JMIR Publications

ABSTRACT

Background:

Chronic inflammation plays a crucial role in tissue injury, osteoporosis and fractures. The dietary inflammatory index (DII) is a way of assessing the potential for inflammation in the diet. However, the association between DII and fractures remains controversial from previous studies.

Objective:

To explore the correlation between DII and fracture risk in Chinese adults.

Methods:

We included 11,999 adults (5,519 men and 6,480 women) who were part of the China Health and Nutrition Survey (1997–2015) prospective cohort. 3-day 24-h meal review method was used to calculate DII score. The fractures were identified by a questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for fractures.

Results:

During the 18 years of follow-up (median follow-up = 9.0 years), 463 males and 439 females developed fractures. The median DII score for the total was 0.64(-1.74,1.46). DII score (0.53(-1.79,1.42)) was positive correlation with risk of fracture among women rather than men. For women, after adjusting for covariates, referencing the lowest DII score group, the HRs (95% CIs) for quintiles of DII was 1.13 (0.72-1.79), 1.24 (0.83-1.86), 1.51 (1.02-2.22), and 1.618 (1.10-2.39) (P for trend =.004). RCS analysis showed a significant association between fracture risk and DII score (P-overall association=.01), since the DII scores>0.53, HRs had shown a significant upward trend. Women with age<50, non-smoker, non-drinker and non-abdominal obesity had higher risk of fracture for the DII quintiles. Among the DII components, thiamin, niacin and folic acid score showed a significant association with the fracture risk in women.

Conclusions:

Pro-inflammatory diet consumption increased fracture risk in Chinese women with age<50. The high consumption of anti-inflammatory foods and the low consumption pro-inflammatory food may be an important strategy to prevent fractures in women.