Abstract
Sepsis – syndrome of infection complicated by organ dysfunction – is responsible for over 750 000 hospitalisations and 200 000 deaths in the USA annually. Despite potential nutritional benefits, the association of diet and sepsis is unknown. Therefore, we sought to determine the association between adherence to a Mediterranean-style diet (Med-style diet) and long-term risk of sepsis in the REasons for Geographic Differences in Stroke (REGARDS) cohort. We analysed data from REGARDS, a population-based cohort of 30 239 community-dwelling adults age ≥45 years. We determined dietary patterns from a baseline FFQ. We defined Med-style diet as a high consumption of fruit, vegetables, legumes, fish, cereal and low consumption of meat, dairy products, fat and alcohol categorising participants into Med-style diet tertiles (low: 0–3, moderate: 4–5, high: 6–9). We defined sepsis events as hospital admission for serious infection and at least two systematic inflammatory response syndrome criteria. We used Cox proportional hazard models to determine the association between Med-style diet tertiles and first sepsis events, adjusting for socio-demographics, lifestyle factors, and co-morbidities. We included 21 256 participants with complete dietary data. Dietary patterns were: low Med-style diet 32⋅0%, moderate Med-style diet 42⋅1% and high Med-style diet 26⋅0%. There were f 109 (5⋅2%) first sepsis events. High Med-style diet was independently associated with sepsis risk; low Med-style diet referent, moderate Med-style diet adjusted hazard ratio (HR) 0⋅93 (95% CI 0⋅81, 1⋅08), high Med-style diet adjusted HR=0⋅74 (95% CI 0⋅61, 0⋅88). High Med-style diet adherence is associated with lower risk of sepsis. Dietary modification may potentially provide an option for reducing sepsis risk.
Highlights
Kidney infection, cellulitis and meningitis can trigger sepsis[1], which is a lifethreatening organ dysfunction resulting from a dysregulated host response to infection[2]
Other studies have shown that a greater adherence to a Western diet – high consumption of red meats, fat/dairy productions and refined grains – is associated with higher levels of biomarkers of endothelial and inflammation dysfunction[10,11,12], which are both implicated in the biological pathway of sepsis[13,14,15]
Med-style diet has been reported as a model for healthy eating secondary to its contributions to a more favourable health status and overall quality of life[18,19], as well as its beneficial roles in reducing CVD and chronic degenerative disease occurrence[18,20]
Summary
Kidney infection, cellulitis and meningitis can trigger sepsis[1], which is a lifethreatening organ dysfunction resulting from a dysregulated host response to infection[2]. Other studies have shown that a greater adherence to a Western diet – high consumption of red meats, fat/dairy productions and refined grains – is associated with higher levels of biomarkers of endothelial and inflammation dysfunction[10,11,12], which are both implicated in the biological pathway of sepsis[13,14,15]. These two human studies show that a Southern and Western dietary pattern are associated with a higher risk of sepsis. We seek to examine the association between adherence to Med-style diet and risk of sepsis in communitydwelling participants of the REasons for Geographic and Racial Differences in Stroke (REGARDS) study
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