{"title":"Dietary inflammatory index and the risk of colorectal adenomas and cancer: a systematic review and dose-response meta-analysis.","authors":"Yi-Jun Wu, Wen-Hua Wang, Yu-Ping Wang, Hong Xu","doi":"10.1186/s12937-025-01202-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The potential association between dietary inflammatory index (DII) and colorectal cancer (CRC) risk, as well as colorectal adenomas (CRA) risk, has been extensively studied, but the findings remain inconclusive. We conducted this systematic review and dose-response meta-analysis to investigate the relationship between the DII and CRC and CRA.</p><p><strong>Methods: </strong>We comprehensively searched the PubMed, Embase, Cochrane Library, and Web of Science databases for cohort and case-control studies reporting the relationship between DII and CRA, or between DII and CRC, as of 15 July 2025. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Dose-response analysis was conducted where possible. Subgroup analyses were conducted to account for possible sources of heterogeneity. Funnel plot, Egger's test, and Begg's test were utilized to assess publication bias.</p><p><strong>Results: </strong>Twenty-two studies were included, involving 7,612 CRA patients, 25,359 CRC patients, and 896,592 controls. The pooled ORs for CRC and CRA in total population comparing the highest DII to the lowest DII were 1.61 (95% CI, 1.42-1.83) and 1.19 (95% CI, 0.96-1.47), respectively. The pooled ORs for CRC and CRA per unit increase in DII were 1.14 (95% CI, 1.08-1.20) and 1.19 (95% CI, 1.03-1.38), respectively. Stratification by sex revealed a positive association between DII and CRC risk in both males and females. However, this association was stronger in males (Highest DII vs. lowest DII: OR = 1.67, 95% CI [1.39, 2.00]) (Continues DII: OR = 1.16, 95%CI [1.06, 1.26]). Dose-response analysis revealed a nonlinear positive correlation between CRC risk and DII (P <sub>for non-linearity</sub> < 0.0001).</p><p><strong>Conclusions: </strong>Our findings suggest that dietary habits characterized by a high inflammatory index may increase the risk of CRA and CRC. TRIAL REGISTRATION : PROSPERO registration number: CRD42025641934.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"24 1","pages":"137"},"PeriodicalIF":3.8000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418642/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12937-025-01202-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The potential association between dietary inflammatory index (DII) and colorectal cancer (CRC) risk, as well as colorectal adenomas (CRA) risk, has been extensively studied, but the findings remain inconclusive. We conducted this systematic review and dose-response meta-analysis to investigate the relationship between the DII and CRC and CRA.
Methods: We comprehensively searched the PubMed, Embase, Cochrane Library, and Web of Science databases for cohort and case-control studies reporting the relationship between DII and CRA, or between DII and CRC, as of 15 July 2025. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Dose-response analysis was conducted where possible. Subgroup analyses were conducted to account for possible sources of heterogeneity. Funnel plot, Egger's test, and Begg's test were utilized to assess publication bias.
Results: Twenty-two studies were included, involving 7,612 CRA patients, 25,359 CRC patients, and 896,592 controls. The pooled ORs for CRC and CRA in total population comparing the highest DII to the lowest DII were 1.61 (95% CI, 1.42-1.83) and 1.19 (95% CI, 0.96-1.47), respectively. The pooled ORs for CRC and CRA per unit increase in DII were 1.14 (95% CI, 1.08-1.20) and 1.19 (95% CI, 1.03-1.38), respectively. Stratification by sex revealed a positive association between DII and CRC risk in both males and females. However, this association was stronger in males (Highest DII vs. lowest DII: OR = 1.67, 95% CI [1.39, 2.00]) (Continues DII: OR = 1.16, 95%CI [1.06, 1.26]). Dose-response analysis revealed a nonlinear positive correlation between CRC risk and DII (P for non-linearity < 0.0001).
Conclusions: Our findings suggest that dietary habits characterized by a high inflammatory index may increase the risk of CRA and CRC. TRIAL REGISTRATION : PROSPERO registration number: CRD42025641934.
期刊介绍:
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.