“Inflammatory potential of the diet and its association with physical, mental, and gut health among Lebanese adults

Abstract

Objective: Chronic inflammatory conditions are now well acknowledged as major causes of mortality and morbidity. More than 50% of all-cause mortalities were attributed to inflammatory diseases like stroke, cardiovascular diseases, cancer, neurodegenerative diseases, or chronic kidney disease. Moreover, diet was found to be associated with major inflammatory biomarkers like C-reactive protein, or adiponectin. From there findings demonstrated through its inflammatory potential diet is associated to several aspects of health, like chronic diseases, gut health and mental health. Recent meta-analyses, found in fact a correlation between a higher dietary inflammatory score and risks of cardiovascular diseases and Type 2 Diabetes. Also, a similar association is seen for mental health, a more inflammatory diet was found to be associated with a 28% higher risk of depression, and 27% higher risk of anxiety. A pro-inflammatory diet was further associated with a higher probability of having gastrointestinal symptoms like finding mucus or liquid in the stools. Unfortunately, Lebanon has been witnessing a shift to a more inflammatory dietary pattern since 2011. Also, due to the current crises affecting all sectors in Lebanon today, physical, mental and gut health are deteriorating. It is therefore timely, to evaluate the association between the diet’s inflammatory capacity and the prevalence of chronic diseases, mental health status, and gut health status in Lebanese adults. Methods: A total of 75 Lebanese people between the ages of 45 and 65 were recruited from several governorates in Lebanon (including Beirut, South Lebanon, and Mount Lebanon) through different social media platforms to participate in this pilot cross-sectional study. Dietary intake was evaluated using a validated 61 items food frequency questionnaire and the Empirical Dietary Inflammatory Index (eDII) was used then used to determine the inflammatory potential of their diets. The gastrointestinal health of the adults was examined using 9-items from the validated Structured Assessment of Gastrointestinal Symptom (SAGIS). The participants' physical health was assessed by self-reported chronic diseases. Mental health was evaluated by assessing depression and anxiety prevalence through the Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7), respectively. STATA version 13 was used to analyze the data. The associations between eDII, mental health, physical health, and gut health, were examined using logistic regression models that were adjusted for sociodemographic and clinical factors. Results: The study sample included 68 Lebanese adults with a mean age of 25.72 (±4.38) years of whom 70.59 percent were women (n=48). Nearly all of the participants were married (n=56; 82.35%) and had either a bachelor's degree or higher from an accredited university (n=40; 60.29%). After correcting for age, gender, education, medication, physical health, and BMI, the logistic regressions showed no significant association between eDII and physical health (OR=0.91; 95%CI:0.64-1.29; p=0.596), eDII and mental health (OR=0.80, 95%CI:0.57-1.12; p=0.191) and eDII and gut health (OR=1.1, 95%CI:0.85-1.42, p=0.476) Conclusion: To conclude, our study showed that the inflammatory potential of the diet was not associated with all three aspects of health (mental, physical, and gut) among a sample of Lebanese adults. Future longitudinal studies with a larger sample size are needed to further explore these associations. In the meantime, encouraging the consumption of vegetables and more specifically dark yellow vegetables and leafy green vegetables is essential for their anti-inflammatory potential, noting that both food groups are major components of the Lebanese diet.