ArticleFrontiers in public health2026
The association between dietary inflammation and fatigue in COPD: a mediating role of systemic inflammation and the moderating effect of BMI.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Fatigue is a common symptom in COPD patients that severely affects quality of life. This study examined whether systemic inflammation (C-reactive protein, CRP) mediates the association between dietary inflammatory potential (Dietary Inflammatory Index, DII) and fatigue, and whether BMI and smoking moderate this pathway. Methods: A cross-sectional study of 400 stable COPD patients from Jinan, China, was conducted. Fatigue was assessed using the Manchester COPD Fatigue Scale (MCFS), DII was derived from a Food Frequency Questionnaire, and serum CRP was measured by ELISA. Mediation and moderated mediation analyses (PROCESS Models 4 and 58, Bootstrap = 5,000) were performed, adjusting for age, sex, smoking, lung function, comorbidities, and physical activity. Multi-group structural equation modeling examined smoking's moderating effect. Results: DII correlated positively with CRP ( Conclusion: Higher dietary inflammation is associated with greater fatigue in COPD, partially mediated by CRP, with BMI moderating this pathway. Anti-inflammatory dietary interventions may be more relevant for patients with lower BMI. Longitudinal studies are needed to confirm causality.
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