Ana Garcia-Arellano1, Miguel A Martínez-González2, Raul Ramallal3, Jordi Salas-Salvadó4, James R Hébert5, Dolores Corella6, Nitin Shivappa7, Luis Forga8, Helmut Schröder9, Carlos Muñoz-Bravo10, Ramón Estruch11, Miquel Fiol12, José Lapetra13, Lluís Serra-Majem14, Emilio Ros15, Javier Rekondo16, Estefanía Toledo17, Cristina Razquin18, Miguel Ruiz-Canela19. 1. Servicio Navarro de Salud (Osasunbidea), Pamplona, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address: agarare@gmail.com. 2. University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA. Electronic address: mamartinez@unav.es. 3. Servicio Navarro de Salud (Osasunbidea), Pamplona, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain. Electronic address: raulramallal@gmail.com. 4. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain. Electronic address: jordi.salas@urv.cat. 5. Cancer Prevention and Control Program, University of South Carolina, Columbia, USA. Electronic address: jhebert@sc.edu. 6. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. Electronic address: dolores.corella@uv.es. 7. Cancer Prevention and Control Program, University of South Carolina, Columbia, USA. Electronic address: shivappa@mailbox.sc.edu. 8. Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra - IdiSNA (Instituto de Investigación Sanitario de Navarra), Pamplona, Spain. Electronic address: lluis.forga.llenas@cfnavarra.es. 9. Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address: HSchoeder@imim.es. 10. Department of Public Health and Psychiatry, University of Malaga, Malaga, Spain. Electronic address: carlosmb@uma.es. 11. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. Electronic address: restruch@clinic.ub.es. 12. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain. Electronic address: miguel.fiol@ssib.es. 13. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Family Medicine, Unit Research, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. Electronic address: jlapetra@ono.com. 14. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain. Electronic address: lluis.serra@ulpgc.es. 15. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. Electronic address: eros@clinic.ub.es. 16. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Cardiology, University Hospital Araba, Vitoria, Spain. Electronic address: javitxin74@gmail.com. 17. University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address: etoledo@unav.es. 18. University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address: crazquin@unav.es. 19. University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address: mcanela@unav.es.
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.
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: Naoko Sasamoto; Tianyi Wang; Mary K Townsend; A Heather Eliassen; Fred K Tabung; Edward L Giovannucci; Ursula A Matulonis; Kathryn L Terry; Shelley S Tworoger; Holly R Harris Journal: Br J Cancer Date: 2022-06-27 Impact factor: 9.075
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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
Authors: Fiona C Malcomson; Naomi D Willis; Iain McCallum; Long Xie; Nitin Shivappa; Michael D Wirth; James R Hébert; Betul Kocaadam-Bozkurt; Aycil Özturan-Sirin; Seamus B Kelly; D Michael Bradburn; Nigel J Belshaw; Ian T Johnson; John C Mathers Journal: Cancer Prev Res (Phila) Date: 2020-10-28