Association of dietary inflammatory index and dietary oxidative balance score with gastrointestinal cancers in NHANES 2005–2018

Sep 21, 2026

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Gastrointestinal (GI) cancers, including gastric, liver, esophageal, pancreatic, and colorectal cancers, impose major global health burdens. Dietary patterns may affect cancer risk through inflammatory and oxidative effects, assessed by the Dietary Inflammatory Index (DII) and Dietary Oxidative Balance Score (DOBS). This study analyzes NHANES 2005–2018 data to evaluate associations between DII, DOBS, their joint links to GI cancers, and mediation by serum albumin and red cell distribution width (RDW).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

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Abstract

Background & Aims

Methods

Results

Conclusion

Introduction

Chang etal. BMC Public Health (2024) 24:2760 BMC Public Health [https://doi.org/10.1186/s12889-024-20268-4](https://doi.org/10.1186/s12889-024-20268-4) RESEARCH Open Access Association of dietary inflammatory index and dietary oxidative balance score with gastrointestinal cancers in NHANES 2005–2018 Yu Chang 1†, Chanjiao Yu 1†, Xianyu Dai 1, Haibo Sun 1* and Tongyu Tang 1* Abstract Background&Aims Gastrointestinal (GI) cancers, including gastric, liver, esophageal, pancreatic, and colorectal cancers, represent significant global health burdens. Emerging evidence suggests that dietary patterns, particularly their inflammatory and oxidative properties, may influence cancer risk. The Dietary Inflammatory Index (DII) and Dietary Oxidative Balance Score (DOBS) assess the inflammatory and oxidative effects of diets, respectively. This study aims to explore the association between DII, DOBS, and the combined risk of GI cancers, and investigates the potential mediating roles of serum albumin and red cell distribution width (RDW) . Methods Data from 26,320 participants in the NHANES 2005–2018 cycles were analyzed. DII was calculated based on 28 dietary components, and DOBS included 17 nutrients (3 pro-oxidants and 14 antioxidants) . Logistic regression models assessed the associations between DII, DOBS, and GI cancers. Restricted cubic spline (RCS) models examined dose-response relationships. Mediation analysis evaluated the roles of serum albumin and RDW. Subgroup analyses explored interactions with demographic and health-related factors. Results Higher DII was associated with increased GI cancer risk (OR: 1. 26, 95% CI: 1.07–1.49 per unit increase), while higher DOBS was associated with reduced risk (OR: 0 . 90, 95% CI: 0 .76–0. 99 per unit increase) . RCS analysis indicateda significant nonlinear relationship between DII and GI cancer risk. Serum albumin and RDW partially mediated the associations between DII, DOBS, and GI cancers. Subgroup analyses showed stronger associations for DII among certain demographics, and significant interactions were found between DII and BMI. For DOBS, significant interactions were observed with age and BMI. Conclusion This study reveals significant associations between dietary inflammatory and oxidative balance scoresand GI cancer risk. Higher DII is linked to increased risk, while higher DOBS is protective. The mediating roles of serum †Yu Chang and Chanjiao Yu contributed equally to this work and should be considered as co-first authors. *Correspondence: Haibo Sun [sunhaibo@jlu.edu.cn](sunhaibo@jlu.edu.cn)[ ](sunhaibo@jlu.edu.cn)Tongyu Tang [tangty@jlu.edu.cn](tangty@jlu.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. Chang et al. BMC Public Health (2024) 24:2760 Page 2 of 13 albumin and RDW provide insights into underlying mechanisms. These findings underscore the potential of dietary modifications in GI cancer prevention and management, emphasizing the importance of anti-inflammatory and antioxidant-rich diets. Keywords Gastrointestinal cancers, Di

FAQs

What are DII and DOBS, and why were they studied for GI cancers?

DII quantifies a diet’s inflammatory potential, while DOBS quantifies its oxidative balance. They were studied because dietary inflammatory and oxidative properties may influence GI cancer risk.

How was the study conducted and what dataset was used?

The analysis used NHANES data from 2005–2018 covering 26,320 participants. DII was calculated from 28 dietary components and DOBS from 17 nutrients, then associations with GI cancers were tested using logistic regression, restricted cubic splines, and mediation analyses.

What were the main findings regarding DII and DOBS?

Higher DII was associated with increased GI cancer risk, and higher DOBS was associated with reduced risk. The relationship between DII and risk showed a significant nonlinear pattern.

Did serum albumin and RDW explain any of these associations?

Yes. Mediation analysis indicated that serum albumin and RDW partially mediated the associations between DII, DOBS, and GI cancers, supporting possible underlying mechanisms.

Sep 21, 2026

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