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Poster display session

1849 - Association between the Dietary Inflammatory Index (DII), urinary enterolignans and C-reactive protein in the National Health and Nutrition Examination Survey-2003-2008


11 Sep 2017


Poster display session


Translational Research


Nitin Shivappa


Annals of Oncology (2017) 28 (suppl_5): v573-v594. 10.1093/annonc/mdx390


N. Shivappa1, M. Wirth1, A. Murphy2, T. Hurley1, J. Hebert1

Author affiliations

  • 1 Epidemiology, university of south carolina, 29210 - Columbia/US
  • 2 Pathology, university of south carolina, 29209 - Columbia/US


Abstract 1849


Enterolignans are important biomarkers of microbiome diversity. Higher levels, indicating greater diversity, have been shown to reduce cancer risk. Diet and inflammation have been shown to play a role in maintaining microbiome diversity. This study examined whether inflammatory potential of diet, as measured by the Dietary Inflammatory IndexTM (DII) has an impact on levels of urinary enterolignans in the National Health and Nutrition Examination Survey (NHANES) 2003-2008. We also carried out validation of the DII with C-reactive protein (CRP).


Data came from NHANES 2003-2008. Enterolignans (enterodiol and enterolactone) and CRP were assayed from urine and serum specimens, respectively. DII scores were calculated from food intakes assessed using 24-hour dietary recalls and expressed per 1,000 calories consumed. Associations were examined using survey-based multivariable linear and logistic regression.


After adjustment, higher DII scores (i.e., relatively more pro inflammatory) were associated with lower levels of creatinine normalized enterodiol (bDIIquartile4vs1 = -1.22; 95% CI = -0.69, -1.74; Ptrend = 


In these NHANES data, there was an association between DII and enterolignans. This study also provided a successful construct validation of the DII using CRP in a nationally representative sample. Using enterolignans as a proxy for gut microbiome, these results indicate that diet-associated inflammation modifies gut diversity.

Clinical trial identification

Legal entity responsible for the study

University of South Carolina




N. Shivappa, M. Wirth, J. Hebert: Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII). Drs. Nitin Shivappa and Michael Wirth are employees of CHI. All other authors have declared no conflicts of interest.

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