A New Dietary Inflammatory Index Predicts Interval Changes in Serum High-Sensitivity C-Reactive Protein1–3

Abstract

Inflammation is associated with a number of chronic conditions, such as cancer and cardiovascular disease. Reducing inflammation may help prevent or treat these conditions. Diet has consistently been shown to modulate inflammation. To facilitate research into the inflammatory effect of diet on health in humans, we sought to develop and validate an Inflammatory Index designed to assess the inflammatory potential of individuals' diets. An Inflammatory Index was developed based on the results of an extensive literature search. Using data from a longitudinal observational study that carefully measured diet and the inflammatory marker, serum high-sensitivity (hs) C-reactive protein (CRP), in approximately 600 adults for 1 y, we conducted analyses to test the effect of Inflammatory Index score on hs-CRP as a continuous and dichotomous (<or=3 mg/L, >3 mg/L) indicator of inflammatory response, while controlling for important potential confounders. Results based on continuous measures of hs-CRP suggested that an increasing Inflammatory Index score (representing movement toward an antiinflammatory diet) was associated with a decrease in hs-CRP. Analyses using hs-CRP as a dichotomous variable showed that an antiinflammatory diet was associated with a decrease in the odds of an elevated hs-CRP (P = 0.049). The results are consistent with the ability of the Inflammatory Index to predict hs-CRP and provide additional evidence that diet plays a role in the regulation of inflammation, even after careful control of a wide variety of potential confounders.

Inflammatory Marker Changes in a Yearlong Randomized Exercise Intervention Trial among Postmenopausal Women

“…Our analyses suggest that (i) the significant intervention effect on CRP levels may be partly explained by decreased dietary fiber intake in the control group that may have increased CRP levels in controls (33)(34)(35) and (ii) decreases in CRP levels were mediated primarily by fat loss. Secondary analyses implied that intervention effects on CRP levels were stronger with increasing exercise adherence, and that intervention effects on CRP levels were stronger in women who were more physically fit at baseline.…”

“…We also assessed possible confounding by unintended dietary change because some dietary components can exhibit pro-or anti-inflammatory properties (33)(34)(35). With guidance from review articles on inflammation and diet, we targeted the following variables for exploration as potential confounders: change in glycemic load, change in fruit and vegetable intake, change in intakes of total fiber, alcohol, fats (total, trans, saturated, polyunsaturated, and monounsaturated), and omega-3 fatty acids (docosahexaenoic acid, alpha-linoleic acid, and eicosapentaenoic acid).…”

High-Sensitivity C-Reactive Protein Levels and Cancer Mortality

“…Nutritional decline represented by PNI in both sexes were also associated with survival in this study. In addition, inadequate nutrition was documented to be related to elevated hs-CRP level in the previous studies (38)(39)(40). Further investigation in other population is needed to examine the differential effect of adiposity on the relation between hs-CRP concentration and specific cancer mortality.…”

Diet-related inflammation and oesophageal cancer by histological type: a nationwide case–control study in Sweden

“…The DII scoring system was originally developed in 2009 [14] and updated by members of our group in 2013 [15]. In the updated version, nearly 2000 papers were reviewed and scored, and 45 food parameters, including foods, nutrients, and other bioactive compounds, were evaluated based on their inflammatory effects associated with these specific inflammatory markers: interleukin (IL)-1, IL-4, IL-6, IL-10, tumour necrosis factor (TNF)-α, and C-reactive protein (CRP) [15].…”