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Inflammation and risk of chronic diseases with a focus on colorectal cancer and the impact of dietary patterns
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
2020 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Inflammation och risk för kroniska sjukdomar med fokus på kolorektalcancer och inverkan av kostmönster (Swedish)
Place, publisher, year, edition, pages
Umeå, Sweden: Umeå university , 2020. , p. 81
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2099
Keywords [en]
nutritional epidemiology, dietary patterns, epidemiology, cancer, colorectal cancer, chronic low-grade inflammation, biomarkers, metabolomics
Keywords [sv]
nutritionsepidemiologi, kostmönster, epidemiologi, cancer, kolorektalcancer, kronisk låggradig inflammation, biomarkörer, metabolomik
National Category
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-176737ISBN: 978-91-7855-366-2 (print)ISBN: 978-91-7855-365-5 (electronic)OAI: oai:DiVA.org:umu-176737DiVA, id: diva2:1501166
Public defence
2020-12-11, Hörsal B, Unod T9, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2020-11-20 Created: 2020-11-16 Last updated: 2022-05-12Bibliographically approved
List of papers
1. Dietary inflammatory index and risk of first myocardial infarction: a prospective population-based study
Open this publication in new window or tab >>Dietary inflammatory index and risk of first myocardial infarction: a prospective population-based study
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2017 (English)In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 21Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Chronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DII(TM)), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up.

METHOD: We conducted a prospective case-control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986-2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population.

RESULTS: Male participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21-2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14-1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03-0.14) and 6% higher IL-6 (95% CI 0.02-0.11) in 605 controls with biomarker data available.

CONCLUSION: A pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
DII Dietary inflammatory index, MI Myocardial infarction, NSHDS Northern Sweden health and disease study, VIP Vasterbotten intervention programme, MONICA Monitoring of trends and determinants in cardiovascular disease, CVD cardiovascular disease, hsCRP high-sensitivity C-reactive protein, IL-6 interleukin 6
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-133833 (URN)10.1186/s12937-017-0243-8 (DOI)000398222800001 ()28376792 (PubMedID)2-s2.0-85016964521 (Scopus ID)
Note

Publicerad som open source med stöd från Arcums strategiska medel.

Available from: 2017-04-18 Created: 2017-04-18 Last updated: 2024-04-08Bibliographically approved
2. The inflammatory potential of diet in determining cancer risk: a prospective investigation of two dietary pattern scores
Open this publication in new window or tab >>The inflammatory potential of diet in determining cancer risk: a prospective investigation of two dietary pattern scores
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2019 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 4, article id e0214551Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Inflammation-related mechanisms may contribute to the link between diet and cancer. We sought to investigate the inflammatory impact of diet on cancer risk using the Dietary inflammatory index (DII) and an adapted Mediterranean diet score (MDS).

METHODS: This population-based, prospective cohort study used self-reported dietary data from the Västerbotten Intervention Programme, including 100,881 participants, of whom 35,393 had repeated measures. Associations between dietary patterns and cancer risk were evaluated using Cox proportional hazards regression. We also used restricted cubic splines to test for potential non-linear associations.

RESULTS: A total of 9,250 incident cancer cases were diagnosed during a median follow-up of 15 years. The two dietary patterns were moderately correlated to each other and had similar associations with cancer risk, predominantly lung cancer in men (DII per tertile decrease: Hazard ratio (HR) 0.81 (0.66-0.99), MDS per tertile increase: HR 0.86 (0.72-1.03)), and gastric cancer in men (DII: 0.73 (0.53-0.99), MDS: 0.73 (0.56-0.96)). Associations were, in general, found to be linear. We found no longitudinal association between 10-year change in diet and cancer risk.

CONCLUSION: We confirm small, but consistent and statistically significant associations between a more anti-inflammatory or healthier diet and reduced risk of cancer, including a lower risk of lung and gastric cancer in men. The dietary indexes produced similar associations with respect to the risk of cancer.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-158790 (URN)10.1371/journal.pone.0214551 (DOI)000464349000016 ()30978193 (PubMedID)2-s2.0-85064346606 (Scopus ID)
Available from: 2019-05-08 Created: 2019-05-08 Last updated: 2023-03-23Bibliographically approved
3. C-reactive Protein and Future Risk of Clinical and Molecular Subtypes of Colorectal Cancer
Open this publication in new window or tab >>C-reactive Protein and Future Risk of Clinical and Molecular Subtypes of Colorectal Cancer
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2020 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 29, no 7, p. 1482-1491Article in journal (Refereed) Published
Abstract [en]

Background: Inflammation has been implicated in colorectal cancer etiology, but the relationship between C-reactive protein (CRP) and colorectal cancer risk is unclear. We aimed to investigate the association between prediagnostic plasma CRP concentrations and the risk of clinical and molecular colorectal cancer subtypes.

Methods: We used prospectively collected samples from 1,010 matched colorectal cancer case-control pairs from two population-based cohorts in Northern Sweden, including 259 with repeated samples. Conditional logistic regression and linear mixed models were used to estimate relative risks of colorectal cancer, including subtypes based on BRAF and KRAS mutations, microsatellite instability status, tumor location, stage, lag time, and (using unconditional logistic regression) body mass index.

Results: CRP was not associated with colorectal cancer risk, regardless of clinical or molecular colorectal cancer subtype. For participants with advanced tumors and blood samples <5 years before diagnosis, CRP was associated with higher risk [OR per 1 unit increase in natural logarithm (In) transformed CRP, 1.32; 95% confidence interval (CI), 1.01-1.73]. CRP levels increased over time, but average time trajectories were similar for cases and controls (P-interaction = 0.19).

Conclusions: Our results do not support intertumoral heterogeneity as an explanation for previous inconsistent findings regarding the role of CRP in colorectal cancer etiology. The possible association in the subgroup with advanced tumors and shorter follow-up likely reflects undiagnosed cancer at baseline. Impact: Future efforts to establish the putative role of chronic, low-grade inflammation in colorectal cancer development will need to address the complex relationship between systemic inflammatory factors and tumor microenvironment, and might consider larger biomarker panels than CRP alone.

Place, publisher, year, edition, pages
American Association for Cancer Research, 2020
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-174012 (URN)10.1158/1055-9965.EPI-19-1339 (DOI)000552627400026 ()32317300 (PubMedID)2-s2.0-85087470027 (Scopus ID)
Available from: 2020-08-19 Created: 2020-08-19 Last updated: 2023-03-23Bibliographically approved
4. Data-driven dietary patterns and their association with colorectal cancer risk and untargeted plasma metabolite profiles
Open this publication in new window or tab >>Data-driven dietary patterns and their association with colorectal cancer risk and untargeted plasma metabolite profiles
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(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nutrition and Dietetics
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-176735 (URN)
Available from: 2020-11-16 Created: 2020-11-16 Last updated: 2022-05-12

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Bodén, Stina

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