Dietary Inflammatory Index (DII)® and Metabolic Syndrome in the Selected Population of Polish Adults: Results of the PURE Poland Sub-Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Definition of the Metabolic Syndrome
- FG ≥ 5.6 mmol/L (100 mg/dL), or drug treatment for elevated glucose;
- Systolic BP ≥ 130 mm Hg, or diastolic BP ≥ 85 mm Hg, or antihypertensive drug treatment for previously diagnosed hypertension;
- HDL-C < 1.0 mmol/L(40 mg/dL) in males and <1.3 mmol/L (50 mg/dL) in women, or a history of drug treatment for this abnormality;
- WC ≥ 80 cm in women and ≥94 cm in men [2].
2.4. Dietary Intake Assessment
2.5. Dietary Inflammatory Index (DII)® Calculation
2.6. Statistical Analysis
2.7. Ethical Approval
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No. | Food Groups | FFQ Dietary Products |
---|---|---|
1. | Low-fat dairy products | Milk 1–2% fat, Buttermilk 0.5% fat Cocoa w/ milk 1–2% fat, Cottage cheese, Low-fat yoghurt, Kefir |
2. | Full-fat dairy products | Milk 3.2% fat, Milk 3.2% fat (from mixed dish—oatmeal w/ milk), Feta Greek cheese Granulated cottage cheese w/ sour cream, Cheese, Edam cheese, Fromage cheese, Yoghurt 2–8% fat, Sour cream 12% fat, Sour cream 18% fat Sour cream 18% fat (from mixed dish—salad w/sour cream) |
3. | Whole grains | Whole-meal rye bread, Mixed bread w/ rye and wheat flour w/ sunflower seeds, Buckwheat groats, boiled, Barley groats, boiled, Pasta w/ durum, boiled, Oatmeal (from mixed dish—oatmeal w/milk) |
4. | Refined grains | Wheat bread, white, White rice, boiled, Wheat roll, white, Mixed bread w/ rye and wheat flour, white, Cornflakes |
5. | Fats w/o oils | Butter, Lard, Fat spread w/ butter, Mayonnaise, Margarine, soft |
6. | Raw fruit | Apple, Banana, Grapefruit, Grapes, Mandarin, Strawberries, Kiwi fruit, Lemon, Orange, Pear, Peach, Prunes, Raspberries |
7. | Fruit juices | Orange juice; Raspberry juice; Carrot juice; Apple juice; Grapefruit juice; Black currant juice; Multifruit juice (local fruits); Multifruit juice (exotic fruits) |
8. | Raw vegetables | Cabbage red, raw; Chinese cabbage, raw; Cabbage white, raw; Carrot, raw Cauliflower, raw; Chives; Cucumber, raw; Garlic cloves, raw; Salad, leaves; Onion, raw Parsley, leaves; Horseradish; Red pepper, raw; Radish; Tomato, raw; Sauerkraut salad Chinese cabbage salad w/ mayonnaise; Salad (from mixed dish—salad w/ sour cream) |
9. | Cooked vegetables | Kidney beans, cooked; Beetroot, cooked; Broccoli; Cabbage white, cooked; Carrot, cooked; Cauliflower, cooked, w/butter; Mushrooms, fried; Red pepper, cooked Tomatoes, cooked; Tomato passata; Spinach, cooked; Zucchini, cooked Green beans, cooked; Corn, canned; Peas, canned; Salad of mixed cooked vegetables w/ mayonnaise |
10. | Potatoes | Potatoes, boiled; Potatoes, mashed; French fries |
11. | Lean meat | Chicken w/ skin boiled/fried; Chicken w/o skin boiled/fried Turkey, roasted |
12. | Red meat | Beef, cutlets; Beef ham, boiled; Pork, bacon; Cutlets of ground beef and pork, fried; Offal |
13. | Meat w/ breadcrumbs | Chicken nuggets; Pork chops, w/ breadcrumbs |
14. | Processed meat/charcuterie | Chicken ham; Sausage; Luncheon meat, pork; Pork ham; Sausage, pork, smoked (traditional polish); Sausage, mixed beef/pork, smoked (traditional polish); Sausage, pork, white, boiled (traditional polish); Turkey ham; Turkey sausage ham; Brawn; Chicken pâté |
15. | Eggs | Eggs, boiled/fried |
16. | Fish | Codfish, fried, w/ breadcrumbs; Herring, w/ cream; Mackerel, smoked |
17. | Mixed dishes | Baked beans w/ tomato sauce; Meat and rice stuffed cabbage w/ tomato Sauce; Dumplings w/ meat, boiled; Dumplings w/ potatoes and cottage cheese, Boiled; Sauerkraut and meat stew |
18. | Beverages w/ added sugar | Fruit drink; Soft drink w/ added sugar |
19. | Low-calorie beverages | Low-calorie soft drink |
20. | Tea, coffee | Coffee; Tea, black; Tea, green/herb |
21. | Alcohol | Beer; Wine; Vodka |
22. | Sweets | Milk chocolate; Dark chocolate; Tea biscuit; Yeast cake; Shortbread cake; Gingerbread; Pound cake; Cheesecake; Halvah; Caramel candy; Other sweets; Candy; Ice cream |
23. | Honey and sugar | Honey; Sugar |
24. | Dried fruits | Raisins |
25. | Nuts and seeds | Walnuts; Other nuts; Seeds |
26. | Soups | Broth; Sour rye soup; Vegetable soup; Barley soup; Tomato soup; Bean soup; Sauerkraut soup |
Total n = 1570 | Females n = 1000 | Males n = 570 | p * | |
---|---|---|---|---|
Age, years, mean ± SD | 54.65 ± 9.83 | 54.90 ± 9.74 | 54.22 ± 9.99 | 0.193 |
BMI, [kg/m2] mean ± SD | 28.17 ± 5.15 | 27.84 ± 5.39 | 28.75 ± 4.66 | 0.001 |
Place of living, n (%) | ||||
Rural | 685 (43.6) | 443 (44.3) | 242 (42.5) | 0.512 |
Urban | 885 (56.4) | 557 (55.7) | 328 (57.5) | |
Marital status, n (%) | ||||
Married / living together | 1166 (74.3) | 667 (66.7) | 499 (87.5) | <0.001 |
Never married | 112 (7.1) | 75 (7.5) | 37 (6.5) | |
Separated / divorced / widowed | 291 (18.5) | 258 (25.8) | 33 (5.8) | |
Education, n (%) | ||||
Primary/trade | 499 (31.8) | 305 (30.5) | 194 (34.0) | 0.034 |
Secondary and high secondary | 612 (39.0) | 414 (41.4) | 198 (34.7) | |
University | 459 (29.2) | 281 (28.1) | 178 (31.2) | |
Smoking, n (%) | ||||
Currently Uses Tobacco Products | 332 (21.1) | 200 (20.0) | 132 (23.2) | <0.001 |
Formerly Used Tobacco Products | 490 (31.2) | 253 (25.3) | 237 (41.6) | |
Never Used Tobacco Products | 748 (47.6) | 547 (54.7) | 201 (35.3) | |
Alcohol, n (%) | ||||
Currently use alcohol products | 1081 (68.9) | 633 (63.3) | 448 (78.6) | <0.001 |
Formerly used alcohol products | 162 (10.3) | 98 (9.8) | 64 (11.2) | |
Never used alcohol products | 327 (20.8) | 269 (26.9) | 58 (10.2) | |
Physical activity, n (%) | ||||
Low and moderate | 418 (26.6) | 254 (25.4) | 164 (28.8) | 0.163 |
High | 1152 (73.4) | 746 (74.6) | 406 (71.2) | |
DII, mean ± SD | −0.11 ± 2.91 | −0.61 ± 2.88 | 0.77 ± 2.75 | <0.001 |
DII, (min; max) | −7.88 to 7.33 | −7.88 to 6.70 | −6.75 to 7.33 | |
Metabolic syndrome, n (%) | 664 (42.3) | 401 (40.1) | 236 (46,1) | 0.023 |
Waist Component, n (%) | 1094 (69.7) | 698 (69.8) | 396 (69.5) | 0.938 |
BP Component, n (%) | 1218 (77.6) | 714 (71.4) | 504 (88.4) | <0.001 |
FG Component, n (%) | 614 (39.1) | 379 (37.9) | 235 (41.2) | 0.213 |
TG Component, n (%) | 387 (24.6) | 212 (21.2) | 175 (30.7) | <0.001 |
HDL Component, n (%) | 310 (19.7) | 234 (23.4) | 76 (13.3) | <0.001 |
No. | Parameter | Total Group | Tercile 1 | Tercile 2 | Tercile 3 | p | Post-Hoc |
---|---|---|---|---|---|---|---|
1. | Low-fat dairy Products | 81.36 (39.22; 178.58) | 83.50 (40.00; 192.58) | 86.43 (37.07; 209.70) | 74.93 (42.14; 142.82) | 0.145 | |
2. | Full-fat dairy products | 73.35 (38.22; 162.15) | 46.02 (25.71; 83.21) | 67.85 (39.87; 140.04) | 150.00 (71.14; 284.98) | <0.001 | 1 < 2 < 3 |
3. | Whole grains | 48.53 (30.00; 87.43) | 51.69 (29.98; 93.53) | 49.70 (29.65; 91.42) | 46.17 (30.67; 73.55) | 0.097 | |
4. | Refined grains | 73.40 (21.08; 118.80) | 25.71 (9.83; 64.29) | 72.86 (27.27; 107.24) | 110.71 (76.97; 155.71) | <0.001 | 1 < 2 < 3 |
5. | Fats w/o oils | 17.81 (10.62; 29.75) | 12.14 (6.43; 17.58) | 17.30 (11.04; 25.36) | 35.85 (18.94; 47.35) | <0.001 | 1 < 2 < 3 |
6. | Raw fruit | 241.84 (160.29; 398.04) | 266.85 (188.59; 448.69) | 249.15 (157.10; 397.84) | 217.14 (142.73; 324.01) | <0.001 | 1 > 2 > 3 |
7. | Fruit juices | 117.68 (49.18; 214.29) | 98.36 (32.79; 159.25) | 114.75 (49.18; 194.96) | 153.40 (68.50; 266.39) | <0.001 | 1 < 2 < 3 |
8. | Raw vegetables | 134.92 (91.54; 197.90) | 169.75 (111.21; 242.01) | 128.49 (84.49; 191.57) | 122.45 (82.84; 157.30) | <0.001 | 1 > 2 > 3 |
9. | Cooked vegetables | 117.80 (79.75; 162.60) | 125.62 (85.98; 184.93) | 115.27 (76.44; 167.00) | 112.02 (78.74; 147.77) | <0.001 | 1 > 2.3 |
10. | Potatoes | 88.77 ± 57.66 | 75.58 ± 54.92 | 94.66 ± 58.60 | 96.06 ± 57.23 | <0.001 | 1 < 2.3 |
11. | Lean meat | 15.08 (13.11; 28.57) | 14.29 (10.84; 28.57) | 15.08 (13.11; 28.57) | 15.08 (14.29; 22.81) | 0.102 | |
12. | Red meat | 18.57 (10.84; 28.59) | 15.08 (8.52; 24.19) | 17.70 (10.84; 28.59) | 22.04 (13.47; 31.69) | <0.001 | 1 < 2 < 3 |
13. | Meat w/ breadcrumbs | 20.84 (13.11; 28.57) | 14.29 (6.56; 20.84) | 20.84 (13.11; 28.57) | 20.84 (13.11; 28.57) | <0.001 | 1 < 2.3 |
14. | Processed meat/charcuterie | 50.07 (29.39; 89.33) | 36.27 (20.32; 55.75) | 46.24 (30.48; 80.56) | 86.08 (42.61; 127.94) | <0.001 | 1 < 2 < 3 |
15. | Eggs | 19.29 (6.43; 19.29) | 6.43 (2.95; 19.29) | 19.29 (6.43; 19.29) | 19.29 (6.43; 19.29) | <0.001 | 1 < 2.3 |
16. | Fish | 13.11 (6.56; 20.84) | 9.84 (6.56; 16.98) | 13.11 (6.56; 17.56) | 14.29 (9.84; 20.84) | <0.001 | 1.2 < 3 |
17. | Mixed dishes | 26.23 (13.11; 33.96) | 19.67 (6.56; 28.57) | 26.23 (14.29; 33.96) | 26.23 (19.67; 33.96) | <0.001 | 1 < 2.3 |
18. | Beverages w/ added sugar | 14.29 (6.56; 42.27) | 6.56 (0.00; 22.95) | 15.34 (6.56; 42.27) | 16.39 (6.56; 50.00) | <0.001 | 1 < 2 < 3 |
19. | Low-calorie beverages | 0.00 (0.00; 35.71) | 0.00 (0.00; 250.00) | 0.00 (0.00; 35.71) | 0.00 (0.00; 0.00) | <0.001 | 1 > 2 > 3 |
20. | Tea, coffee | 952.58 ± 459.02 | 1 081.96 ± 509.61 | 903.61 ± 438.31 | 872.26 ± 394.32 | <0.001 | 1 > 2.3 |
21. | Alcohol | 9.31 (0.00; 47.14) | 9.31 (0.00; 47.14) | 9.31 (0.00; 42.63) | 12.13 (0.00; 49.96) | 0.354 | |
22. | Sweets | 41.48 (23.13; 63.36) | 26.09 (13.44; 43.01) | 40.76 (25.65; 61.41) | 58.39 (40.43; 82.28) | <0.001 | 1 < 2 < 3 |
23. | Honey and sugar | 15.43 (2.86; 21.14) | 6.86 (1.31; 16.00) | 16.00 (3.91; 22.29) | 17.31 (9.71; 40.00) | <0.001 | 1 < 2 < 3 |
24. | Dried fruits | 4.92 (0.00; 4.92) | 4.92 (0.00; 4.92) | 4.92 (0.00; 4.92) | 4.92 (0.00; 4.92) | 0.073 | |
25. | Nuts and seeds | 5.44 (0.00; 9.00) | 6.10 (1.43; 11.88) | 5.44 (0.52; 9.33) | 1.95 (0.00; 6.10) | <0.001 | 1 > 2 > 3 |
26. | Soups | 223.89 (162.06; 307.26) | 214.52 (157.38; 307.25) | 228.57 (162.06; 317.92) | 245.43 (183.61; 281.03) | 0.026 | 1 < 2.3 |
DII Tercile | Present n (%) | Absent n (%) | OR (95% Cl) | Adjusted OR (95% Cl) 1 |
---|---|---|---|---|
Metabolic syndrome | ||||
1 | 216 (32.5) | 307 (33.9) | Ref. | Ref. |
2 | 218 (32.8) | 306 (33.8) | 1.01 (0.79 to 1.29) | 0.92 (0.69 to 1.23) |
3 | 230 (34.6) | 293 (32.3) | 1.12 (0.87 to 1.43) | 0.77 (0.56 to 1.06) |
Raised WC | ||||
1 | 362 (33.1) | 161 (33.8) | Ref. | Ref. |
2 | 356 (32.5) | 168 (35.3) | 0.94 (0.73 to 1.22) | 1.02 (0.68 to 1.54) |
3 | 376 (34.4) | 147 (30.9) | 1.14 (0.87 to 1.49) | 1.22 (0.79 to 1.90) |
Raised BP | ||||
1 | 416 (34.2) | 107 (30.4) | Ref. | Ref. |
2 | 394 (32.3) | 130 (36.9) | 0.78 (0.58 to 1.04) | 0.83 (0.59 to 1.15) |
3 | 408 (33.5) | 115 (32.7) | 0.91 (0.68 to 1.23) | 0.90 (0.63 to 1.29) |
Reduced HDL-C | ||||
1 | 95 (30.6) | 428 (34.0) | Ref. | Ref. |
2 | 113 (36.5) | 411 (32.6) | 1.24 (0.91 to 1.68) | 1.27 (0.91 to 1.77) |
3 | 102 (32.9) | 421 (33.4) | 1.09 (0.80 to 1.49) | 1.02 (0.71 to 1.47) |
Raised TG | ||||
1 | 113 (29.2) | 410 (34.7) | Ref. | Ref. |
2 | 133 (34.4) | 391 (33.1) | 1.23 (0.93 to 1.65) | 1.14 (0.83 to 1.55) |
3 | 141 (36.4) | 382 (32.3) | 1.34 (1.01 to 1.78) | 1.01 (0.73 to 1.41) |
Raised FG | ||||
1 | 204 (33.2) | 319 (33.4) | Ref. | Ref. |
2 | 186 (30.3) | 338 (35.4) | 0.86 (0.67 to 1.11) | 0.71 (0.54 to 0.94) |
3 | 224 (36.5) | 299 (31.3) | 1.17 (0.92 to 1.50) | 0.78 (0.58 to 1.05) |
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Szypowska, A.; Zatońska, K.; Szuba, A.; Regulska-Ilow, B. Dietary Inflammatory Index (DII)® and Metabolic Syndrome in the Selected Population of Polish Adults: Results of the PURE Poland Sub-Study. Int. J. Environ. Res. Public Health 2023, 20, 1056. https://doi.org/10.3390/ijerph20021056
Szypowska A, Zatońska K, Szuba A, Regulska-Ilow B. Dietary Inflammatory Index (DII)® and Metabolic Syndrome in the Selected Population of Polish Adults: Results of the PURE Poland Sub-Study. International Journal of Environmental Research and Public Health. 2023; 20(2):1056. https://doi.org/10.3390/ijerph20021056
Chicago/Turabian StyleSzypowska, Alicja, Katarzyna Zatońska, Andrzej Szuba, and Bożena Regulska-Ilow. 2023. "Dietary Inflammatory Index (DII)® and Metabolic Syndrome in the Selected Population of Polish Adults: Results of the PURE Poland Sub-Study" International Journal of Environmental Research and Public Health 20, no. 2: 1056. https://doi.org/10.3390/ijerph20021056