European Journal of Nutrition

, Volume 56, Issue 2, pp 683–692

Inflammatory potential of diet and all-cause, cardiovascular, and cancer mortality in National Health and Nutrition Examination Survey III Study

  • Nitin Shivappa
  • Susan E. Steck
  • James R. Hussey
  • Yunsheng Ma
  • James R. Hebert
Original Contribution

Abstract

Background

Various dietary components have been studied in relation to overall mortality; however, little is known about the relationship between the inflammatory potential of overall diet and mortality.

Materials and methods

We examined the association between the dietary inflammatory index (DII) and mortality in the National Health and Nutrition Examination Survey III follow-up study. The DII was computed from baseline dietary intake assessed using 24-h dietary recalls (1988–1994). Mortality was determined from the National Death Index records through 2006. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence interval (95 % CI). During the follow-up, 2795 deaths were identified, including 1233 due to cardiovascular disease (CVD), and 615 due to cancer, 158 of which were due to digestive-tract cancers.

Results

Multivariate Cox proportional hazards regression analyses, adjusting for age, race, diabetes status, hypertension, physical activity, body mass index, poverty index, and smoking, revealed positive associations between higher DII scores and mortality. Comparing subjects in DII tertile 3 versus tertile 1, significant associations were noted for all-cause mortality (HRTertile3vs1 1.34; 95 % CI 1.19–1.51, Ptrend < 0.0001), CVD mortality (HRTertile3vs1 1.46; 95 % CI 1.18–1.81, Ptrend = 0.0006), cancer mortality (HRTertile3vs1 1.46; 95 % CI 1.10–1.96, Ptrend = 0.01), and digestive-tract cancer mortality (HRTertile3vs1 2.10; 95 % CI 1.15–3.84, Ptrend = 0.03).

Conclusion

These results indicate that a pro-inflammatory diet, as indicated by higher DII scores, was associated with higher risk of all-cause, CVD, and cancer mortality.

Keywords

Dietary inflammatory index Mortality NHANES III 

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Nitin Shivappa
    • 1
    • 2
  • Susan E. Steck
    • 1
    • 2
  • James R. Hussey
    • 2
  • Yunsheng Ma
    • 3
  • James R. Hebert
    • 1
    • 2
  1. 1.Cancer Prevention and Control ProgramUniversity of South CarolinaColumbiaUSA
  2. 2.Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  3. 3.Division of Preventive and Behavioral Medicine, Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA

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