PLoS ONE (Jan 2015)

Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the SUN Cohort.

  • Raúl Ramallal,
  • Estefanía Toledo,
  • Miguel A Martínez-González,
  • Aitor Hernández-Hernández,
  • Ana García-Arellano,
  • Nitin Shivappa,
  • James R Hébert,
  • Miguel Ruiz-Canela

DOI
https://doi.org/10.1371/journal.pone.0135221
Journal volume & issue
Vol. 10, no. 9
p. e0135221

Abstract

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Diet is known to play a key role in atherogenesis and in the development of cardiovascular events. Dietary factors may mediate these processes acting as potential modulators of inflammation. Potential Links between inflammatory properties of diet and the occurrence of cardiovascular events have not been tested previously.We aimed to assess the association between the dietary inflammatory index (DII), a method to assess the inflammatory potential of the diet, and incident cardiovascular disease.In the prospective, dynamic SUN cohort, 18,794 middle-aged, Spanish university graduates were followed up for 8.9 years (median). A validated 136-item food-frequency questionnaire was used to calculate the DII. The DII is based on scientific evidence about the relationship between diet and inflammatory biomarkers (C-reactive protein, IL-1β, IL-4, IL-6, IL-10 and TNF-α). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the DII and incident cardiovascular disease (myocardial infarction, stroke or cardiovascular death).The risk for cardiovascular events progressively increased with each increasing quartile of DII (ptrend = 0.017). The multivariable-adjusted HR for participants in the highest (most pro-inflammatory) vs. the lowest quartile of the DII was 2.03 (95% CI 1.06-3.88).A pro-inflammatory diet was associated with a significantly higher risk for developing cardiovascular events.