Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) trial

Abstract

The dietary inflammatory index (DII) is a new tool to assess the inflammatory potential of the diet. In the present study, we aimed to determine the association between the DII and BMI, waist circumference and waist:height ratio (WHtR). We conducted a cross-sectional study of 7236 participants recruited into the PREvención con DIeta MEDiterránea trial. Information from a validated 137-item FFQ was used to calculate energy, food and nutrient intakes. A fourteen-item dietary screener was used to assess adherence to the Mediterranean diet (MeDiet). Sex-specific multivariable linear regression models were fitted to estimate differences (and 95% CI) in BMI, waist circumference and WHtR across the quintiles of the DII. All nutrient intakes, healthy foods and adherence to the MeDiet were higher in the quintile with the lowest DII score (more anti-inflammatory values) except for intakes of animal protein, saturated fat and monounsaturated fat. Although an inverse association between the DII and total energy was apparent, the DII was associated with higher average BMI, waist circumference and WHtR after adjusting for known risk factors. The adjusted difference in the WHtR for women and men between the highest and lowest quintiles of the DII was 1.60% (95% CI 0.87, 2.33) and 1.04% (95% CI 0.35, 1.74), respectively. Pro-inflammatory scores remained associated with obesity after controlling for the effect that adherence to a MeDiet had on inflammation. In conclusion, the present study shows a direct association between the DII and indices of obesity, and supports the hypothesis that diet may have a role in the development of obesity through inflammatory modulation mechanisms.

Association between inflammatory potential of diet and mortality among women in the Swedish Mammography Cohort

“…Thus far, the DII has been found to be associated with C-reactive protein [24,25], interleukin-6 [26][27][28], and homocysteine [26]. Additionally, DII has been shown to be associated with glucose intolerance and dyslipidemia components of the metabolic syndrome [25,29], anthropometric measurements in Spain [30], asthma in Australia [28], respiratory conditions in Italy [31], bone mineral density among postmenopausal women in Iran [28], colorectal cancer in two case-control studies in Spain and Italy [32,33], and three cohort studies in the USA [34][35][36], pancreatic [37], prostate [38,39] and esophageal cancers [40,41] and mortality in a cohort among US women [42].…”

Dietary inflammatory index and inflammatory biomarkers in adolescents from LabMed physical activity study

“…For the updated version, several studies have found associations between DII score and CRP, in adults and seniors [26], and IL-6, tumour necrosis factor-alpha (TNF-α) and another score of combined inflammatory biomarker in postmenopausal women [27]. The DII score has been used in several studies to predict mortality [28,29], survival [30], and diseases, especially cancer [30,31], but also obesity [32], cardiovascular disease [33] and metabolic syndrome [32,34].…”

Association between previously diagnosed circulatory conditions and a dietary inflammatory index

“…Previously, the DII has predicted C-reactive protein and interleukin-6 levels using 24-hour dietary recalls (24HR) and 7-day recalls, as well as a food frequency questionnaire (FFQ) [15–17]. The DII also has been shown to be associated with the glucose intolerance component of MetSyn, increased odds of asthma, anthropometric measurements, and several cancers [16–25]. It also has been shown that shiftworkers from the National Health and Nutrition Examination Study (NHANES) had statistically significant greater DII values (i.e., more pro-inflammatory) compared to day workers [26].…”