Associations of the Empirical Dietary Inflammatory Index (EDII) with Perceived Stress, Physical Activity, Upper Respiratory Symptoms, and Quality of Life Among Malaysian Adults in Klang Valley
DOI:
https://doi.org/10.70851/jfines.2026.3(2).97.118Keywords:
Anti-inflammatory diet, Dietary inflammatory index, Respiratory infections, Clinical nutrition, Public health nutrition, Adults, Malaysia, Life ProductivityAbstract
Upper respiratory symptoms represent a significant public health concern globally, affecting quality of life (QOL) and increasing morbidity. Modifiable factors such as diet, stress, and lifestyle are known contributors to respiratory health outcomes. Pro-inflammatory diets, characterized by high consumption of energy-dense, nutrient-poor foods, have been linked to chronic inflammation, weakened immunity, and increased susceptibility to upper respiratory symptoms. Meanwhile, stress and physical inactivity may further exacerbate immune dysfunction and negatively impact QOL. However, the relationship between dietary inflammatory potential, stress, physical activity, upper respiratory symptoms, and QOL remains underexplored, particularly in Malaysia’s diverse cultural and environmental context. This cross-sectional study was conducted among 159 adults recruited from community centers, health clinics, and public spaces in Klang Valley, Malaysia. Data were collected using validated instruments, including the Food Frequency Questionnaire to calculate the Empirical Dietary Inflammatory Index (EDII), the Perceived Stress Scale (PSS-10), the Global Physical Activity Questionnaire (GPAQ), and the Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Anthropometric measurements (height, weight, and BMI) were recorded, and quality of life was assessed using a validated QOL questionnaire. Data were analyzed using descriptive statistics, correlation analyses, and multiple linear regression models. A significant negative correlation was observed between anti-inflammatory dietary scores and body weight (r = -0.121, p = 0.003). Higher pro-inflammatory and EDII scores were significantly associated with poorer QOL and greater upper respiratory symptom severity. Multiple linear regression analysis demonstrated that higher EDII scores were independently associated with poorer QOL [-4.013 (95% CI: -5.116 to -2.910)] and increased upper respiratory symptom severity [2.643 (95% CI: 1.758 to 3.528)], after adjustment for relevant covariates. In conclusion, higher dietary inflammatory potential was associated with poorer quality of life and increased upper respiratory symptom burden among Malaysian adults. These findings highlight the potential importance of anti-inflammatory dietary patterns in promoting respiratory health and overall well-being.
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