Table 3.
Percent change in the relative concentrations (95% CI) of plasma markers of inflammation, hormonal and insulin response across categories of each of the six WCRF/AICR recommendations in women and men1,2
| Nurses’ Health Study | Health Professionals Follow-up Study | |||||
|---|---|---|---|---|---|---|
|
| ||||||
| WCRF/AICR score categories | ||||||
|
| ||||||
| Biomarker | 0 (not adherent) reference | 0.5 | 1 (adherent) | 0 (not adherent) reference | 0.5 | 1 (adherent) |
| Body weight | ||||||
| CRP | 1 | −37% (−43%, −30%) | −62% (−66%, −59%) | 1 | −39% (−45%, −32%) | −58% (−62%,−53%) |
| IL6 | 1 | −18% (−23%, −11%) | −34% (−38%, −29%) | 1 | −26% (−41%, −16%) | −33% (−41%, −24%) |
| TNFαR2 | 1 | −8% (−11%, −6%) | −14% (−16%, −11%) | 1 | −6% (−9%, −4%) | 8% (−10%, −5%) |
| ADIPO | 1 | +12% (+7%, +19%) | +35% (+29%, +42%) | 1 | +10% (+5%, +16%) | +31% (+24%, +38%) |
| CPEP | 1 | −21% (−25%, −17%) | −41% (−43%, −38%) | 1 | −23% (−28%, −18%) | −40% (−44%, −35%) |
| TG/HDL | 1 | −10% (−16%, −3%) | −36% (−40%, −31%) | 1 | −18% (−24%, −11%) | −42% (−47%, −37%) |
| Estrone | 1 | −22% (−29%, −15%) | −35% (−40%, −29%) | NA | NA | NA |
| Estradiol | 1 | −26% (−33%, −17%) | −46% (−52%, −40%) | NA | NA | NA |
|
| ||||||
| Physical activity | ||||||
| CRP | 1 | −10% (−19%, +1%) | −16% (−23%, −8%) | 1 | −12% (−23%, +1%) | −17% (−25%, −8%) |
| IL6 | 1 | −5% (13%, +2%) | −10% (−15%, −5%) | 1 | −10% (−23%, +5%) | −15% (−24%, −5%) |
| TNFαR2 | 1 | 0% (−3%, +3%) | −1% (−4%, +1%) | 1 | +1% (−3%, +4%) | −2% (−5%, +1%) |
| ADIPO | 1 | 0% (−4%, +6%) | +2% (−2%, +6%) | 1 | +2 (−4%, +9%) | +3% (−2%, +7%) |
| CPEP | 1 | −5% (−10%, −1%) | −7% (−11%, −4%) | 1 | −6% (−14%, +3%) | −12% (−17%, −6%) |
| TG/HDL | 1 | −9% (−16%, −2%) | −11% (−16%, −6%) | 1 | −4% (−14%, +7%) | 8% (−15%, −1%) |
| Estrone | 1 | +4 (−6%, +15%) | −2% (−9%, +5%) | NA | NA | NA |
| Estradiol | 1 | −4% (−15%, +8%) | −4% (−12%, +5%) | NA | NA | NA |
|
| ||||||
| Energy density | ||||||
| CRP | 1 | −7% (−18%, +6%) | +8 (−22%, +8%) | 1 | −3% (−11%, +8%) | +2% (−13%, +20%) |
| IL6 | 1 | −7% (−15%, +1%) | −4% (−14%, +7%) | 1 | −3% (−11%, +8%) | +1% (−14%, +20%) |
| TNFαR2 | 1 | −1% (−5%, +2%) | +1% (−4%, +5%) | 1 | 0% (−2%, +2%) | 0% (−4%, +4%) |
| ADIPO | 1 | +4% (−2%, +11%) | +9% (0%, +18%) | 1 | +1% (−4%, +5%) | +1% (−6%, +9%) |
| CPEP | 1 | −5% (−11%, 0%) | −4% (−10%, +3%) | 1 | +1% (−5%, +6%) | +3% (−6%, +14%) |
| TG/HDL | 1 | −7% (−15%, +2%) | −10% (−19%, +1%) | 1 | −2% (−9%, +6%) | +3% (−9%, +17%) |
| Estrone | 1 | +2% (−8%, +14%) | +3% (−11%, +18%) | NA | NA | NA |
| Estradiol | 1 | 0% (−12%, +14%) | +4% (−11%, +23%) | NA | NA | NA |
|
| ||||||
| Plant foods | ||||||
| CRP | 1 | −15% (−26%, −3%) | −17% (−28%, −3%) | 1 | −5% (−45%, +65%) | −11% (−48%, +55%) |
| IL6 | 1 | −11% (−19%, −3%) | −7% (−16%, +3%) | 1 | −42% (−69%, +7%) | −43% (−69%, +5%) |
| TNFαR2 | 1 | −1% (−5%, +3%) | −1% (−5%, +3%) | 1 | −3% (−17%, +14%) | −3% (−17%, +13%) |
| ADIPO | 1 | −2% (−8%, +5%) | −1% (−8%, +7%) | 1 | 0% (−22%, +27%) | −1% (−22%, +26%) |
| CPEP | 1 | −4% (−10%, +1%) | −6% (−12%, 0%) | 1 | 1% (−23%, +32%) | −1% (−24%, +30%) |
| TG/HDL | 1 | −6% (−14%, +4%) | −2% (−11%, +9%) | 1 | +27% (−15%, +88%) | +27% (−15%, +89%) |
| Estrone | 1 | +1% (−10%, +13%) | +1% (−11%, +14%) | NA | NA | NA |
| Estradiol | 1 | −5% (−17%, +9%) | −6% (−19%, +10%) | NA | NA | NA |
|
| ||||||
| Animal foods | ||||||
| CRP | 1 | +21% (−34%, +120%) | +32% (−27%, +139%) | 1 | −21% (−43%, +9%) | −24% (−45%, +5%) |
| IL6 | 1 | +15% (−24%, +75%) | +18% (−22%, +78%) | 1 | +12% (−21%, +57%) | +9% (−22%, +53%) |
| TNFαR2 | 1 | −1% (−16%, +18%) | −1% (−16%, +17%) | 1 | −2% (−10%, +7%) | −2% (−10%, +7%) |
| ADIPO | 1 | −7% (−31%, +25) | −5% (−29%, +27%) | 1 | +5% (−9%, +21%) | +3% (−10%, +19%) |
| CPEP | 1 | +8% (−16%, +38%) | 0% (−22%, +27%) | 1 | −7% (−23%, +11%) | −5% (−21%, +13%) |
| TG/HDL | 1 | +17% (−20%, +72%) | +10% (−25%, +60%) | 1 | +10% (−14%, +40%) | +9% (−14%, +39%) |
| Estrone | 1 | +21% (−21%, +85%) | +11% (−27%, +68%) | NA | NA | NA |
| Estradiol | 1 | +21% (−28%, +103%) | +13% (−32%, +18%) | NA | NA | NA |
|
| ||||||
| Alcohol intake | ||||||
| CRP | 1 | −9% (−23%, +8%) | −5% (−17%, +10%) | 1 | −11% (−24%, +5%) | 0% (−10%, +11%) |
| IL6 | 1 | −6% (−17%, +6%) | −5% (−14%, +5%) | 1 | −4% (−20%, +14%) | 0% (−11%, +12%) |
| TNFαR2 | 1 | +2% (−2%, +8%) | +7% (+3%, +11%) | 1 | 0% (−4%, +5%) | +6% (+3%, +9%) |
| ADIPO | 1 | −7% (−14%, +2%) | −11% (−18%, −5%) | 1 | +3% (−4%, +12%) | −5% (−9%, 0%) |
| CPEP | 1 | −2% (−9%, +5%) | +1% (−5%, +7%) | 1 | −4% (−12%, +5%) | +1% (−5%, +7%) |
| TG/HDL | 1 | +6% (−6%, +20%) | +22% (+10%, +35%) | 1 | +3% (−10%, +17%) | +23% (+13%, +34%) |
| Estrone | 1 | −2% (−16%, +13%) | −5% (−16%, +8%) | NA | NA | NA |
| Estradiol | 1 | −8% (−23%, +10%) | −11% (−24%, +3%) | NA | NA | NA |
Linear regression models were used to estimate the percent change in the relative concentrations of biomarkers, i.e., differences in biomarker concentrations between higher dietary index quintiles relative to quintile 1 as the reference (e.g. biomarker concentration in Q5 minus concentration in Q1). 95%CI not including 0 are statistically significant. Multivariable models were adjusted for age, smoking status (never, former, current), regular use of aspirin/non-steroidal anti-inflammatory drugs (yes/no), race (white, nonwhite), case-control status, and chronic disease comorbidity score. Chronic diseases/conditions included in the score: hypercholesterolemia, cancer, diabetes, high blood pressure, heart disease, ulcerative colitis and rheumatoid/other arthritis;
Biomarker sample sizes vary: in NHS, n=3,550 for all four inflammatory markers, n=5,834 for C-peptide and n=3,826 for TG/HDL ratio, n=1,217 for estrone, n=1,254 for estradiol. Estrone and estradiol were examined only among postmenopausal women not using exogenous hormones; and in HPFS, n=5,157 for C-reactive protein, n=3,044 for interleukin-6, n=4,072 for tumor necrosis factor alpha receptor 2, n=4,348 for adiponectin, n=3,955 for C-peptide and n=3,575 for TG/HDL ratio in HPFS;
CRP=C-reactive protein, IL6=interleukin-6, TNFαR2=tumor necrosis factor alpha receptor 2, ADIPO=adiponectin, CPEP=C-peptide, TG=triglycerides, HDL=high density lipoprotein cholesterol;