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Nutrients. 2015 May 29;7(6):4124-38. doi: 10.3390/nu7064124.

Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the PREDIMED Study.

Author information

1
Department of Emergency, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona 31008, Spain. raulramallal@hotmail.com.
2
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. raulramallal@hotmail.com.
3
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. raulramallal@hotmail.com.
4
Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona 31008, Spain. raulramallal@hotmail.com.
5
Department of Cardiology, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona 31008, Spain. raulramallal@hotmail.com.
6
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. jordi.salas@urv.cat.
7
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. jordi.salas@urv.cat.
8
Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus 43201, Spain. jordi.salas@urv.cat.
9
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. dolores.corella@uv.es.
10
Department of Preventive Medicine, University of Valencia, Valencia 46071, Spain. dolores.corella@uv.es.
11
South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208 USA. shivappa@email.sc.edu.
12
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. HSchoeder@imim.es.
13
Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona 08003, Spain. HSchoeder@imim.es.
14
South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208 USA. JHEBERT@mailbox.sc.edu.
15
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. EROS@clinic.ub.es.
16
Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, University of Barcelona, Barcelona 08036, Spain. EROS@clinic.ub.es.
17
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. egomezgracia@uma.es.
18
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. egomezgracia@uma.es.
19
Department of Preventive Medicine, University of Malaga, Malaga 29010, Spain. egomezgracia@uma.es.
20
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. restruch@clinic.ub.es.
21
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. restruch@clinic.ub.es.
22
Department of Internal Medicine Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, University of Barcelona, Barcelona 08036, Spain. restruch@clinic.ub.es.
23
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. jlapetra@ono.com.
24
Department of Family Medicine, Primary Care Division of Seville, San Pablo Health Center, Seville 41007, Spain. jlapetra@ono.com.
25
Department of Cardiology, University Hospital of Alava, Vitoria 01009, Spain. raulramallal@hotmail.com.
26
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. miquelfiol@yahoo.es.
27
Institute of Health Sciences (IUNICS), University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca 07120, Spain. miquelfiol@yahoo.es.
28
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. agarare@gmail.com.
29
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. agarare@gmail.com.
30
Research Institut of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas 35001, Spain. agarare@gmail.com.
31
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. xpinto@bellvitgehospital.cat.
32
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. xpinto@bellvitgehospital.cat.
33
Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona 08907, Spain. xpinto@bellvitgehospital.cat.
34
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. nancy.babio@urv.cat.
35
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. nancy.babio@urv.cat.
36
Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus 43201, Spain. nancy.babio@urv.cat.
37
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. arraez@uv.es.
38
Department of Preventive Medicine, University of Valencia, Valencia 46071, Spain. arraez@uv.es.
39
Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona 08003, Spain. miquelfiol@yahoo.es.
40
The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid 28029, Spain. jalfmtz@unav.es.
41
Centro de Investigación Biomédica en Epidemiología y Salud Pública, Madrid 28029, Spain. jalfmtz@unav.es.
42
Department of Physiology and Nutrition, University of Navarra, Pamplona 31008, Spain. jalfmtz@unav.es.
43
Department of Emergency, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, Pamplona 31008, Spain. agarare@gmail.com.

Abstract

Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HR(quartile2) = 1.42 (95%CI = 0.97-2.09); HR(quartile3) = 1.85 (1.27-2.71); and HR(quartile4) = 1.73 (1.15-2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06-1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.

KEYWORDS:

PREDIMED; cardiovascular disease; dietary inflammatory index; inflammation

PMID:
26035241
PMCID:
PMC4488776
DOI:
10.3390/nu7064124
[Indexed for MEDLINE]
Free PMC Article

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