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. 2022 Nov 8;14(22):4719.
doi: 10.3390/nu14224719.

The Dietary Inflammatory Index Is Associated with Subclinical Mastitis in Lactating European Women

Myriam C Afeiche  1 , Alison Iroz  2 , Frank Thielecke  3   4 , Antonio C De Castro  5 , Gregory Lefebvre  6 , Colleen F Draper  7 , Cecilia Martínez-Costa  8 , Kirsti Haaland  9 , Giovanna Marchini  10 , Massimo Agosti  11 , Magnus Domellöf  12 , Thameur Rakza  13 , Maria José Costeira  14   15   16 , Mireille Vanpee  17   18 , Claude Billeaud  19 , Jean-Charles Picaud  20   21 , Daryl Lim Kah Hian  22 , Guimei Liu  22 , Nitin Shivappa  23   24 , James R Hébert  23   24 , Tinu M Samuel  25
Affiliations

The Dietary Inflammatory Index Is Associated with Subclinical Mastitis in Lactating European Women

Myriam C Afeiche et al. Nutrients. .

Abstract

Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis. Multivariable logistic regression was used to examine the association between nutrient intake and the DII score in relation to SCM. Women without SCM had a lower median DII score (0.60) than women with moderate (1.12) or severe (1.74) SCM (p < 0.01). A one-unit increase in DII was associated with about 41% increased odds of having SCM, adjusting for country and mode of delivery, p = 0.001. Women with SCM had lower mean intakes of several anti-inflammatory nutrients. We show for the first time exploratory evidence that SCM may be associated with a pro-inflammatory diet and women with SCM have lower intakes of several antioxidant and anti-inflammatory nutrients.

Keywords: dietary inflammatory index; lactating women; multicenter longitudinal cohort; subclinical mastitis.

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Conflict of interest statement

M.C. Afeiche, A.N. Iroz, A.C. De Castro, C.F. Draper, G. Lefebvre, and T.M. Samuel are/were employees of Société des Produits Nestlé SA and participated in the design of the study, interpretation of results, and the writing of the manuscript. F.T. received funding for the research and contributions to the manuscript. C. Billeaud, J.C. Picaud, M. Agosti, M.J. Costeira, M.G. Silva, G. Marchini, K. Haaland, C. Martínez-Costa, M. Vanpee, M. Domellöf, D.L. Kah Hian, and G. Liu received funding from Société des Produits Nestlé SA to conduct the study. J.R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII®) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

Figures

Figure 1
Figure 1
Median DII score by SCM status in lactating women from the ATLAS study (n = 177). * Comparison of women without SCM vs. any SCM performed with Mann–Whitney Test, p = 0.0055. ** Comparison of women without SCM vs. moderate or severe SCM performed with Kruskal–Wallis Test p = 0.0097. Women without SCM defined as Na:K ratio ≤0.6. Women with any SCM defined as Na:K ratio >0.6. Women with moderate SCM defined as Na:K ratio >0.6 and ≤1.0. Women with severe SCM defined as Na:K ratio >1.0. Standard deviations: no SCM = 1.71; any SCM = 1.82; moderate SCM = 1.86; severe SCM = 1.70. Abbreviations: DII, dietary inflammatory index; SCM, subclinical mastitis; NA:K, sodium potassium ratio.
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