title: Association between inflammatory potential of diet and mortality among women in the Swedish Mammography Cohort.
abstract: OBJECTIVE
  Diet and dietary components have been studied previously in relation to mortality; however, little is known about the relationship between the inflammatory potential of overall diet and mortality.
  
  
  METHODS
  We examined the association between the Dietary Inflammatory Index (DII) and mortality among 33,747 participants in the population-based Swedish Mammography Cohort. The DII score was calculated based on dietary information obtained from a self-administered food frequency questionnaire. Mortality was determined through linkage to the Swedish Cause of Death Registry through 2013. Cox proportional hazard regression was used to estimate hazard ratios (HR). During 15 years of follow-up, 7095 deaths were identified, including 1996 due to cancer, 602 of which were due to digestive-tract cancer, and 2399 due to cardiovascular disease.
  
  
  RESULTS
  After adjusting for age, energy intake, education, alcohol intake, physical activity, BMI, and smoking status, analyses revealed a positive association between higher DII score and all-cause mortality. When used as a continuous variable (range -4.19 to 5.10), DII score was associated with all-cause mortality (HRContinuous = 1.05; 95 % CI 1.01-1.09) and digestive-tract cancer mortality (HRContinuous = 1.15; 95 % CI 1.02-1.29). Comparing subjects in the highest quintile of DII (≥1.91) versus the lowest quintile (DII ≤ -0.67), a significant association was observed for all-cause mortality (HR = 1.25; 95 % CI 1.07-1.47, P trend = 0.003).
  
  
  CONCLUSIONS
  These results indicate that a pro-inflammatory diet, as indicated by higher DII score, was associated with all-cause and digestive-tract cancer mortality.
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA. shivappa@email.sc.edu.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. shivappa@email.sc.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: Division of Nutritional Epidemiology, The National Institute for Environmental Medicine, Karolinska Institutet, PO Box 210, 171 77, Stockholm, Sweden.|Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, 02115, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Harris
authors.affiliation: Division of Nutritional Epidemiology, The National Institute for Environmental Medicine, Karolinska Institutet, PO Box 210, 171 77, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
mesh_terms: D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000401:mortality*; D008327:Mammography; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Dietary Inflammatory Index; Mortality; Swedish women