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Title: Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies
Authors: 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, Luis 
Ros, Emilio
Rekondo, Javier
Toledo, Estefanía
Razquin, Cristina
Ruiz-Canela, Miguel
Alonso, A.
Barrio Lopez, M. T.
Basterra-Gortari, F. J.
Benito Corchon, S.
Bes-Rastrollo, M.
Beunza, J. J.
Carlos, S.
Cervantes, S.
de Irala, J.
de la Rosa, P. A.
de la Fuente, C.
Donat-Vargas, C. L.
Donazar, M.
Fernandez Montero, A.
Gea, A.
Goni-Ochandorena, E.
Guillen-Grima, F.
Lahortiga, F.
Llorca, J.
Lopez del Burgo, C.
Mari-Sanchıs, A.
Marti, A.
Mendonça, R.
Nuñez-Cordoba, J. M.
Pimenta, A. M.
Rico, A.
Ruiz Zambrana, A.
Sayon-Orea, C.
Toledo-Atucha, J.
Vazquez Ruiz, Z.
Zazpe Garcıa, I.
Sánchez-Tainta, A.
Buil-Cosiales, P.
Díez-Espino, J.
Sanjulian, B.
Martínez, J. A.
Serrano-Martínez, M.
Extremera-Urabayen, J. V.
Garcia-Pérez, L.
Arroyo-Azpa, C.
Barcena, A. F.
Oreja-Arrayago, C.
Lasanta-Sáez, M. J.
Cia-Lecumberri, P.
Elcarte-Lopez, T.
Artal-Moneva, F.
Esparza-López, J. M.
Figuerido-Garmendia, E.
Tabar-Sarrias, J. A.
Fernández-Urzainqui, L.
Ariz-Arnedo, M. J.
Cabeza-Beunza, J. A.
Pascual-Pascual, P.
Martínez-Mazo, M. D.
Arina-Vergara, E.
Macua-Martínez, T.
Pascual Pascual, P.
Garcés Ducar, M. L.
Martí Massó, R.
Villanueva Moreno, R.
Parra-Osés, A.
Serra-Mir, M.
Sánchez Villegas, Almudena 
UNESCO Clasification: 32 Ciencias médicas
Keywords: Mediterranean diet
Cohort studies
Inflammation, et al
Issue Date: 2019
Publisher: 0261-5614
Journal: Clinical Nutrition 
Abstract: 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 as NCT02669602 and at as ISRCTN35739639, respectively.
ISSN: 0261-5614
DOI: 10.1016/j.clnu.2018.05.003
Source: Clinical Nutrition [ISSN 0261-5614], vol. 38(3), p. 121-131
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