Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
J Am Coll Cardiol. 2020 Nov 10;76(19):2181-2193. doi: 10.1016/j.jacc.2020.09.535.
Inflammation plays an important role in cardiovascular disease (CVD) development. Diet modulates inflammation; however, it remains unknown whether dietary patterns with higher inflammatory potential are associated with long-term CVD risk.
This study sought to examine whether proinflammatory diets are associated with increased CVD risk.
We prospectively followed 74,578 women from the Nurses' Health Study (NHS) (1984-2016), 91,656 women from the NHSII (1991-2015), and 43,911 men from the Health Professionals Follow-up Study (1986-2016) who were free of CVD and cancer at baseline. Diet was assessed by food frequency questionnaires every 4 years. The inflammatory potential of diet was evaluated using a food-based empirical dietary inflammatory pattern (EDIP) score that was pre-defined based on levels of 3 systemic inflammatory biomarkers.
During 5,291,518 person-years of follow-up, we documented 15,837 incident CVD cases, including 9,794 coronary heart disease (CHD) cases and 6,174 strokes. In pooled analyses of the 3 cohorts, after adjustment for use of anti-inflammatory medications and CVD risk factors including body mass index, a higher dietary inflammatory potential, as indicated by higher EDIP scores, was associated with an increased risk of CVD (hazard ratio [HR] comparing the highest to lowest quintiles: 1.38; 95% confidence interval [CI]: 1.31 to 1.46; p for trend <0.001), CHD (HR: 1.46; 95% CI: 1.36 to 1.56; p for trend <0.001), and stroke (HR: 1.28; 95% CI: 1.17- to 1.39; p for trend <0.001). These associations were consistent across cohorts and between sexes, and they remained significant after further adjustment for other dietary quality indices. In a subset of study participants (n = 33,719), a higher EDIP was associated with a higher circulating profile of proinflammatory biomarkers, lower levels of adiponectin, and an unfavorable blood lipid profile (p < 0.001).
Dietary patterns with a higher proinflammatory potential were associated with higher CVD risk. Reducing the inflammatory potential of the diet may potentially provide an effective strategy for CVD prevention.
炎症在心血管疾病（CVD）发展中起着重要作用。饮食可以调节炎症；然而，尚不清楚具有更高炎症潜力的饮食模式是否与长期 CVD 风险相关。
本研究旨在探讨促炎饮食是否与增加 CVD 风险相关。
我们前瞻性地随访了来自护士健康研究（NHS）（1984-2016 年）的 74578 名女性、来自护士健康研究 II 期（NHSII）（1991-2015 年）的 91656 名女性和来自健康专业人员随访研究（1986-2016 年）的 43911 名男性，这些人在基线时均无 CVD 和癌症。饮食通过每 4 年进行一次的食物频率问卷进行评估。饮食的炎症潜力是通过基于 3 种系统性炎症生物标志物水平预先定义的基于食物的经验性饮食炎症模式（EDIP）评分来评估的。
在 5291580 人年的随访期间，我们记录了 15837 例新发 CVD 病例，包括 9794 例冠心病（CHD）病例和 6174 例中风。在这 3 个队列的汇总分析中，在校正了抗炎药物的使用和 CVD 风险因素（包括体重指数）后，较高的饮食炎症潜力，表现为较高的 EDIP 评分，与 CVD 风险增加相关（最高五分位组与最低五分位组相比的风险比：1.38；95%置信区间：1.31 至 1.46；趋势检验 p<0.001）、CHD（HR：1.46；95%CI：1.36 至 1.56；趋势检验 p<0.001）和中风（HR：1.28；95%CI：1.17 至 1.39；趋势检验 p<0.001）。这些关联在队列间和性别间是一致的，并且在进一步调整其他饮食质量指数后仍然显著。在研究参与者的一个亚组（n=33719）中，较高的 EDIP 与促炎生物标志物的循环水平升高、脂联素水平降低以及不良的血脂谱相关（p<0.001）。
具有更高促炎潜力的饮食模式与 CVD 风险增加相关。降低饮食的炎症潜力可能为 CVD 预防提供一种有效的策略。
