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Prospective association between the Dietary Inflammatory Index and mortality: modulation by antioxidant supplementation in the SU.VI.MAX randomized controlled trial.
Am J Clin Nutr 2016; 103(3):878-85AJ

Abstract

BACKGROUND

Chronic inflammation is a central mechanism involved in cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, 4 leading causes of mortality. Diet is a major source of pro- and anti-inflammatory bioactive compounds. The Dietary Inflammatory Index (DII) was designed to estimate the overall inflammatory potential of the diet.

OBJECTIVE

Our aim was to study the prospective association between the DII and mortality, as well as assess whether antioxidant supplementation could modulate this association.

DESIGN

The Supplémentation en Vitamines et Minéraux Antioxydants study was a randomized, double-blind, placebo-controlled trial in which participants received low-dose antioxidants or a placebo from 1994 to 2002. In this observational prospective analysis, 8089 participants (mean ± SD age at baseline: 49.0 ± 6.3 y) were followed between 1994 and 2007 (median: 12.4 y). The DII was calculated from repeated 24-h dietary records; higher scores correspond to more proinflammatory diets. A total of 207 deaths occurred during follow-up, including 123 due to cancer and 41 due to cardiovascular events. Multivariate Cox proportional hazards models were computed.

RESULTS

Sex-specific tertiles of the DII were positively associated with cardiovascular + cancer mortality (HR for tertile 3 compared with tertile 1 = 1.53; 95% CI: 1.01, 2.32; P-trend = 0.05) and specific cancer mortality (HR for tertile 3 compared with tertile 1 = 1.83; 95% CI: 1.12, 2.99; P-trend = 0.02). The corresponding P value was 0.07 for all-cause mortality. The DII was statistically significantly associated with increased all-cause mortality in the placebo group (HR for tertile 3 compared with tertile 1 = 2.10; 95% CI: 1.15, 3.84; P-trend = 0.02) but not in the antioxidant-supplemented group (P-trend = 0.8; P-interaction = 0.098).

CONCLUSION

These results suggest that a proinflammatory diet is associated with increased all-cause and cancer mortality and antioxidants may counteract some of the proinflammatory effects of the diet. This trial was registered at clinicaltrials.gov as NCT00272428.

Authors+Show Affiliations

Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;AgroParisTech and INRA, Research Center in Human Nutrition from the Ile-de-France region, Mixt Research Unit 914 Nutrition Physiology and Ingestive Behavior, Paris, France;Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and.Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and.Cancer Prevention and Control Program, and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and Connecting Health Innovations LLC, Columbia, SC; and.Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France.Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France; Public Health Department, Avicenne Hospital, Bobigny, France.Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France;Sorbonne Paris Cité Epidemiology and Statistics Research Center, French National Institutes of Health and Medical Research (Inserm) U1153, French National Institute for Agricultural Research (INRA) U1125, French National Conservatory of Arts and Crafts (Cnam), Paris 13 University, Nutritional Epidemiology Research Team, Bobigny, France; m.touvier@eren.smbh.univ-paris13.fr.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26864363

Citation

Graffouillère, Laurie, et al. "Prospective Association Between the Dietary Inflammatory Index and Mortality: Modulation By Antioxidant Supplementation in the SU.VI.MAX Randomized Controlled Trial." The American Journal of Clinical Nutrition, vol. 103, no. 3, 2016, pp. 878-85.
Graffouillère L, Deschasaux M, Mariotti F, et al. Prospective association between the Dietary Inflammatory Index and mortality: modulation by antioxidant supplementation in the SU.VI.MAX randomized controlled trial. Am J Clin Nutr. 2016;103(3):878-85.
Graffouillère, L., Deschasaux, M., Mariotti, F., Neufcourt, L., Shivappa, N., Hébert, J. R., ... Touvier, M. (2016). Prospective association between the Dietary Inflammatory Index and mortality: modulation by antioxidant supplementation in the SU.VI.MAX randomized controlled trial. The American Journal of Clinical Nutrition, 103(3), pp. 878-85. doi:10.3945/ajcn.115.126243.
Graffouillère L, et al. Prospective Association Between the Dietary Inflammatory Index and Mortality: Modulation By Antioxidant Supplementation in the SU.VI.MAX Randomized Controlled Trial. Am J Clin Nutr. 2016;103(3):878-85. PubMed PMID: 26864363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective association between the Dietary Inflammatory Index and mortality: modulation by antioxidant supplementation in the SU.VI.MAX randomized controlled trial. AU - Graffouillère,Laurie, AU - Deschasaux,Mélanie, AU - Mariotti,François, AU - Neufcourt,Lola, AU - Shivappa,Nitin, AU - Hébert,James R, AU - Wirth,Michael D, AU - Latino-Martel,Paule, AU - Hercberg,Serge, AU - Galan,Pilar, AU - Julia,Chantal, AU - Kesse-Guyot,Emmanuelle, AU - Touvier,Mathilde, Y1 - 2016/02/10/ PY - 2015/10/26/received PY - 2015/12/28/accepted PY - 2017/03/01/pmc-release PY - 2016/2/12/entrez PY - 2016/2/13/pubmed PY - 2016/7/9/medline KW - Dietary Inflammatory Index KW - antioxidants KW - inflammation KW - mortality KW - prospective study SP - 878 EP - 85 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 3 N2 - BACKGROUND: Chronic inflammation is a central mechanism involved in cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, 4 leading causes of mortality. Diet is a major source of pro- and anti-inflammatory bioactive compounds. The Dietary Inflammatory Index (DII) was designed to estimate the overall inflammatory potential of the diet. OBJECTIVE: Our aim was to study the prospective association between the DII and mortality, as well as assess whether antioxidant supplementation could modulate this association. DESIGN: The Supplémentation en Vitamines et Minéraux Antioxydants study was a randomized, double-blind, placebo-controlled trial in which participants received low-dose antioxidants or a placebo from 1994 to 2002. In this observational prospective analysis, 8089 participants (mean ± SD age at baseline: 49.0 ± 6.3 y) were followed between 1994 and 2007 (median: 12.4 y). The DII was calculated from repeated 24-h dietary records; higher scores correspond to more proinflammatory diets. A total of 207 deaths occurred during follow-up, including 123 due to cancer and 41 due to cardiovascular events. Multivariate Cox proportional hazards models were computed. RESULTS: Sex-specific tertiles of the DII were positively associated with cardiovascular + cancer mortality (HR for tertile 3 compared with tertile 1 = 1.53; 95% CI: 1.01, 2.32; P-trend = 0.05) and specific cancer mortality (HR for tertile 3 compared with tertile 1 = 1.83; 95% CI: 1.12, 2.99; P-trend = 0.02). The corresponding P value was 0.07 for all-cause mortality. The DII was statistically significantly associated with increased all-cause mortality in the placebo group (HR for tertile 3 compared with tertile 1 = 2.10; 95% CI: 1.15, 3.84; P-trend = 0.02) but not in the antioxidant-supplemented group (P-trend = 0.8; P-interaction = 0.098). CONCLUSION: These results suggest that a proinflammatory diet is associated with increased all-cause and cancer mortality and antioxidants may counteract some of the proinflammatory effects of the diet. This trial was registered at clinicaltrials.gov as NCT00272428. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26864363/Prospective_association_between_the_Dietary_Inflammatory_Index_and_mortality:_modulation_by_antioxidant_supplementation_in_the_SU_VI_MAX_randomized_controlled_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.126243 DB - PRIME DP - Unbound Medicine ER -