Dietary inflammatory index and risk of first myocardial infarction; a prospective population-based study

Abstract

BackgroundChronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DIITM), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up.MethodWe conducted a prospective case–control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986–2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population.ResultsMale participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21–2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14–1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03–0.14) and 6% higher IL-6 (95% CI 0.02–0.11) in 605 controls with biomarker data available.ConclusionA pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-017-0243-8) contains supplementary material, which is available to authorized users.

Dietary inflammatory index and cardiovascular risk factors in Spanish children and adolescents

“…In this same line of inquiry, the SU.VI.MAX study reported that a higher DI score was associated with higher diastolic and systolic blood pressure in adults (30–60 years) (Neufcourt et al, ). Another prospective population‐based study also indicated that men (though not women) with higher DII scores showed higher systolic blood pressure ( p = .005) (Bodén et al, ). Once again, age difference may contribute to the disparity in results between younger and older study cohorts.…”

“…The DII has been validated in previous studies with different measures of inflammation such as C‐reactive protein (CRP), IL‐6, and TNF‐α‐R2 (Shivappa et al, ; Wirth et al, ). Additionally, the DII has also been reported to be associated with several chronic inflammation‐related health outcomes such as cancer incidence and CVD (Bodén et al, ; Bondonno et al, ; Garcia‐Arellano et al, ; O'Neil et al, ; Ramallal et al, ; Zheng et al, ).…”

Association between dietary inflammatory index and risk of cardiovascular disease in the Mashhad stroke and heart atherosclerotic disorder study population

“…However, these studies have reported inconsistent results for the relationship of anti‐inflammatory diet and CVD. Although a positive association of dietary inflammatory index (DII) and CVD was reported in several studies, no significant relationship was found in other investigations . In a systematic review and meta‐analysis study, it was reported that a high DII score appears to increase the risk of CVD by about 35% .…”

“…12 A Western dietary pattern rich in red meat, refined grains, butter, processed meat, high-fat dairy products, sweets, desserts, potatoes, eggs, hydrogenated fats, and sugared-sweetened beverages is known to increase levels of inflammatory markers; a Mediterranean dietary pattern rich in olive oil, nuts, fruits, vegetables, whole grains, and fish decreases these levels. 5,13 A high-fat diet may stimulate the activation of endothelial cells, enhancing the expression of adhesion molecules. A healthy diet is a rich source of antioxidants and fiber, and decreases the inflammatory responses.…”

Dietary inflammatory index is associated with lipid profile and interleukin-6 in postmenopausal women: A cross-sectional study

“…In addition, multiple studies demonstrated the positive link between adherence to proinflammatory diet (the higher DII score) and levels of serum glucose, as well as, the association between the DII score and serum levels of lipid profile [37][38][39][40]. Previous studies have shown that there is the association between the DII score and different chronic diseases such as obesity [41], metabolic syndrome (MetS) [42], cancers [35,[43][44][45], and CVDs [46][47][48]. In Iran, DII has been shown to be associated with various cancers [44,[49][50][51] and cataract [52] and specifically among Iranian women, a positive association has been observed between higher DII scores and spontaneous abortion [36], gestational diabetes mellitus [53] and decreased bone mineral density among postmenopausal women [54].…”