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. 2024 Jun 6;16(11):1793.
doi: 10.3390/nu16111793.

Association of Pro-Inflammatory Diet, Smoking, and Alcohol Consumption with Bladder Cancer: Evidence from Case-Control and NHANES Studies from 1999 to 2020

Chunying Teng  1 , Weihong Lu  1 , Jiawen Che  2 , Yanhong Wu  2 , Danqun Meng  2 , Yujuan Shan  2   3
Affiliations

Association of Pro-Inflammatory Diet, Smoking, and Alcohol Consumption with Bladder Cancer: Evidence from Case-Control and NHANES Studies from 1999 to 2020

Chunying Teng et al. Nutrients. .

Abstract

Background and purpose: Diet might be a modifiable factor in preventing cancer by modulating inflammation. This study aims to explore the association between the dietary inflammatory index (DII) score and the risk of bladder cancer (BC).

Methods: A total of 112 BC patients and 292 control subjects were enrolled in a case-control trial. Additionally, we tracked a total of 109 BC patients and 319 controls, whose propensity scores were obtained from the Nutrition Examination Survey (NHANES) database spanning from 1999 to 2020. The baseline index and dietary intake data were assessed using a food frequency questionnaire (FFQ). DII scores were calculated based on the dietary intake of 20 nutrients obtained from participants and categorized into four groups. The association between the inflammatory potential of the diet and BC risk was investigated using multivariate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: High DII scores were associated with a pro-inflammatory diet and a higher risk of BC, with higher DII scores positively associated with a higher risk of BC (quartiles 4 vs. 1, ORs 4.89, 95% CIs 2.09-11.25 p < 0.001). Specifically, this might promote BC development by inducing oxidative stress and affecting DNA repair mechanisms. This result was consistent with the NHANES findings (quartiles 4 vs. 1, ORs 2.69, 95% CIs 1.25-5.77, p = 0.006) and further supported the association of pro-inflammatory diet and lifestyle factors with the risk of BC.

Conclusions: Diets with the highest pro-inflammatory potential were associated with an increased risk of BC. By adjusting lifestyle factors, individuals might effectively lower their DII, thereby reducing the risk of developing BC. The results are consistent with the NHANES cohort.

Keywords: NHANES; bladder cancer; dietary inflammatory index; positive synergistic interactions.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow chart of the study population (case–control study).
Figure 2
Figure 2
The population distribution of dietary inflammatory index. (A) Density curves showing the distribution of DII in the total participants. (B) Distribution of DII in different populations.
Figure 3
Figure 3
Distribution of dietary inflammatory indices for all participants. (A) Case–control study (n = 405). (B) NHANES (n = 428). Differences between subgroups were tested by analysis of variance (ANOVA) and post hoc Bonferroni correction. ns = not significant, * p < 0.05, ** p < 0.01, and *** p < 0.0001.
Figure 4
Figure 4
ROC curves of model for predicting bladder cancer risk. (A) Bladder cancer case–control trial. (B) NHANES trial.
Figure 5
Figure 5
Forest map of subgroup analysis between dietary inflammatory index and bladder cancer risk. (A) Bladder cancer case–control trial. (B) NHANES trial.
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