Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose-response meta-analysis of observational studies

Zahra Aslani; Omid Sadeghi; Motahar Heidari-Beni; Hoda Zahedi; Fereshteh Baygi; Nitin Shivappa; James R Hébert; Sajjad Moradi; Gity Sotoudeh; Hamid Asayesh; Shirin Djalalinia; Mostafa Qorbani

doi:10.1186/s13098-020-00592-6

Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose-response meta-analysis of observational studies

Diabetol Metab Syndr. 2020 Oct 7:12:86. doi: 10.1186/s13098-020-00592-6. eCollection 2020.

Authors

Zahra Aslani^{1

2}, Omid Sadeghi^{1

2}, Motahar Heidari-Beni³, Hoda Zahedi⁴, Fereshteh Baygi⁵, Nitin Shivappa^{6

7

8}, James R Hébert^{6

7

8}, Sajjad Moradi^{9

10}, Gity Sotoudeh¹, Hamid Asayesh¹¹, Shirin Djalalinia^{12

13}, Mostafa Qorbani^{14

15}

Affiliations

¹ Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
² Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³ Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.
⁶ Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA.
⁷ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA.
⁸ Connecting Health Innovations LLC, Columbia, SC 29201 USA.
⁹ Halal Research Center of IRI, FDA, Tehran, Iran.
¹⁰ Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
¹¹ Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
¹² Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran.
¹³ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
¹⁴ Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
¹⁵ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Context: The association of dietary inflammatory index (DII®), as an index of inflammatory quality of diet, with cardiometabolic diseases (CMDs) and risk factors (CMRFs) has been inconsistent in previous studies.

Objective: The current systematic review and dose-response meta-analysis was performed to investigate the association of the DII score with CMDs and CMRFs.

Data sources: All published observational studies (cohort, case-control and cross-sectional) using PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar databases were retrieved from inception through November 2019.

Data extraction: Two reviewers independently extracted the data from included studies.

Data analysis: Pooled hazard ratio (HR) or odds ratio (OR) were calculated by using a random-effects model.

Results: Ten prospective cohort studies (total n = 291,968) with 31,069 CMDs-specific mortality, six prospective cohort studies (total n = 43,340) with 1311 CMDs-specific morbidity, two case-control studies with 2140 cases and 6246 controls and one cross-sectional study (total n = 15,613) with 1734 CMDs-specific morbidity were identified for CMDs. Meta-analyses of published observational studies demonstrated that the highest DII score category versus the lowest DII score category was associated with 29% increased risk of CMDs mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41). Moreover, there was a significant association between the DII score and risk of CMDs in cohort studies (HR = 1.35; 95% CI 1.13, 1.61) and non-cohort study (HR = 1.36; 95% CI 1.18, 1.57). We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension. None-linear dose response meta-analysis showed that there was a significant association between the DII score and risk of CMDs mortality (P_nonlinearity < 0.001). Moreover, evidence of none-linear association between the DII score and risk of CMDs was not observed (p-value = 0.1).

Conclusions: Adherence to pro-inflammatory diet was associated with increased risk of CMDs, mortality and MetS.

Keywords: Cardiovascular diseases; Diet; Dietary inflammatory index; Inflammation.

Publication types

Review