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Dietary Inflammatory Index and Colorectal Cancer Risk—A Meta-Analysis

Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Connecting Health Innovations LLC, Columbia, SC 29201, USA
Inflammation Society, Church Hill, Orpington, London BR6OHH, UK
Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, 95123 Catania, Italy
NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge CB4 0WS, UK
Author to whom correspondence should be addressed.
Nutrients 2017, 9(9), 1043;
Received: 8 August 2017 / Revised: 31 August 2017 / Accepted: 18 September 2017 / Published: 20 September 2017
(This article belongs to the Special Issue Effects of Polyphenol-Rich Foods on Human Health)
Diet and chronic inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet, measured through the Dietary Inflammatory Index (DII®), and CRC has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from nine studies were eligible, of which five were case-control and four were cohort studies. Results from meta-analysis showed a positive association between increasing DII scores, indicating a pro-inflammatory diet, and CRC. Individuals in the highest versus the lowest (reference) DII category showed an overall 40% increased risk of CRC with moderate evidence of heterogeneity [relative risk (RR) = 1.40, 95% confidence interval (CI): 1.26, 1.55; I2 = 69%, p < 0.001]. When analyzed as a continuous variable, results showed an increased risk of CRC of 7% for a 1-point increase in the DII score. Results remained unchanged when analyses were restricted to the four prospective studies. Results of our meta-analysis support the importance of adopting a healthier anti-inflammatory diet in preventing CRC. These results further substantiate the utility of DII as tool to characterize the inflammatory potential of diet and to predict CRC. View Full-Text
Keywords: diet; cytokines; nutrition; inflammation; epidemiology; dietary inflammatory index; colorectal cancer; meta-analysis diet; cytokines; nutrition; inflammation; epidemiology; dietary inflammatory index; colorectal cancer; meta-analysis
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Shivappa, N.; Godos, J.; Hébert, J.R.; Wirth, M.D.; Piuri, G.; Speciani, A.F.; Grosso, G. Dietary Inflammatory Index and Colorectal Cancer Risk—A Meta-Analysis. Nutrients 2017, 9, 1043.

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