Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies. Issue 3 (June 2019)

• Record Type: Journal Article
• Authors: Garcia-Arellano, Ana; Martínez-González, Miguel A.; Ramallal, Raul; Salas-Salvadó, Jordi; Hébert, James R.; Corella, Dolores; Shivappa, Nitin; Forga, Luis; Schröder, Helmut; Muñoz-Bravo, Carlos; Estruch, Ramón; Fiol, Miquel; Lapetra, José; Serra-Majem, Lluís; Ros, Emilio; Rekondo, Javier; Toledo, Estefanía; Razquin, Cristina; Ruiz-Canela, Miguel
• Is Part Of: Clinical nutrition. Volume 38:Issue 3(2019)
• Page Start: 1221
• Page End: 1231
• Publication Date: 2019-06
• Subjects: Mediterranean diet -- Cohort studies -- CRP -- Mortality -- Inflammation -- Dietary inflammatory index; CRP C-Reactive Protein -- DII Dietary Inflammatory Index -- EVOO Extra virgin olive oil -- FFQs Food frequency questionnaires -- HR Hazard Ratio -- Hs-CRP high sensitivity C-Reactive Protein -- PREDIMED PREvención con Dieta MEDiterránea -- SUN Seguimiento Universidad de Navarra; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2018.05.003
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII ® ) was developed to appraise the inflammatory potential of the diet. Objective: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts. Design: We assessed 18, 566 participants in the "Seguimiento Universidad de Navarra" (SUN) cohort followed-up during 188, 891 person-years and 6790 participants in the "PREvencion con DIeta MEDiterránea" (PREDIMED) randomized trial representing 30, 233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality. Results: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII). Conclusion: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered atclinicaltrials.gov asNCT02669602 and atisrctn.com as ISRCTN35739639, respectively.