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Open AccessArticle

Adiposity Mediates the Association between the Dietary Inflammatory Index and Markers of Type 2 Diabetes Risk in Middle-Aged Black South African Women

1
South African Medical Research Council/University of the Witwatersrand Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
2
Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7725, South Africa
3
Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden
4
Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208, USA
5
Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 400, Columbia, SC 29208, USA
6
Connecting Health Innovations, LLC, 1417 Gregg Street, Columbia, SC 29201, USA
7
Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie Van Zijl, Parow Valley, Cape Town 7505, South Africa
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(6), 1246; https://doi.org/10.3390/nu11061246
Received: 20 March 2019 / Revised: 23 April 2019 / Accepted: 2 May 2019 / Published: 31 May 2019
(This article belongs to the Special Issue Dietary Inflammatory Indices in Human Health and Disease)
The dietary inflammatory index (DII®), a validated tool used to measure the inflammatory potential of the diet, has been associated with metabolic disorders in various settings, but not in African populations. The aim of this study was to investigate whether the DII is associated with markers of type 2 diabetes (T2D) risk, and if this association is mediated by adiposity and/or low-grade inflammation, in black South Africa women. Energy-adjusted-DII (E-DII) scores were calculated in 190 women (median age, 53 years) from the Birth-to-Twenty plus cohort using a validated food frequency questionnaire. Fasting glucose, insulin, HbA1c, and inflammatory cytokines were measured, and an oral glucose tolerance test performed. Basic anthropometry and dual-energy x-ray absorptiometry-derived body fat, including estimate of visceral adipose tissue (VAT) area, were measured. E-DII scores were associated with all markers of T2D risk, namely, fasting glucose and insulin, HbA1c, HOMA2-IR, two-hour glucose and Matsuda index (all p < 0.05). After adjusting for age, measures of adiposity, but not inflammatory cytokines, mediated the association between E-DII and markers of T2D risk (p < 0.05). Measures of central obesity had proportionally higher (range: 23.5–100%) mediation effects than total obesity (range: 10–60%). The E-DII is associated with T2D risk through obesity, in particular central obesity, among black middle-aged South African women. View Full-Text
Keywords: DII; diet-induced inflammation; obesity; VAT; mediation; T2D risk; South African women DII; diet-induced inflammation; obesity; VAT; mediation; T2D risk; South African women
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MDPI and ACS Style

Mtintsilana, A.; Micklesfield, L.K.; Chorell, E.; Olsson, T.; Shivappa, N.; Hebert, J.R.; Kengne, A.P.; Goedecke, J.H. Adiposity Mediates the Association between the Dietary Inflammatory Index and Markers of Type 2 Diabetes Risk in Middle-Aged Black South African Women. Nutrients 2019, 11, 1246.

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