Dietary inflammatory potential and risk of mortality in metabolically healthy and unhealthy phenotypes among overweight and obese adults

Research paper by Yong-Moon Mark Park, Moon Kyung Choi; Seong-Su Lee; Nitin Shivappa; Kyungdo Han; Susan E. Steck; James R. Hébert; Anwar T. Merchant; Dale P. Sandler

Indexed on: 28 Apr '18Published on: 24 Apr '18Published in: Clinical Nutrition


Publication date: Available online 16 April 2018 Source:Clinical Nutrition Author(s): Yong-Moon Mark Park, Moon Kyung Choi, Seong-Su Lee, Nitin Shivappa, Kyungdo Han, Susan E. Steck, James R. Hébert, Anwar T. Merchant, Dale P. Sandler Background & aims This study was designed to investigate the association between the dietary inflammatory index (DII®) scores, metabolic phenotypes, and risk of mortality risk in overweight/obese individuals from a representative sample of the U.S. population. Methods Data from 3733 overweight/obese adults (BMI ≥ 25 kg/m2) aged 20–90 years from the National Health and Nutrition Examination Survey III, 1988–1994 were analyzed; these participants were followed for mortality through December 31, 2011. DII scores were computed based on baseline dietary intake using 24-h dietary recalls. Metabolically unhealthy status was defined as having 2 or more of these metabolic abnormalities: high glucose, insulin resistance, elevated blood pressure, triglycerides, C-reactive protein levels, or low high-density lipoprotein-cholesterol values. Results In metabolically unhealthy overweight/obese (MUO) individuals, DII score was associated with increased risk of all-cause mortality (HRTertile 3 vs Tertile 1 1.44; 95% CI 1.11–1.86 Ptrend = 0.008; HR1SD increase 1.08; 95% CI 0.99–1.18). Additionally, a stronger association with cardiovascular mortality was observed (HRT3 vs T1 3.29; 95% CI 2.01–5.37 Ptrend < 0.001; HR1SD increase 1.40; 95% CI 1.18–1.66), after adjusting for potential confounders. Furthermore, when analyses were restricted to obese individuals (BMI ≥ 30 kg/m2), the association was more pronounced, especially for cardiovascular mortality (HRT3 vs T1 5.55; 95% CI 2.11–14.57 Ptrend = 0.006; HR1SD increase 1.74; 95% CI 1.21–2.50). No association was observed between DII score and risk of mortality in individuals with metabolically healthy overweight/obese (MHO) phenotype, or for cancer mortality in either MHO or MUO phenotype. Conclusions A pro-inflammatory diet appears to increase risk of all-cause and cardiovascular mortality in the MUO phenotype, but not among the MHO phenotype.