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

• Published in: Public health nutrition 2024-09, Vol.27 (1), p.e184, Article e184
• Main Authors: Meadows, Rachel J, Paskett, Electra D, Bower, Julie K, Kaye, Gail L, Lemeshow, Stanley, Harris, Randall E
• Format: Article
• Language: English
• Subjects: Adult; Adults; Age; Age groups; Aged; Agriculture; Alcohol; Angina pectoris; Biomarkers; Black or African American - statistics & numerical data; Cardiovascular disease; Chronic illnesses; Cross-Sectional Studies; Demographics; Demography; Diabetes; Diet; Diet - statistics & numerical data; Dietary intake; Disparities; Economics; Education; Energy; Estimates; Ethnicity; Family medical history; Female; Food intake; Food security; Heart attacks; Hispanic or Latino - statistics & numerical data; Humans; Hypertension; Income; Inflammation; Inflammation - epidemiology; Male; Meals; Middle Aged; Minority & ethnic groups; Missing data; Multiple imputation; NHANES; Nutrition research; Nutrition Surveys; Nutritional epidemiology; Patient Protection & Affordable Care Act 2010-US; Population; Questionnaires; Race; Research Paper; Sex; Sociodemographic Factors; Socioeconomic Factors; Socioeconomics; Statistical analysis; Subpopulations; Surveys; United States - epidemiology; Vitamins; White People - statistics & numerical data; Young Adult
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980024001800

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). 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. USA. 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. 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 %. 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.