Abstract
Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]Quintile 5 vs. 1 1.43; 95% CI 1.04–1.96) and in women (HRQuintile 5 vs. 1 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HRQuintile 5 vs. 1 1.80; 95% CI 1.03–3.12), obese men (HRQuintile 5 vs. 1 1.77; 95% CI 1.13–2.76) and men who smoked (HRQuintile 5 vs. 1 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HRQuintile 5 vs. 1 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.
Highlights
Diet has been known to play an important role in modulating chronic inflammation [1,2,3].Chronic inflammation is characterized by the constant presence in the blood stream of pro-inflammatory cytokines that are associated with tissue injury as a result of histamine produced by damaged mast cells [4]
We observed that the Korean participants who had higher Dietary Inflammatory Index (DII) scores were at 63% higher risk of developing overall cardiovascular diseases (CVD), which was attenuated after multivariable-adjustment (32% higher risk of overall CVD)
We found a null association between DII and myocardial infarction (MI) risk, while we did observe a positive association between the DII and stroke
Summary
Chronic inflammation is characterized by the constant presence in the blood stream of pro-inflammatory cytokines that are associated with tissue injury as a result of histamine produced by damaged mast cells [4]. Inflammation is caused as a response to repeated injury and involves the release of pro-inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin (IL)-1, and IL-6 [5], which promotes the progression of atherosclerosis, leading to plaque rupture and thrombosis [4]. Data from the United States alone suggest that approximately 0.55 million first episodes and 0.2 million repeated episodes of acute MI occur annually [8], while 15 million people suffer from stroke worldwide with five million deaths and Nutrients 2020, 12, 588; doi:10.3390/nu12020588 www.mdpi.com/journal/nutrients. MI and stroke have affected large numbers of people around the world [10,11,12] including Korea [13]
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