Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies Academic Article uri icon

abstract

  • 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 at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.

authors

  • Garcia-Arellano, Ana
  • Martinez-Gonzalez, 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
  • Alonso, A
  • Barrio Lopez, MT
  • Basterra-Gortari, FJ
  • Benito Corchon, S
  • Bes-Rastrollo, M
  • Beunza, JJ
  • Carlos, S
  • Cervantes, S
  • de Irala, J
  • de la Rosa, PA
  • de la Fuente, C
  • Donat-Vargas, CL
  • Donazar, M
  • Fernandez Montero, A
  • Gea, A
  • Goni-Ochandorena, E
  • Guillen-Grima, F
  • Lahortiga, F
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  • Lopez del Burgo, C
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  • Marti, A
  • Mendonça, R
  • Nuñez-Cordoba, JM
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publication date

  • 2018