Introduction We investigated cross‐sectional associations between the Dietary Inflammatory Index (DII) and measures of brain volume and cerebral small vessel disease among participants of the Framingham Heart Study Offspring cohort. Methods A total of 1897 participants (mean ± standard deviation, age 62±9) completed Food Frequency Questionnaires and brain magnetic resonance imaging (MRI). Results Higher (pro‐inflammatory) DII scores, averaged across a maximum of three time points, were associated with smaller total brain volume (beta ± standard error: –0.16 ± 0.03; P < .0001) after adjustment for demographic, clinical, and lifestyle covariates. In addition, higher DII scores were associated with smaller total gray matter volume (–0.08 ± 0.03; P = .003) and larger lateral ventricular volume (0.04 ± 0.02; P = .03). No associations were observed with other brain MRI measures. Discussion Our findings showed associations between higher DII scores and global brain MRI measures. As we are one of the first groups to report on the associations between higher DII scores and brain volume, replication is needed to confirm our findings.

BackgroundNutritional factors can abet or protect against systemic chronic inflammation, which plays an important role in the development and progression of dementia. We evaluated whether higher (i.e. pro‐inflammatory) Dietary Inflammatory Index(DII) scores were associated with accelerated cognitive decline in the community‐based Offspring Framingham Heart Study(FHS).Method889 older adults (mean age 59 years [standard deviation (SD)], 8;58.3% women]) completed validated 126‐item Food Frequency Questionnaires(FFQ), administered at FHS examination cycle 7 (1998‐2001) and examination cycle 5 (1991‐1995) and/or 6 (1995‐1998). We created a DII score (based on the published method by Shivappa et al. 2014); a cumulative DII score was calculated by averaging across a maximum of three FFQs. Cognitive testing was completed at examination cycles 7, 8 (2005‐2008) and 9 (2011‐2014). Exam 7 was considered as study baseline and participants were followed over a mean time of 13.4 years (SD 1.3). We excluded participants with prevalent dementia or stroke at baseline and those with no cognitive testing follow‐up data. We examined associations between the cumulative DII score and cognitive test scores over time using linear mixed models adjusting for age, age‐squared, sex, education, time from exam 7 to neuropsychological exam 7, and time (model1) and additionally for apolipoprotein e4, body mass index, total energy intake, total cholesterol: high‐density lipoprotein ratio, physical activity, smoking and anti‐cholesterol medication (model2).ResultHigher DII scores were significantly associated with accelerated decline in performance on the Trail Making Test B minus A(TMT‐B minus A) (processing speed and executive function), following adjustment for model 1 covariates (β±SE, ‐0.001± 0.0004,p = 0.03). but the association failed to reach significance in Model 2 (‐0.001±0.0003,p = 0.08). We observed no relationship between higher DII scores and other cognitive domains. Stratified analyses showed that higher DII scores were associated with accelerated decline in TMT‐B minus A scores among apolipoprotein e4 carriers (Model 2:‐0.002±0.001,p = 0.047) but not among non‐carriers (Model 2:‐0.0004±0.0004,p = 0.33).ConclusionHigher DII scores were not associated with cognitive decline. To date, such studies have been very limited, most studies that found a relationship, were cross‐sectional and have used less sensitive testing. Future studies are encouraged to examine whether our findings can be replicated.

Objectives We evaluated whether higher (i.e., pro-inflammatory) Dietary Inflammatory Index (DII) scores were associated with increased concentrations of inflammatory markers in the community-based Framingham Heart Study (FHS) Offspring Cohort. Methods We studied 1978 participants (age 61 [SD, 9] years, 53.9% women) from the Offspring cohort who completed a validated 126-item Food Frequency Questionnaire (FFQ) at exam 7 (1998–2001) and at least one of exams 5 (1991–1995) or exam 6 (1995–1998), and on whom inflammatory markers were measured at exam 7. We created a DII score based on the published scoring algorithm by Shivappa et al. 2014, (developed from previous studies linking individual dietary factors to six inflammatory markers); a cumulative DII score was calculated by averaging across a maximum of three FFQs. We used linear regression models to test associations between the cumulative DII score and natural log-transformed concentrations of adiponectin, cluster of differentiation 40 (CD40), C-reactive protein (CRP), fibrinogen, intracellular adhesion molecule (ICAM), interleukin (IL)-6, IL-18, resistin, and TNF-α. Results Higher DII scores were independently associated with higher mean concentrations of four inflammatory markers after adjustment for demographic, clinical, and lifestyle covariates (β± SE, CRP 0.14 mg/L ± 0.04; P &lt; 0.0001, IL-6 0.07 pg/mL ± 0.02; P &lt; 0.003, resistin 0.04 ng/mL ± 0.02 ng/mL; P = 0.01). Exclusion of individuals who smoke currently did not change the results. Additionally, we observed that body mass index had a partially mediating effect on all relationships except the relationships with TNF-α. Further, we observed no significant interactions between higher DII scores and sex in their associations with each inflammatory marker. Conclusions Higher DII scores were associated with higher concentrations of four out of nine inflammatory markers. Our results suggest that anti-inflammatory diets, which correlate with low DII scores may lower systemic chronic inflammation, a process that plays an important role in the development and progression of chronic disease. Funding Sources ASPEN Rhoads Research Foundation and NIH.

Background: Nutrition is hypothesized to protect against systemic chronic inflammation, which plays an important role in the development and progression of disease including dementia. We evaluated whether higher (i.e. pro-inflammatory) Dietary Inflammatory Index (DII) scores were associated with increased incidence of all-cause dementia and Alzheimer's disease (AD) in the community-based Offspring Framingham Heart Study (FHS). Method: 1021 older adults (mean age 69 years [standard deviation (SD)], 5;52.3% women]) completed a validated 126-item Food Frequency Questionnaire (FFQ). We created a DII score (based on the published method by Shivappa et al. 2014) based on previous studies linking individual dietary factors to six inflammatory markers (i.e. C-reactive protein, interleukin (IL)-1β , IL-4, IL-6, IL-10 and tumor necrosis factoralpha, consisting of 31 components. A cumulative DII score was calculated by averaging across a maximum of three FFQs (administered at FHS exams 5 (1991-1995), 6 (1995-1998), and 7 (1998-2001)). Exam 7 was considered as study baseline and participants were followed over a mean 12.6 years (SD 5.5). We excluded participants aged <60 years, those with prevalent dementia and/or other neurological conditions, and/or no dementia follow-up.Result: 150 participants developed all-cause dementia (including 118 participants who developed AD). Higher DII scores were associated with an increased incidence of all-cause dementia following adjustment for age and sex (HR1.11,95%CI 1.01-1.22,p=0.03). The relationship remained after additional adjustment for education, apolipoprotein e4, body mass index, smoking status, physical activity index score, total energy intake, lipid lowering medication and total cholesterol:high-density lipoproteinratio (HR1.14,95%CI 1.01-1.29,p=0.04). We observed no relationship between higher DII scores and incident AD. Additionally, we observed no significant interactions between higher DII scores and sex, the presence of an APOE ε4 allele, or physical activity in their associations with incident all-cause dementia or AD.