Pro-inflammatory dietary intake as a risk factor for CVD in men: a 5-year longitudinal study

Abstract

Convincing evidence has identified inflammation as an initiator of atherosclerosis, underpinning CVD. We investigated (i) whether dietary inflammation, as measured by the ‘dietary inflammatory index (DII)’, was predictive of 5-year CVD in men and (ii) its predictive ability compared with that of SFA intake alone. The sample consisted of 1363 men enrolled in the Geelong Osteoporosis Study who completed an FFQ at baseline (2001–2006) (excluding participants who were identified as having previous CVD). DII scores were computed from participants’ reported intakes of carbohydrate, micronutrients and glycaemic load. DII scores were dichotomised into a pro-inflammatory diet (positive values) or an anti-inflammatory diet (negative values). The primary outcome was a formal diagnosis of CVD resulting in hospitalisation over the 5-year study period. In total, seventy-six events were observed during the 5-year follow-up period. Men with a pro-inflammatory diet at baseline were twice as likely to experience a CVD event over the study period (OR 2·07; 95 % CI 1·20, 3·55). This association held following adjustment for traditional CVD risk factors and total energy intake (adjusted OR 2·00; 95 % CI 1·03, 3·96). This effect appeared to be stronger with the inclusion of an age-by-DII score interaction. In contrast, SFA intake alone did not predict 5-year CVD events after adjustment for covariates (adjusted OR 1·40; 95 % CI 0·73, 2·70). We conclude that an association exists between a pro-inflammatory diet and CVD in Australian men. CVD clinical guidelines and public health recommendations may have to expand to include dietary patterns in the context of vascular inflammation.

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

“…Our findings are consistent with some previous results for DII and incident CVD as well as all-cause mortality [19–23]; although null associations have also been reported [24, 25]. Effect sizes for CVD risk have generally been in the range of approximately OR 1.5 to 2, which is comparable to our results for men.…”

“…Effect sizes for CVD risk have generally been in the range of approximately OR 1.5 to 2, which is comparable to our results for men. The DII scores in our study population were also comparable to those of previous studies [19–22, 36], including the SEASONS study, in which DII was validated against the inflammatory marker hsCRP [36]. Also in line with previous studies [35, 36], the DII was weakly, but statistically significantly, associated with both hsCRP and the inflammatory marker IL-6 in a subset of our control participants with biomarker data available.…”

“…The effect sizes observed for the DII in relation to cardiovascular endpoints are generally modest [19–23], which is not surprising, given the many other potential contributing factors to low-grade chronic inflammation. However, the general consistency of results suggests that the inflammatory impact of diet is a potential target for CVD prevention.…”

“…A pro-inflammatory diet, as estimated by the DII, has been associated with an increased risk of CVD in several populations, [19–23]; though some conflicting results also have been published [24, 25]. …”

Integrating diet and inflammation to calculate cardiovascular risk

“…The authors demonstrated that men with positive DII (high pro-inflammatory diet) had 2 times the probability of CVD compared with men with a negative DII. A very robust result was found when the authors considered only the first three (out of the total five) years of follow-up [19]. …”