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Review

Dietary inflammatory index significantly affects lipids profile among adults: An updated systematic review and meta-analysis

Published Online:November 05, 2020https://doi.org/10.1024/0300-9831/a000688

Abstract

Abstract.Background: The available data on the relationship between dietary inflammatory index (DII®) and serum lipids are controversial. This systematic review and meta-analysis aimed to investigate the relationship between DII® and serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) in general populations. Methods: PubMed, Web of Science, SCOPUS, and Cochrane electronic databases were systematically searched from inception to December 2019. Case-control, cohort or cross-sectional studies that evaluated the relationship between DII® and serum lipids were included. The random-effects model was applied to evaluate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Results: In total, twenty-four cross-sectional and one case-control studies with a total sample size of 129,759 were included in the meta-analysis. The pooled results showed that the highest category of DII® was associated with 5.16 mg/dl increase in TC (Pooled WMD: 5.16; 95% CI: 0.58–9.73, p = 0.02) and 3.99 mg/dl increase in LDL-C (Pooled WMD: 3.99; 95% CI: 1.16–6.81, p = 0.006). However, no significant association between DII® scores, HDL-C and TG was found. In subgroup analysis, the geographical region, gender, and dietary assessment methods were potent sources of heterogeneity. Conclusion: This study showed that a higher level of DII® was associated with higher levels of TC and LDL-C in apparently healthy populations. Since the included studies had observational designs, therefore, no conclusion of causality was possible. More studies with interventional designs are required to elucidate the causality of the observed association between DII® and the risk of abnormal lipid profile.

References

  • 1 Nelson RH. Hyperlipidemia as a risk factor for cardiovascular disease. Prim Care. 2013;40(1):195–211. First citation in articleCrossref Medline, Google Scholar

  • 2 Smith DG. Epidemiology of dyslipidemia and economic burden on the healthcare system. Am J Manag Care. 2007;13:S68–71. First citation in articleMedline, Google Scholar

  • 3 Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288(20):2569–78. First citation in articleCrossref Medline, Google Scholar

  • 4 Thiengwiboonwong S, Chongsuwat R, Temcharoen P, Pandii W, Pavadhgul P. Efficacy of dietary modification following the National Cholesterol Education Program (NCEP) recommendation on lipid profiles among hyperlipidemia subjects. J Med Assoc Thai. 2013;96(10):1257–67. First citation in articleMedline, Google Scholar

  • 5 O’Neil A, Shivappa N, Jacka FN, Kotowicz MA, Kibbey K, Hebert JR, et al. Pro-inflammatory dietary intake as a risk factor for CVD in men: a 5-year longitudinal study. Br J Nutr. 2015;114:2074–82. First citation in articleCrossref Medline, Google Scholar

  • 6 Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc. 2004;104:615–35. First citation in articleCrossref Medline, Google Scholar

  • 7 Ramallal R, Toledo E, Martínez-González MA, Hernandez-Hernandez A, Garcia-Arellano A, Shivappa N, et al. Dietary inflammatory index and incidence of cardiovascular disease in the SUN cohort. PLoS One. 2015;10(9):e0135221. First citation in articleCrossref Medline, Google Scholar

  • 8 Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102(1):42–7. First citation in articleCrossref Medline, Google Scholar

  • 9 McCarty MF. Interleukin-6 as a central mediator of cardiovascular risk associated with chronic inflammation, smoking, diabetes, and visceral obesity: down-regulation with essential fatty acids, ethanol and pentoxifylline. Med Hypotheses. 1999;52(5):465–77. First citation in articleCrossref Medline, Google Scholar

  • 10 Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO III, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499–511. First citation in articleCrossref Medline, Google Scholar

  • 11 Boden S, Myte R, Wennberg M, Harlid S, Johansson I, Shivappa N, et al. The inflammatory potential of diet in determining cancer risk: A prospective investigation of two dietary pattern scores. PLoS One. 2019;14(4):e0214551. First citation in articleCrossref Medline, Google Scholar

  • 12 Mirmiran P, Moslehi N, Morshedzadeh N, Shivappa N, Hébert JR, Farsi F, et al. Does the inflammatory potential of diet affect disease activity in patients with inflammatory bowel disease? Nutr J. 2019;18(1):65. First citation in articleCrossref Medline, Google Scholar

  • 13 Tabung FK, Smith-Warner SA, Chavarro JE, Fung TT, Hu FB, Willett WC, et al. An empirical dietary inflammatory pattern score enhances prediction of circulating inflammatory biomarkers in adults. J Nutr. 2017;147(8):1567–77. First citation in articleCrossref Medline, Google Scholar

  • 14 Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17:1689–96. First citation in articleCrossref Medline, Google Scholar

  • 15 Cavicchia PP, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS, et al. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. Nutr J. 2009;139:2365–72. First citation in articleCrossref, Google Scholar

  • 16 Shivappa N, Godos J, Hebert JR, Wirth MD, Piuri G, Speciani AF, et al.. Dietary inflammatory index and colorectal cancer risk-a meta-analysis. Nutrients. 2017;9:1043. First citation in articleCrossref Medline, Google Scholar

  • 17 Shivappa N, Godos J, Hebert JR, Wirth MD, Piuri G, Speciani AF, et al. Dietary Inflammatory index and cardiovascular risk and mortality-a meta-analysis. Nutrients. 2018;10(2):200. First citation in articleCrossref Medline, Google Scholar

  • 18 Steck SE, Guinter M, Zheng J, Thomson CA. Index-based dietary patterns and colorectal cancer risk: a systematic review. Adv Nutr. 2015;6(6):763–73. First citation in articleCrossref Medline, Google Scholar

  • 19 Wang L, Liu C, Zhou C, Zhuang J, Tang S, Yu J, et al. Meta-analysis of the association between the dietary inflammatory index (DII) and breast cancer risk. Eur J Clin Nutr. 2019;73(4):509–17. First citation in articleCrossref Medline, Google Scholar

  • 20 Zahedi H, Djalalinia S, Sadeghi O, Asayesh H, Noroozi M, Gorabi AM, et al. Dietary inflammatory potential score and risk of breast cancer: systematic review and meta-analysis. Clin Breast Cancer. 2018;18(4):e561–70. First citation in articleCrossref Medline, Google Scholar

  • 21 Namazi N, Larijani B, Azadbakht L. Dietary inflammatory index and its association with the risk of cardiovascular diseases, metabolic syndrome, and mortality: a systematic review and meta-analysis. Horm Metab Res. 2018;50(05):345–58. First citation in articleCrossref Medline, Google Scholar

  • 22 Zhong X, Guo L, Zhang L, Li Y, He R, Cheng G. Inflammatory potential of diet and risk of cardiovascular disease or mortality: A meta-analysis. Sci Rep. 2017;7:6367. First citation in articleCrossref Medline, Google Scholar

  • 23 Farhangi MA, Vajdi M. The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis. Int J Vitam Nutr Res. 2020;1–18. First citation in articleLink, Google Scholar

  • 24 Garcia-Arellano A, Martinez-Gonzalez MA, Ramallal R, Salas-Salvado J, Hebert JR, Corella D, et al. Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies. Clin Nutr. 2019;38:1221–31. First citation in articleCrossref Medline, Google Scholar

  • 25 Okada E, Shirakawa T, Shivappa N, Wakai K, Suzuki K, Date C, et al. Dietary Inflammatory Index is associated with risk of all-cause and cardiovascular disease mortality but not with cancer mortality in middle-aged and older Japanese adults. Nutr J. 2019;149(8):1451–9. First citation in articleCrossref, Google Scholar

  • 26 Laclaustra M, Rodriguez-Artalejo F, Guallar-Castillon P, Banegas JR, Graciani A, Garcia-Esquinas E, et al. The inflammatory potential of diet is related to incident frailty and slow walking in older adults. Clin Nutr. 2020;39(1):185–91. First citation in articleCrossref Medline, Google Scholar

  • 27 Godos J, Ferri R, Caraci F, Cosentino FI, Castellano S, Shivappa N, et al. Dietary inflammatory index and sleep quality in Southern Italian adults. Nutrients. 2019;11(6):1324. First citation in articleCrossref Medline, Google Scholar

  • 28 Vahid F, Shivappa N, Karamati M, Naeini AJ, Hebert JR, Davoodi SH. Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study. Appl Physiol Nutr Metab. 2017;42(4):399–404. First citation in articleCrossref Medline, Google Scholar

  • 29 Mazidi M, Shivappa N, Wirth MD, Hebert JR, Mikhailidis DP, Kengne AP, et al. Dietary inflammatory index and cardiometabolic risk in US adults. Atherosclerosis. 2018;276:23–7. First citation in articleCrossref Medline, Google Scholar

  • 30 Corley J, Shivappa N, Hébert J, Starr J, Deary I. Associations between dietary inflammatory index scores and inflammatory biomarkers among older adults in the Lothian birth cohort 1936 study. J Nutr Health Aging. 2019;23(7):628–36. First citation in articleCrossref Medline, Google Scholar

  • 31 Guinter MA, Merchant AT, Tabung FK, Wirth MD, Shivappa N, Hurley TG, et al. Adiposity does not modify the effect of the dietary inflammatory potential on type 2 diabetes incidence among a prospective cohort of men. J Nutr Intermed Metab. 2019;16:100095. First citation in articleCrossref Medline, Google Scholar

  • 32 Farhangi MA, Vajdi M, Nikniaz L, Nikniaz Z. The interaction between dietary inflammatory index and 6 P21 rs2010963 gene variants in metabolic syndrome. Eat Weight Disord. 2019;1–12. First citation in articleGoogle Scholar

  • 33 Aa Alkerwi, Shivappa N, Crichton G, Hebert JR. No significant independent relationships with cardiometabolic biomarkers were detected in the Observation of Cardiovascular Risk Factors in Luxembourg study population. Nutr Res. 2014;34(12):1058–65. First citation in articleCrossref Medline, Google Scholar

  • 34 Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9. First citation in articleCrossref Medline, Google Scholar

  • 35 Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The NewcastleOttawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses [Internet]. Ottawa: The Ottawa Hospital; 2011. [cited 2019]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp First citation in articleGoogle Scholar

  • 36 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58. First citation in articleCrossref Medline, Google Scholar

  • 37 Phillips CM, Shivappa N, Hebert JR, Perry IJ. Dietary inflammatory index and biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis in adults. Nutrients. 2018;10(8):1033. First citation in articleCrossref Medline, Google Scholar

  • 38 Farhangi MA, Najafi M. Dietary inflammatory index: a potent association with cardiovascular risk factors among patients candidate for coronary artery bypass grafting (CABG) surgery. Nutr J. 2018;17(1):20. First citation in articleCrossref Medline, Google Scholar

  • 39 Ren Z, Zhao A, Wang Y, Meng L, Szeto IM-Y, Li T, et al. Association between dietary inflammatory index, C-reactive protein and metabolic syndrome: a cross-sectional study. Nutrients. 2018;10(7):831. First citation in articleCrossref Medline, Google Scholar

  • 40 Sokol A, Wirth MD, Manczuk M, Shivappa N, Zatonska K, Hurley TG, et al. Association between the dietary inflammatory index, waist-to-hip ratio and metabolic syndrome. Nutr Res. 2016;36(11):1298–303. First citation in articleCrossref Medline, Google Scholar

  • 41 Laouali N, Mancini FR, Hajji-Louati M, El Fatouhi D, Balkau B, Boutron-Ruault M-C, et al. Dietary inflammatory index and type 2 diabetes risk in a prospective cohort of 70,991 women followed for 20 years: the mediating role of BMI. Diabetologia. 2019;62(12):2222–32. First citation in articleCrossref Medline, Google Scholar

  • 42 Meneguelli TS, Hinkelmann JV, de Novaes JF, Rosa C, Filgueiras MDS, Silveira B. Dietary inflammatory index is associated with excessive body weight and dietary patterns in subjects with cardiometabolic risk. J Food Nutr Res. 2019;7(7):491–9. First citation in articleCrossref, Google Scholar

  • 43 Morimoto M, Shivappa N, Genaro PdS, Martini LA, Schuch NJ, Hebert JR, et al. Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: The Brazilian Osteoporosis Study (BRAZOS). Adv. Rheumatol. 2019;59(1):16. First citation in articleGoogle Scholar

  • 44 Na W, Yu TY, Sohn C. Development of a food-based index of dietary inflammatory potential for Koreans and its relationship with metabolic syndrome. Nutr Res Pract. 2019;13(2):150–8. First citation in articleCrossref Medline, Google Scholar

  • 45 Nilsson A, Halvardsson P, Kadi F. Adherence to dash-style dietary pattern impacts on adiponectin and clustered metabolic risk in older women. Nutrients. 2019;11(4):805. First citation in articleCrossref Medline, Google Scholar

  • 46 Pocovi-Gerardino G, Correa-Rodríguez M, Callejas-Rubio J-L, Ríos-Fernández R, Martín-Amada M, Cruz-Caparros M-G, et al. Dietary inflammatory index score and cardiovascular disease risk markers in women with systemic lupus erythematosus. J Acad Nutr Diet. 2020;120(2):280–7. First citation in articleCrossref Medline, Google Scholar

  • 47 Muhammad HFL, van Baak MA, Mariman EC, Sulistyoningrum DC, Huriyati E, Lee YY, et al. Dietary inflammatory index score and its association with body weight, blood pressure, lipid profile, and leptin in Indonesian adults. Nutrients. 2019;11(1):148. First citation in articleCrossref Medline, Google Scholar

  • 48 Shin D, Lee KW, Brann L, Shivappa N, Hebert JR. Dietary inflammatory index is positively associated with serum high-sensitivity C-reactive protein in a Korean adult population. Nutrition. 2019;63:155–61. First citation in articleCrossref Medline, Google Scholar

  • 49 Mirmajidi S, Izadi A, Saghafi-Asl M, Vahid F, Karamzad N, Amiri P, et al. Inflammatory potential of diet: association with chemerin, omentin, lipopolysaccharide-binding protein, and insulin resistance in the apparently healthy obese. J Am Coll Nutr. 2019;38(4):302–10. First citation in articleCrossref Medline, Google Scholar

  • 50 Abdurahman AA, Azadbakhat L, Rasouli M, Chamari M, Qorbani M, Dorosty AR. Association of dietary inflammatory index with metabolic profile in metabolically healthy and unhealthy obese people. Nutr Diet. 2019;76(2):192–8. First citation in articleCrossref Medline, Google Scholar

  • 51 Shivappa N, Bonaccio M, Hebert JR, Di Castelnuovo A, Costanzo S, Ruggiero E, et al. Association of proinflammatory diet with low-grade inflammation: results from the Moli-sani study. Nutrition. 2018;54:182–8. First citation in articleCrossref Medline, Google Scholar

  • 52 Park YM, Choi MK, Lee SS, Shivappa N, Han K, Steck SE, et al. Dietary inflammatory potential and risk of mortality in metabolically healthy and unhealthy phenotypes among overweight and obese adults. Clin Nutr. 2018;38:682–8. First citation in articleCrossref Medline, Google Scholar

  • 53 Nikniaz L, Nikniaz Z, Shivappa N, Hebert JR. The association between dietary inflammatory index and metabolic syndrome components in Iranian adults. Prim Care Diabetes. 2018;12(5):467–72. First citation in articleCrossref Medline, Google Scholar

  • 54 Kim HY, Lee J, Kim J. Association between dietary inflammatory index and metabolic syndrome in the general Korean population. Nutrients. 2018;10(5):648. First citation in articleCrossref Medline, Google Scholar

  • 55 Denova-Gutiérrez E, Muñoz-Aguirre P, Shivappa N, Hébert JR, Tolentino-Mayo L, Batis C, et al. Dietary inflammatory index and type 2 diabetes mellitus in adults: the diabetes mellitus survey of Mexico City. Nutrients. 2018;10(4):385. First citation in articleCrossref Medline, Google Scholar

  • 56 Naja F, Shivappa N, Nasreddine L, Kharroubi S, Itani L, Hwalla N, et al. Role of inflammation in the association between the western dietary pattern and metabolic syndrome among Lebanese adults. Int J Food Sci Nutr. 2017;68(8):997–1004. First citation in articleCrossref Medline, Google Scholar

  • 57 Camargo-Ramos CM, Correa-Bautista JE, Correa-Rodríguez M, Ramírez-Vélez R. Dietary inflammatory index and cardiometabolic risk parameters in overweight and sedentary subjects. Int J Environ Res Public Health. 2017;14(10):1104. First citation in articleCrossref Medline, Google Scholar

  • 58 Wirth M, Burch J, Shivappa N, Violanti JM, Burchfiel CM, Fekedulegn D, et al. Association of a dietary inflammatory index with inflammatory indices and the metabolic syndrome among police officers. J Occup Environ Med. 2014;56(9):986. First citation in articleCrossref Medline, Google Scholar

  • 59 Hodge AM, Bassett JK, Dugué P-A, Shivappa N, Hebert JR, Milne R, et al. Dietary inflammatory index or Mediterranean diet score as risk factors for total and cardiovascular mortality. Nutr Metab Cardiovasc Dis. 2018;28(5):461–9. First citation in articleCrossref Medline, Google Scholar

  • 60 Neufcourt L, Assmann KE, Fezeu LK, Touvier M, Graffouillere L, Shivappa N, et al. Prospective association between the dietary inflammatory index and cardiovascular diseases in the SUpplémentation en VItamines et Minéraux AntioXydants (SU. VI. MAX) cohort. J Am Heart Assoc. 2016;5(3):e002735. First citation in articleCrossref Medline, Google Scholar

  • 61 Garcia-Calzon S, Zalba G, Ruiz-Canela M, Shivappa N, Hebert JR, Martinez JA, et al. Dietary inflammatory index and telomere length in subjects with a high cardiovascular disease risk from the PREDIMED-NAVARRA study: cross-sectional and longitudinal analyses over 5 y. Am J Clin Nutr. 2015;102(4):897–904. First citation in articleCrossref Medline, Google Scholar

  • 62 Shivappa N, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS, et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutr. 2014;17(8):1825–33. First citation in articleCrossref Medline, Google Scholar

  • 63 Herbert KE, Erridge C. Regulation of low-density lipoprotein cholesterol by intestinal inflammation and the acute phase response. Cardiovasc. Res. 2018;114(2):226–32. First citation in articleCrossref Medline, Google Scholar

  • 64 Smith JD. Myeloperoxidase, inflammation, and dysfunctional high-density lipoprotein. J Clin Lipidol. 2010;4(5):382–8. First citation in articleCrossref Medline, Google Scholar

  • 65 Papageorgiou N, Tousoulis D. Interaction between HDL and inflammation: when the good turns to be bad. Int J Cardiol. 2015;189:15–7. First citation in articleCrossref Medline, Google Scholar

  • 66 García-Gómez C, Bianchi M, de la Fuente D, Badimon L, Padró T, Corbella E, et al. Inflammation, lipid metabolism and cardiovascular risk in rheumatoid arthritis: A qualitative relationship? World J Orthop. 2014;5(3):304. First citation in articleCrossref Medline, Google Scholar

  • 67 Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev. 2013;71(8):511–27. First citation in articleCrossref Medline, Google Scholar

  • 68 Hoffmann K, Zyriax B-C, Boeing H, Windler E. A dietary pattern derived to explain biomarker variation is strongly associated with the risk of coronary artery disease. T Am J Clin Nutr. 2004;80(3):633–40. First citation in articleCrossref Medline, Google Scholar

  • 69 Tuttolomondo A, Casuccio A, Butta C, Pecoraro R, Di Raimondo D, Della Corte V, et al. Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index. Atherosclerosis. 2015;243(1):260–7. First citation in articleCrossref Medline, Google Scholar

  • 70 Neufcourt L, Assmann K, Fezeu L, Touvier M, Graffouillère L, Shivappa N, et al. Prospective association between the dietary inflammatory index and metabolic syndrome: Findings from the SU. VI. MAX study. Nutr Metab Cardiovasc Dis. 2015;25(11):988–96. First citation in articleCrossref Medline, Google Scholar

  • 71 Ruiz-Canela M, Zazpe I, Shivappa N, Hebert JR, Sanchez-Tainta A, Corella D, et al. Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvencion con DIeta MEDiterranea) trial. Br J Nutr. 2015;113(6):984–95. First citation in articleCrossref Medline, Google Scholar

  • 72 Farhangi MA, Nikniaz L, Nikniaz Z, Dehghan P. Dietary inflammatory index potentially increases blood pressure and markers of glucose homeostasis among adults: findings from an updated systematic review and meta-analysis. Public Health Nutr. 2020;23(8):1362–80. First citation in articleCrossref Medline, Google Scholar

  • 73 Alkerwi AA, Vernier C, Crichton GE, Sauvageot N, Shivappa N, Hebert JR. Cross-comparison of diet quality indices for predicting chronic disease risk: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study. Br J Nutr. 2015;113(2):259–69. First citation in articleCrossref Medline, Google Scholar