Socio-demographic differences in the dietary inflammatory index from National Health and Nutrition Examination Survey 2005-2018: a comparison of multiple imputation versus complete case analysis

Abstract Objective: Studies using the dietary inflammatory index often perform complete case analyses (CCA) to handle missing data, which may reduce the sample size and increase the risk of bias. Furthermore, population-level socio-economic differences in the energy-adjusted dietary inflammatory ind...

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Main Authors: Rachel J Meadows (Author), Electra D Paskett (Author), Julie K Bower (Author), Gail L Kaye (Author), Stanley Lemeshow (Author), Randall E Harris (Author)
Format: Book
Published: Cambridge University Press, 2024-01-01T00:00:00Z.
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Summary:Abstract Objective: Studies using the dietary inflammatory index often perform complete case analyses (CCA) to handle missing data, which may reduce the sample size and increase the risk of bias. Furthermore, population-level socio-economic differences in the energy-adjusted dietary inflammatory index (E-DII) have not been recently studied. Therefore, we aimed to describe socio-demographic differences in E-DII scores among American adults and compare the results using two statistical approaches for handling missing data, i.e. CCA and multiple imputation (MI). Design: Cross-sectional analysis. E-DII scores were computed using a 24-hour dietary recall. Linear regression was used to compare the E-DII scores by age, sex, race/ethnicity, education and income using both CCA and MI. Setting: USA. Participants: This study included 34 547 non-Hispanic White, non-Hispanic Black and Hispanic adults aged ≥ 20 years from the 2005-2018 National Health and Nutrition Examination Survey. Results: The MI and CCA subpopulations comprised 34 547 and 23 955 participants, respectively. Overall, 57 % of the American adults reported 24-hour dietary intakes associated with inflammation. Both methods showed similar patterns wherein 24-hour dietary intakes associated with high inflammation were commonly reported among males, younger adults, non-Hispanic Black adults and those with lower education or income. Differences in point estimates between CCA and MI were mostly modest at ≤ 20 %. Conclusions: The two approaches for handling missing data produced comparable point estimates and 95 % CI. Differences in the E-DII scores by age, sex, race/ethnicity, education and income suggest that socio-economic disparities in health may be partially explained by the inflammatory potential of diet.
Item Description:10.1017/S1368980024001800
1368-9800
1475-2727