title: Prospective Association Between the Dietary Inflammatory Index and Cardiovascular Diseases in the SUpplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) Cohort.
abstract: BACKGROUND
  Cardiovascular diseases (CVD) are the leading cause of death in the world, and diet plays a major role in CVD incidence, especially through lipid oxidation mechanisms. This, in turn, leads to tissue inflammation and formation of atheromatous plaques.
  
  
  RESULTS
  Our objective was to evaluate the association between the inflammatory potential of the diet and the incidence of overall CVD or its subclasses. We included 7743 participants from the Supplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) cohort. All cardiovascular events were recorded using self-reported information or clinical visits, and were validated. The dietary inflammatory index (DII) was computed using repeated 24-hour dietary records (mean=9.5±3.4 records/subject). Hazard ratio and 95% CI for outcomes (CVD and subclasses) were estimated across sex-specific quartiles of the DII using Cox proportional hazard models. A total of 292 cardiovascular events were recorded and validated during an average of 11.4 years of follow-up: 93 myocardial infarctions, 58 strokes, 128 angina pectoris and revascularization interventions, and 13 sudden deaths. When considering CVD subclasses, a diet with pro-inflammatory properties, as expressed by higher DII scores, was significantly associated with a higher risk of myocardial infarction (hazard ratioQuartile 4 versus Quartile 1=2.24, 95% CI: 1.08-4.67). No significant association was observed between the DII score and stroke or both angina pectoris and revascularization intervention.
  
  
  CONCLUSIONS
  A pro-inflammatory diet, as measured by a higher DII score, was prospectively associated with a higher risk of myocardial infarction. Promotion of a diet exhibiting anti-inflammatory properties may help prevent myocardial infarctions.
authors.affiliation: 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, Bobigny, France.
authors.forename: Lola
authors.initials: L
authors.lastname: Neufcourt
authors.affiliation: 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, Bobigny, France k.assmann@eren.smbh.univ-paris13.fr.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Assmann
authors.affiliation: 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, Bobigny, France.
authors.forename: Léopold K
authors.initials: LK
authors.lastname: Fezeu
authors.affiliation: 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, Bobigny, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Touvier
authors.affiliation: 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, Bobigny, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Graffouillère
authors.affiliation: Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC Connecting Health Innovations LLC, Columbia, SC.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC Connecting Health Innovations LLC, Columbia, SC.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.affiliation: Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC Connecting Health Innovations LLC, Columbia, SC.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wirth
authors.affiliation: 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, Bobigny, France Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: 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, Bobigny, France.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: 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, Bobigny, France Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Julia
authors.affiliation: 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, Bobigny, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004032:Diet / Q000009:adverse effects*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D000975:Antioxidants; D014815:Vitamins
keywords: cardiovascular disease; diet; epidemiology; inflammation; nutrition