title: Inflammatory potential of the diet and mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain).
abstract: Low-grade chronic inflammation is associated with several chronic conditions, and diet is known to play a role in chronic inflammation. We aimed to evaluate the association between the inflammatory potential of the diet and mortality in the Spanish population from the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain).
  
  
  
  The study included 41 199 participants (62% female) aged 29-69 years from five Spanish regions. During 18 years of follow-up 3316 deaths were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 30 dietetic components and their corresponding inflammatory scores (weights). The association between the ISD and mortality was analyzed by multivariate Cox regression models. There was a significant association between ISD and mortality: subjects classified in the fifth quintile of the ISD (more proinflammatory diets) had a hazard ratio of 1.42 (95%-confidence interval 1.25-1.60) as compared with those in the first quintile; the corresponding figures were 1.89 (1.48-2.40) for cardiovascular diseases mortality and 1.44 (1.22-1.69) for death by cancer.
  
  
  
  Consuming more proinflammatory diets, expressed by means of the ISD, is associated with higher mortality; this effect seems to be stronger for deaths by cardiovascular diseases.
authors.affiliation: Unit of Nutrition and Cancer, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.affiliation: Unit of Nutrition and Cancer, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Masegú
authors.affiliation: Unit of Nutrition and Cancer, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Catalina
authors.initials: C
authors.lastname: Bonet
authors.affiliation: Unit of Nutrition and Cancer, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Jakszyn
authors.affiliation: Public Healt Directorate, Asturias, Spain.
authors.forename: J Ramon
authors.initials: JR
authors.lastname: Quirós
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Navarra Public Health Institute, Pamplona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Navarra Public Health Institute, Pamplona, Spain.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISECC) Pamplona, Spain.
authors.forename: Conchi
authors.initials: C
authors.lastname: Moreno-Iribas
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Navarra Public Health Institute, Pamplona, Spain.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.|BioDonostia Research Institute, Murcia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.|BioDonostia Research Institute, Murcia, Spain.
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.affiliation: Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.|BioDonostia Research Institute, Murcia, Spain.
authors.forename: Saioa
authors.initials: S
authors.lastname: Chamosa
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.|BioDonostia Research Institute, Murcia, Spain.
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Public Health Department of Gipuzkoa, Government of the Basque Country, San Sebastian, Spain.|BioDonostia Research Institute, Murcia, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors.forename: María-Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Cirera
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Gavrila
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors.forename: José-María
authors.initials: JM
authors.lastname: Huerta
authors.affiliation: Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodríguez-Barranco
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Molina-Portillo
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain.|Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000209:etiology / Q000401:mortality; D016016:Proportional Hazards Models; D013030:Spain / Q000453:epidemiology
keywords: Chronic inflammation; Inflammatory score of the diet; Mortality; Nutrition; Prospective studies