Abstract
ContextThe association of dietary inflammatory index (DII®), as an index of inflammatory quality of diet, with cardiometabolic diseases (CMDs) and risk factors (CMRFs) has been inconsistent in previous studies.ObjectiveThe current systematic review and dose–response meta-analysis was performed to investigate the association of the DII score with CMDs and CMRFs.Data SourcesAll published observational studies (cohort, case–control and cross-sectional) using PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar databases were retrieved from inception through November 2019.Data extractionTwo reviewers independently extracted the data from included studies.Data analysisPooled hazard ratio (HR) or odds ratio (OR) were calculated by using a random-effects model.ResultsTen prospective cohort studies (total n = 291,968) with 31,069 CMDs-specific mortality, six prospective cohort studies (total n = 43,340) with 1311 CMDs-specific morbidity, two case–control studies with 2140 cases and 6246 controls and one cross-sectional study (total n = 15,613) with 1734 CMDs-specific morbidity were identified for CMDs. Meta-analyses of published observational studies demonstrated that the highest DII score category versus the lowest DII score category was associated with 29% increased risk of CMDs mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41). Moreover, there was a significant association between the DII score and risk of CMDs in cohort studies (HR = 1.35; 95% CI 1.13, 1.61) and non-cohort study (HR = 1.36; 95% CI 1.18, 1.57). We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension. None-linear dose response meta-analysis showed that there was a significant association between the DII score and risk of CMDs mortality (Pnonlinearity < 0.001). Moreover, evidence of none-linear association between the DII score and risk of CMDs was not observed (p-value = 0.1).ConclusionsAdherence to pro-inflammatory diet was associated with increased risk of CMDs, mortality and MetS.
Highlights
Chronic inflammation happens through frequent stress factors such as poor diet and obesity [1] and it is recognized with high levels of serum inflammatory biomarkersAslani et al Diabetol Metab Syndr (2020) 12:86 including high sensitivity C-reactive protein, interleukin (IL)-6, and tumor necrosis factor-α (TNFα)
Meta-analyses of published observational studies demonstrated that the highest dietary inflammatory index (DII) score category versus the lowest DII score category was associated with 29% increased risk of car‐ diometabolic diseases (CMDs) mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41)
We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension
Summary
Aslani et al Diabetol Metab Syndr (2020) 12:86 including high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and tumor necrosis factor-α (TNFα). This situation is associated with chronic outcomes including cardiovascular diseases (CVDs) [2], type 2 diabetes mellitus [3], cancer [4], obesity [5], and metabolic syndrome (MetS) and its components [6]. The dietary inflammatory index (DII) is a novel and validated tool designed in 2009 [13] and updated in 2014 to estimate the inflammatory potential of an individual’s diet [14] According to this index, the food items, macronutrients, and micronutrients (45 food parameters) based on their effect on inflammatory biomarkers (IL-1β, IL-4, IL-6, IL-10, TNF-α, and CRP) were classified into pro-inflammatory, anti-inflammatory, and inflammatory neutral [14]
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