ArticleFrontiers in nutrition2025
Associations between an inflammatory diet index and nonunion: a prospective study of 172,839 UK biobank participants.
Article in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Association between energy-adjusted dietary inflammatory index and increased risk of all-cause Crohn's disease: a prospective cohort study.Frontiers in public health · 2026Article
- Radial extracorporeal shock wave promotes the treatment of non-union of femoral shaft fractures in children: a case report.Frontiers in surgery · 2025Article
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Authors and funding
9 authors.
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Abstract
Purposes: This study utilizes prospective cohort data from the UK Biobank to investigate the association between the energy-adjusted dietary inflammation index (E-DII) and the development of fracture nonunion. Methods: In this study, COX regression was used to analyze the correlation between E-DII and nonunion. Among 172,839 participants free of prior nonunion at baseline, 2,341 (1.4%) developed nonunion during a median follow-up of 14.2 years. E-DII scores, calculated from five separate 24-h dietary recall assessments, were used to quantify dietary inflammatory potential, with higher values indicating pro-inflammatory patterns. Results: Multivariable-adjusted analyses revealed that participants with anti-inflammatory dietary patterns (E-DII < -1) exhibited a significantly elevated risk of impaired fracture healing compared to those with pro-inflammatory diets (E-DII > 1), yielding an adjusted hazard ratio (HR) of 1.89 (95% CI: 1.45-3.11). A nonlinear U-shaped dose-response relationship was identified, with the nadir of nonunion risk observed at E-DII values between 0.3 and 1.2. Conversely, values outside this range were associated with progressively higher risks. Transcriptomic profiling identified differential expression of 35 inflammation-related genes-including CD3E and CX3CR1-significantly downregulated in nonunion cases compared to controls. These genes are functionally enriched in pathways governing immune response regulation and leukocyte activation. Conclusion: These findings propose that a moderately pro-inflammatory dietary pattern may confer protection against impaired bone healing, whereas both strongly anti-inflammatory and excessively pro-inflammatory diets were associated with compromised healing outcomes. Based on these results, tailored dietary strategies designed to optimize inflammatory homeostasis during fracture recovery are recommended to enhance clinical outcomes.
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