scholarly journals Dietary Inflammatory Index and Cardiovascular Risk and Mortality—A Meta-Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (2) ◽  
pp. 200 ◽  
Author(s):  
Nitin Shivappa ◽  
Justyna Godos ◽  
James Hébert ◽  
Michael Wirth ◽  
Gabriele Piuri ◽  
...  

Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and CVD. Individuals in the highest versus the lowest (reference) DII category showed a 36% increased risk of CVD incidence and mortality, with moderate evidence of heterogeneity (relative risk (RR) = 1.36, 95% confidence interval (CI): 1.19, 1.57; heterogeneity index I2 = 69%, p < 0.001). When analyzed as a continuous variable, results showed an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score. Results remained unchanged when analyses were restricted to the prospective studies. Results of our meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality. In conclusion, a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality. These results further substantiate the utility of DII as tool to characterize the inflammatory potential of diet and to predict CVD incidence and mortality.

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 588
Author(s):  
Imran Khan ◽  
Minji Kwon ◽  
Nitin Shivappa ◽  
James R. Hébert ◽  
Mi Kyung Kim

Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]Quintile 5 vs. 1 1.43; 95% CI 1.04–1.96) and in women (HRQuintile 5 vs. 1 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HRQuintile 5 vs. 1 1.80; 95% CI 1.03–3.12), obese men (HRQuintile 5 vs. 1 1.77; 95% CI 1.13–2.76) and men who smoked (HRQuintile 5 vs. 1 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HRQuintile 5 vs. 1 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.


2018 ◽  
Vol 22 (4) ◽  
pp. 654-660 ◽  
Author(s):  
Jian Wang ◽  
Yao Zhou ◽  
Kang Chen ◽  
Yuntian Jing ◽  
Jiaan He ◽  
...  

AbstractObjectiveThe purpose of the present meta-analysis was to evaluate the association between the inflammatory potential of diet, determined by the dietary inflammatory index (DII®) score, and depression.DesignSystematic review and meta-analysis.SettingA comprehensive literature search was conducted in PubMed, Web of Science and EMBASE databases up to August 2018. All observational studies that examined the association of the DII score with depression/depressive symptoms were included.SubjectsFour prospective cohorts and two cross-sectional studies enrolling a total of 49 584 subjects.ResultsOverall, individuals in the highest DII v. the lowest DII category had a 23 % higher risk of depression (risk ratio (RR)=1·23; 95 % CI 1·12, 1·35). When stratified by study design, the pooled RR was 1·25 (95 % CI 1·12, 1·40) for the prospective cohort studies and 1·16 (95 % CI 0·96, 1·41) for the cross-sectional studies. Gender-specific analysis showed that this association was observed in women (RR=1·25; 95 % CI 1·09, 1·42) but was not statistically significant in men (RR=1·15; 95 % CI 0·83, 1·59).ConclusionsThe meta-analysis suggests that pro-inflammatory diet estimated by a higher DII score is independently associated with an increased risk of depression, particularly in women. However, more well-designed studies are needed to evaluate whether an anti-inflammatory diet can reduce the risk of depression.


2021 ◽  
pp. 1-24
Author(s):  
Pâmela Ferreira Todendi ◽  
Rafaela Salla ◽  
Nitin Shivappa ◽  
James R. Hebert ◽  
Julianna Ritter ◽  
...  

Abstract Dietary factors play a role in modulating chronic inflammation and in the development of cardiovascular disease. We aimed to investigate the association between the dietary inflammatory index (DII) and cardiometabolic risk factors among adolescents.A total of 31,684 Brazilian adolescents (12–17 years), from the Study of Cardiovascular Risks in Adolescents (ERICA) were included. Dietary intake was assessed using a 24-hour dietary recall. The E-DII (energy-adjusted)score was calculated based on data for 25available nutrients. The anthropometric profile, blood pressure, lipid profile, glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and glycated hemoglobin were measured. Poisson regression models were used to examine the associations between sex-specific quartiles of the E-DII and cardiometabolic risk factors. In the energy-adjusted models, when comparing a high pro-inflammatory diet (quartile 4) withananti-inflammatory diet (quartile 1), there was a positive association with high HOMA-IR among boys(prevalence ratios (PR)Q4=1.37, 95%CI: 1.04–1.79); and with high fasting glucose (PRQ4 = 1.96, 95%CI: 1.02–3.78), high triglycerides (PRQ4 = 1.92, 95%CI: 1.06–3.46),low HDL-c (PRQ4 = 1.16, 95%CI: 1.02–1.32) and high LDL-c (PRQ4 = 1.93, 95%CI: 1.12–3.33) among girls. Additionally, a moderately pro-inflammatory diet was positively associated with high HOMA-IR (PRQ2 = 1.14, 95%CI: 1.02–1.29) among girls, and high total cholesterol (PRQ3 = 1.56, 95%CI: 1.20–2.01) among boys.In conclusion, this study provides new evidence on the association between inflammatory diets with cardiometabolic risk factors among adolescents.


2018 ◽  
Vol 24 (7) ◽  
pp. 965-986 ◽  
Author(s):  
Camille Lassale ◽  
G. David Batty ◽  
Amaria Baghdadli ◽  
Felice Jacka ◽  
Almudena Sánchez-Villegas ◽  
...  

AbstractWith depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55–0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63–0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50–0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews under the number CRD42017080579.


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 148 ◽  
Author(s):  
Harry Muhammad ◽  
Marleen van Baak ◽  
Edwin Mariman ◽  
Dian Sulistyoningrum ◽  
Emy Huriyati ◽  
...  

It was previously reported that dietary intake is an important trigger for systemic inflammation and one of the lifestyle factors for the development of cardiovascular diseases. The aim of this study was to evaluate the association between Dietary Inflammatory Index (DII) score and body weight, blood pressure, lipid profile and leptin in an Indonesian population. This was a cross-sectional study conducted in 503 Indonesian adults. The DII score was calculated based on data of 30 nutrients and food components. Anthropometric profile, blood pressure, lipid profile, and leptin were measured. The association of these variables with the DII score was analyzed. The DII score was not associated with body weight, body mass index (BMI), body fat, waist circumference, hip circumference, systolic and diastolic blood pressure, triglycerides, and high-density lipoprotein (HDL) (both unadjusted and after adjustment for covariates). However, plasma leptin concentration was significantly associated with the DII score (B = 0.096, p = 0.020). Plasma leptin also increased significantly across tertiles of the DII score (ANCOVA, p = 0.031). This positive association between the DII score and plasma leptin concentration suggests a role for the inflammatory properties of the diet in regulating adipose tissue inflammation.


2011 ◽  
Vol 120 (04) ◽  
pp. 217-223 ◽  
Author(s):  
T. Tian ◽  
L. Zhang ◽  
X. Ma ◽  
J. Zhou ◽  
J. Shen

AbstractEpidemiologic studies have examined the possible associations between diabetes mellitus (DM) and gastric cancer (GC), but the results are inconclusive. We conducted a meta-analysis to assess the evidence regarding the associations between diabetes and incidences of, or mortality from, gastric cancer.PubMed, Embase and Web of Science were searched up to Oct 20, 2011. We identified studies that included effects estimates with 95% confidence intervals (CIs) of the associations between GC and diabetes. Summary RRs for the GC incidence and mortality were calculated using random-effects model; subgroup analyses were also performed. Heterogeneity among studies was examined using Q and I2 statistics.A total of 7 case-control and 18 cohort studies met the inclusion criteria. The summary RR showed a slightly statistical link between history of DM and GC incidence (RR=1.11, 95% CI: 1.00–1.24, p=0.045, I2=79.5%). In the subgroup analyses, a positive association was noted among the studies conducted in Asia (summary RR=1.19, 95% CI: 1.07–1.32, I2=29.8%). Additionally, slight associations between DM and GC were observed by pooling the data of type 2 DM, cohort studies and the studies controlling more confounders, respectively. Furthermore, mortality from GC with diabetes was increased compared with individuals without diabetes (summary RR=1.29, 95% CI: 1.04–1.59). No publication bias was found.Individuals with diabetes have an increased risk of developing gastric cancer, and are positively associated with gastric cancer mortality. Large better-designed cohort studies are needed to verify this conclusion.


2016 ◽  
Vol 47 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Nitin Shivappa ◽  
James R. Hebert ◽  
Maryam Behrooz ◽  
Bahram Rashidkhani

Background: Diet and inflammation have been suggested to be important risk factors for multiple sclerosis (MS). Objectives: In this study, we examined the ability of the dietary inflammatory index (DII) to predict MS in a case-control study conducted in Iran. Methods: This study included 68 MS cases and 140 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Logistic regression models were used to estimate ORs adjusted for age, energy, sex, body mass index, season of birth, rubella history, history of routine exercise before MS, smoking and history of consumption of cow's milk in the first 2 years of life. Results: Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of MS, with the DII being used both as a continuous variable (ORcontinuous 1.66; 95% CI 1.19-2.31; 1 unit increase corresponding to ≈15% of its range in the current study) and a categorical variable (ORDII (>1.43 vs.≤1.43) 2.68; 95% CI 1.15-6.26). Conclusions: These results indicate that a pro-inflammatory diet is associated with increased risk of MS.


2017 ◽  
Vol 42 (4) ◽  
pp. 399-404 ◽  
Author(s):  
Farhad Vahid ◽  
Nitin Shivappa ◽  
Mohsen Karamati ◽  
Alireza Jafari Naeini ◽  
James R. Hebert ◽  
...  

The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DIIT3VS1: b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DIIT3VS1: b = 8.76; 95% CI 1.78, 15.73), HbA1c (DIIT3VS1: b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DIIT3VS1: b = 16.37; 95% CI 11.04, 21.69), triglyceride (DIIT3VS1: b = 21.01; 95% CI 8.61, 33.42) and body fat (DIIT3VS1: b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DIIT3VS1: b = −3.39; 95% CI −5.94, −0.84) and lean body mass (DIIT3VS1: b = −3.11; 95% CI −4.83, −1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DIIT3VS1: OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DIIcontinuous: OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.


2021 ◽  
pp. 1-8
Author(s):  
Qian Yi ◽  
Xue Li ◽  
Yazhou He ◽  
Wei Xia ◽  
Jing Shao ◽  
...  

Abstract Objective: Inflammation has been suggested to play an important role in the development and progression of metabolic syndrome (MetS). Dietary inflammatory index (DII), a measurement of inflammatory potential in diets, was suggested to be associated with MetS. The aim of this systematic review and meta-analysis was to establish the associations of DII with MetS and its components based on available observational studies. Design: Systematic review and meta-analysis. Setting: A comprehensive literature search of studies that assessed the associations between DII and MetS was conducted in PubMed, Medline and Embase, using a combination of search terms relating to DII and MetS. Participants: Eighteen articles were eligible, of which fourteen were cross-sectional and four were cohort in design. Results: Results from the random effects meta-analysis showed significantly positive associations of higher DII (top v. bottom quartiles) with MetS (OR: 1·23 (95 % CI 1·10, 1·37)), abdominal obesity (OR: 1·15 (95 % CI 1·02, 1·29)), high blood pressure (OR: 1·17 (95 % CI 1·07, 1·29)), hyperglycaemia (OR: 1·18 (95 % CI 1·05, 1·33)) and hypertriacylglycerolaemia (OR: 1·17 (95 % CI 1·07, 1·28)). The effects of summary OR became stronger when analyses were restricted to cohorts, studies that adjudged for covariates (including BMI, physical activity and total energy intake). Conclusions: Higher DII, representing pro-inflammatory diet, is associated with higher odds of MetS and its components, except for low HDL-cholesterol. The findings prompt dietary interventions for preventing MetS from the aspect of inflammation.


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