Dietary inflammatory index or Mediterranean diet score as risk factors for total and cardiovascular mortality

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 28; no. 5; pp. 461 - 469
• Main Authors: Hodge, A.M., Bassett, J.K., Dugué, P.-A., Shivappa, N., Hébert, J.R., Milne, R.L., English, D.R., Giles, G.G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-05-2018
• Subjects: Adult; Aged; Cardiovascular disease; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Coronary heart disease; Diet - adverse effects; Diet Surveys; Diet, Healthy; Diet, Mediterranean; Dietary inflammatory index; Epidemiology; Feeding Behavior; Female; Humans; Inflammation - diagnosis; Inflammation - mortality; Inflammation - prevention & control; Male; Mediterranean diet score; Middle Aged; Mortality; Nutritive Value; Prospective; Prospective Studies; Protective Factors; Risk Assessment; Risk Factors; Time Factors; Victoria - epidemiology; Victoria; Prospective; Mortality; Cardiovascular disease; Mediterranean diet score; Dietary inflammatory index; Coronary heart disease; Epidemiology
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2018.01.010

Dietary patterns are associated with risk of cardiovascular disease (CVD). We aimed to examine associations of the Dietary Inflammatory Index (DII) and the Mediterranean Diet Score (MDS) with total, cardiovascular disease (CVD) and coronary heart disease (CHD) mortality in the Melbourne Collaborative Cohort Study; and compare the strengths of the associations.
In our prospective cohort study of 41,513 men and women aged 40–69 years, a food frequency questionnaire was completed at baseline and mortality data were obtained via linkage with local and national registries over an average of 19 years follow up. At baseline, questionnaires were completed and physical measures and blood samples taken. Cox proportional hazards models, adjusting for age, alcohol consumption, sex, region of origin, personal history of CVD or diabetes and family history of CVD, were used to assess associations between dietary scores and mortality.
More Mediterranean or less inflammatory diets were associated with lower total, CVD and CHD mortality. The hazard ratio for total mortality comparing the highest and lowest quintiles was 1.16 (95%CI: 1.08–1.24) for DII; and 0.86 (95%CI: 0.80–0.93) comparing the highest and lowest three categories of MDS. Using the Bayesian information criterion, there was no evidence that the DII score was more strongly associated with total and CVD mortality than was the MDS.
The MDI and the DII show similar associations with total and cardiovascular mortality, consistent with the consensus that plant-based diets are beneficial for health.
•More Mediterranean or less inflammatory diets associated with lower mortality.•DII score was not more strongly associated with mortality than was the MDS.•The results are consistent with plant-based diets being beneficial for health.