Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy.
Adv Nutr. 2021 Oct 1;12(5):1681-1690. doi: 10.1093/advances/nmab037.
Numerous observational studies have investigated the role of the Dietary Inflammatory Index (DII®) in chronic disease risk. The aims of this umbrella review and integrated meta-analyses were to systematically synthesize the observational evidence reporting on the associations between the DII and health outcomes based on meta-analyses, and to assess the quality and strength of the evidence for each associated outcome. This umbrella review with integrated meta-analyses investigated the association between the DII and a range of health outcomes based on meta-analyses of observational data. A credibility assessment was conducted for each outcome using the following criteria: statistical heterogeneity, 95% prediction intervals, evidence for small-study effect and/or excess significance bias, as well as effect sizes and P values using calculated random effects meta-analyses. In total, 15 meta-analyses reporting on 38 chronic disease-related outcomes were included, incorporating a total population of 4,360,111 subjects. Outcomes (n = 38) were examined through various study designs including case-control (n = 8), cross-sectional (n = 5), prospective (n = 5), and combination (n = 20) study designs. Adherence to a pro-inflammatory dietary pattern had a significant positive association with 27 (71%) of the included health outcomes (P value < 0.05). Using the credibility assessment, Class I (Convincing) evidence was identified for myocardial infarction only, Class II (Highly suggestive) evidence was identified for increased risk of all-cause mortality, overall risk of incident cancer, and risk of incident site-specific cancers (colorectal, pancreatic, respiratory, and oral cancers) with increasing (more pro-inflammatory) DII score. Most outcomes (n = 31) presented Class III (Suggestive) or lower evidence (Weak or No association). Pro-inflammatory dietary patterns were nominally associated with an increased risk of many chronic disease outcomes. However, the strength of evidence for most outcomes was limited. Further prospective studies are required to improve the precision of the effect size.
大量观察性研究探讨了饮食炎症指数（DII®）在慢性病风险中的作用。本综述和综合荟萃分析的目的是系统地综合报告 DII 与健康结果之间关联的观察证据，基于荟萃分析评估每个相关结果的证据质量和强度。本项使用观察性数据进行荟萃分析的综述和综合荟萃分析，调查了 DII 与一系列健康结果之间的关联。使用以下标准对每个结果进行可信度评估：统计学异质性、95%预测区间、小样本研究效应和/或过度显著性偏差的证据，以及使用计算的随机效应荟萃分析的效应大小和 P 值。总共纳入了 15 项报告 38 种与慢性疾病相关的结果的荟萃分析，其中包含了 4360111 名受试者的总人口。通过各种研究设计（包括病例对照研究[ n = 8]、横断面研究[ n = 5]、前瞻性研究[ n = 5]和组合研究[ n = 20]）检查了结果（ n = 38）。遵循促炎饮食模式与 27 种（71%）纳入的健康结果呈显著正相关（ P 值<0.05）。使用可信度评估，仅确定了心肌梗死的 I 级（有说服力）证据，确定了全因死亡率、所有癌症发病风险、特定部位癌症（结直肠癌、胰腺癌、呼吸道癌和口腔癌）发病风险升高与 DII 评分升高（更促炎）的 II 级（高度提示性）证据。大多数结果（ n = 31）的证据为 III 级（提示性）或更低（弱或无关联）。促炎饮食模式与许多慢性疾病结果的风险增加有一定关联。然而，大多数结果的证据强度有限。需要进一步的前瞻性研究来提高效应大小的精度。
