Metabolic syndrome (MetS) is a major public health challenge throughout the world, although studies on its association with the inflammatory potential of diet are inconsistent. The aim of this prospective study was to assess the association between the Dietary Inflammatory Index (DII®) and the risk of MetS and its components in a Korean population. Data from 157,812 Korean adults (mean age 52.8 years; 53,304 men and 104,508 women with mean follow-up of 7.4 years) collected by members of the Korean Genome and Epidemiology Study form the basis for this report. DII scores were calculated based on Semi-Quantitative Food-Frequency Questionnaire data. Multivariable-adjusted Cox proportional hazard models were used to estimate the association between DII scores and MetS. In women, higher DII scores (pro-inflammatory diet) increased the risk of MetS (hazard ratio [HR]quintile5 v. 1 1.43; 95% confidence interval (CI) 1.21-1.69; p for trend ≤ 0.0001) and its five components. A positive association was observed for postmenopausal women, with a 50% higher risk of developing MetS (HRquintile5 v. 1 1.50; 95% CI 1.23-1.83; p for trend = 0.0008) after fully adjusting for potential confounders. Irrespective of the menopausal status of women, higher DII (=Q5) scores were positively associated with all 5 components of MetS (p < 0.05). In men, higher DII scores significantly increased the risk of low HDL cholesterol [HR]quintile5 v. 1 1.59 (1.27-1.99); p for trend = 0.0001], elevated waist circumferences [HR]quintile5 v. 1 1.28 (1.08-1.52); p for trend = 0.01], and high blood pressure [HR]quintile5 v. 1 1.17 (1.03-1.32); p for trend = 0.05]. These results indicate that diet with pro-inflammatory potential, as represented by higher DII scores, is prospectively associated with increased risk of MetS, and the relationship is stronger in women than in men.
Keywords: HDL-C; KoGES cohort; chronic inflammation; dietary inflammatory index; metabolic syndrome.