Dietary Inflammatory Index and clinical outcome measures in adults with moderate to severe asthma

Edith Visser*, Kim de Jong, Tim van Zutphen, Huib A M Kerstjens, Anneke Ten Brinke

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

1 Citaat (Scopus)
13 Downloads (Pure)


BACKGROUND: Diet is increasingly recognized as a modifiable factor in lung health, predominantly due to the immunomodulatory effects of nutrients. The Dietary Inflammatory Index (DII) is a score developed to express the inflammatory potential of a diet.

OBJECTIVE: We aimed to assess the association of the DII and food groups, with clinical, functional and inflammatory asthma outcomes in adults with asthma.

METHODS: Patients with moderate to severe asthma were included in this cross-sectional study between June 2019 and October 2021, and completed a 3-day food diary, to calculate the DII and intake of food groups (i.e. fruits, whole grains, processed meats and sugar-sweetened beverages). Functional outcomes included pulmonary function tests and the 6-minute walking distance, while clinical outcomes were assessed using questionnaires on asthma control, quality of life, and healthcare utilization. Inflammatory markers were exhaled nitric oxide and blood leukocytes, eosinophils and interleukin-6. Multivariable regression analyses were used to examine the association of DII and food groups with asthma outcomes.

RESULTS: A total of 109 patients participated (35% male, mean±SD age 51.8 ± 14.2 years, BMI 27.4 ± 5.3 kg/m 2). Overall, 62% had a DII score >0, indicating a pro-inflammatory diet, which was not related to asthma severity. A more pro-inflammatory diet was consistently associated to lower FVC (%pred), but inconsistent results were observed with respect to airway obstruction. Neither the DII nor food groups were associated with clinical outcomes. Except for higher levels of exhaled nitric oxide in relation to an anti-inflammatory diet, we found no associations between inflammatory markers and the DII.

CONCLUSION: Results from this cross-sectional study among patients with moderate to severe asthma do not support the hypothesis that a pro-inflammatory diet is associated with worse asthma outcomes, although limitations in study design and dietary intake estimation should be considered. Future well-designed experimental studies are needed to assess whether targeting the inflammatory potential of diet could lead to better outcomes in adults with asthma.

Originele taal-2English
Pagina's (van-tot)3680-3689.e7
Aantal pagina's17
TijdschriftThe journal of allergy and clinical immunology. In practice
Nummer van het tijdschrift12
Vroegere onlinedatum29-aug.-2023
StatusPublished - dec.-2023

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