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Horm Metab Res 2018; 50(05): 345-358
DOI: 10.1055/a-0596-8204
Review
© Georg Thieme Verlag KG Stuttgart · New York

Dietary Inflammatory Index and its Association with the Risk of Cardiovascular Diseases, Metabolic Syndrome, and Mortality: A Systematic Review and Meta-Analysis

Nazli Namazi
1   Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
,
Bagher Larijani
2   Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
,
Leila Azadbakht
3   Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
4   Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
5   Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
› Author Affiliations
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Publication History

received 11 February 2018

accepted 13 March 2018

Publication Date:
03 May 2018 (online)

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Abstract

Findings from previous studies on the association between the Dietary Inflammatory Index (DII) and the risk of chronic diseases and mortality have been inconsistent. We aimed to summarize studies on the association of the DII and the risk for cardiovascular disease (CVD), metabolic syndrome (MetS), and mortality in a systematic review and meta-analysis. We performed a systematic search in PubMed/Medline, Web of Knowledge, and Scopus databases for relevant studies written in English and published until 31 December 2017. Studies that reported the relative risk (RR), odd ratio (OR) or hazard ratio (HR) for the most pro-inflammatory versus the most anti-inflammatory diets were included. Finally, 17 studies [CVD (n=6), MetS (n=5), mortality (n=6)] were included for systematic review and meta-analysis. Findings indicated a trend toward a positive relationship between the DII and the risk for CVD (pooled RR: 1.35; 95% CI: 1.13, 1.60; I2: 28.6%, p=0.21), all-cause mortality (pooled HR: 1.21; 95% CI: 1.09, 1.35; I2: 72.6%, p=0.003), CVD mortality (pooled HR: 1.30, 95% CI: 1.07, 1.57; I2: 74.0%, p=0.009) and cancer mortality (pooled HR: 1.28; 95% CI: 1.07, 1.53; I2: 62.5%, p=0.03). However, no significant association was found between the DII and the risk for MetS (pooled RR: 1.01; 95% CI: 0.82, 1.24; I2: 32.6%, p=0.20). Although in the current meta-analysis the most pro-inflammatory diet versus the most anti-inflammatory diet was not associated with the risk of MetS, we observed a substantial association between the DII and the risk for CVD and all types of mortality. However, further cohort studies in different populations are needed to clarify this association.

Key words

inflammation - cardiovascular disease - metabolic syndrome - death

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  • References

  • 1 Ramallal R, Toledo E, Martínez-González MA, Hernández-Hernández A, García-Arellano A, Shivappa N. Dietary inflammatory index and incidence of cardiovascular disease in the SUN cohort. PloS One 2015; 4: 1-15
    PubMedGoogle Scholar
  • 2 Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: A systematic literature review. Nutr Rev 2013; 71: 511-527
    CrossrefPubMedGoogle Scholar
  • 3 Vissers LE, Waller MA, van der Schouw YT, Hebert JR, Shivappa N, Schoenaker DA. The relationship between the dietary inflammatory index and risk of total cardiovascular disease, ischemic heart disease and cerebrovascular disease: Findings from an Australian population-based prospective cohort study of women. Atherosclerosis 2016; 253: 164-170
    CrossrefPubMedGoogle Scholar
  • 4 Ruiz-Canela M, Bes-Rastrollo M, Martínez-González MA. The role of dietary inflammatory index in cardiovascular disease, metabolic syndrome and mortality. Int J Mol Sci 2016; 17: 1265
    CrossrefPubMedGoogle Scholar
  • 5 O’Neil A, Shivappa N, Jacka FN, Kotowicz MA, Kibbey K, Hebert JR. Pro-inflammatory dietary intake as a risk factor for CVD in men: A 5-year longitudinal study. Br J Nutr 2015; 114: 2074-2082
    CrossrefPubMedGoogle Scholar
  • 6 Shivappa N, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutr 2014; 17: 1825-1833
    CrossrefPubMedGoogle Scholar
  • 7 Cavicchia PP, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr 2009; 139: 2365-2372
    CrossrefPubMedGoogle Scholar
  • 8 Wirth M, Burch J, Shivappa N, Violanti JM, Burchfiel CM, Fekedulegn D. Association of a dietary inflammatory index with inflammatory indices and the metabolic syndrome among police officers. Int J Occup Environ Med 2014; 56: 986
    PubMedGoogle Scholar
  • 9 Neufcourt L, Assmann K, Fezeu L, Touvier M, Graffouillère L, Shivappa N. Prospective association between the dietary inflammatory index and metabolic syndrome: Findings from the SU. VI. MAX study. Nutr Metab Cardiovasc Dis 2015; 25: 988-996
    CrossrefPubMedGoogle Scholar
  • 10 San KMM, Fahmida U, Wijaksono F, Lin H, Zaw KK, Htet MK. Chronic low grade inflammation measured by dietary inflammatory index and its association with obesity among school teachers in Yangon, Myanmar. Asia Pac J Clin Nutr 2018; 27: 92
    PubMedGoogle Scholar
  • 11 Julia C, Meunier N, Touvier M, Ahluwalia N, Sapin V, Papet I. Dietary patterns and risk of elevated C-reactive protein concentrations 12 years later. Br J Nutr 2013; 110: 747-754
    CrossrefPubMedGoogle Scholar
  • 12 Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 2006; 83: 1369-1379
    CrossrefPubMedGoogle Scholar
  • 13 Garcia-Arellano A, Ramallal R, Ruiz-Canela M, Salas-Salvadó J, Corella D, Shivappa N. Dietary inflammatory index and incidence of cardiovascular disease in the PREDIMED study. Nutrients 2015; 7: 4124-4138
    CrossrefPubMedGoogle Scholar
  • 14 Shivappa N, Blair CK, Prizment AE, Jacobs DR, Steck SE, Hébert JR. Association between inflammatory potential of diet and mortality in the Iowa Women’s Health study. Eur J Clin Nutr 2016; 55: 1491-1502
    CrossrefPubMedGoogle Scholar
  • 15 Deng FE, Shivappa N, Tang Y, Mann JR, Hebert JR. Association between diet-related inflammation, all-cause, all-cancer, and cardiovascular disease mortality, with special focus on prediabetics: Findings from NHANES III. Eur J Nutr 2016; 56: 1085-1109
    PubMedGoogle Scholar
  • 16 Pimenta AM, Toledo E, Rodriguez-Diez MC, Gea A, Lopez-Iracheta R, Shivappa N. Dietary indexes, food patterns and incidence of metabolic syndrome in a Mediterranean cohort: The SUN project. Clin Nutr 2015; 34: 508-514
    CrossrefPubMedGoogle Scholar
  • 17 Sokol A, Wirth MD, Manczuk M, Shivappa N, Zatonska K, Hurley TG. Association between the dietary inflammatory index, waist-to-hip ratio and metabolic syndrome. Nutr Res 2016; 36: 1298-1303
    CrossrefPubMedGoogle Scholar
  • 18 Shivappa N, Harris H, Wolk A, Hebert JR. Association between inflammatory potential of diet and mortality among women in the Swedish Mammography Cohort. Eur J Clin Nutr 2016; 55: 1891-1900
    CrossrefPubMedGoogle Scholar
  • 19 Moher D, Liberati A, Tetzlaff J, Altman DG. Group P . Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med 2009; 18: 264-269
    PubMedGoogle Scholar
  • 20 Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010; 25: 603-605
    CrossrefPubMedGoogle Scholar
  • 21 Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Obtaining standard errors from confidence intervals and P values: Absolute (difference) measures. New York: Wiley; 2011
    Google Scholar
  • 22 Kerkhoffs GM, Servien E, Dunn W, Dahm D, Bramer JA, Haverkamp D. The influence of obesity on the complication rate and outcome of total knee arthroplasty. J Bone Joint Surg Am 2012; 94: 1839-1844
    CrossrefPubMedGoogle Scholar
  • 23 Shivappa N, Steck SE, Hussey JR, Ma Y, Hebert JR. Inflammatory potential of diet and all-cause, cardiovascular, and cancer mortality in National Health and Nutrition Examination Survey III Study. Eur J Clin Nutr 2017; 6: 1-10
    PubMedGoogle Scholar
  • 24 Wirth MD, Shivappa N, Hurley TG, Hébert JR. Association between previously diagnosed circulatory conditions and a dietary inflammatory index. Nutr Res 2016; 36: 227-233
    CrossrefPubMedGoogle Scholar
  • 25 Zaslavsky O, Zelber-Sagi S, Hebert JR, Steck SE, Shivappa N, Tabung FK, Wirth MD, Bu Y, Shikany JM, Orchard T, Wallace RB, Snetselaar L, Tinker LF. Biomarker-calibrated nutrient intake and healthy diet index associations with mortality risks among older and frail women from the Women’s Health Initiative. Am J Clin Nutr 2017; 105: 1399-1407
    PubMedGoogle Scholar
  • 26 Graffouillère L, Deschasaux M, Mariotti F, Neufcourt L, Shivappa N, Hébert JR. Prospective association between the Dietary Inflammatory Index and mortality: Modulation by antioxidant supplementation in the SU. VI. MAX randomized controlled trial. Am J Clin Nutr 2016; 103: 878-885
    CrossrefPubMedGoogle Scholar
  • 27 Neufcourt L, Assmann KE, Fezeu LK, Touvier M, Graffouillère L, Shivappa N, Hébert JR, Wirth MD, Hercberg S, Galan P, Julia C, Kesse-Guyot E. Prospective Association Between the Dietary Inflammatory Index and Cardiovascular Diseases in the Supplementation en VItamines et Mineraux AntioXydants (SU.VI.MAX) Cohort. J Am Heart Assoc 2016; 5: e002735 doi: 10.1161/JAHA.115.002735
    CrossrefPubMedGoogle Scholar
  • 28 Shivappa N, Harris H, Wolk A, Hebert JR. Association between inflammatory potential of diet and mortality among women in the Swedish Mammography Cohort. Eur J Clin Nutr 2016; 55: 1891-1900
    CrossrefPubMedGoogle Scholar
  • 29 Naja F, Shivappa N, Nasreddine L, Kharroubi S, Itani L, Hwalla N, Mehio Sibai A, Hebert JR. Role of inflammation in the association between the western dietary pattern and metabolic syndrome among Lebanese adults. Int J Food Sci Nutr 2017; 68: 997-1004
    CrossrefPubMedGoogle Scholar
  • 30 Wirth MD, Hébert JR, Shivappa N, Hand GA, Hurley TG, Drenowatz C. Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices. Nutr Res 2016; 36: 214-219
    CrossrefPubMedGoogle Scholar
  • 31 Hermsdorff HHM, Zulet MÁ, Abete I, Martínez JA. A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects. Eur JNutr 2011; 50: 61-69
    PubMedGoogle Scholar
  • 32 Hermsdorff HHM, Zulet MÁ, Puchau B, Martínez JA. Fruit and vegetable consumption and proinflammatory gene expression from peripheral blood mononuclear cells in young adults: A translational study. Nutr Metab 2010; 7: 42
    CrossrefPubMedGoogle Scholar
  • 33 Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 2006; 84: 1489-1497
    CrossrefPubMedGoogle Scholar
  • 34 Casas-Agustench P, López-Uriarte P, Bulló M, Ros E, Cabré-Vila J, Salas-Salvadó J. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis 2011; 21: 126-135
    CrossrefPubMedGoogle Scholar
  • 35 Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 2014; 17: 1689-1696
    CrossrefPubMedGoogle Scholar
  • 36 Collaboration ERF . C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: An individual participant meta-analysis. Lancet 2010; 375: 132-140
    CrossrefPubMedGoogle Scholar
  • 37 Shim JS, Oh K, Kim HC. Dietary assessment methods in epidemiologic studies. Epidemiol Health 2014; 36: 1-8
    PubMedGoogle Scholar
  • 38 Kaptoge S, Seshasai SRK, Gao P, Freitag DF, Butterworth AS, Borglykke A. Inflammatory cytokines and risk of coronary heart disease: New prospective study and updated meta-analysis. Eur Heart J 2013; 367:
    PubMed
  • 39 Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr. 2007; 137: 992-998
    CrossrefPubMedGoogle Scholar
  • 40 Maghsoudi Z, Azadbakht L. How dietary patterns could have a role in prevention, progression, or management of diabetes mellitus? Review on the current evidence. J Res Med Sci 2012; 17: 694-709
    PubMedGoogle Scholar