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Osteoporosis International

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01-04-2021 | Osteoporosis | Original Article

Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis

Authors: Y. Fang, J. Zhu, J. Fan, L. Sun, S. Cai, C. Fan, Y. Zhong, Y. Li

Published in: Osteoporosis International | Issue 4/2021

Abstract

Summary

Our systematic review and meta-analysis indicated that pro-inflammatory diets, as measured by higher Dietary Inflammatory Index scores, are significantly associated with lower BMD of lumbar spine and total hip as well as elevated risk of osteoporosis and fractures. These findings may contribute to the development of public health strategies.

Introduction

Inflammatory Index (DII) is a method to assess the inflammatory potential of diets; it has been reported to be associated with several diseases. However, the relation between DII and bone health remains controversial for the inconsistent findings from previous studies. This systematic review and meta-analysis aimed to ascertain the underlying relationships between DII and bone mineral density (BMD), osteoporosis risk, and fracture risk.

Methods

We systematically searched PubMed and Web of Science for all relevant epidemiological studies published up to May 1, 2020. Fixed-effects model or random-effects model was employed to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs).

Results

Eleven studies with a total of 127,769 participants were included. We found that continuous DII was negatively associated with BMD of lumbar spine (odds ratios [OR]: 0.990; 95% CI: 0.984, 0.995) and total hip (OR: 0.995; 95% CI: 0.990, 0.999), but not femoral neck (OR: 0.998; 95% CI: 0.994, 1.002). Moreover, the highest category of DII displayed significantly associations to increased risk of osteoporosis (ES: 1.31; 95% CI: 1.16, 1.48) and fractures (ES: 1.28; 95% CI: 1.03, 1.59) compared with the lowest category of DII, respectively.

Conclusion

Our analysis indicated that diets with high pro-inflammatory components might increase the risk of osteoporosis and fractures and lower BMD of lumbar spine and total hip. More prospective studies involving populations of diverse ages and genders are expected to further verify the universality of the results.

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Kanis JA, Cooper C, Rizzoli R, Reginster JY, Scientific Advisory Board of the European Society for C, Economic Aspects of O, the Committees of Scientific A, National Societies of the International Osteoporosis F (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30(1):3–44. https://doi.org/10.1007/s00198-018-4704-5CrossRefPubMed

Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4(6):368–381. https://doi.org/10.1007/BF01622200CrossRefPubMed

Weaver CM, Alexander DD, Boushey CJ, Dawson-Hughes B, Lappe JM, LeBoff MS, Liu S, Looker AC, Wallace TC, Wang DD (2016) Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 27(1):367–376. https://doi.org/10.1007/s00198-015-3386-5CrossRefPubMed

Calder PC, Albers R, Antoine JM, Blum S, Bourdet-Sicard R, Ferns GA, Folkerts G, Friedmann PS, Frost GS, Guarner F, Lovik M, Macfarlane S, Meyer PD, M’Rabet L, Serafini M, van Eden W, van Loo J, Vas Dias W, Vidry S, Winklhofer-Roob BM, Zhao J (2009) Inflammatory disease processes and interactions with nutrition. Br J Nutr 101 Suppl 1:S1–45. https://doi.org/10.1017/S0007114509377867

Barbour KE, Boudreau R, Danielson ME, Youk AO, Wactawski-Wende J, Greep NC, LaCroix AZ, Jackson RD, Wallace RB, Bauer DC, Allison MA, Cauley JA (2012) Inflammatory markers and the risk of hip fracture: the Women’s Health Initiative. J Bone Miner Res 27(5):1167–1176. https://doi.org/10.1002/jbmr.1559CrossRefPubMed

Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC (2007) Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr 137(4):992–998. https://doi.org/10.1093/jn/137.4.992CrossRefPubMed

Neale EP, Batterham MJ, Tapsell LC (2016) Consumption of a healthy dietary pattern results in significant reductions in C-reactive protein levels in adults: a meta-analysis. Nutr Res 36(5):391–401. https://doi.org/10.1016/j.nutres.2016.02.009CrossRefPubMed

Hodges JK, Zhu J, Yu Z, Vodovotz Y, Brock G, Sasaki GY, Dey P, Bruno RS (2020) Intestinal-level anti-inflammatory bioactivities of catechin-rich green tea: rationale, design, and methods of a double-blind, randomized, placebo-controlled crossover trial in metabolic syndrome and healthy adults. Contemp Clin Trials Commun 17:100495. https://doi.org/10.1016/j.conctc.2019.100495CrossRefPubMed

Sánchez-Moreno C, Cano MP, de Ancos B, Plaza L, Olmedilla B, Granado F, Martín A (2004) Consumption of high-pressurized vegetable soup increases plasma vitamin C and decreases oxidative stress and inflammatory biomarkers in healthy humans. J Nutr 134(11):3021–3025. https://doi.org/10.1093/jn/134.11.3021CrossRefPubMed

10.

Dumas JA, Bunn JY, Nickerson J, Crain KI, Ebenstein DB, Tarleton EK, Makarewicz J, Poynter ME, Kien CL (2016) Dietary saturated fat and monounsaturated fat have reversible effects on brain function and the secretion of pro-inflammatory cytokines in young women. Metabolism 65(10):1582–1588. https://doi.org/10.1016/j.metabol.2016.08.003CrossRefPubMedPubMedCentral

11.

Stock JK (2019) Cholesterol and inflammatory risk: insights from secondary and primary prevention. Atherosclerosis 280:192–193. https://doi.org/10.1016/j.atherosclerosis.2018.10.009CrossRefPubMed

12.

Samraj AN, Pearce OM, Läubli H, Crittenden AN, Bergfeld AK, Banda K, Gregg CJ, Bingman AE, Secrest P, Diaz SL, Varki NM, Varki A (2015) A red meat-derived glycan promotes inflammation and cancer progression. Proc Natl Acad Sci U S A 112(2):542–547. https://doi.org/10.1073/pnas.1417508112CrossRefPubMed

13.

Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17(8):1689–1696. https://doi.org/10.1017/S1368980013002115CrossRefPubMed

14.

Shivappa N, Hebert JR, Rietzschel ER, De Buyzere ML, Langlois M, Debruyne E, Marcos A, Huybrechts I (2015) Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr 113(4):665–671. https://doi.org/10.1017/S000711451400395XCrossRefPubMedPubMedCentral

15.

Shivappa N, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS, Tabung F, Hebert JR (2014) A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutr 17(8):1825–1833. https://doi.org/10.1017/S1368980013002565CrossRefPubMed

16.

Jayedi A, Emadi A, Shab-Bidar S (2018) Dietary inflammatory index and site-specific cancer risk: a systematic review and dose-response meta-analysis. Adv Nutr 9(4):388–403. https://doi.org/10.1093/advances/nmy015CrossRefPubMedPubMedCentral

17.

Shivappa N, Godos J, Hebert JR, Wirth MD, Piuri G, Speciani AF, Grosso G (2018) Dietary inflammatory index and cardiovascular risk and mortality-a meta-analysis. Nutrients 10(2). https://doi.org/10.3390/nu10020200

18.

Farhangi MA, Vajdi M (2020) The association between dietary inflammatory index and risk of central obesity in adults: an updated systematic review and meta-analysis. Int J Vitam Nutr Res:1–18. doi:https://doi.org/10.1024/0300-9831/a000648

19.

Tolkien K, Bradburn S, Murgatroyd C (2019) An anti-inflammatory diet as a potential intervention for depressive disorders: a systematic review and meta-analysis. Clin Nutr 38(5):2045–2052. https://doi.org/10.1016/j.clnu.2018.11.007CrossRefPubMed

20.

Zhang ZQ, Cao WT, Shivappa N, Hebert JR, Li BL, He J, Tang XY, Liang YY, Chen YM (2017) Association between diet inflammatory index and osteoporotic hip fracture in elderly Chinese population. J Am Med Dir Assoc 18(8):671–677. https://doi.org/10.1016/j.jamda.2017.02.011CrossRefPubMed

21.

Mazidi M, Shivappa N, Wirth MD, Hebert JR, Vatanparast H, Kengne AP (2017) The association between dietary inflammatory properties and bone mineral density and risk of fracture in US adults. Eur J Clin Nutr 71(11):1273–1277. https://doi.org/10.1038/ejcn.2017.133CrossRefPubMed

22.

Orchard T, Yildiz V, Steck SE, Hebert JR, Ma Y, Cauley JA, Li W, Mossavar-Rahmani Y, Johnson KC, Sattari M, LeBoff M, Wactawski-Wende J, Jackson RD (2017) Dietary inflammatory index, bone mineral density, and risk of fracture in postmenopausal women: results from the Women’s Health Initiative. J Bone Miner Res 32(5):1136–1146. https://doi.org/10.1002/jbmr.3070CrossRefPubMed

23.

Cervo MM, Shivappa N, Hebert JR, Oddy WH, Winzenberg T, Balogun S, Wu F, Ebeling P, Aitken D, Jones G, Scott D (2020) Longitudinal associations between dietary inflammatory index and musculoskeletal health in community-dwelling older adults. Clin Nutr 39(2):516–523. https://doi.org/10.1016/j.clnu.2019.02.031CrossRefPubMed

24.

Shivappa N, Hebert JR, Karamati M, Shariati-Bafghi SE, Rashidkhani B (2016) Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran. Eur J Nutr 55(2):561–568. https://doi.org/10.1007/s00394-015-0875-4CrossRefPubMed

25.

Cervo MMC, Scott D, Seibel MJ, Cumming RG, Naganathan V, Blyth FM, Le Couteur DG, Handelsman DJ, Ribeiro RV, Waite LM, Shivappa N, Hebert JR, Hirani V (2020) Proinflammatory diet increases circulating inflammatory biomarkers and falls risk in community-dwelling older men. J Nutr 150(2):373–381. https://doi.org/10.1093/jn/nxz256CrossRefPubMed

26.

Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012. https://doi.org/10.1016/j.jclinepi.2009.06.005CrossRefPubMed

27.

Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605. https://doi.org/10.1007/s10654-010-9491-zCrossRefPubMed

28.

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560. https://doi.org/10.1136/bmj.327.7414.557CrossRefPubMedPubMedCentral

29.

Zeng X, Zhang Y, Kwong JS, Zhang C, Li S, Sun F, Niu Y, Du L (2015) The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med 8(1):2–10. https://doi.org/10.1111/jebm.12141CrossRefPubMed

30.

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634. https://doi.org/10.1136/bmj.315.7109.629CrossRefPubMedPubMedCentral

31.

Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRefPubMed

32.

Park S, Na W, Sohn C (2018) Relationship between osteosarcopenic obesity and dietary inflammatory index in postmenopausal Korean women: 2009 to 2011 Korea National Health and Nutrition Examination Surveys. J Clin Biochem Nutr 63(3):211–216. https://doi.org/10.3164/jcbn.18-10CrossRefPubMedPubMedCentral

33.

Na W, Park S, Shivappa N, Hebert JR, Kim MK, Sohn C (2019) Association between inflammatory potential of diet and bone-mineral density in Korean postmenopausal women: data from fourth and fifth Korea National Health and Nutrition Examination Surveys. Nutrients 11(4). https://doi.org/10.3390/nu11040885

34.

Veronese N, Stubbs B, Koyanagi A, Hebert JR, Cooper C, Caruso MG, Guglielmi G, Reginster JY, Rizzoli R, Maggi S, Shivappa N (2018) Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study. Osteoporos Int 29(1):143–151. https://doi.org/10.1007/s00198-017-4251-5CrossRefPubMed

35.

Morimoto M, Shivappa N, de Souza GP, Martini LA, Schuch NJ, Hebert JR, Pinheiro MM (2019) Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS). Adv Rheumatol 59(1):16. https://doi.org/10.1186/s42358-019-0059-7CrossRefPubMed

36.

Kim HS, Sohn C, Kwon M, Na W, Shivappa N, Hebert JR, Kim MK (2018) Positive association between dietary inflammatory index and the risk of osteoporosis: results from the KoGES_Health Examinee (HEXA) cohort study. Nutrients 10(12). https://doi.org/10.3390/nu10121999

37.

Sponholtz TR, Zhang X, Fontes JD, Meigs JB, Cupples LA, Kiel DP, Hannan MT, McLean RR (2014) Association between inflammatory biomarkers and bone mineral density in a community-based cohort of men and women. Arthritis Care Res 66(8):1233–1240. https://doi.org/10.1002/acr.22270CrossRef

38.

Ehnert S, Baur J, Schmitt A, Neumaier M, Lucke M, Dooley S, Vester H, Wildemann B, Stockle U, Nussler AK (2010) TGF-beta1 as possible link between loss of bone mineral density and chronic inflammation. PLoS One 5(11):e14073. https://doi.org/10.1371/journal.pone.0014073CrossRefPubMedPubMedCentral

39.

Fuggle NR, Westbury LD, Syddall HE, Duggal NA, Shaw SC, Maslin K, Dennison EM, Lord J, Cooper C (2018) Relationships between markers of inflammation and bone density: findings from the Hertfordshire Cohort Study. Osteoporos Int 29(7):1581–1589. https://doi.org/10.1007/s00198-018-4503-zCrossRefPubMedPubMedCentral

40.

Wong SK, Chin KY, Suhaimi FH, Ahmad F, Jamil NA, Ima-Nirwana S (2018) Osteoporosis is associated with metabolic syndrome induced by high-carbohydrate high-fat diet in a rat model. Biomed Pharmacother 98:191–200. https://doi.org/10.1016/j.biopha.2017.12.042CrossRefPubMed

41.

Ilich JZ, Kelly OJ, Kim Y, Spicer MT (2014) Low-grade chronic inflammation perpetuated by modern diet as a promoter of obesity and osteoporosis. Arh Hig Rada Toksikol 65(2):139–148. https://doi.org/10.2478/10004-1254-65-2014-2541CrossRefPubMed

42.

Haring B, Crandall CJ, Wu C, LeBlanc ES, Shikany JM, Carbone L, Orchard T, Thomas F, Wactawaski-Wende J, Li W, Cauley JA, Wassertheil-Smoller S (2016) Dietary patterns and fractures in postmenopausal women: results from the Women’s Health Initiative. JAMA Intern Med 176(5):645–652. https://doi.org/10.1001/jamainternmed.2016.0482CrossRefPubMedPubMedCentral

43.

Jennings A, Mulligan AA, Khaw KT, Luben RN, Welch AA (2020) A Mediterranean diet is positively associated with bone and muscle health in a non-Mediterranean region in 25,450 men and women from EPIC-Norfolk. Nutrients 12(4). https://doi.org/10.3390/nu12041154

44.

Melaku YA, Gill TK, Adams R, Shi Z (2016) Association between dietary patterns and low bone mineral density among adults aged 50 years and above: findings from the North West Adelaide Health Study (NWAHS). Br J Nutr 116(8):1437–1446. https://doi.org/10.1017/s0007114516003366CrossRefPubMed

45.

Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R, National Osteoporosis F (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25(10):2359–2381. https://doi.org/10.1007/s00198-014-2794-2CrossRefPubMedPubMedCentral

Title: Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis
Authors: Y. Fang
J. Zhu
J. Fan
L. Sun
S. Cai
C. Fan
Y. Zhong
Y. Li
Publication date: 01-04-2021
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Osteoporosis International / Issue 4/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05578-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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