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Open AccessArticle

Increased Dietary Inflammatory Index Is Associated with Schizophrenia: Results of a Case–Control Study from Bahrain

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Ministry of Health, Manama, Bahrain
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College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, P. O. Box 27272 Sharjah, UAE
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Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan
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Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
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Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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Connecting Health Innovations LLC, Columbia, SC 29201, USA
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Author to whom correspondence should be addressed.
Nutrients 2019, 11(8), 1867; https://doi.org/10.3390/nu11081867
Received: 10 July 2019 / Revised: 1 August 2019 / Accepted: 8 August 2019 / Published: 11 August 2019
(This article belongs to the Special Issue Dietary Inflammatory Indices in Human Health and Disease)
Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII®), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed based on dietary intake assessed using a comprehensive food frequency questionnaire (FFQ). Logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders including age, sex, body mass index, education, employment, diabetes, hypertension, and cardiovascular disease with E-DII expressed both as a continuous variable and categorized as quartiles. Results: The mean E-DII score for the entire sample was 1.79 ± 1.52, indicating a generally pro-inflammatory diet. The cases with schizophrenia appeared to have a higher E-DII score compared to controls: 1.99 ± 1.39 vs. 1.60 ± 1.38, respectively (p = 0.009). For every one unit increase in the E-DII score, the odds of having schizophrenia increased by 62% (OR 1.62; 95% CI 1.17–2.26). Similarly, increased risk was observed when the E-DII was used as quartiles, with participants in most pro-inflammatory quartile 4 being nearly 6 times more likely to be schizophrenic than participants in the most anti-inflammatory group quartile 1 (OR 5.96; 1.74–20.38; p-trend = 0.01). Conclusions: The data suggest that a pro-inflammatory diet, as indicated by increasing E-DII score, is associated with schizophrenia. This is the first study to examine the association between the DII and schizophrenia in a Middle Eastern population. Although these results are consistent with findings from research conducted in depression, additional studies are required before generalizing the findings to other populations. View Full-Text
Keywords: dietary inflammatory index (DII); schizophrenia; case–control study dietary inflammatory index (DII); schizophrenia; case–control study
MDPI and ACS Style

Jahrami, H.; Faris, M. .-I.; Ghazzawi, H.A.; Saif, Z.; Habib, L.; Shivappa, N.; Hébert, J.R. Increased Dietary Inflammatory Index Is Associated with Schizophrenia: Results of a Case–Control Study from Bahrain. Nutrients 2019, 11, 1867.

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