Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies
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Dietary inflammatory index and all-cause mortality in large cohorts : The SUN and PREDIMED studies. / Garcia-Arellano, Ana; Martínez-González, Miguel A.; Ramallal, Raul; Salas-Salvadó, Jordi; Hébert, James R.; Corella, Dolores; Shivappa, Nitin; Forga, Luis; Schröder, Helmut; Muñoz-Bravo, Carlos; Estruch, Ramón; Fiol, Miquel; Lapetra, José; Serra-Majem, Lluís; Ros, Emilio; Rekondo, Javier; Toledo, Estefanía; Razquin, Cristina; Ruiz-Canela, Miguel; Guasch-Ferré, M. (Member of author collaboration).
In: Clinical Nutrition, Vol. 38, No. 3, 2019, p. 1221-1231.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Dietary inflammatory index and all-cause mortality in large cohorts
T2 - The SUN and PREDIMED studies
AU - Garcia-Arellano, Ana
AU - Martínez-González, Miguel A.
AU - Ramallal, Raul
AU - Salas-Salvadó, Jordi
AU - Hébert, James R.
AU - Corella, Dolores
AU - Shivappa, Nitin
AU - Forga, Luis
AU - Schröder, Helmut
AU - Muñoz-Bravo, Carlos
AU - Estruch, Ramón
AU - Fiol, Miquel
AU - Lapetra, José
AU - Serra-Majem, Lluís
AU - Ros, Emilio
AU - Rekondo, Javier
AU - Toledo, Estefanía
AU - Razquin, Cristina
AU - Ruiz-Canela, Miguel
A2 - Guasch-Ferré, M.
N1 - Publisher Copyright: © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
PY - 2019
Y1 - 2019
N2 - Background: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. Objective: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts. Design: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality. Results: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII). Conclusion: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.
AB - Background: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. Objective: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts. Design: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality. Results: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII). Conclusion: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.
KW - Cohort studies
KW - CRP
KW - Dietary inflammatory index
KW - Inflammation
KW - Mediterranean diet
KW - Mortality
U2 - 10.1016/j.clnu.2018.05.003
DO - 10.1016/j.clnu.2018.05.003
M3 - Journal article
C2 - 30651193
AN - SCOPUS:85048193329
VL - 38
SP - 1221
EP - 1231
JO - Clinical Nutrition
JF - Clinical Nutrition
SN - 0261-5614
IS - 3
ER -
ID: 357998470