title: Inflammatory potential of diet and all-cause, cardiovascular, and cancer mortality in National Health and Nutrition Examination Survey III Study.
abstract: BACKGROUND
  Various dietary components have been studied in relation to overall 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 in the National Health and Nutrition Examination Survey III follow-up study. The DII was computed from baseline dietary intake assessed using 24-h dietary recalls (1988-1994). Mortality was determined from the National Death Index records through 2006. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95 % confidence interval (95 % CI). During the follow-up, 2795 deaths were identified, including 1233 due to cardiovascular disease (CVD), and 615 due to cancer, 158 of which were due to digestive-tract cancers.
  
  
  RESULTS
  Multivariate Cox proportional hazards regression analyses, adjusting for age, race, diabetes status, hypertension, physical activity, body mass index, poverty index, and smoking, revealed positive associations between higher DII scores and mortality. Comparing subjects in DII tertile 3 versus tertile 1, significant associations were noted for all-cause mortality (HRTertile3vs11.34; 95 % CI 1.19-1.51, Ptrend< 0.0001), CVD mortality (HRTertile3vs11.46; 95 % CI 1.18-1.81, Ptrend= 0.0006), cancer mortality (HRTertile3vs11.46; 95 % CI 1.10-1.96, Ptrend= 0.01), and digestive-tract cancer mortality (HRTertile3vs12.10; 95 % CI 1.15-3.84, Ptrend= 0.03).
  
  
  CONCLUSIONS
  These results indicate that a pro-inflammatory diet, as indicated by higher DII scores, was associated with higher risk of all-cause, CVD, and cancer mortality.
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA. shivappa@mailbox.sc.edu.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. shivappa@mailbox.sc.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.affiliation: 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: Hussey
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, 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: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects*; D004067:Digestive System Neoplasms / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009309:National Center for Health Statistics, U.S.; D009369:Neoplasms / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Dietary inflammatory index; Mortality; NHANES III