Dietary Inflammatory Index and Cardiovascular Disease Risk Factors in Patients With Chronic Kidney Disease and Type 2 Diabetes

Abstract

Abstract Objectives Inflammation is associated with several chronic diseases, including chronic kidney disease (CKD) and type 2 diabetes (T2D). Because dietary choices may impact chronic inflammation, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of the diet. Using the DII, this study examined the association of cardiovascular disease (CVD) risk factors and diet in patients with CKD and T2D. Methods Baseline three-day food records were obtained from 241 participants in a lifestyle intervention study, and analyzed using Nutrition Data System for Research (2014). DII scores were calculated, with higher scores suggesting a more pro-inflammatory diet. Participants were dichotomized into an anti-inflammatory diet (AID; DII < 0; n = 118) or pro-inflammatory diet (PID; DII ≥ 0; n = 123) group, based on DII score. CVD risk factors included estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), systolic blood pressure (BP), diastolic BP, pulse wave velocity, fasting lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), and hemoglobin A1C (HbA1C). Independent two sample t-tests assessed differences in CVD risk factors between groups. Results Participants were 50% male, 88% non-Hispanic, 66% white, and 65 ± 9SD years of age with a mean body mass index of 33.7 ± 5.1SD kg/m2. Approximately 51% of the participants followed a diet that would be considered pro-inflammatory. Participants in the AID group had a higher eGFR (AID: 75 ± 21SD mL/min/1.73m2, PID: 68 ± 20SD mL/min/1.73m2; p = 0.017) compared to the PID group. No significant differences were found between groups for the other CVD risk factors (CRP, systolic BP, diastolic BP, pulse wave velocity, fasting lipids [total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides], and HbA1C). Conclusions Participants reporting an AID had a higher eGFR than those reporting a PID. Contrary to expectations, other CVD risk factors did not differ between groups. Additional research should examine the role of an AID, emphasizing whole grains, fruits, vegetables, fatty fish, nuts, and legumes, for disease management in patients with CKD and T2D. Funding Sources Supported by NIH RO1 DK100492.