Associations between dietary patterns and intestinal inflammation among HIV-infected and uninfected adults: A cross-sectional study in Tanzania

Abstract

The increased burden of non-communicable diseases (NCDs) is fueled by lifestyle factors including diet. This cross-sectional study explored among Tanzanian adults whether unhealthy dietary patterns are associated with intestinal and systemic inflammation which could increase the risk of NCDs. The study included 574 participants, with both diet and inflammatory markers data. Dietary patterns were derived using principal component analysis and reduced rank regression, revealing three main patterns: vegetable-rich, vegetable-poor, and carbohydrate-dense diets. Fecal myeloperoxidase (MPO) and neopterin (NEO) were markers of intestinal inflammation whereas plasma lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP) were assessed as markers of systemic inflammation. Ordinal logistic regression was used to assess associations between terciles of dietary patterns and quintiles of the inflammatory markers adjusting for potential confounders. High adherence to a vegetable-poor dietary pattern was associated with elevated MPO (adjusted OR, 1.7 95% CI 1.1, 2.8). NEO tended to be higher in people with high adherence to both vegetable-poor pattern (adjusted OR, 2.6 95% CI 1.0, 6.4) and vegetable-rich pattern (adjusted OR, 2.7, 95% CI 1.1, 6.5). No associations were found between dietary patterns and systemic inflammation markers (LBP and CRP). We found links between dietary vegetable intake and intestinal inflammation but not systemic inflammation. However, the cross-sectional nature of the study limits establishing causality and the sample size for some variables may have been inadequate, emphasizing the need for further studies to understand how dietary habits influence inflammation in this population.

Fig 1. Participants flow chart.

Fig 2

A: Distribution of fecal myeloperoxidase (MPO) across the terciles of vegetable-rich, vegetable-poor and carbohydrate-dense dietary patterns. B: Distribution of fecal neopterin across the terciles of vegetable-rich, vegetable-poor and carbohydrate-dense dietary patterns. C: Distribution of plasma lipopolysaccharide binding protein (LBP) across the terciles of vegetable-rich, vegetable-poor and carbohydrate-dense dietary patterns. D: Distribution of plasma C—reactive protein (CRP) across the terciles of vegetable-rich, vegetable-poor and carbohydrate-dense dietary patterns.