@article{ref1,
title="Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies",
journal="Clinical nutrition",
year="2019",
author="Garcia-Arellano, Ana and Martinez-Gonzalez, Miguel A. and Ramallal, Raul and Salas-Salvadó, Jordi and Hébert, James R. and Corella, Dolores and Shivappa, Nitin and Forga, Luis and Schroder, Helmut and Muñoz-Bravo, Carlos and Estruch, Ramón and Fiol, Miquel and Lapetra, José and Serra-Majem, Lluis and Ros, Emilio and Rekondo, Javier and Toledo, Estefania and Razquin, Cristina and Ruiz-Canela, Miguel and SUN and PREDIMED Study Investigators, ",
volume="38",
number="3",
pages="1221-1231",
abstract="BACKGROUND: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. OBJECTIVE: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts. DESIGN: We assessed 18,566 participants in the &quot;Seguimiento Universidad de Navarra&quot; (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the &quot;PREvencion con DIeta MEDiterránea&quot; (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality. RESULTS: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%-32%, for the highest vs lowest category of DII). CONCLUSION: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.<p /><p>Language: en</p>",
language="en",
issn="0261-5614",
doi="10.1016/j.clnu.2018.05.003",
url="http://dx.doi.org/10.1016/j.clnu.2018.05.003"
}