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Title

Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies

AuthorsGarcía-Arellano, Ana; Martínez-González, Miguel Ángel; Ramallal, Raul; Salas-Salvadó, Jordi; Hébert, James R.; Corella, Dolores; Shivappa, Nitin; Forga, Luis; Schröder, Helmut; Muñoz-Bravo, C.; Estruch, Ramón; Sánchez-Villegas, A.; Muñoz-Aguayo, D.; Fiol, F.; Montull, I.; Warnberg, J.; Sarmiendo de la Fe, F.; Sáiz, C.; Altés, A.; Ibarrola, N.; Ginard, M.; González, J. I.; Ruiz Zambrana, A.; Cabeza-Beunza, J. A.; Cofán, Montserrat; Álvarez-Pérez, J.; Santos-Lozano, J. M.; Alonso, A.; Cia-Lecumberri, P.; Elcarte-Lopez, T.; Rovira, A.; Corchado, Y.; Lasanta-Saez, M. J.; Diéz-Espino, Javier; Coltell, O.; Rosa, Pedro Antonio de la; Tur, Josep A.; Razquin, Cristina; Fernández-Carrión, Rebeca; Guillem-Saiz, P.; Gonzaláz-Monje, I.; Benito Crochon, S.; Simón, C.; Basells, J.; Quiles, L.; Santamaria, M. I.; Mendonça, R.; Jover, A.; Amorós, M.; Llauradó, M.; Tabar-Sarrias, J. A.; Quinzavos, L.; Cervantes, S.; Corbella, E.; Vivo, M.; García, Y.; Villanueva Moreno, R.; Castañer, Olga; Diego Salas, J. de; Nuñez-Córdoba, J. M.; Vázquez Ruiz, Z.; Baca Osorio, A.; Gil Zarzosa, J.; Sánchez Luque, J. J.; Vargas López, E.; Basora-Gallisa, J.; Simón García, C.; Papandreou, Christopher; Osma, R.; Francisco, S.; Romaguera, Dora; Irala, J. de; Artal-Moneva, F.; Maldonado Díaz, I.; García, J.; Ortega-Azorín, C.; Portolés, Olga; Pla, I.; Cabre, M.; Toledo, Estefania; Sáez, G.; Valls-Pedret, C.; Castellote-Bargalló, A. I.; Rosique-Esteban, N.; Bulló, Mònica; Algorta, J.; Ortega-Calvo, M.; Viñas, C.; Esparza-Lopez, J. M.; Martinez-Mazo, M. D.; Leal, M.; Martínez, E.; Mellado, L.; Garcés Ducar, M. L.; Miró-Moriano, L.; Iglesias, C.; Brau, A.; Rovira, A.; Ruiz-Canela, Miguel; Fernandez-Crehuet, J.; Martínez, J. A.; Domínguez-Espinaco, C.; Fuente, Carmen de la; Parra, L.; Guarner, A.; Serrano-Martinez, M.; Fernandez-Rodríguez, M. J.; Sanz, E.; Martínez-González, José; Donat-Vargas, Carolina; Ferreira, C.; Farré, M.; Felipe, I.; Sanchez-Tainta, A.; Gea, A.; Rovira, M.A.; Elosua, R.; Rekondo, Javier; Serra-Mir, M.; Pimenta, A. M.; Vizcaíno, J.; Falcón Sanabria, I.; Mena, G.; Liroz, M.; Manzano, E.; Macías Gutiérrez, B.; Santana Santana, A. J.; Cruz, E. de la; Sala-Vila, A.; Pages, M. A.; Galera, A.; Pérez-Heras, A.; Hernández, P.; Donazar, M.; del Hierro, T.; Munar, J. A.; Maestre, E.; Godoy, D.; González, R.; Figuerido-Garmendia, E.; Pascual, V.; Barragán, R.; Lamuela-Raventos, R.; Fernandez, M.; Canudas, S.; Paris, F.; Gutierrez, E.; Murillo, C.; García, J.; Tafalla, M.; Basterra-Gortari, F. J.; Frontera, G.; Díez Benítez, E.; Vinyoles, E.; Bobe, I.; Molina, C.; Marrugat, J.; Sanjulian, B.; Fernandez Montero, A.; Tresserra-Rimbau, A.; Salaverria, I.; Munuera, S.; Altirriba, J.; Clos, J.; Alonso, A; Toledo-Atucha, J.; García-Valdueza, M.; García-Rodriguez, A.; Cabezas, C.; Goni-Ochandorena, E.; Schroder, H.; Carrasco, P.; Guillen-Grima, F.; Lahortiga, F.; Llorca, J.; Asensio, E. M.; Lopez del Burgo, C.; Riera, C.; Medina-Remon, A.; Lozano-Rodríguez, J. M.; Roura, P.; Ros, Emilio; Mari-Sanchıs, A.; Martínez, P.; Carratala-Calvo, A.; Parra-Osés, A.; Guasch‐Ferré, Marta; Marti, A.; Baby, P.; Juan, C.de; Basterra-Gortari, F. Javier; López-Sabater, M. C.; Ramos, A.; Pedret, R.; García Roselló, J.; Pascual-Pascual, P.; Vaquero-Díaz, S.; Sánchez, M. S.; Guillen, M.; Serra-Majem, Lluis; Estremera-Urabayen, J. V.; Navajas, R.; Sánchez-Navarro, S.; Casi, A.; García-Pérez, L.; Arroyo-Azpa, C.; Barcena, A. F.; Loma-Osorio, A.; Trias, F.; Oreja-Arrayago, C.; Proenza, A.; Sorlí, J.; Muñoz, Miguel Ángel; Portillo, M. P.; Bes-Rastrollo, M.; Sarasa, I; Benítez Pont, R.; Molina, N.; Pintó-Salas, X.; Bautista Castaño, I.; Villanueva, P.; Prieto, R.; Bestard, F.; Baena, J. M.; García, M. ; Oller, M.; Amat, J.; Díaz-López, A.; Solis, E.; Buil-Cosiales, Pilar; Duaso, I.; Bianchi Alba, M.; Iglesias, P.; Segarra, R.; Lapetra, Jose; Zazpe Garcia, I; Goday, A.; Cervello, T.; San Vicente, J.; Valero-Barcelo, C.; Mestres, G.; Díaz, A.; Yuste, M. C.; Ariz-Arnedo, M. J.; Martín, F.; Román, P.; Quifer-Rada, P.; Tort, N.; Isach, A.; Babio, Nancy; Salas-Huetos, A.; Carlos, Silvia; Giménez, F. J.; Rico, A.; Marti Massó, R.; Martín, M. T.; Becerra-Tomás, N.; Gómez-Huelgas, R.; Rodríguez, M.A.; Francés, F.; Giardina, S.; Arina-Vergara, E.; Casas, R.; Fiol, Miquel; Sayón-Orea, Carmen; Macua-Martínez, T.; Coll, L.; M.T. Barrio López, María; Sorlí, José V.; Marti, A.; Beunza, J.J.; Bonet, M. T.; Fernández-Ballart, J.; Mata, M.; Corbella, X.; Garcia, L.; Balanza, R.; Tello, S.; Vila, J.; Mengual, L.; Torre de la, R.; Araque, M.; Velasco García, V.; Fernandez-Urzainqui, L.; Benavent, J.; Domenech, M.
KeywordsMediterranean diet
Cohort studies
CRP
Mortality
Inflammation
Dietary inflammatory index
Issue DateJun-2019
PublisherElsevier
CitationClinical Nutrition 38(3): 1221-1231 (2019)
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 “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (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.
Publisher version (URL)http://dx.doi.org/10.1016/j.clnu.2018.05.003
URIhttp://hdl.handle.net/10261/214772
DOIhttp://dx.doi.org/10.1016/j.clnu.2018.05.003
ISSN0261-5614
E-ISSN1532-1983
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