The Dietary Inflammatory Index and All-Cause, Cardiovascular Disease, and Cancer Mortality in the Multiethnic Cohort Study

Abstract

Diet quality based on inflammatory potential, assessed by the Dietary Inflammatory Index (DII®), has been related to mortality, but studies from racially/ethnically diverse populations are scarce. Using data from the Multiethnic Cohort Study in Hawaii and California, we investigated the association of the DII with all-cause, cardiovascular disease (CVD) and cancer mortality, both overall and by race/ethnicity. The analysis included 150,405 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 47,436 deaths during an average follow-up of 18.2 ± 4.9 years. In multivariable-adjusted Cox models, the hazard ratios (95% confidence intervals) for the highest vs. lowest quintile of the DII in men and women were 1.15 (1.09–1.21) and 1.22 (1.14–1.28) for all-cause, 1.13 (1.03–1.23) and 1.29 (1.17–1.42) for CVD, and 1.10 (1.00–1.21) and 1.13 (1.02–1.26) for cancer mortality. In men, an increased risk of all-cause mortality with higher DII scores was found in all racial/ethnic groups except for Native Hawaiians (P for heterogeneity < 0.001). Similarly, in women, an increased risk of CVD mortality was found in the four racial/ethnic groups, but not in Native Hawaiians. These findings support the association of a pro-inflammatory diet with a higher risk of mortality and suggest the association may vary by race/ethnicity.

Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

“…The link between dietary habits and NCDs has been extensively examined [5,6]. Many NCDs are, to a large extent, preventable and modifiable lifestyle-related risk factors including an unhealthy diet play a significant role [7,8,9,10,11,12]. The Global Burden of Diseases Nutrition and Chronic Diseases Expert Group examined global dietary quality trends among adults across 187 nations over 20 years (1990–2010).…”

A Traditional Korean Diet with a Low Dietary Inflammatory Index Increases Anti-Inflammatory IL-10 and Decreases Pro-Inflammatory NF-κB in a Small Dietary Intervention Study

“…Fruits and vegetables as well as fiber, vitamin C, vitamin D and β-carotene have consistently shown to be associated with reducing chronic subclinical inflammation [ 6 ]. However, the effect of diet on inflammation is more complicated because various pro- and anti-inflammatory components may interact and modify inflammation [ 7 ]. The Western-style diet, which consists of high amounts of red meat, simple carbohydrates and refined grains, has been associated with higher levels of CRP and IL-6, whereas the Mediterranean diet, which consists of high amount of fresh fruits and vegetables, whole grains, nuts and fish along with high consumption of wine and olive oil, has been associated with lower levels of such pro-inflammatory markers [ 8 ].…”

The Dietary Inflammatory Index Is Associated With Diabetes Severity

“…The DII is a measure derived from analysis of multiple databases to measure the impact of 45 specific types of food on inflammatory biomarkers including IL-1␤, IL-4, IL-6, IL-10, TNF-␣, and C-reactive protein (CRP). 1 Following the initial study that described the DII, subsequent studies have explored the association of the DII and a variety of chronic medical conditions, including chronic kidney disease, 2 cardiovascular disease, 3 depression, 4 and metabolic syndrome. 5 Diabetes has not been studied extensively in relation to the DII, but it represents an important medical condition that has been associated with inflammation 6 -9 and diet 10 -12 in a variety of studies.…”