A pro-inflammatory diet is associated with higher body adiposity in kidney transplant recipients

The dietary inflammatory index (DII) has been associated with obesity and cardiovascular risk factors (CVRF) in the general population. We hypothesized that in kidney transplant recipients (KTR), a positive relationship between DII, body adiposity and CVRF would also be observed. To test this hypothesis, we conducted a cross-sectional study with adult KTR. Body mass index (BMI), body adiposity index (BAI) and waist circumference (WC) were assessed. Total fat mass (FM), trunk FM, and load-capacity index (LCI) were evaluated using dual-energy X-ray absorptiometry. Energy-adjusted DII (E-DII) was estimated based on three 24-h recalls and stratified as anti-inflammatory (E-DII<0) and pro-inflammatory (E-DII>0). CVRF included hypertension, diabetes, dyslipidemia, and metabolic syndrome. A total of 170 KTR, 59% male, with 49.5 (42-57) years and E-DII from -2.89 to 4.78 were evaluated. KTR with E-DII>0, compared to those with E-DII<0, exhibited significantly higher values of BAI, total FM (kg), and LCI. In multiple adjusted linear regression, E-DII was significantly associated with WC, total FM (kg), and trunk FM (kg). Logistic regression analysis indicated that E-DII>0 was significantly associated with obesity, as assessed by BAI. E-DII was not associated with CVRF. The present study suggests that a pro-inflammatory diet is associated with higher total and central body adiposity in KTR. Interventions targeting an anti-inflammatory diet may contribute to reducing excessive body adiposity in this population.