Prospective association between the dietary inflammatory index and metabolic syndrome: findings from the SU.VI.MAX study.
OBJECTIVE
The prevention of the metabolic syndrome (MetS) is of major concern and nutrition has been shown to modulate at least partly MetS risk. Our objective was to investigate whether a pro-inflammatory diet was associated with a higher risk of MetS and its components in a large cohort of French adults.


RESULTS
A total of 3726 participants from the Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) cohort were included in this study. The MetS status was identified at baseline and after 13 years of follow-up using self-reported medication, data from clinical investigations and biological measurements. The dietary inflammatory index (DII) was computed using repeated 24 h-dietary records (n = 10.1 ± 3.1). Logistic and linear regression analyses were conducted to assess the prospective association of the DII (as Q, quartiles) with the incidence of MetS and with the traits contributing to the MetS-definition (blood pressure, glycaemia, triglycerides, HDL-cholesterol, waist circumference). A diet with pro-inflammatory properties, as expressed by higher DII scores, was significantly associated with a higher risk of developing the MetS (OR comparing Q4 to Q1: 1.39, 95% confidence interval 1.01-1.92, P = 0.047). Moreover, higher DII scores were associated with higher systolic and diastolic blood pressure (Ptrend across quartiles = 0.03 and 0.05, respectively) and triglycerides (Ptrend = 0.01), and with lower HDL-cholesterol (Ptrend = 0.03).


CONCLUSIONS
A higher DII score was prospectively associated with a higher risk of MetS, with associations with blood pressure, triglycerides and HDL-cholesterol. Promotion of a healthy diet exhibiting anti-inflammatory properties may contribute to prevent cardio-metabolic disorders.
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Neufcourt
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Assmann
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Fezeu
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Touvier
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Graffouillère
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; Connecting Health Innovations LLC, Columbia, SC 29229, USA.
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Shivappa
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; Connecting Health Innovations LLC, Columbia, SC 29229, USA.
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Hébert
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; Connecting Health Innovations LLC, Columbia, SC 29229, USA.
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Wirth
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France; Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France.
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Hercberg
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
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Galan
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France; Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France.
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Julia
Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France. Electronic address: e.kesse@uren.smbh.univ-paris13.fr.
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Kesse-Guyot
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000175:diagnosis* / Q000453:epidemiology*; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055105:Waist Circumference
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D053583:Interleukin-1beta; D015850:Interleukin-6; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D002097:C-Reactive Protein
Dietary inflammatory index; Metabolic syndrome; Prospective study