Table 1.
Studies included in systematic review and meta-analysis of DII and fracture
| First author (year) |
country | Mean (SD)age (range) |
gender | Sample size | Study population (health status) | Type of study | Follow up (number of incident case) | Dietary inflammatory index tool | Unit of *comparison | Bone health status (methods of measurement) |
Effect size measure (95%CI) |
Adjusted for* |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
T.Orchard (2017)[18] |
USA |
63 (50-79) |
F | 10,290 | Postmenopausal women | Cohort |
11.4±3.3 y (total=47,974 hip=3738) |
122- item FFQ |
Q4 vs. Q1 (2.98 vs. -3.63) |
Hip fracture (self-reported or medical record) Lower arm fracture (self-reported or medical record) Total fracture (self-reported or medical record) |
HR= 1.02 (0.92-1.14) HR*= 0.92 (0.86-0.98) HR*= 0.95 (0.92-0.98) |
1,2,3,4,5,6,7,8,9, 10,11,12,13,14,15, 16,17,18,19 |
|
N.Veronese (2017)[19] |
USA |
60.6 (9.1) 45-79 |
F/M |
3648 M=1577 F=2071 |
With or at risk of knee osteoarthritis | Cohort |
8 y (560= 198 M, 362 F) |
70- item FFQ |
Per 1-SD increment DII (1.68 points) Q5 vs. Q1 |
Fracture (self- reported) |
F HR*= 1.14 (1.02–1.27) M HR= 0.95 (0.82–1.11) Overall HR=1.22 (0.91-1.64) F HR*=1.46 (1.02-2.11) M HR=0.91 (0.54-1.54) |
1, 2, 3, 4, 21, 24, 26,27,28,29 |
|
H.S kim (2018)[20] |
Korea |
52.34(8.24) 40-79 |
F/M |
159,846 M=57,740 F=102,106 |
Healthy adults | Cohort |
7.9 years (2572= 148 M, 2424 F) |
106- item FFQ |
Q5vs.Q1 (-9.12 to -0.98) vs. (2.1762 to 7.1055) |
Fracture (self –report ) |
Total HR*= 1.33 (1.12-1.58) F HR*= 1.33 (1.11- 1.59) M HR=1.32 (0.64-2.71) |
1, 3, 4, 5, 14, 26,30, 31 |
|
MM.Cervo (2019)[21] |
Australia |
63.0 (7.5) 51-79 |
F/M |
1098 M=559 F=538 |
Non-institutionalized older adults | Cohort |
10 years (total=566) |
74-item FFQ | 1- unit increase in E-DII |
Any fracture (self–report) Non-vertebral fracture (self-reported) |
M HR*= 1.090 (1.011-1.017) F HR*=0.878 (0.800-0.964) M HR= 1.074 (0.995-1.159) F HR=0.911 (0.827-1.003) |
1,4,31,32,34,35 |
|
ZQ. Zhang (2017)[22] |
70.62 (7.55) 52-83 |
F/M |
2100 F=781 M=269 |
Elders |
Case- control (case=1050 control=1050) |
NA | 79- item FFQ | Q4 vs. Q1 |
Hip fracture (self –report) |
Total OR*= 2.44 (1.73-3.45) Female OR*= 2.08 (1.38-3.12) Male OR*=4.30 (1.89-9.80) |
3, 4, 5, 8, 21, 23, 27,32 | |
|
M. Morimoto (2019)[23] |
Brazil |
57.9 (13.5) ≥40 |
F/M |
2269 F=1585 M=684 |
Healthy adults | Cross-sectional | NA | 24-hr recall |
Q4 vs.Q1 (>1.89 vs. ≤ 0.49) |
low impact fracture (self–report) |
OR: 0.98 (0.8-1.21) |
|
|
M. Mazidi (2017)[24] |
USA | 47.43 (0.27) | F/M |
18,318 F= 8921 M=9397 |
Healthy adults | Cross-sectional | NA | 24-h diet recall | Q4 vs. Q1 |
Hip fracture* Wrist* spine* |
OR;1.00(0.94-1.06) OR;1.03(0.97-1.09) OR;1.00(0.94-1.07) |
1,2,3,4,5,21,33 |
QUS: Quantitative ultrasonometry, Y: years, F: females, M: males, FFQ: food frequency questionnaire, HR: hazard ratio, OR: odds ratio, Q: quartile, T: tertile, DII: dietary inflammatory index, E-DII: Energy adjusted dietary inflammatory index, BD: Bone density
*1-age, 2-race, 3- BMI, 4-smoking, 5- physical activity, 6-DII (baseline),7-CT(clinical trial assignment), 8-parental history of fracture, 9-personal history of fracture at age 55 years or older, 10-region, 11-diabetes, 12-female hormone use, 13-NSAID use, 14-total calcium intake, 15- corticosteroid use (screening), 16-inflammatory bowel disease,17- rheumatoid arthritis, 18-weight, 19-height, 20- parity, 21- education, 22- fragility fracture history, 23- supplement intake, 24-antiresoptive drug use, 25- age at menarche, 26- total energy intake, 27-yearly income,28-Charlson comorbidityIndex,29-physical activity scale for the elderly, 30-gender, 31-alcohol consumption, 32- calcium supplement, 33-C-reactive protein, 34-percnetage body fat, 35- step per day,36- baseline T-score, 37- feeding modes, 38- time of complementary foods, 39-stage of sexual maturation, 40-muscle cross-sectional area,, 41-postmenopausal period, 42- vitamin D, 43- CES-D, 44-use of medications for Knee OA