Associations Between Pre- and Post-Diagnosis Dietary Inflammatory Patterns and Ovarian Cancer Survival: Results From the Ovarian Cancer Follow-Up Study
Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. Howeve...
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| Published in | Journal of the Academy of Nutrition and Dietetics Vol. 125; no. 9; pp. 1256 - 1274.e13 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Elsevier Inc
01.09.2025
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| Subjects | |
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| Abstract | Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse.
The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS).
This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles.
Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022.
OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive.
Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ2 test for categorical variables and Student t test or Kruskal–Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS.
High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HRtertile3vs tertile1 1.84; 95% CI 1.12 to 3.01; HRtertile3vs tertile1 1.70; 95% CI 1.04 to 2.79; and HRtertile3vs tertile1 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HRtertile3vs tertile1 2.71; 95% CI 1.15 to 6.40 and HRtertile3vs tertile1 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57).
Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival. |
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| AbstractList | Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse.
The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS).
This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles.
Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022.
OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive.
Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ
test for categorical variables and Student t test or Kruskal-Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS.
High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HR
1.84; 95% CI 1.12 to 3.01; HR
1.70; 95% CI 1.04 to 2.79; and HR
1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HR
2.71; 95% CI 1.15 to 6.40 and HR
2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57).
Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival. Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse. The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS). This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles. Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022. OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive. Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ2 test for categorical variables and Student t test or Kruskal–Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS. High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HRtertile3vs tertile1 1.84; 95% CI 1.12 to 3.01; HRtertile3vs tertile1 1.70; 95% CI 1.04 to 2.79; and HRtertile3vs tertile1 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HRtertile3vs tertile1 2.71; 95% CI 1.15 to 6.40 and HRtertile3vs tertile1 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57). Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival. Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse.BACKGROUNDDietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse.The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS).OBJECTIVEThe aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS).This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles.DESIGNThis study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles.Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022.PARTICIPANTS/SETTINGParticipants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022.OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive.MAIN OUTCOME MEASURESOS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive.Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ2 test for categorical variables and Student t test or Kruskal-Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS.STATISTICAL ANALYSES PERFORMEDDifferences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ2 test for categorical variables and Student t test or Kruskal-Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS.High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HRtertile3vs tertile1 1.84; 95% CI 1.12 to 3.01; HRtertile3vs tertile1 1.70; 95% CI 1.04 to 2.79; and HRtertile3vs tertile1 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HRtertile3vs tertile1 2.71; 95% CI 1.15 to 6.40 and HRtertile3vs tertile1 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57).RESULTSHigh pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HRtertile3vs tertile1 1.84; 95% CI 1.12 to 3.01; HRtertile3vs tertile1 1.70; 95% CI 1.04 to 2.79; and HRtertile3vs tertile1 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HRtertile3vs tertile1 2.71; 95% CI 1.15 to 6.40 and HRtertile3vs tertile1 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57).Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival.CONCLUSIONSPre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival. Dietary factors impact systemic inflammation, which not only correlates with poorer outcomes in patients with ovarian cancer (OC), but also promotes cancer development through increased cell division, genetic alterations, and malignant transformation of epithelial cells at inflammatory sites. However, evidence between dietary inflammatory patterns and OC survival remains sparse. The aim of this study was to examine associations between pre- and post-diagnosis dietary inflammatory patterns, including their changes, and overall survival (OS). This study analyzed data from the hospital-based prospective, longitudinal cohort study: the Ovarian Cancer Follow-Up Study. Dietary intake information was collected at baseline (pre-diagnosis) and 12 months after diagnosis (post-diagnosis) using a 111-item food frequency questionnaire. Three inflammatory dietary scores were analyzed: dietary inflammatory index (DII), inflammatory score of the diet (ISD), and empirical dietary inflammatory pattern. The dietary inflammatory scores were calculated for each person and categorized in tertiles. Participants included 560 patients aged 18 through 79 years, who were newly diagnosed with OC, recruited at the Shengjing Hospital of China Medical University between 2015 and 2022. OS time was defined as the interval between the histologic diagnosis of OC and the date of death from any cause or the date of last follow-up (February 16, 2023) for patients who were still alive. Differences in general and clinical characteristics according to the tertile of inflammatory dietary pattern scores were assessed using χ² test for categorical variables and Student t test or Kruskal–Wallis test for continuous variables. Cox proportion hazard models were used to calculate hazard ratios (HRs) and 95% CIs for the associations of the pre- and post-diagnosis inflammatory dietary patterns with OS. High pre-diagnosis DII, ISD, and empirical dietary inflammatory pattern scores were associated with worse OS (HRₜₑᵣₜᵢₗₑ₃ᵥₛ ₜₑᵣₜᵢₗₑ₁ 1.84; 95% CI 1.12 to 3.01; HRₜₑᵣₜᵢₗₑ₃ᵥₛ ₜₑᵣₜᵢₗₑ₁ 1.70; 95% CI 1.04 to 2.79; and HRₜₑᵣₜᵢₗₑ₃ᵥₛ ₜₑᵣₜᵢₗₑ₁ 1.64; 95% CI 1.14 to 2.35, respectively). High post-diagnosis DII and ISD scores were related to worse OS (HRₜₑᵣₜᵢₗₑ₃ᵥₛ ₜₑᵣₜᵢₗₑ₁ 2.71; 95% CI 1.15 to 6.40 and HRₜₑᵣₜᵢₗₑ₃ᵥₛ ₜₑᵣₜᵢₗₑ₁ 2.84; 95% CI 1.25 to 6.49). Compared with those who maintained stable scores (change ± 20%), patients whose DII or ISD scores increased (>20%) from pre- to post-diagnosis had worse OS (DII: HR 2.00; 95% CI 1.30 to 3.08; ISD: HR 1.56; 95% CI 1.10 to 2.21), whereas patients whose empirical dietary inflammatory pattern score decreased (>20%) had better OS (HR 0.67; 95% CI 0.45 to 0.99). Moreover, compared with persistently low scores, patients who changed from low pre-diagnosis to high post-diagnosis scores had worse OS (DII: HR 2.47; 95% CI 1.54 to 3.94; ISD: HR 2.88; 95% CI 1.81-4.57). Pre- and post-diagnosis adherence to inflammatory dietary patterns was associated with poor OC survival. |
| Author | Zhang, De-Yu Liu, Chuan Wang, Jia-Yi Wang, Xiao-Ying Luan, Meng Li, Yi-Zi Liu, Jia-Xin Xiao, Qian Huang, Dong-Hui Li, Xiao-Ying Wu, Qi-Jun Bao, Qi Chen, Yu-Han Bao, Rui-Han Gong, Ting-Ting Liu, Jia-Ming Wu, Lang Liu, Fang-Hua Xu, He-Li Wei, Yi-Fan Gao, Song |
| Author_xml | – sequence: 1 givenname: Jia-Xin surname: Liu fullname: Liu, Jia-Xin organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 2 givenname: Rui-Han surname: Bao fullname: Bao, Rui-Han organization: School of Undergraduate, China Medical University, Shenyang, China – sequence: 3 givenname: Meng surname: Luan fullname: Luan, Meng organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 4 givenname: Chuan surname: Liu fullname: Liu, Chuan organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 5 givenname: Lang orcidid: 0000-0001-9938-3627 surname: Wu fullname: Wu, Lang organization: Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI – sequence: 6 givenname: Fang-Hua surname: Liu fullname: Liu, Fang-Hua organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 7 givenname: Yi-Zi surname: Li fullname: Li, Yi-Zi organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 8 givenname: He-Li surname: Xu fullname: Xu, He-Li organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 9 givenname: Yi-Fan surname: Wei fullname: Wei, Yi-Fan organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 10 givenname: Qian surname: Xiao fullname: Xiao, Qian organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 11 givenname: Dong-Hui surname: Huang fullname: Huang, Dong-Hui email: huangdh_cc@163.com organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 12 givenname: Xiao-Ying surname: Li fullname: Li, Xiao-Ying email: xyingl0608@163.com organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 13 givenname: Qi surname: Bao fullname: Bao, Qi organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 14 givenname: Jia-Yi surname: Wang fullname: Wang, Jia-Yi organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 15 givenname: Yu-Han surname: Chen fullname: Chen, Yu-Han organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 16 givenname: Jia-Ming surname: Liu fullname: Liu, Jia-Ming organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 17 givenname: Song surname: Gao fullname: Gao, Song organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 18 givenname: Xiao-Ying surname: Wang fullname: Wang, Xiao-Ying organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 19 givenname: De-Yu surname: Zhang fullname: Zhang, De-Yu organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 20 givenname: Ting-Ting surname: Gong fullname: Gong, Ting-Ting email: gongtt@sj-hospital.org organization: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China – sequence: 21 givenname: Qi-Jun orcidid: 0000-0001-9421-5114 surname: Wu fullname: Wu, Qi-Jun email: wuqj@sj-hospital.org organization: Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39983993$$D View this record in MEDLINE/PubMed |
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| Issue | 9 |
| Keywords | Inflammatory Dietary patterns Cohort Survival Ovarian cancer |
| Language | English |
| License | Copyright © 2025 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved. |
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| Title | Associations Between Pre- and Post-Diagnosis Dietary Inflammatory Patterns and Ovarian Cancer Survival: Results From the Ovarian Cancer Follow-Up Study |
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