title: Dietary inflammatory index as a potential determinant of a length of hospitalization among surgical patients treated for colorectal cancer.
abstract: OBJECTIVE
  Inflammation is a central process responsible for health outcomes among surgical patients. Immunonutrition has been investigated as a promising modifying factor; however, inflammatory properties of habitual diet have not yet been investigated. The purpose of this study was to describe inflammatory properties of diet measured by the dietary inflammatory index (DII) among surgical patients treated for colorectal cancer and to link inflammatory properties of habitual diet with a duration of hospitalization.
  
  
  METHODS
  A follow-up study among colorectal cancer patients treated surgically was performed in Krakow, Poland. In total, 689 patients were recruited for the study. Habitual diet was assessed using a standardized semiquantitative food frequency questionnaire. Overall, 23 dietary items (including macro-and micronutrients) were used to calculate individuals' DII. Gender, age, marital status, body mass index, smoking status, lifetime physical activity, taking vitamin supplements, number of chronic diseases, cancer site, Duke's staging and surgery type were considered as potential covariates.
  
  
  RESULTS
  Participants were aged 58 years, with the average hospitalization time of 11 days. Higher DII (meaning diet with higher anti-inflammatory properties) was negatively associated with the duration of hospitalization (univariable linear regression: b=-0.59; P=0.005). Multivariable logistic regression has shown the decrease of the risk of longer stays (>7 days) among patients with the DII >-4.25, but only among younger (⩽60 years) patients, irrespective of Duke's staging.
  
  
  CONCLUSIONS
  The DII might be used as a potential predictor of longer hospitalization among colorectal cancer patients treated surgically. The study provides evidence for the role of dietary-related low-grade inflammation among surgical patients.
authors.affiliation: Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Galas
authors.affiliation: Department of Gastroenterological Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Kulig
authors.affiliation: Department of Gastroenterological Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D004032:Diet / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011044:Poland