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Association between inflammatory potential of diet and mortality in the Iowa Women’s Health study

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Abstract

Purpose

Chronic diseases such as cancer and cardiovascular disease (CVD) are well-established causes of disability and premature deaths. Dietary components that are known to affect chronic inflammation have been implicated in the etiology and prognosis of these chronic diseases. We examined the ability of the dietary inflammatory index (DII) to predict overall, cancer and CVD mortality in the Iowa Women’s Health study.

Methods

The DII was computed from baseline dietary intake assessed in this cohort of 37,525 women, who were aged 55–69 years when enrolled starting in 1986. During the follow-up period, through December 31, 2010, in a total of 17,793 deaths, 5044 cancer- and 6528 CVD-related deaths were identified through mortality record linkage. Cox proportional hazards regression was used to estimate hazard ratios (HR) with DII expressed both as a continuous variable and as quartiles.

Results

Comparing subjects in DII Quartile 4 versus Quartile 1, modest positive associations were noted for all-cause mortality (HRQ4vsQ1 1.07; 95 % CI 1.01–1.13; p-trend = 0.006), digestive cancer mortality (HRQ4vsQ1 1.19; 95 % CI 1.00–1.43; p-trend = 0.05), CVD mortality (HRQ4vsQ1 1.09; 95 % CI 1.01–1.18; p-trend = 0.08), non-cancer/non-CVD/non-acute mortality (HRQ4vsQ1 1.09; 95 % CI 1.00–1.19; p-trend = 0.19), coronary heart disease (CHD) mortality (HRQ4vsQ1 1.17; 95 % CI 1.05–1.30; p-trend = 0.001) and chronic obstructive pulmonary disease (COPD) mortality (HRQ4vsQ1 1.43; 95 % CI 1.18–1.75; p-trend = 0.0006). No substantial associations were observed for mortality from stroke, Alzheimer’s disease or unspecified dementia.

Conclusion

These results indicate that a pro-inflammatory diet, as evidenced by higher DII scores, may be associated with total mortality as well as mortality from digestive cancer, CVD, CHD and COPD.

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Acknowledgments

This study was supported by National Cancer Institute Grant R01 CA39742. Drs. N. Shivappa and J.R. Hebert were supported by Grant Number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases. A.E. Prizment was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA

    Nitin Shivappa, Susan E. Steck & James R. Hébert

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Nitin Shivappa, Susan E. Steck & James R. Hébert

  3. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA

    Cindy K. Blair, Anna E. Prizment & David R. Jacobs Jr.

  4. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA

    Anna E. Prizment

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  1. Nitin Shivappa
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Correspondence to Nitin Shivappa.

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Ethical disclosure:

Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr Nitin Shivappa is an employee of CHI.

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Shivappa, N., Blair, C.K., Prizment, A.E. et al. Association between inflammatory potential of diet and mortality in the Iowa Women’s Health study. Eur J Nutr 55, 1491–1502 (2016). https://doi.org/10.1007/s00394-015-0967-1

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