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.
Eur J Nutr. 2019 Oct;58(7):2755-2766. doi: 10.1007/s00394-018-1825-8. Epub 2018 Sep 25.
Diet and inflammation have been suggested to be important risk factors for lung cancer. We examined the ability of the dietary inflammatory index (DII) to predict lung cancer in the Singapore Chinese Health Study (SCHS). The DII is a diet quality index based on the literature linking foods and nutrients with inflammatory biomarkers.
Using data from the SCHS for 60,232 participants, including 1851 lung cancer cases, we investigated the associations of baseline DII scores calculated from a food frequency questionnaire with risk of developing lung cancer over an average of 17.6 years of follow-up. Hazard ratios (HR) were estimated using Cox regression, adjusting for smoking status and other risk factors.
After excluding cancers diagnosed in the first 2 years of follow-up, the DII was non-significantly associated with risk of lung cancer (HR = 1.13; 95% CI 0.94-1.35; P-trend = 0.24) after adjusting for age, dialect group, sex, interview year, education, body mass index, total calorie intake, physical activity and various smoking variables. In stratified analysis, stronger, statistically significant associations were evident in current smokers (HR 1.44; 95% CI 1.11-1.86; P = 0.03, P for interaction = 0.003) and in male ever-smokers (HR = 1.37; 95% CI 1.07-1.77; P-trend = 0.03).
A pro-inflammatory diet, as shown by higher DII scores, is associated with an elevated risk of lung cancer for subjects with a history of smoking. Public health measures should be adopted to promote consumption of a healthy, anti-inflammatory diet to reduce the risk of lung cancer, especially in current and former smokers.
饮食和炎症被认为是肺癌的重要危险因素。我们研究了饮食炎症指数（DII）在新加坡华人健康研究（SCHS）中预测肺癌的能力。DII 是一种基于文献中与炎症生物标志物相关的食物和营养素的饮食质量指数。
使用来自 SCHS 的 60232 名参与者的数据，包括 1851 例肺癌病例，我们调查了基线 DII 评分与平均 17.6 年随访期间肺癌发病风险之间的关联。使用 Cox 回归估计风险比（HR），并调整了吸烟状况和其他危险因素。
在排除随访前 2 年内诊断的癌症后，DII 与肺癌风险无显著相关性（HR=1.13；95%CI 0.94-1.35；P 趋势=0.24），调整了年龄、方言组、性别、访谈年份、教育程度、体重指数、总热量摄入、身体活动和各种吸烟变量。在分层分析中，在当前吸烟者（HR 1.44；95%CI 1.11-1.86；P=0.03，交互作用 P=0.003）和男性曾吸烟者（HR=1.37；95%CI 1.07-1.77；P 趋势=0.03）中，相关性更强，具有统计学意义。
较高的 DII 评分表明促炎饮食与有吸烟史的个体肺癌风险升高相关。应采取公共卫生措施，促进健康、抗炎饮食的消费，以降低肺癌风险，尤其是在当前和曾经吸烟者中。
