Anti-Inflammatory Diets Linked to Lower Risk of Heart Disease, Stroke

Jun Li, MD, PhD

New data from an analysis of 3 major health studies detail the potential benefits derived from a diet characterized by a greater intake of anti-inflammatory foods.

The analysis, which included more than 5.2 million years of follow-up data, suggests diets with greater proinflammatory potential were associated with increased risk of cardiovascular disease, coronary heart disease, and stroke among men and women in the US.

"Using an empirically-developed, food-based dietary index to evaluate levels of inflammation associated with dietary intake, we found that dietary patterns with higher inflammatory potential were associated with an increased rate of cardiovascular disease," said lead investigator Jun Li, MD, PhD, a research scientist in the department of nutrition at Harvard T.H. Chan School of Public Health, in a statement. "Our study is among the first to link a food-based dietary inflammatory index with long-term risk of cardiovascular disease."

To further understand the impact of dietary inflammatory potential on risk of cardiovascular disease, Li and a team of colleagues from Harvard Medical School and Brigham and Women’s Hospital designed an analysis using data from the Nurses Health Studies (NHS) I (1984-2016) and II (1991-2015) and the Health Professionals Follow-up Study (1986-2016). From these studies, investigators obtained information related to more than 160,000 women and 43,000 men without cardiovascular disease and cancer at baseline. Using this cohort, investigators had 5,291,518 person-years of follow-up data for the current analysis.

Hear from Dr. Gregory Weiss on the importance of counseling patients on dietary choices in a recently submitted column hosted by Practical Cardiology.​

During these studies, diet was assessed every 4 years by food frequency questionnaires. Investigators used this information and a previously validated empirical dietary inflammatory pattern (EDIP) score to evaluate the inflammatory potential of diets.

During the follow-up period, 15,837 incident cases of cardiovascular disease were observed. Of these, 9894 were coronary heart disease cases and 6174 were strokes. In pooled analyses adjusted for use of anti-inflammatory medications and cardiovascular disease risk factors, diets with a higher dietary inflammatory were associated with an increased risk of cardiovascular disease (HR, 1.38; 95% CI, 1.31-1.46; P <.001), coronary heart disease (HR, 1.46; 95% CI, 1.36-1.56; P <.001), and stroke (HR, 1.28; 95% CI, 1.17-1.39; P <.001) when comparing those in the highest EDIP quintiles to the lowest.

Further analysis indicated these associations were consistent across the 3 cohorts and between sexes. Investigators also noted these associations remained significant in analyses adjusted for further dietary quality indices.

Investigators performed an analysis using a subset of 33,719 patients with biomarker data from a blood draw. This analysis indicated higher EDIP scores were associated with a higher circulating profile of pro-inflammatory biomarkers, lower levels of adiponectin, and an unfavorable lipid profile (P <.001).

In an editorial comment, Ramon Estruch, MD, PhD, senior consultant in the department of internal medicine at Hospital Clinic in Barcelona, noted the importance of emphasizing the role of dietary patterns in mitigating risk for a slew of conditions.

“These protective effects could also be used for other highly prevalent chronic diseases in which chronic inflammation plays a relevant role, such as diabetes, cancer, depression, cognitive decline, and Alzheimer’s disease,” wrote Estruch. “When choosing the foods in our diet, we should beware of their pro- and anti-inflammatory potential!”

This study, “Dietary Inflammatory Potential and Risk of Cardiovascular Disease Among Men and Women in the U.S.,” was published in the Journal of the American College of Cardiology.