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Dietary Inflammation Index and Its Association with Long-Term All-Cause and Cardiovascular Mortality in the General US Population by Baseline Glycemic Status.

ABSTRACT: Dietary inflammatory potential has been proven to be correlated with the incidence of diabetes and cardiovascular diseases. However, the evidence regarding the impact of dietary inflammatory patterns on long-term mortality is scarce. This cohort study aims to investigate the dietary inflammatory pattern of the general US individuals by baseline glycemic status and to estimate its association with long-term mortality. A total of 20,762 general American adults with different glycemic statuses from the National Health and Nutrition Examination Survey were included. We extracted 24-h dietary information, and the dietary inflammatory index (DII) was calculated. The outcomes were defined as 5-year all-cause and cardiovascular mortality. Compared with the normoglycemia group, individuals with prediabetes and type 2 diabetes had higher DII scores (overall weighted p < 0.001). Compared with low DII scores, participants with high DII scores were at a higher risk of long-term all-cause mortality (HR: 1.597, 95% CI: 1.370, 1.861; p < 0.001) and cardiovascular mortality (HR: 2.036, 95% CI: 1.458, 2.844; p < 0.001). The results were stable after adjusting for potential confounders. Moreover, the prognostic value of DII for long-term all-cause mortality existed only in diabetic individuals but not in the normoglycemia or prediabetes group (p for interaction = 0.006). In conclusion, compared to the normoglycemia or prediabetes groups, participants with diabetes had a higher DII score, which indicates a greater pro-inflammatory potential. Diabetic individuals with higher DII scores were at a higher risk of long-term all-cause and cardiovascular mortality.

SUBMITTER: Yuan S

PROVIDER: S-EPMC9268060 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe Healthy Eating Index-2015 (HEI-2015) score measures adherence to recommendations from the 2015-2020 Dietary Guidelines for Americans. The HEI-2015 was altered from the HEI-2010 by reclassifying sources of dietary protein and replacing the empty calories component with 2 new components: saturated fats and added sugars.ObjectivesOur aim was to assess whether the HEI-2015 score, along with 3 other previously defined indices, were associated with incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality.MethodsWe conducted a prospective analysis of 12,413 participants aged 45-64 y (56% women) from the Atherosclerosis Risk in Communities (ARIC) Study. The HEI-2015, Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension Trial (DASH) scores were computed using the average dietary intakes of Visits 1 (1987-1989) and 3 (1993-1995). Incident CVD, CVD mortality, and all-cause mortality data were ascertained from baseline through 31 December, 2017. We used Cox proportional hazards models to estimate HRs and 95% CIs.ResultsThere were 4509 cases of incident CVD, 1722 cases of CVD mortality, and 5747 cases of all-cause mortality over a median of 24-25 y of follow-up. Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a 16% lower risk of incident CVD (HR: 0.84; 95% CI: 0.76-0.93; P-trend < 0.001), 32% lower risk of CVD mortality (HR: 0.68; 95% CI: 0.58-0.80; P-trend < 0.001), and 18% lower risk of all-cause mortality (HR: 0.82; 95% CI: 0.75-0.89; P-trend < 0.001) after adjusting for demographic and lifestyle covariates. There were similar protective associations for AHEI-2010, aMed, and DASH scores, and no significant interactions by race.ConclusionsHigher adherence to the 2015-2020 Dietary Guidelines for Americans was associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among US adults.

Project description:BACKGROUND: The relationship between dietary glycemic index, glycemic load and risk of coronary heart disease (CHD), stroke, and stroke-related mortality is inconsistent. METHODS: We systematically searched the MEDLINE, EMBASE, and Science Citation Index Expanded databases using glycemic index, glycemic load, and cardiovascular disease and reference lists of retrieved articles up to April 30, 2012. We included prospective studies with glycemic index and glycemic load as the exposure and incidence of fatal and nonfatal CHD, stroke, and stroke-related mortality as the outcome variable. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects models. RESULTS: Fifteen prospective studies with a total of 438,073 participants and 9,424 CHD cases, 2,123 stroke cases, and 342 deaths from stroke were included in the meta-analysis. Gender significantly modified the effects of glycemic index and glycemic load on CHD risk, and high glycemic load level was associated with higher risk of CHD in women (RR=1.49, 95%CI 1.27-1.73), but not in men (RR=1.08, 95%CI 0.91-1.27). Stratified meta-analysis by body mass index indicated that among overweight and obese subjects, dietary glycemic load level were associated with increased risk of CHD (RR=1.49, 95%CI 1.27-1.76; P for interaction=0.003). Higher dietary glycemic load, but not glycemic index, was positively associated with stroke (RR=1.19, 95% CI 1.00-1.43). There is a linear dose-response relationship between dietary glycemic load and increased risk of CHD, with pooled RR of 1.05 (95%CI 1.02-1.08) per 50-unit increment in glycemic load level. CONCLUSION: High dietary glycemic load is associated with a higher risk of CHD and stroke, and there is a linear dose-response relationship between glycemic load and CHD risk. Dietary glycemic index is slightly associated with risk of CHD, but not with stroke and stroke-related death. Further studies are needed to verify the effects of gender and body weight on cardiovascular diseases.

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Dietary Inflammation Index and Its Association with Long-Term All-Cause and Cardiovascular Mortality in the General US Population by Baseline Glycemic Status.

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