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Association between Paleolithic diet fraction and systemic low-grade chronic inflammation in the Malmö diet and cancer study cohort

Carrera-Bastos, Pedro LU ; Rydhög, Björn LU ; Granfeldt, Yvonne LU ; Sundquist, Kristina LU ; Sonestedt, Emily LU orcid ; Nilsson, Peter M. LU and Jönsson, Tommy LU (2025) In European Journal of Nutrition 64(8).
Abstract

Purpose: The Paleolithic Diet Fraction (PDF) estimates the proportion of absolute dietary intake derived from food groups included in the Paleolithic diet. In the Malmö Diet and Cancer Study (MDCS), higher PDF and lower systemic low-grade chronic inflammation (SLGCI) have been associated with lower cardiometabolic morbidity and mortality. We examined associations between PDF and SLGCI in the MDCS. Methods: The study population (n = 23,250; 63% women; ages 44–74 years) excluded participants with prior coronary events, diabetes, stroke, high-grade inflammation, or missing baseline covariate data. PDF was calculated from baseline dietary data collected via food frequency questionnaires, seven-day food records, and interviews. Biomarkers of... (More)

Purpose: The Paleolithic Diet Fraction (PDF) estimates the proportion of absolute dietary intake derived from food groups included in the Paleolithic diet. In the Malmö Diet and Cancer Study (MDCS), higher PDF and lower systemic low-grade chronic inflammation (SLGCI) have been associated with lower cardiometabolic morbidity and mortality. We examined associations between PDF and SLGCI in the MDCS. Methods: The study population (n = 23,250; 63% women; ages 44–74 years) excluded participants with prior coronary events, diabetes, stroke, high-grade inflammation, or missing baseline covariate data. PDF was calculated from baseline dietary data collected via food frequency questionnaires, seven-day food records, and interviews. Biomarkers of SLGCI included total leukocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) measured at baseline, and C-reactive protein (CRP) measured ~ 4 months later in a subpopulation (n = 4196). Results: PDF was significantly and inversely associated with all three biomarkers of SLGCI in both simple and fully adjusted models (adjusted for age, sex, physical activity level, BMI, smoking status, education level, living alone, born in Sweden, season of dietary data collection, and dietary method version): TLC (B = −0.008), NLR (B = −0.003), and lnCRP (B = −0.005), respectively (p < 0.001). Inflammatory biomarkers were weakly but significantly correlated: TLC with NLR (rs = 0.263), TLC with CRP (rs = 0.262), and NLR with CRP (rs = 0.062) (p < 0.001). Conclusion: PDF was inversely associated with SLGCI biomarkers, suggesting that SLGCI may mediate its relationship with cardiometabolic outcomes. Given the cross-sectional design and CRP measurement lag, these findings should be interpreted with caution.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
C-reactive protein, Malmö diet and cancer study, Neutrophil-to-lymphocyte ratio, Paleolithic diet fraction, Systemic low-grade chronic inflammation, Total leukocyte count
in
European Journal of Nutrition
volume
64
issue
8
article number
317
publisher
Springer
external identifiers
  • pmid:41222611
  • scopus:105021460754
ISSN
1436-6207
DOI
10.1007/s00394-025-03838-z
language
English
LU publication?
yes
id
034fd883-1f44-4ed7-868f-b970b6cbbf5b
date added to LUP
2026-01-12 14:25:02
date last changed
2026-01-26 15:50:05
@article{034fd883-1f44-4ed7-868f-b970b6cbbf5b,
  abstract     = {{<p>Purpose: The Paleolithic Diet Fraction (PDF) estimates the proportion of absolute dietary intake derived from food groups included in the Paleolithic diet. In the Malmö Diet and Cancer Study (MDCS), higher PDF and lower systemic low-grade chronic inflammation (SLGCI) have been associated with lower cardiometabolic morbidity and mortality. We examined associations between PDF and SLGCI in the MDCS. Methods: The study population (n = 23,250; 63% women; ages 44–74 years) excluded participants with prior coronary events, diabetes, stroke, high-grade inflammation, or missing baseline covariate data. PDF was calculated from baseline dietary data collected via food frequency questionnaires, seven-day food records, and interviews. Biomarkers of SLGCI included total leukocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) measured at baseline, and C-reactive protein (CRP) measured ~ 4 months later in a subpopulation (n = 4196). Results: PDF was significantly and inversely associated with all three biomarkers of SLGCI in both simple and fully adjusted models (adjusted for age, sex, physical activity level, BMI, smoking status, education level, living alone, born in Sweden, season of dietary data collection, and dietary method version): TLC (B = −0.008), NLR (B = −0.003), and lnCRP (B = −0.005), respectively (p &lt; 0.001). Inflammatory biomarkers were weakly but significantly correlated: TLC with NLR (r<sub>s</sub> = 0.263), TLC with CRP (r<sub>s</sub> = 0.262), and NLR with CRP (r<sub>s</sub> = 0.062) (p &lt; 0.001). Conclusion: PDF was inversely associated with SLGCI biomarkers, suggesting that SLGCI may mediate its relationship with cardiometabolic outcomes. Given the cross-sectional design and CRP measurement lag, these findings should be interpreted with caution.</p>}},
  author       = {{Carrera-Bastos, Pedro and Rydhög, Björn and Granfeldt, Yvonne and Sundquist, Kristina and Sonestedt, Emily and Nilsson, Peter M. and Jönsson, Tommy}},
  issn         = {{1436-6207}},
  keywords     = {{C-reactive protein; Malmö diet and cancer study; Neutrophil-to-lymphocyte ratio; Paleolithic diet fraction; Systemic low-grade chronic inflammation; Total leukocyte count}},
  language     = {{eng}},
  number       = {{8}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Association between Paleolithic diet fraction and systemic low-grade chronic inflammation in the Malmö diet and cancer study cohort}},
  url          = {{http://dx.doi.org/10.1007/s00394-025-03838-z}},
  doi          = {{10.1007/s00394-025-03838-z}},
  volume       = {{64}},
  year         = {{2025}},
}