Dietary Inflammatory Index and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Prospective Study

SIMPLE SUMMARY: Our study investigated the association between the inflammatory potential of the diet, as calculated by the Energy-adjusted Dietary Inflammatory Index (E-DII(TM)), and total and cause-specific mortality. We analyzed the data of 101,832 participants from the Prostate, Lung, Colorectal and Ovarian (PLCO) trial with 17 years of follow-up. We found that the E-DII was significantly associated with all-cause mortality. The HR (95% CI) in the highest E-DII quintile compared to the lowest quintile was 1.23 (1.18–1.29) (p for trend <0.001). Based on the fully adjusted model, the E-DII was also statistically significantly associated with CVD and cancer mortality. The findings of our study provide more evidence to help guide recommendations regarding anti-inflammatory food intake. ABSTRACT: The Energy-adjusted Dietary Inflammatory Index (E-DII(TM)) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 101,832 individuals were included, with 24,141 deaths recorded after a median of 17.0 years of follow-up. In multivariable-adjusted analyses, the E-DII score was significantly associated with all-cause mortality. The HR (95% CI) in the highest E-DII quintile compared to the lowest quintile was 1.23 (1.18–1.29). The E-DII was also statistically related to CVD mortality (Q5 vs. Q1; HR, 1.30 [95% CI, 1.20–1.41]) and cancer mortality (Q5 vs. Q1; HR, 1.14 [95% CI, 1.06–1.24]). Similar results were obtained from sensitivity analyses and subgroup analyses. In conclusion, the inflammatory potential of the diet, as calculated by the E-DII, was significantly associated with overall and CVD- and cancer-specific mortality risk in the PLCO study.