Public Health Education and Promotion Commons^™

Pre-Exposure Prophylaxis (Prep) For Hiv Prevention: A Mixed-Methods Study Of Sexual Risks And Knowledge, Perceptions, And Willingness Of Prep Use Among African American Women In The South, Jamie Troutman

Theses and Dissertations

There are approximately 1.1 million people living with HIV in United States, with nearly 40,000 new diagnoses annually. Significant regional and racial disparities are associated with HIV diagnoses — with the South experiencing the greatest burden of HIV and African American women accounting for 60% of new diagnoses among women. Pre-exposure prophylaxis (PrEP) has been designated as an effective tool to prevent HIV transmission among individuals who may be at risk of HIV infection. Earlier PrEP research has focused mainly on at-risk groups such as men who have sex with men (MSM). Previous PrEP research involving African American women included …

Evaluating Impacts Of A Multilevel Resilience-Based Psychosocial Intervention On Mental Health Of Children Affected By Parental Hiv In China, Yanping Jiang

Theses and Dissertations

Background: Children affected by parental HIV are commonly exposed to multiple risk factors, including parental illness and death, other traumatic life events, HIV stigma, and poverty, all of which in turn put them at elevated risk of experiencing poor mental health outcomes. Previous research has suggested the promise of psychosocial interventions in improving mental health for children affected by parental HIV through an integrated and multilevel resilience-based approach. However, there are few multilevel resilience-based interventions for this group, and the efficacy of such interventions on mental health outcomes has not been fully examined. Furthermore, very few studies have examined whether …

The Cost Of Improving Nutritional Outcomes Through Food‐Assisted Maternal And Child Health And Nutrition Programmes In Burundi And Guatemala, Jessica Heckert, Jef L. Leroy, Deanna K. Olney, Susan Richter, Elyse Iruhiriye, Marie T. Ruel

Faculty Publications

Evidence on the cost‐effectiveness of multisectoral maternal and child health and nutrition programmes is scarce. We conducted a prospective costing study of two food‐assisted maternal and child health and nutrition programmes targeted to pregnant women and children during the first 1,000 days (pregnancy to 2 years). Each was paired with a cluster‐randomized controlled trial to evaluate impact and compare the optimal quantity and composition of food rations (Guatemala, five treatment arms) and their optimal timing and duration (Burundi, three treatment arms). We calculated the total and per beneficiary cost, conducted cost consequence analyses, and estimated the cost savings from extending …

Parenting Styles Are Associated With Overall Child Dietary Quality Within Low-Income And Food-Insecure Households, Michael P. Burke, Sonya J. Jones, Edward A. Frongillo Jr., Christine E. Blake, Maryah S. Fram

Faculty Publications

Objective: To examine the association between parenting styles and overall child dietary quality within households that are low-income and food-insecure.

Design: Child dietary intake was measured via a 24 h dietary recall. Dietary quality was assessed using the Healthy Eating Index-2005 (HEI-2005). Parenting styles were measured and scored using the Parenting Styles and Dimensions Questionnaire. Linear regressions were used to test main and interaction associations between HEI-2005 scores and parenting styles.

Setting: Non-probability sample of low-income and food-insecure households in South Carolina, USA.

Participants: Parent–child dyads (n 171). Parents were ≥18 years old and children were …

Using Big Data Analytics To Improve Hiv Medical Care Utilisation In South Carolina: A Study Protocol, Bankole Olatosi, Jiajia Zhang, Sharon Weissman, Jianjun Hu, Mohammad Rifat Haider, Xiaoming Li

Faculty Publications

Introduction Linkage and retention in HIV medical care remains problematic in the USA. Extensive health utilisation data collection through electronic health records (EHR) and claims data represent new opportunities for scientific discovery. Big data science (BDS) is a powerful tool for investigating HIV care utilisation patterns. The South Carolina (SC) office of Revenue and Fiscal Affairs (RFA) data warehouse captures individual-level longitudinal health utilisation data for persons living with HIV (PLWH). The data warehouse includes EHR, claims and data from private institutions, housing, prisons, mental health, Medicare, Medicaid, State Health Plan and the department of health and human services. The …

Temporal Trends In Cardiovascular Hospital Discharges Following A Mass Chlorine Exposure Event In Graniteville, South Carolina, Ashley V. Howell, John E. Vena, Bo Cai, Daniel T. Lackland, Lucy Ingram, Andrew B. Lawson, Erik R. Svendsen

Faculty Publications

Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds of hospitalizations and outpatient visits in the subsequent weeks. While chlorine gas primarily affects the respiratory tract, a growing body of evidence suggests that acute exposure may also cause vascular injury and cardiac toxicity. Here, we describe the incidence of cardiovascular hospitalizations among residents of the zip codes most affected by the chlorine gas plume, and compare the incidence of cardiovascular discharges in the years leading up to the …

Comparison Of Methods Used To Estimate The Global Burden Of Disease Related To Undernutrition And Suboptimal Breastfeeding, Alexander C. Mclain, Edward A. Frongillo Jr., Sonja Y. Hess, Ellen G. Piwoz

Faculty Publications

The Global Burden of Disease study (GBD) is an ambitious effort to estimate the disease burden attributable to various risk factors. The results from the GBD are used around the world to monitor the UN established Sustainable Development Goals, set health policies and research strategies, among others. The GBD along with other studies, such as those from the Maternal Child Epidemiology Estimation Group and the Lancet Breastfeeding Series Group, produce estimates of the nutrition-related global burden of disease that exhibit considerable differences. These differences are difficult to reconcile due to the estimation methods, which in recent years have substantially increased …

Prevalence And Risk Factors Of Postpartum Depression Within One Year After Birth In Urban Slums Of Dhaka, Bangladesh, Rashidul Azad, Rukhshan Fahmi, Sadichhya Shrestha, Hemraj Joshi, Mehedi Hasan, Abdullah Nurus Salam Khan, Mohiuddin Ahsanul Kabir Chowdhury, Shams El Arifeen, Sk Masum Billah

Faculty Publications

Postpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother’s perinatal wellbeing; and child’s physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent’s socio-economic characteristics and …

Perspective: Challenges In Use Of Adolescent Anthropometry For Understanding The Burden Of Malnutrition, Alison Tumilowicz, Ty Beal, Lynnette M. Neufeld, Edward A. Frongillo Jr.

Faculty Publications

Improving nutritional status during adolescence is an opportunity to improve the lives of this generation and the next. Estimating the burden of malnutrition at a population level is fundamental to targeting interventions and measuring progress over time, and for adolescents, we usually depend on survey data and the 2007 WHO Growth Reference to do so. There is substantial risk of misguided conclusions regarding adolescent prevalence estimates, however, when underlying methodological limitations of the indicators and reference are not adequately considered. We use national prevalence estimates among girls and young women 10-22 y of age from the 2014 State of Food …

How Do Neighbourhood Definitions Influence The Associations Between Built Environment And Physical Activity?, Suzanne Mavoa, Nasser Bagheri, Mohammad Javad Koohsari, Andrew T. Kaczynski, Karen E. Lamb, Koichiro Oka, David O'Sullivan, Karen Witten

Faculty Publications

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, …

How Do Neighbourhood Definitions Influence The Associations Between Built Environment And Physical Activity?, Suzanne Mavoa, Nasser Bagheri, Mohammad Javad Koohsari, Andrew T. Kaczynski, Karen E. Lamb, Koichiro Oka, David O'Sullivan, Karen Witten

Faculty Publications

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, …

Association Between Inflammatory Potential Of Diet And Bone-Mineral Density In Korean Postmenopausal Women: Data From Fourth And Fifth Korea National Health And Nutrition Examination Surveys, Woori Na, Susan Park, Nitin Shivappa, James F. Thrasher, Mi Kyung Kim, Cheongmin Sohn

Faculty Publications

Post menopause is considered a critical period for bone-mass loss. Impaired bone metabolism during this phase can increase the risk of fractures in old age. Inflammation is a risk factor for bone health, and diet is a potential source of inflammation. However, few studies have examined the association between the dietary inflammatory index (DII^®) and bone-mineral density (BMD) in postmenopausal women in Korea. The objective of this study was to determine, by means of a Korean cross-sectional investigation, whether higher DII scores are associated with decreased BMD in postmenopausal women. To that end, the raw data from the …

Stimulation Of Heat Shock Protein 90 Chaperone Function Through Binding Of A Novobiocin Analog Ku-32, Bhaskar K. Chatterjee, Abhilash Jayaraj, Vinay Kumar, Brian Blagg, Rachel E. Davis, B Jayaram, Shashank Deep, Tapan K. Chaudhuri

Faculty Publications

Heat shock protein 90 (Hsp90) is a eukaryotic chaperone responsible for the folding and functional activation of numerous client proteins, many of which are oncoproteins. Thus, Hsp90 inhibition has been intensely pursued, resulting in the development of many potential Hsp90 inhibitors, not all of which are well-characterized. Hsp90 inhibitors not only abrogate its chaperone functions, but also could help us gain insight into the structure-function relationship of this chaperone. Here, using biochemical and cell-based assays along with isothermal titration calorimetry, we investigate KU-32, a derivative of the Hsp90 inhibitor novobiocin (NB), for its ability to modulate Hsp90 chaperone function. Although …

The Inflammatory Potential Of Diet In Determining Cancer Risk; A Prospective Investigation Of Two Dietary Pattern Scores, Stina Bodén, Robin Myte, Maria Wennberg, Sophia Harlid, Ingegerd Johansson, Nitin Shivappa, James R. Hébert, Bethany Van Guelpen, Lena Maria Nilsson

Faculty Publications

Purpose Inflammation-related mechanisms may contribute to the link between diet and cancer. We sought to investigate the inflammatory impact of diet on cancer risk using the Dietary inflammatory index (DII) and an adapted Mediterranean diet score (MDS).

Methods This population-based, prospective cohort study used self-reported dietary data from the Västerbotten Intervention Programme, including 100,881 participants, of whom 35,393 had repeated measures. Associations between dietary patterns and cancer risk were evaluated using Cox proportional hazards regression. We also used restricted cubic splines to test for potential non-linear associations.

Results A total of 9,250 incident cancer cases were diagnosed during a median …

Lack Of Association Between Dietary Inflammatory Index And Low Impact Fractures In The Brazilian Population: The Brazilian Osteoporosis Study (Brazos), Melissa Morimoto, Nitin Shivappa, Patricia De Souza Genaro, Ligia Araujo Martini, Natielen Jacques Schuch, James R. Hebert, Marcelo Medeiros Pinheiro

Faculty Publications

Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures.

Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men …

Impact Of Removing Cost Sharing Under The Affordable Care Act (Aca) On Mammography And Pap Test Use, Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather M. Brandt, Cole Garrett Chapman

Faculty Publications

Background The Affordable Care Act (ACA) required private insurers and Medicare to cover recommended preventive services without any cost sharing to improve utilization of these services. This study is an attempt to identify the impact of removing cost sharing on mammography and pap test utilization rates.

Methods Counterfactual analysis was used to predict what would have been the screening rates in post-ACA if ACA was not there. This was done by estimating a model that examines determinants of dependent variable for the pre-ACA year (pre-ACA year is 2009). The estimated model was then used to predict the dependent variable for …

Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women, Abeer G. Alharbi, M. Mahmud Khan, Ronnie Horner, Heather M. Brandt, Cole Garrett Chapman

Faculty Publications

Introduction The Affordable Care Act (ACA) expanded the coverage of Medicaid to include entire population with income below 138% of federal poverty line. It remains unclear whether this policy change has improved access to and utilization of health care, particularly use of mammography and Pap tests among poor women.

Methods We used a difference-in-difference (DID) design to estimate the impact of Medicaid expansion on mammography and Pap tests utilization among low-income women. Expansion states are the treatment group and non-expansion states are the control group. The years 2012–13 are the pre-expansion period and 2015–16 are the post-expansion period for the …

The Impact Of Nutritional Changes On Dietary Inflammatory Index: New Soul Study, Callie Mclean

Senior Theses

The Impact of Nutritional Changes on Dietary Inflammatory Index: NEWSoul

Callie McLean; Gabrielle Turner-McGrievy, PhD, MS, RD; Michael Wirth, PhD; Anthony Crimarco, MS

Background: Historically, a soul food diet consisted of mainly plant-based foods in West Africa and evolved to a mostly meat-based diet in the Southeastern United States. As a result, many soul foods today often exceed the recommended dietary guidelines for saturated fats and cholesterol. This is important to consider for dietary interventions focusing on African American populations, since they are at a greater risk for cardiovascular disease and chronic illness compared to all other ethnic groups. One …

Role Of Resources For Care In Improving Care Behaviors, Children’S Nutritional Status And Early Childhood Development In Low- And Middle-Income Countries, Sulochana Basnet

Theses and Dissertations

Poor child growth and suboptimal early childhood development are global health problems. Provision of appropriate care may help to achieve optimum child growth and development. Maternal resources for care such as education, knowledge, health, autonomy, reasonable workload, and social support may be needed to provide appropriate care behaviors, and improve children’s nutritional status, and early childhood development. The overall goal of this research was to understand the role of resources for care in improving care behaviors, child nutritional status, and early childhood development. The baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia were used. We examined the …

Parenting And Child Self-Regulation As Mechanisms For The Relationship Of Household Food Insecurity With Child Dietary Behavior, Hoa Thi Mai Nguyen

Theses and Dissertations

Background: Food insecurity is both a nutritional problem and a stressful life experience of adults and children in households dealing with food shortage. Potential mechanisms of the associations between food insecurity and adverse outcomes in children’s health and development are through parenting and child self-regulation.

Objectives: We investigated parenting and child self-regulation as potential mechanisms for the relationship of food insecurity with child dietary behaviors with two specific aims. Specific aim 1 was to understand how food insecurity and its change over time relate to parenting in early childhood. Specific aim 2 was to understand the relationship of parenting in …

An Investigation Into The Relationship Between Academic Pressure And Non-Medical Prescription Stimulant Use Among University Of South Carolina Undergraduate Students, Arslan Valimohamed

Senior Theses

One hundred and six undergraduate students of the University of South Carolina were surveyed to understand misuse of prescription stimulants and how perceived academic pressure may play a role in this behavior. Overall, the survey revealed that 33.0% of participants reported illicit use of prescription stimulants in the last 30 days, and 52.8% reported illicitly using prescription stimulants at least once during their time in college. Data from the survey responses indicated that students perceiving academic pressure were more likely to have misused prescription stimulants at least once during their time in college, but only if these students also reported …

Host Country Responses To Non-Communicable Diseases Amongst Syrian Refugees: A Review, Chaza Akik, Hala Ghattas Ph.D., Sandra Mesmar, Miriam Rabkin, Wafaa M. El-Sadr, Fouad M. Fouad

Faculty Publications

Background:

Since the beginning of the Syrian conflict in 2011, Jordan, Lebanon and Turkey have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs).

Objectives:

We aimed to describe the ways in which these three host country health systems have provided NCD services to Syrian refugees over time, and to highlight the successes and challenges they encountered.

Methods:

We conducted a descriptive review of the academic and grey literature, published between March 2011 and March 2017, using PubMed and Google searches complemented with documents provided by relevant stakeholders.

Results:

Forty-one articles and reports met our search …

Food Insecurity And Violence In A Prospective Cohort Of Women At Risk For Or Living With Hiv In The U.S., Amy A. Conroy, Mardge H. Cohen, Edward A. Frongillo Jr., Alexander C. Tsai, Tracey E. Wilson, Eryka L. Wentz, Adaora A. Adimora, Daniel Merenstein, Ighovwerha Ofotokun, Lisa Metsch, Mirjam-Colette Kempf, Adebola Adedimeji, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Background Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV.

Methods Study participants completed six assessments from 2013–16 on food insecurity (operationalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling …

Immunological And Virologic Outcomes Of People Living With Hiv In Guangxi, China: 2012-2017, Xueying Yang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background Limited data are available on clinical outcomes of people living with HIV (PLWH) in China, especially after the implementation of the 2016 national treatment guideline. The objective of the current study is to examine the treatment patterns, clinical outcomes and their associated factors among PLWH in Guangxi, China before and after this new guideline.

Methods Data from three community-based projects conducted at different time points over a period of six years (2012–2017) in Guangxi were analyzed in our study. The interviewer-administered questionnaire was used for data collection. Measures of clinical outcomes were retrieved from the patients’ medical records. Descriptive …

Trajectories Of Body Mass Index Among Active-Duty U.S. Army Soldiers, Julianna M. Jayne, Christine E. Blake, Edward A. Frongillo Jr., Angela D. Liese, Bo Cai, D. Alan Nelson, Lianne M. Kurina, Leslee Funderburk

Faculty Publications

Establishing the shape and determinants of trajectories of body mass index (BMI) among Soldiers is critical given the importance of weight management to military service requirements. To establish the shape and determinants of BMI trajectories among Soldiers, we aimed to (1) model the overall BMI trajectory of Soldiers, (2) find the most common trajectory groups among Soldiers, (3) investigate the relationship between BMI trajectories and sociodemographic and military-specific characteristics, and (4) determine if there were Soldiers with large fluctuations in BMI. The study population included all US Army Soldiers on active-duty between 2011 and 2014 who were age 17–62 (n …

Virus-Specific Memory T Cells Populate Tumors And Can Be Repurposed For Tumor Immunotherapy, Pamela C. Rosato, Sathi Wijeyesinghe, J Michael Stolley, Christine E. Nelson, Rachel Davis, Luke S. Manlove, Christopher A. Pennell, Bruce R. Blazar, Clark C. Chen, Melissa A. Geller, Vaiva Vezys, David Masopust

Faculty Publications

The immunosuppressive tumor microenvironment limits the success of current immunotherapies. The host retains memory T cells specific for previous infections throughout the entire body that are capable of executing potent and immediate immunostimulatory functions. Here we show that virus-specific memory T cells extend their surveillance to mouse and human tumors. Reactivating these antiviral T cells can arrest growth of checkpoint blockade-resistant and poorly immunogenic tumors in mice after injecting adjuvant-free non-replicating viral peptides into tumors. Peptide mimics a viral reinfection event to memory CD8+ T cells, triggering antigen presentation and cytotoxic pathways within the tumor, activating dendritic cells and natural …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexandra A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanne C. Schuster, Justin B. Stoler, Amber Wutich, Jonathan Maupin, Monet Niesluchowski, Asiki Gershim, Divya Krishnakumar

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which waterrelated problems have been reported (eg, shortages, excess …

Nutrition Interventions Integrated Into An Existing Maternal, Neonatal, And Child Health Program Reduce Food Insecurity Among Recently Delivered And Pregnant Women In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Tina Sanghvi, Zeba Mahmud, Bachera Aktar, Silvia Alayon, Purnima Menon

Faculty Publications

Background

Antenatal care may be a means to reduce food insecurity in pregnancy and postpartum periods.

Objective

With the use of a cluster-randomized design, we tested whether participation in nutrition-focused antenatal care intending to improve household knowledge about the importance of nutrition for pregnant and lactating women and encourage allocation of household resources to ensure sufficient quality and quantity of foods, without providing food assistance, would reduce household food insecurity.

Methods

Alive & Thrive integrated nutrition interventions into an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. The nutrition-focused MNCH package was delivered in 10 subdistricts through antenatal …

Multilayered Stigma And Vulnerabilities For Hiv Infection And Transmission: A Qualitative Study On Male Sex Workers In Zimbabwe, Elleen Yuk-Ha Tsang, Shan Qiao Ph.D., Jeffrey S. Wilkinson, Annis Lai-Chu Fung, Freddy Lipeleke, Xiaoming Li Ph.D.

Faculty Publications

Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture (“homosexuality is un-African, introduced by the Whites”), religion …

The Role Of Food Processing In The Inflammatory Potential Of Diet During Pregnancy, Carolina Assis Silva, Izabela Da Silva Santos, Nitin Shivappa, James R. Hebert, Livia Castro Crivellenti, Daniela Saes Sartorelli

Faculty Publications

The aim was to investigate the relationship between the energy contribution (E%) of foods according to the degree of industrial processing and the energy-adjusted dietary inflammatory index (E-DII) in pregnancy. Two 24-hour dietary recalls were obtained from each of the 784 pregnant women. Adjusted linear regression models allowed observing an inverse association between E-DII scores and E% from minimally processed foods β = -0.049 (95%CI -0.055– -0.042) and a direct association with the E% of ultra-processed foods β = 0.052 (95%CI 0.045–0.058), indicating a relationship between the dietary inflammatory potential and the degree of industrial processing of foods.