Iribas C54,55,56, Perez B57,58, Aragonés N59,60, Castello A61,62,63, Huerta JM64,65, Dierssen-Sotos T66,67, Gómez-Acebo I68,69, Molina-Barceló A70, Pollán M71,72,73, Kogevinas M74,75,76,77, Moreno V78,79,80,81, Amiano P82,83,84.

Author information

1
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. mobon@idibell.cat.
2
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. mobon@idibell.cat.
3
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. mobon@idibell.cat.
4
Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. mariaadoracion.romaguera@ssib.es.
5
Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain. mariaadoracion.romaguera@ssib.es.
6
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain. mariaadoracion.romaguera@ssib.es.
7
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. esther.gracia@isglobal.org.
8
Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. esther.gracia@isglobal.org.
9
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. esther.gracia@isglobal.org.
10
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. au-molinuevo@euskadi.eus.
11
Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), 28029 Madrid, Spain. memolina@cnio.es.
12
Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain. memolina@cnio.es.
13
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. shivappa@email.sc.edu.
14
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. shivappa@email.sc.edu.
15
Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA. shivappa@email.sc.edu.
16
Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. JHEBERT@mailbox.sc.edu.
17
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. JHEBERT@mailbox.sc.edu.
18
Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA. JHEBERT@mailbox.sc.edu.
19
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. atardon@uniovi.es.
20
Department of Medicine, University of Oviedo, 33006 Oviedo, Spain. atardon@uniovi.es.
21
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. gemma.castano@isglobal.org.
22
Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. gemma.castano@isglobal.org.
23
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. gemma.castano@isglobal.org.
24
, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain. gemma.castano@isglobal.org.
25
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. fmoratalla@iconcologia.net.
26
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. fmoratalla@iconcologia.net.
27
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. fmoratalla@iconcologia.net.
28
Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain. fmoratalla@iconcologia.net.
29
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. e.guino@iconcologia.net.
30
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. e.guino@iconcologia.net.
31
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. e.guino@iconcologia.net.
32
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. rmarcos@iconcologia.net.
33
Genetics and Cancer Prevention Group, Epidemiology Unit and Girona Cancer Registry, Descriptive Epidemiology, IdIbGi, Catalan Institute of Oncology, 17007 Girona, Spain. rmarcos@iconcologia.net.
34
Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. koor-tolosa@euskadi.eus.
35
Biodonostia Research Institute, 20014 San Sebastian, Spain. koor-tolosa@euskadi.eus.
36
Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. l-gil@euskadi.eus.
37
Biodonostia Research Institute, 20014 San Sebastian, Spain. l-gil@euskadi.eus.
38
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. rocioolmedo@ugr.es.
39
Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain. rocioolmedo@ugr.es.
40
Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, 18014 Granada, Spain. rocioolmedo@ugr.es.
41
Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, Spain. macarenalozano@ugr.es.
42
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. juan.alguacil@dbasp.uhu.es.
43
Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21071Huelva, Spain. juan.alguacil@dbasp.uhu.es.
44
The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. tferv@unileon.es.
45
Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. tferv@unileon.es.
46
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. vicente.martin@unileon.es.
47
The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. vicente.martin@unileon.es.
48
Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. vicente.martin@unileon.es.
49
The Research Group in Gene - Environment and Health Interactions (GIIGAS) / Institut of Biomedicine (IBIOMED), Universidad de León, 24071 León, Spain. ajmolt@unileon.es.
50
Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, 24071 León, Spain. ajmolt@unileon.es.
51
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. maria.ederra.sanz@cfnavarra.es.
52
Navarra Public Health Institute, 31003 Pamplona, Spain. maria.ederra.sanz@cfnavarra.es.
53
Navarra Institute for Health Research (IdiSNA), 31003 Pamplona, Spain. maria.ederra.sanz@cfnavarra.es.
54
Navarra Public Health Institute, 31003 Pamplona, Spain. mc.moreno.iribas@cfnavarra.es.
55
Navarra Institute for Health Research (IdiSNA), 31003 Pamplona, Spain. mc.moreno.iribas@cfnavarra.es.
56
REDISSEC Red de Investigación en Servicios de Salud en Enfermedades Crónicas, 28029 Madrid, Spain. mc.moreno.iribas@cfnavarra.es.
57
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. bperez@isciii.es.
58
Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. bperez@isciii.es.
59
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. nuria.aragones@salud.madrid.org.
60
Department of Health of Madrid, Cancer Epidemiology Section, Public Health Division, 28029 Madrid, Spain. nuria.aragones@salud.madrid.org.
61
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. acastello@isciii.es.
62
Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. acastello@isciii.es.
63
Department of Surgery and Medical and Social Sciences. Alcalá de Henares University, 28801 Alcalá de Henares, Madrid, Spain. acastello@isciii.es.
64
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. jmhuerta.carm@gmail.com.
65
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain. jmhuerta.carm@gmail.com.
66
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. trinidad.dierssen@unican.es.
67
Preventive Medicine, Universidad de Cantabria-IDIVAL, 39011 Santander, Spain. trinidad.dierssen@unican.es.
68
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. ines.gomez@unican.es.
69
Preventive Medicine, Universidad de Cantabria-IDIVAL, 39011 Santander, Spain. ines.gomez@unican.es.
70
Cancer and Public Health Area, FISABIO-Public Health, 46020 Valencia, Spain. molina_anabar@gva.es.
71
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. mpollan@isciii.es.
72
Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain. mpollan@isciii.es.
73
Department of Health of Madrid, Cancer Epidemiology Section, Public Health Division, 28029 Madrid, Spain. mpollan@isciii.es.
74
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. manolis.kogevinas@isglobal.org.
75
Instituto de Salud Global de Barcelona (ISGlobal), 08036 Barcelona, Spain. manolis.kogevinas@isglobal.org.
76
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain. manolis.kogevinas@isglobal.org.
77
, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain. manolis.kogevinas@isglobal.org.
78
Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, 08908 Barcelona, Spain. v.moreno@iconcologia.net.
79
ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain. v.moreno@iconcologia.net.
80
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. v.moreno@iconcologia.net.
81
Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain. v.moreno@iconcologia.net.
82
Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain. epicss-san@euskadi.eus.
83
Public Health Division of Gipuzkoa, 20003 San Sebastian, Spain. epicss-san@euskadi.eus.
84
Biodonostia Research Institute, 20014 San Sebastian, Spain. epicss-san@euskadi.eus.

Abstract

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score combining E-DII and NEAC. E-DII was associated with colorectal cancer risk (OR = 1.93, highest quartile versus lowest, 95%CI:1.60-2.32; p-trend: <0.001); this increase was observed for both colon and rectal cancer. Less pronounced increased risks were observed for breast cancer (OR = 1.22, highest quartile versus lowest, 95%CI:0.99-1.52, p-trend: >0.10). The combined score of high E-DII scores and low antioxidant values were associated with colorectal cancer risk (OR = 1.48, highest quartile versus lowest, 95%CI: 1.26-1.74; p-trend: <0.001), but not breast cancer. This study provides evidence that a pro-inflammatory diet is associated with increased colorectal cancer risk while findings for breast cancer were less consistent.

KEYWORDS:

MCC-Spain; NEAC; antioxidants; breast cancer; case-control study; colorectal cancer; diet; dietary inflammatory index

PMID:
31234427
DOI:
10.3390/nu11061406
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Conflict of interest statement

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 smartphone 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. The authors have no other potential competing interest to disclose. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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