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

Abstract

The dietary inflammatory index (DII) is a novel way of describing diet that has been studied in relation to various health conditions, including cardiovascular disease (CVD) in several populations. We aimed to investigate the association between DII and CVD events among a representative population sample in northeastern Iran. This prospective cohort study was a subsample of 4,672 adults aged 35–65 years, and recruited as part of Mashhad stroke and heart atherosclerotic disorder cohort study population. The DII was computed at baseline according to a 65‐item validated food frequency questionnaire. Cox regression was used to determine the association of DII with incident CVD. One hundred twenty‐four participants developed CVD (including 24 cases of myocardial infarction [MI], 34 cases of stable angina [SA], and 66 cases of unstable angina [UA]). After adjusting for potential confounding factors, a hazard ratios of 1.06 (95% confidence interval: 0.70–1.60), 1.36 (95% confidence interval: 0.52–3.52), 1.33 (95% confidence interval: 0.60–2.94), and 0.86 (95% confidence interval: 0.48–1.53) were found for total CVD, MI, SA, and UA events, respectively, among the participants with proinflammatory diet (DII ≥ 0) versus those with anti‐inflammatory diet (DII < 0). There was no statistically significant association between the DII and total CVD, MI, SA, or UA in this population of middle‐aged Iranian men and women.

Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

“…These results suggested that inflammation-a phenomenon with numerous underlying causes triggered by a pro-inflammatory diet-is associated with CVD risk. However, in contrast to our findings, several studies have reported a null association between DII and overall CVD [25,26]. The difference between our study and that of Vissers et al [25] could be attributed to the difference in the population studied, as they used only women participants and data on 25 of the 45 DII food parameters were available from the validated food frequency questionnaire (FFQ) that was used for calculating the DII, as compared to our 37 food parameters.…”

“…The difference between our study and that of Vissers et al [25] could be attributed to the difference in the population studied, as they used only women participants and data on 25 of the 45 DII food parameters were available from the validated food frequency questionnaire (FFQ) that was used for calculating the DII, as compared to our 37 food parameters. Moreover, the difference in the findings between ours and that of Asadi et al [26] could be attributed to fewer incident cases CVD (n = 124), and regional specificity, which might be associated with different culture and lifestyle factors, and therefore, cannot be generalized to the general population of Iran. In addition, their validated FFQ had fewer food items (65 items) compared with the FFQ used (106 items) in the present study.…”

“…The relationship between DII and CVD have been investigated in different cohorts and have suggested an association between DII scores and CVD risk [20,23] and MI in particular [24], though null associations have also been reported [25,26]. For example, no significant association between the DII and stroke has been reported in studies in France and Australia [24,25].…”

“…Moreover, the broader application of this approach to non-Western populations is also limited, as indicated by the relative lack of studies conducted in Asian populations that have addressed the association between the DII and CVD risk [26,28,29]. For example, Asadi et al [26] recently reported the association between DII and CVD and its subtypes, MI, stable angina, and unstable angina risk in northeastern Iran; however, the incidence rate was very low and regionally specific, which makes it difficult to generalize the results to the entire Iranian population, let alone outside of Iran. Another Asian study from Japan reported the association between the DII and overall CVD and stroke mortality among other diseases, but failed to address the disease incidence risk [29].…”

The Association Between Adherence to The Dietary Approaches to Stop Hypertension (DASH) Diet and Neuro-Psychological Function in Young Women

“…A valid and reliable 65 item semi-quantitative food frequency questionnaire was used to assess the food intake of subjects over the previous year (20,21). Experienced dietitians, asked participants to describe their consumption frequency for each food item during the previous year on a daily, weekly, monthly, rarely or never basis.…”