Han YuNan, Li Lin, Wang YongXiang, Fan Wen
Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China.
Department of Medicine, Yangtze University, Jingzhou, Hubei, China.
Front Nutr. 2025 Aug 22;12:1607162. doi: 10.3389/fnut.2025.1607162. eCollection 2025.
Inflammation and oxidative stress (OS) are critical factors in the pathogenesis of chronic diseases (CDs), with dietary factors being a central modifiable determinant. This study aimed to assess the association of the Dietary Inflammation Index (DII) and Dietary Oxidative Balance Score (DOBS) with all-cause and cardiovascular (CV) mortality in non-diabetic adults.
Data on non-diabetic adults were extracted from the National Health and Nutrition Examination Survey (NHANES) (2009-2018). Dietary information was collected via 24-h recalls, and DII and DOBS were calculated. Multivariate weighted Cox proportional hazards models, Kaplan-Meier (KM) survival analysis, and restricted cubic spline (RCS) analyses were conducted to assess mortality associations. Subgroup analyses were performed based on gender, age, BMI, smoking status, hypertension, and hyperlipidemia.
After applying multivariable-weighted Cox proportional hazards regression, participants with the highest DII quartile exhibited elevated risks of all-cause mortality [Q4: HR = 1.554 (1.258, 1.934)] and CV mortality [Q4: HR = 2.100 (1.307, 3.375)]. In contrast, the highest DOBS quartile was linked to reduced all-cause mortality [Q4: HR = 0.724 (0.553, 0.946)], with no significant association observed for CV mortality. RCS analyses confirmed a positive dose-response between DII and both mortality outcomes, as well as an inverse relationship for DOBS. Subgroup analyses revealed that high DOBS (Q4) scores were negatively associated with all-cause and CV mortality in women, individuals aged ≥60 years, current smokers, hypertensive individuals, and those without dyslipidemia. High DII (Q4) scores were positively associated with all-cause mortality across all sexes, individuals aged ≥60 years, smokers, and those with hypertension or dyslipidemia. Additionally, high DII scores were associated with CV mortality among women, both smokers and non-smokers, and individuals without hypertension or dyslipidemia.
Higher DOBS levels are associated with lower all-cause mortality, while higher DII levels are linked to increased all-cause and CV mortality. Dietary interventions targeting inflammation may reduce mortality risks, thereby informing public health strategies.
炎症和氧化应激（OS）是慢性病（CDs）发病机制中的关键因素，饮食因素是一个可改变的核心决定因素。本研究旨在评估饮食炎症指数（DII）和饮食氧化平衡评分（DOBS）与非糖尿病成年人全因死亡率和心血管（CV）死亡率之间的关联。
从国家健康与营养检查调查（NHANES）（2009 - 2018年）中提取非糖尿病成年人的数据。通过24小时回忆法收集饮食信息，并计算DII和DOBS。进行多变量加权Cox比例风险模型、Kaplan - Meier（KM）生存分析和受限立方样条（RCS）分析以评估死亡率关联。基于性别、年龄、体重指数、吸烟状况、高血压和高脂血症进行亚组分析。
应用多变量加权Cox比例风险回归后，DII四分位数最高的参与者全因死亡率风险升高[Q4：HR = 1.554（1.258，1.934）]和CV死亡率风险升高[Q4：HR = 2.100（1.307，3.375）]。相比之下，DOBS四分位数最高与全因死亡率降低相关[Q4：HR = 0.724（0.553，0.946）]，未观察到与CV死亡率有显著关联。RCS分析证实DII与两种死亡率结果之间存在正剂量反应关系，DOBS则呈反比关系。亚组分析显示，高DOBS（Q4）评分与女性、年龄≥60岁的个体、当前吸烟者、高血压个体以及无血脂异常者的全因死亡率和CV死亡率呈负相关。高DII（Q4）评分与所有性别、年龄≥60岁的个体、吸烟者以及患有高血压或血脂异常者的全因死亡率呈正相关。此外，高DII评分与女性（无论吸烟与否）以及无高血压或血脂异常者的CV死亡率相关。
较高的DOBS水平与较低的全因死亡率相关，而较高的DII水平与全因死亡率和CV死亡率增加相关。针对炎症的饮食干预可能降低死亡风险，从而为公共卫生策略提供依据。
