Nitin Shivappa1,2, Andrea Schneider3, James R Hébert1,2, Wolfgang Koenig4,5,6, Annette Peters3,6, Barbara Thorand3. 1. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA. 2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 3. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. 4. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. 5. Department of Internal Medicine II - Cardiology, University Hospital Ulm, Ulm Medical Center, Ulm, Germany. 6. DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
Abstract
Background: Chronic diseases such as cancer and cardiovascular diseases (CVDs) are well-established causes of disability and premature death. Dietary components have been implicated in the etiology of these chronic diseases. Methods: We examined the ability of the Dietary Inflammatory Index (DIITM) to predict all-cause, coronary heart disease (CHD), CVD and cancer mortality and incident CHD in the MONICA-KORA Cohort Studies. DII scores were computed from baseline 7-day dietary records in this cohort of 1297 men, who were aged 45-64 years when enrolled. During the follow-up period, 551 total (155 CHD, 244 CVD and 175 cancer-related deaths) and 213 validated incident CHD events were identified through mortality record linkage and active follow-up. Spearman correlation coefficients were calculated between DII scores and the inflammatory marker C-reactive protein (CRP). Cox proportional hazards regression was used to estimate hazard ratios (HR) for the endpoints described above. Results: DII scores were significantly positively correlated with CRP (P value <0.0001). Positive associations were noted between DII and all-cause mortality (HRQ4vsQ1: 1.41; 95%CI 1.04-1.90; P-trend = 0.007) and incident CHD (HRQ4vsQ1: 1.83; 95%CI 1.12-3.01; P-trend = 0.008). These associations were attenuated after further adjustment for smoking status, but remained significant for all-cause mortality. When stratified by smoking status, DII was associated with all-cause and cancer mortality among ex-smokers, in the absence of significant heterogeneity. Conclusion: These results indicate that a pro-inflammatory diet as expressed by higher DII scores is associated with all-cause mortality. This association was more pronounced among ex-smokers in whom a significant association with cancer mortality was observed.
Background: Chronic diseases such as cancer and cardiovascular diseases (CVDs) are well-established causes of disability and premature death. Dietary components have been implicated in the etiology of these chronic diseases. Methods: We examined the ability of the Dietary Inflammatory Index (DIITM) to predict all-cause, coronary heart disease (CHD), CVD and cancer mortality and incident CHD in the MONICA-KORA Cohort Studies. DII scores were computed from baseline 7-day dietary records in this cohort of 1297 men, who were aged 45-64 years when enrolled. During the follow-up period, 551 total (155 CHD, 244 CVD and 175 cancer-related deaths) and 213 validated incident CHD events were identified through mortality record linkage and active follow-up. Spearman correlation coefficients were calculated between DII scores and the inflammatory marker C-reactive protein (CRP). Cox proportional hazards regression was used to estimate hazard ratios (HR) for the endpoints described above. Results:DII scores were significantly positively correlated with CRP (P value <0.0001). Positive associations were noted between DII and all-cause mortality (HRQ4vsQ1: 1.41; 95%CI 1.04-1.90; P-trend = 0.007) and incident CHD (HRQ4vsQ1: 1.83; 95%CI 1.12-3.01; P-trend = 0.008). These associations were attenuated after further adjustment for smoking status, but remained significant for all-cause mortality. When stratified by smoking status, DII was associated with all-cause and cancer mortality among ex-smokers, in the absence of significant heterogeneity. Conclusion: These results indicate that a pro-inflammatory diet as expressed by higher DII scores is associated with all-cause mortality. This association was more pronounced among ex-smokers in whom a significant association with cancer mortality was observed.
Authors: Fred K Tabung; Susan E Steck; Jiajia Zhang; Yunsheng Ma; Angela D Liese; Ilir Agalliu; Melanie Hingle; Lifang Hou; Thomas G Hurley; Li Jiao; Lisa W Martin; Amy E Millen; Hannah L Park; Milagros C Rosal; James M Shikany; Nitin Shivappa; Judith K Ockene; James R Hebert Journal: Ann Epidemiol Date: 2015-03-19 Impact factor: 3.797
Authors: Nitin Shivappa; Cindy K Blair; Anna E Prizment; David R Jacobs; Susan E Steck; James R Hébert Journal: Eur J Nutr Date: 2015-07-01 Impact factor: 5.614
Authors: Nitin Shivappa; Susan E Steck; Thomas G Hurley; James R Hussey; Yunsheng Ma; Ira S Ockene; Fred Tabung; James R Hébert Journal: Public Health Nutr Date: 2013-10-10 Impact factor: 4.022
Authors: Nitin Shivappa; Justyna Godos; James R Hébert; Michael D Wirth; Gabriele Piuri; Attilio F Speciani; Giuseppe Grosso Journal: Nutrients Date: 2018-02-12 Impact factor: 5.717
Authors: Catherine M Phillips; Ling-Wei Chen; Barbara Heude; Jonathan Y Bernard; Nicholas C Harvey; Liesbeth Duijts; Sara M Mensink-Bout; Kinga Polanska; Giulia Mancano; Matthew Suderman; Nitin Shivappa; James R Hébert Journal: Nutrients Date: 2019-08-12 Impact factor: 5.717