- Email: [email protected]
Association between dietary inflammatory index and high-sensitive C-reactive protein levels in cancer screening in Japanese
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437
S347
P6-3
P6-4
Association between dietary inflammatory index and high-sensitive C-reactive protein levels in cancer screening in Japanese
Factors associated with moderate acute malnutrition among 6–59 months children in the Lake Tchad region: A case-control study
A. Kotemori a,∗ , N. Sawada a , M. Iwasaki a , T. Yamaji a , N. Shivappa b , J.R. Hebert b a Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan b Cancer Prevention and Control Program, University of South Carolina, South Carolina, United States ∗ Corresponding author. E-mail address: [email protected] (A. Kotemori)
D. Bahya-Batinda a,b,∗ , M. Dramaix-Wilmet a,c , P. Donnen d,e a School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium b Joint Research Unit (UMR 204)-NUTRIPASS, French National Institute Research for Sustainable Development, Montpellier, France c Research Unit in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Brussels, Belgium d School of Public Health, Brussels, Belgium e Research Center in Politic and health systems-international health, Université Libre de Bruxelles, Brussels, Belgium ∗ Corresponding author. E-mail address: [email protected] (D. Bahya-Batinda)
Introduction Inflammation is related to the development of many cancers. Diet plays an important role in the regulation of inflammation. The dietary ® inflammatory index (DII ) is a literature-derived dietary index designed to assess the impact of diet on individual inflammation status. However, most validation studies of DII conducted to date have been done in Western countries, indicating the need for evaluation in Asian populations. The aim of this study was to validate DII scores derived from a food frequency questionnaire (FFQ) with high-sensitive C-reactive protein (hs-CRP) levels in participants undergoing cancer screening in Japan. Methods In cancer screenings conducted from 2009 to 2013 in the National Cancer Center in Japan, 7919 participants aged 40–70 years answered the FFQ and received blood analysis for hs-CRP. Of these, we excluded participants with a body mass index (BMI) of < 14 kg/m2 or > 40 kg/m2 (n = 13); missing data on smoking status (n = 1) or metabolic equivalents (Mets, n = 1); history of cancer, stroke, or myocardial infarction (n = 877); extreme energy intake (upper and lower 2.5 percentiles, n = 349); missing data on alcohol consumption (n = 120); and missing data of hs-CRP, or hs-CRP > 1.0 mg/dL (n = 84). Finally, 6474 participants (3825 for men and 2649 for women) were included in this analysis. DII was calculated from crude intake from the FFQ and adjusted for energy using the density method. Adjusted geometric mean levels of hs-CRP were calculated using a multivariable linear regression model by quartiles of DII score. P for trend across quartiles of DII score were calculated using DII quartiles as continuous variables. Further, logistic regression analysis was also applied to estimate odds ratio (OR) [95% confidence interval (95% CI)] of hs-CRP > 0.3 mg/dL across quartiles of DII score. These statistical models were adjusted by age, body mass index (BMI), smoking status, and metabolic equivalents. Results Mean (standard deviation, SD) energy-adjusted DII for men and women was 0.62 (1.93) and −1.01 (2.25), respectively. Mean (SD) hs-CRP levels for men and women was 0.09 (0.11) mg/dL and 0.07 (0.10) mg/dL, respectively. We found a significant positive association between DII scores and geometric means of hs-CRP levels in men (P < 0.01), but not in women (P = 0.46). As well, OR (95% CI) of hs-CRP > 0.3 mg/dL was 1.17 (1.02–1.35) in men and 0.99 (0.79–1.24) in women. On stratified analysis by age and BMI in women, a marginal positive association was observed in women with 25 ≤ BMI < 40, but no significant associations were observed. Conclusions DII assessed by FFQ was correlated with hs-CRP level in Japanese men, but not in Japanese women. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.299
Introduction In Lake Chad, a region located on the Sahelian strip, malnutrition is recurrent and constitute a real public health problem. Of children aged 6 to 59 months, 14.7% suffered of global acute malnutrition and 12.6% (95% CI: 10.7%–14.8%) of moderate acute malnutrition (MAM) with a mortality rate of 0.98/10,000 children per day (Smart, 2014). Government, international and non-governmental organizations, adopt policies, deploy resources to fight against malnutrition in Chad and especially in this Region, but the crisis persists [1]. Studies have documented the factors of malnutrition and recognized inadequate nutrition and diseases as immediate causes. Added to this are the underlying causes such as situations of food insecurity, inadequate dietary practices, etc. [2]. However, all these factors occur alone or in aggregate according to specific contexts [Food and Agriculture Organization–World Health Organization (WHO), 1992]. Apart from general descriptive surveys such as Multiple Indicator Cluster Survey (Mics), Food Security Assessment (Ensa), few studies have studied and/or documented specific factors of malnutrition in this region. Therefore, this study aimed to study the factors associated with MAM in children from 6–59 months in the Lake Chad region. Methods This study was conducted from March to April 2015 in six Nutritional Units of Sanitary Districts of Bol and Ngouri, in the Lake Chad Region. This was a matched case-control study for sex and age with a sample of 252 pairs of children aged 6 to 59 months. Anthropometric data of the children were measured. “Cases” were defined for any child, girl or boy whose weight-forheight was between −3 and −2 Z-scores, and without edema (WHO standard included in the 2014 version of the National Management Protocol of Malnutrition in Chad). “Controls” were diagnosed unharmed of malnutrition (acute malnutrition, stunting, overweight or obesity). They live in the social environment as close as possible to the cases (same neighborhood or village). In this work, we studied sociodemographic factors, obstetric factors, dietary and health factors (breastfeeding, dietary diversity score according to the seven food groups - WHO standard, morbidity of the child, nutritional status of the mother), the factors related to the health system, water, hygiene and sanitation. A conditional logistic regression model was used to calculate association measures (adjusted odds ratios: ORa) and their 95% confidence intervals. Results This results focused on the 252 pairs of children included in the study. Our analyzes showed that the odds of malnutrition were four times higher when children’s diets were not diversified (consumed food belonging to less than four of the seven food groups) than when it was (ORa = 4.03 [1.86–8.73], P < 0.001). Children with recent diarrhea had about ten times the odds of moderate acute malnutrition (ORa = 9.62 [5.05–18.33], P < 0.001) than children without diarrhea. The odds of moderate acute malnutrition was approximately three times higher in children whose mothers had a MUAC less than 210 mm (a sign of moderate or severe acute malnutrition) than in those whose mothers had normal nutritional status, were overweight or obese (ORa = 2.91 [1.15–7.33], P = 0.02). Conclusion This work allowed us to explore and identify the factors associated with MAM in the Lake Chad Region. The results confirm some of our specific hypotheses that, children whose diet was not diversified, those with recent diarrhea and children whose mothers had a Muac less than 210 mm were the most affected by moderate acute malnutrition. Disclosure of interest est.
The authors declare that they have no competing inter-
S347
P6-3
P6-4
Association between dietary inflammatory index and high-sensitive C-reactive protein levels in cancer screening in Japanese
Factors associated with moderate acute malnutrition among 6–59 months children in the Lake Tchad region: A case-control study
A. Kotemori a,∗ , N. Sawada a , M. Iwasaki a , T. Yamaji a , N. Shivappa b , J.R. Hebert b a Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan b Cancer Prevention and Control Program, University of South Carolina, South Carolina, United States ∗ Corresponding author. E-mail address: [email protected] (A. Kotemori)
D. Bahya-Batinda a,b,∗ , M. Dramaix-Wilmet a,c , P. Donnen d,e a School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium b Joint Research Unit (UMR 204)-NUTRIPASS, French National Institute Research for Sustainable Development, Montpellier, France c Research Unit in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Brussels, Belgium d School of Public Health, Brussels, Belgium e Research Center in Politic and health systems-international health, Université Libre de Bruxelles, Brussels, Belgium ∗ Corresponding author. E-mail address: [email protected] (D. Bahya-Batinda)
Introduction Inflammation is related to the development of many cancers. Diet plays an important role in the regulation of inflammation. The dietary ® inflammatory index (DII ) is a literature-derived dietary index designed to assess the impact of diet on individual inflammation status. However, most validation studies of DII conducted to date have been done in Western countries, indicating the need for evaluation in Asian populations. The aim of this study was to validate DII scores derived from a food frequency questionnaire (FFQ) with high-sensitive C-reactive protein (hs-CRP) levels in participants undergoing cancer screening in Japan. Methods In cancer screenings conducted from 2009 to 2013 in the National Cancer Center in Japan, 7919 participants aged 40–70 years answered the FFQ and received blood analysis for hs-CRP. Of these, we excluded participants with a body mass index (BMI) of < 14 kg/m2 or > 40 kg/m2 (n = 13); missing data on smoking status (n = 1) or metabolic equivalents (Mets, n = 1); history of cancer, stroke, or myocardial infarction (n = 877); extreme energy intake (upper and lower 2.5 percentiles, n = 349); missing data on alcohol consumption (n = 120); and missing data of hs-CRP, or hs-CRP > 1.0 mg/dL (n = 84). Finally, 6474 participants (3825 for men and 2649 for women) were included in this analysis. DII was calculated from crude intake from the FFQ and adjusted for energy using the density method. Adjusted geometric mean levels of hs-CRP were calculated using a multivariable linear regression model by quartiles of DII score. P for trend across quartiles of DII score were calculated using DII quartiles as continuous variables. Further, logistic regression analysis was also applied to estimate odds ratio (OR) [95% confidence interval (95% CI)] of hs-CRP > 0.3 mg/dL across quartiles of DII score. These statistical models were adjusted by age, body mass index (BMI), smoking status, and metabolic equivalents. Results Mean (standard deviation, SD) energy-adjusted DII for men and women was 0.62 (1.93) and −1.01 (2.25), respectively. Mean (SD) hs-CRP levels for men and women was 0.09 (0.11) mg/dL and 0.07 (0.10) mg/dL, respectively. We found a significant positive association between DII scores and geometric means of hs-CRP levels in men (P < 0.01), but not in women (P = 0.46). As well, OR (95% CI) of hs-CRP > 0.3 mg/dL was 1.17 (1.02–1.35) in men and 0.99 (0.79–1.24) in women. On stratified analysis by age and BMI in women, a marginal positive association was observed in women with 25 ≤ BMI < 40, but no significant associations were observed. Conclusions DII assessed by FFQ was correlated with hs-CRP level in Japanese men, but not in Japanese women. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.299
Introduction In Lake Chad, a region located on the Sahelian strip, malnutrition is recurrent and constitute a real public health problem. Of children aged 6 to 59 months, 14.7% suffered of global acute malnutrition and 12.6% (95% CI: 10.7%–14.8%) of moderate acute malnutrition (MAM) with a mortality rate of 0.98/10,000 children per day (Smart, 2014). Government, international and non-governmental organizations, adopt policies, deploy resources to fight against malnutrition in Chad and especially in this Region, but the crisis persists [1]. Studies have documented the factors of malnutrition and recognized inadequate nutrition and diseases as immediate causes. Added to this are the underlying causes such as situations of food insecurity, inadequate dietary practices, etc. [2]. However, all these factors occur alone or in aggregate according to specific contexts [Food and Agriculture Organization–World Health Organization (WHO), 1992]. Apart from general descriptive surveys such as Multiple Indicator Cluster Survey (Mics), Food Security Assessment (Ensa), few studies have studied and/or documented specific factors of malnutrition in this region. Therefore, this study aimed to study the factors associated with MAM in children from 6–59 months in the Lake Chad region. Methods This study was conducted from March to April 2015 in six Nutritional Units of Sanitary Districts of Bol and Ngouri, in the Lake Chad Region. This was a matched case-control study for sex and age with a sample of 252 pairs of children aged 6 to 59 months. Anthropometric data of the children were measured. “Cases” were defined for any child, girl or boy whose weight-forheight was between −3 and −2 Z-scores, and without edema (WHO standard included in the 2014 version of the National Management Protocol of Malnutrition in Chad). “Controls” were diagnosed unharmed of malnutrition (acute malnutrition, stunting, overweight or obesity). They live in the social environment as close as possible to the cases (same neighborhood or village). In this work, we studied sociodemographic factors, obstetric factors, dietary and health factors (breastfeeding, dietary diversity score according to the seven food groups - WHO standard, morbidity of the child, nutritional status of the mother), the factors related to the health system, water, hygiene and sanitation. A conditional logistic regression model was used to calculate association measures (adjusted odds ratios: ORa) and their 95% confidence intervals. Results This results focused on the 252 pairs of children included in the study. Our analyzes showed that the odds of malnutrition were four times higher when children’s diets were not diversified (consumed food belonging to less than four of the seven food groups) than when it was (ORa = 4.03 [1.86–8.73], P < 0.001). Children with recent diarrhea had about ten times the odds of moderate acute malnutrition (ORa = 9.62 [5.05–18.33], P < 0.001) than children without diarrhea. The odds of moderate acute malnutrition was approximately three times higher in children whose mothers had a MUAC less than 210 mm (a sign of moderate or severe acute malnutrition) than in those whose mothers had normal nutritional status, were overweight or obese (ORa = 2.91 [1.15–7.33], P = 0.02). Conclusion This work allowed us to explore and identify the factors associated with MAM in the Lake Chad Region. The results confirm some of our specific hypotheses that, children whose diet was not diversified, those with recent diarrhea and children whose mothers had a Muac less than 210 mm were the most affected by moderate acute malnutrition. Disclosure of interest est.
The authors declare that they have no competing inter-