Servicio Navarro de Salud (Osasunbidea), Pamplona, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.
University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigacion Sanitario de Navarra (IdiSNA), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA.
Clin Nutr. 2019 Jun;38(3):1221-1231. doi: 10.1016/j.clnu.2018.05.003. Epub 2018 May 24.
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.
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.
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.
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).
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.
炎症与包括心血管疾病、多种癌症、肥胖、2 型糖尿病、抑郁自杀和其他慢性疾病在内的主要死亡原因有关。在整个饮食模式的背景下，开发了饮食炎症指数（DII）来评估饮食的炎症潜力。
我们前瞻性评估了两个大型西班牙队列中 DII 评分与全因死亡率之间的关系，并评估了这两个队列之间的一致性和基于其他队列的研究结果。
我们评估了“纳瓦拉大学随访研究”（SUN）队列中的 18566 名参与者，随访 188891 人年，以及“预防地中海饮食研究”（PREDIMED）随机试验中的 6790 名参与者，随访 30233 人年。DII 评分均根据经过验证的 FFQ 在两个队列中计算。更高的 DII 评分对应于更促炎的饮食。SUN 和 PREDIMED 分别有 230 例和 302 例死亡。在一项随机效应荟萃分析中，我们纳入了 12 项前瞻性研究（SUN、PREDIMED 和 10 项额外研究），评估了 DII 评分与全因死亡率之间的关系。
在调整了广泛的潜在混杂因素后，DII 极端四分位的比较与 SUN 队列（危险比[HR] = 1.85；95%置信区间：1.15，2.98；P 趋势 = 0.004）和 PREDIMED 队列（HR = 1.42；95%置信区间：1.00，2.02；P 趋势 = 0.009）中的全因死亡率呈正相关且有统计学意义。在 12 项队列的荟萃分析中，DII 与全因死亡率增加 23%显著相关（95%置信区间：16%-32%，DII 最高与最低分类）。
我们的结果为促炎饮食与全因死亡率增加相关的假设提供了强有力且一致的支持。SUN 队列和 PREDIMED 试验分别在 clinicaltrials.gov 上注册为 NCT02669602 和在 isrctn.com 上注册为 ISRCTN35739639。
