title: Long-term adherence to healthy dietary guidelines and chronic inflammation in the prospective Whitehall II study.
abstract: BACKGROUND
  Inflammation plays an important role in the cause of cardiovascular diseases and may contribute to the association linking an unhealthy diet to chronic age-related diseases. However, to date the long-term associations between diet and inflammation have been poorly described. Our aim was to assess the extent to which adherence to a healthy diet and dietary improvements over a 6-year exposure period prevented subsequent chronic inflammation over a 5-year follow-up in a large British population of men and women.
  
  
  METHODS
  Data were drawn from 4600 adults (mean ± standard deviation, age 49.6 ± 6.1 years, 28% were women) from the prospective Whitehall cohort II study. Adherence to a healthy diet was measured using Alternative Healthy Eating Index (AHEI) scores in 1991-1993 (50.7 ± 11.9 points) and 1997-1999 (51.6 ± 12.4 points). Chronic inflammation, defined as average levels of serum interleukin-6 from 2 measures 5 years apart, was assessed in 1997-1999 and 2002-2004.
  
  
  RESULTS
  After adjustment for sociodemographic factors, health behaviors, and health status, participants who maintained a high AHEI score (ie, a healthy diet, n = 1736, 37.7%) and those who improved this score over time (n = 681, 14.8%) showed significantly lower mean levels of interleukin-6 (1.84 pg/mL, 95% confidence interval [CI], 1.71-1.98 and 1.84 pg/mL, 95% CI, 1.70-1.99, respectively) than those who had a low AHEI score (n = 1594, 34.6%) over the 6-year exposure period (2.01 pg/mL, 95% CI, 1.87-2.17).
  
  
  CONCLUSIONS
  These data suggest that maintaining and improving adherence to healthy dietary recommendations may reduce the risk of long-term inflammation.
authors.affiliation: Inserm U710, Montpellier, F-34000, France; University Montpellier II, Montpellier, France; EPHE, Paris, France; Department of Epidemiology and Public Health, University College London, London, United Kingdom. Electronic address: tasnime.akbaraly@inserm.fr.
authors.forename: Tasnime N
authors.initials: TN
authors.lastname: Akbaraly
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Gordon
authors.initials: G
authors.lastname: Lowe
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Hamer
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D010349:Patient Compliance / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D015850:Interleukin-6
keywords: Alternative Healthy Eating Index; Diet quality indices; Inflammatory marker; Interleukin-6; Middle-aged population; Nutritional Epidemiology; Prospective cohort