Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the PREDIMED Study

Nutrients. 2015 May 29;7(6):4124-38. doi: 10.3390/nu7064124.


Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HR(quartile2) = 1.42 (95%CI = 0.97-2.09); HR(quartile3) = 1.85 (1.27-2.71); and HR(quartile4) = 1.73 (1.15-2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06-1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.

Keywords: PREDIMED; cardiovascular disease; dietary inflammatory index; inflammation.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Diet, Mediterranean*
  • Endpoint Determination
  • Energy Intake
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Inflammation*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nuts
  • Olive Oil
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Treatment Outcome


  • Olive Oil