Dietary inflammatory index and the risk of prostate cancer: a dose-response meta-analysis

Emerging epidemiological studies have assessed the potential relationship between the inflammatory potential of diet measured using the dietary inflammatory index (DII) and the risk of prostate cancer and found inconsistent results. The aim of this study was to systematically evaluate this issue using a meta-analysis approach. A comprehensive literature search of papers published through March 2019 was performed in the PubMed and EMBASE databases. The summary odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a DerSimonian and Laird random effects model. A categorized analysis and linear and nonlinear dose-response analyses were performed. Ten studies met the inclusion criteria for our meta-analysis. The highest DII score category was associated with a significantly higher risk of prostate cancer than the lowest DII score category (OR = 1.73, 95% CI 1.34-2.23). In the dose-response analysis, the summary OR of prostate cancer for an increment of one unit of the DII was 1.10 (95% CI 1.04-1.17). The sensitivity analysis indicated that exclusion of any single study did not materially alter the pooled risk estimates. Finally, there was no evidence of significant publication bias with Begg's test or with Egger's test. In conclusion, this meta-analysis suggests that an increased DII is related to a higher risk of prostate cancer and that the risk increases by 10.0% per unit of the DII. However, further well-designed prospective trials with larger sample sizes should be performed to validate our preliminary findings.