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Pro-inflammatory dietary intake as a risk factor for CVD in men: a 5-year longitudinal study

  • Adrienne O’Neil (a1) (a2) (a3), Nitin Shivappa (a4) (a5), Felice N. Jacka (a1) (a6) (a7), Mark A. Kotowicz (a1) (a8) (a9), Katherine Kibbey (a9) (a10), James R. Hebert (a4) (a5) and Julie A. Pasco (a1) (a8) (a11)...


Convincing evidence has identified inflammation as an initiator of atherosclerosis, underpinning CVD. We investigated (i) whether dietary inflammation, as measured by the ‘dietary inflammatory index (DII)’, was predictive of 5-year CVD in men and (ii) its predictive ability compared with that of SFA intake alone. The sample consisted of 1363 men enrolled in the Geelong Osteoporosis Study who completed an FFQ at baseline (2001–2006) (excluding participants who were identified as having previous CVD). DII scores were computed from participants’ reported intakes of carbohydrate, micronutrients and glycaemic load. DII scores were dichotomised into a pro-inflammatory diet (positive values) or an anti-inflammatory diet (negative values). The primary outcome was a formal diagnosis of CVD resulting in hospitalisation over the 5-year study period. In total, seventy-six events were observed during the 5-year follow-up period. Men with a pro-inflammatory diet at baseline were twice as likely to experience a CVD event over the study period (OR 2·07; 95 % CI 1·20, 3·55). This association held following adjustment for traditional CVD risk factors and total energy intake (adjusted OR 2·00; 95 % CI 1·03, 3·96). This effect appeared to be stronger with the inclusion of an age-by-DII score interaction. In contrast, SFA intake alone did not predict 5-year CVD events after adjustment for covariates (adjusted OR 1·40; 95 % CI 0·73, 2·70). We conclude that an association exists between a pro-inflammatory diet and CVD in Australian men. CVD clinical guidelines and public health recommendations may have to expand to include dietary patterns in the context of vascular inflammation.


Corresponding author

* Corresponding author: Dr A. O’Neil, email


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Disclaimer: A. O’N. and F. N. J. have received funding from the Meat and Livestock Board of Australia. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. J. R. H. owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the DII from the University of South Carolina in order to develop computer and smart phone applications for patient counselling and dietary intervention in clinical settings. N. S. is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.



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British Journal of Nutrition
  • ISSN: 0007-1145
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