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Epidemiology

Longitudinal changes in the dietary inflammatory index: an assessment of the inflammatory potential of diet over time in postmenopausal women

European Journal of Clinical Nutrition volume 70, pages 1374–1380 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

The dietary inflammatory index (DII) measured at one time point is associated with risk of several chronic diseases, but disease risk may change with longitudinal changes in DII scores. Data are lacking regarding changes in DII scores over time; therefore, we assessed changes in the DII in the Women’s Health Initiative (WHI).

Subjects/Methods:

DII scores were calculated using data from repeated food frequency questionnaires in the WHI Observational Study (OS; n=76 671) at baseline and year 3, and the WHI Dietary Modification trial (DM; n=48482) at three time points. Lower DII scores represent more anti-inflammatory diets. We used generalized estimating equations to compare mean changes in DII over time, adjusting for multiple comparisons, and multivariable-adjusted linear regression analyses to determine predictors of DII change.

Results:

In the OS, mean DII decreased modestly from −1.14 at baseline to −1.50 at year 3. In the DM, DII was −1.32 in year 1, −1.60 in year 3 and −1.48 in year 6 in the intervention arm and was −0.65 in year 1, −0.94 in year 3 and −0.96 in year 6 in the control arm. These changes were modified by body mass index, education and race/ethnicity. A prediction model explained 22% of the variance in the change in DII scores in the OS.

Conclusions:

In this prospective investigation of postmenopausal women, reported dietary inflammatory potential decreased modestly over time. Largest reductions were observed in normal-weight, highly educated women. Future research is warranted to examine whether reductions in DII are associated with decreased chronic disease risk.

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Acknowledgements

FKT and JRH were supported by National Cancer Institute grants numbers F31CA177255 and K05CA136975, respectively. The WHI program was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, the US Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C and HHSN271201100004C.

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Authors and Affiliations

  1. Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    F K Tabung

  2. Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA

    F K Tabung, S E Steck, J Zhang, A D Liese & J R Hebert

  3. Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA

    F K Tabung, S E Steck & J R Hebert

  4. Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC, USA

    S E Steck & A D Liese

  5. Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA

    Y Ma & J K Ockene

  6. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    F A Tylavsky

  7. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA

    M Z Vitolins

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  1. F K Tabung
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  2. S E Steck
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  4. Y Ma
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Corresponding author

Correspondence to S E Steck.

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Competing interests

JRH owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings.

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Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website

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Tabung, F., Steck, S., Zhang, J. et al. Longitudinal changes in the dietary inflammatory index: an assessment of the inflammatory potential of diet over time in postmenopausal women. Eur J Clin Nutr 70, 1374–1380 (2016). https://doi.org/10.1038/ejcn.2016.116

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  • DOI: https://doi.org/10.1038/ejcn.2016.116

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