Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, Minneapolis, MN, USA.
J Nutr. 2021 Apr 8;151(4):930-939. doi: 10.1093/jn/nxaa388.
Exogenous exposures collectively may contribute to chronic, low-grade inflammation and increase risks for major chronic diseases and mortality. We previously developed, validated, and reported a novel, FFQ-based and lifestyle questionnaire-based, inflammation biomarker panel-weighted, predominantly whole foods-based 19-component dietary inflammation score (DIS) and 4-component lifestyle inflammation score (LIS; comprising physical activity, alcohol intake, BMI, and current smoking status). Both scores were more strongly associated with circulating biomarkers of inflammation in 3 populations than were previously reported dietary inflammation indices. Associations of the DIS and LIS with mortality risk have not been reported.
To investigate separate and joint associations of the DIS and LIS with all-cause, all-cancer, and cardiovascular disease (CVD) mortality risks in the prospective Iowa Women's Health Study (1986-2012; n = 33,155 women, ages 55-69 years, of whom 17,431 died during follow-up, including 4379 from cancer and 6574 from CVD).
We summed each study participant's scores' components, weighted by their published weights, to yield the participant's inflammation score; a higher score was considered more pro-inflammatory. We assessed DIS and LIS mortality associations using multivariable Cox proportional hazards regression.
Among participants in the highest relative to the lowest DIS and LIS quintiles, the adjusted HRs for all-cause mortality were 1.11 (95% CI: 1.05-1.16) and 1.60 (95% CI: 1.53-1.68), respectively; for all-cancer mortality were 1.07 (95% CI: 0.97-1.17) and 1.51 (95% CI: 1.38-1.66), respectively; and for CVD mortality were 1.12 (95% CI: 1.03-1.21) and 1.79 (95% CI: 1.66-1.94), respectively (all Ptrend values < 0.01). Among those in the highest relative to the lowest joint LIS/DIS quintiles, the HRs for all-cause, all-cancer, and all-CVD mortality were 1.88 (95% CI: 1.71-2.08), 1.82 (95% CI: 1.50-2.20), and 1.92 (95% CI: 1.64-2.24), respectively.
More pro-inflammatory diets and lifestyles, separately but especially jointly, may be associated with higher all-cause, all-cancer, and all-CVD mortality risks among women.
外源性暴露可能共同导致慢性、低水平炎症，并增加主要慢性疾病和死亡的风险。我们之前开发、验证并报告了一种新的、基于 FFQ 和基于生活方式问卷的炎症生物标志物面板加权的、主要基于全食物的 19 成分饮食炎症评分（DIS）和 4 成分生活方式炎症评分（LIS；包括身体活动、饮酒量、BMI 和当前吸烟状况）。这两个评分与 3 个群体中的循环炎症生物标志物的相关性均强于之前报告的饮食炎症指数。DIS 和 LIS 与死亡率风险的关联尚未报道。
在前瞻性爱荷华州妇女健康研究（1986-2012 年；n=33155 名 55-69 岁女性，其中 17431 人在随访期间死亡，包括 4379 人死于癌症和 6574 人死于心血管疾病（CVD））中，分别研究 DIS 和 LIS 与全因、全癌和心血管疾病（CVD）死亡率风险的单独和联合关联。
我们将每个研究参与者的评分组成部分相加，按其已发表的权重加权，得出参与者的炎症评分；分数越高表示炎症越严重。我们使用多变量 Cox 比例风险回归评估 DIS 和 LIS 与死亡率的关联。
在 DIS 和 LIS 最高五分位组与最低五分位组相比，全因死亡率的调整 HR 分别为 1.11（95%CI：1.05-1.16）和 1.60（95%CI：1.53-1.68）；全癌死亡率分别为 1.07（95%CI：0.97-1.17）和 1.51（95%CI：1.38-1.66）；CVD 死亡率分别为 1.12（95%CI：1.03-1.21）和 1.79（95%CI：1.66-1.94）（所有 Ptrend 值均<0.01）。在最高五分位组与最低五分位组相比，全因、全癌和全-CVD 死亡率的 HR 分别为 1.88（95%CI：1.71-2.08）、1.82（95%CI：1.50-2.20）和 1.92（95%CI：1.64-2.24）。
饮食和生活方式更具炎症性，单独或联合起来，可能与女性全因、全癌和全-CVD 死亡率风险增加有关。
