Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Nutrition in acute and chronic diseases

Associations of empirical dietary inflammatory index with heart failure in adults from the United States

Abstract

Background

Recent evidence has shown associations between cardiovascular disease and a proinflammatory diet. We hypothesized that a proinflammatory diet, assessed using the Empirical Dietary Inflammatory Index (EDII), is associated with increased risk of prevalent heart failure (HF).

Methods

This analysis included 13,687 participants (44.8 ± 19.4 years; 45.7% male, 67.8% whites) from the Third National Health and Nutrition Examination Survey. EDII score was calculated from the Food Frequency Questionnaire. Prevalent HF was determined by physician-diagnosed self-report. Multivariable logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between EDII score and prevalent HF across tertiles (reference group first tertile) and per 1-unit standard deviation (1-SD) increase.

Results

About 1.4% (n = 190) of the participants reported a history of HF. Each 1-SD increase in EDII score (0.276) conferred 25% increased odds of prevalent HF (OR (95% CI): 1.25 (1.07–1.46); p value = 0.006). Odds of HF increased as EDII tertile increased, indicating a dose–response relationship (OR (95% CI) for 2nd and 3rd tertiles compared to 1st tertile: 1.42 (0.99–2.04), 1.68 (1.15–2.46), respectively). These results were consistent in subgroups of the participants stratified by demographics and comorbidities.

Conclusions

Proinflammatory dietary patterns are associated with an increased risk of HF. The risk of HF could potentially be reduced by avoiding proinflammatory dietary patterns.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Data availability

All data used in this study was obtained from NHANES-III. This data is fully anonymized and publicly available at https://wwwn.cdc.gov/nchs/nhanes/nhanes3/datafiles.aspx.

References

  1. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6:606–19.

    CAS  Article  Google Scholar 

  2. Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006;83:456S–60S.

    CAS  Article  Google Scholar 

  3. Vasan RS, Sullivan LM, Roubenoff R, Dinarello CA, Harris T, Benjamin EJ, et al. Inflammatory markers and risk of heart failure in elderly subjects without prior myocardial infarction: the Framingham heart study. Circulation. 2003;107:1486–91.

    CAS  Article  Google Scholar 

  4. Dick SA, Epelman S. Chronic heart failure and inflammation: what do we really know? Circ Res. 2016;119:159–76.

    CAS  Article  Google Scholar 

  5. Alonso-Martinez JL, Llorente-Diez B, Echegaray-Agara M, Olaz-Preciado F, Urbieta-Echezarreta M, Gonzalez-Arencibia C. C-reactive protein as a predictor of improvement and readmission in heart failure. Eur J Heart Fail. 2002;4:331–6.

    CAS  Article  Google Scholar 

  6. Maeda K, Tsutamoto T, Wada A, Mabuchi N, Hayashi M, Tsutsui T, et al. High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure. J Am Coll Cardiol. 2000;36:1587–93.

    CAS  Article  Google Scholar 

  7. Tabung FK, Smith-Warner SA, Chavarro JE, Wu K, Fuchs CS, Hu FB, et al. Development and validation of an empirical dietary inflammatory index. J Nutr. 2016;146:1560–70.

    CAS  Article  Google Scholar 

  8. Li J, Lee DH, Hu J, Tabung FK, Li Y, Bhupathiraju SN, et al. Dietary inflammatory potential and risk of cardiovascular disease among men and women in the U.S. J Am Coll Cardiol. 2020;76:2181–93.

    CAS  Article  Google Scholar 

  9. Plan and operation of the Third National Health and Nutrition Examination Survey, 1988-94. Series 1: programs and collection procedures. Vital Health Stat. 1. 1994:1–407.

  10. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:1269–324.

    CAS  Article  Google Scholar 

  11. Colditz GA, Manson JE, Hankinson SE. The Nurses’ health study: 20-year contribution to the understanding of health among women. J Women’s Health. 1997;6:49–62.

    CAS  Article  Google Scholar 

  12. Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol. 1992;135:1114–26. discussion 27-36

    CAS  Article  Google Scholar 

  13. Soltani S, Moslehi N, Hosseini-Esfahani F, Vafa M. The association between empirical dietary inflammatory pattern and metabolic phenotypes in overweight/obese adults. Int J Endocrinol Metab. 2018;16:e60048.

    Article  Google Scholar 

  14. Shakeri Z, Mirmiran P, Khalili-Moghadam S, Hosseini-Esfahani F, Ataie-Jafari A, Azizi F. Empirical dietary inflammatory pattern and risk of metabolic syndrome and its components: Tehran lipid and glucose study. Diabetol Metab Syndr. 2019;11:16.

    Article  Google Scholar 

  15. Hurley M, Tenny S Mean. StatPearls. Treasure Island (FL) 2021.

  16. Liu Z, Liu H, Deng Q, Sun C, He W, Zheng W, et al. Association between dietary inflammatory index and heart failure: results from NHANES (1999-2018). Front Cardiovasc Med. 2021;8:702489.

    Article  Google Scholar 

  17. 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.

    Article  Google Scholar 

  18. 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;147:1567–77.

    CAS  Article  Google Scholar 

  19. Tabung FK, Giovannucci EL, Giulianini F, Liang L, Chandler PD, Balasubramanian R, et al. An empirical dietary inflammatory pattern score is associated with circulating inflammatory biomarkers in a multi-ethnic population of postmenopausal women in the United States. J Nutr. 2018;148:771–80.

    Article  Google Scholar 

  20. Schwingshackl L, Hoffmann G. Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials. Nutr Metab Cardiovasc Dis. 2014;24:929–39.

    CAS  Article  Google Scholar 

  21. Martinez-Gonzalez MA, Gea A, Ruiz-Canela M. The mediterranean diet and cardiovascular health. Circ Res. 2019;124:779–98.

    CAS  Article  Google Scholar 

  22. Carbone S, Canada JM, Buckley LF, Trankle CR, Billingsley HE, Dixon DL, et al. Dietary fat, sugar consumption, and cardiorespiratory fitness in patients with heart failure with preserved ejection fraction. JACC Basic Transl Sci. 2017;2:513–25.

    Article  Google Scholar 

  23. Carbone S, Billingsley HE, Canada JM, Kadariya D, Medina de Chazal H, Rotelli B, et al. Unsaturated fatty acids to improve cardiorespiratory fitness in patients with obesity and HFpEF: the UFA-preserved pilot study. JACC Basic Transl Sci. 2019;4:563–5.

    Article  Google Scholar 

  24. Everett BM, Cornel JH, Lainscak M, Anker SD, Abbate A, Thuren T, et al. Anti-inflammatory therapy with canakinumab for the prevention of hospitalization for heart failure. Circulation. 2019;139:1289–99.

    CAS  Article  Google Scholar 

  25. Chien SC, Lo CI, Lin CF, Sung KT, Tsai JP, Huang WH, et al. Malnutrition in acute heart failure with preserved ejection fraction: clinical correlates and prognostic implications. ESC Heart Fail. 2019;6:953–64.

    Article  Google Scholar 

Download references

Acknowledgements

There were no further contributions to this project beyond those of the listed authors.

Funding

Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001420 (EZS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

Authors

Contributions

WP: Writing – original draft. RA: Writing – original draft. TS: Software, formal analysis, data curation, writing – original draft, visualization. ES: Conceptualization, methodology, writing – review and editing, supervision.

Corresponding author

Correspondence to Wesley R. Parker.

Ethics declarations

Competing interests

The authors whose names are listed certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

No ethical approval was required since data in NHANES-III are publicly available and fully anonymized.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Parker, W.R., Annabathula, R.V., Skipina, T.M. et al. Associations of empirical dietary inflammatory index with heart failure in adults from the United States. Eur J Clin Nutr (2022). https://doi.org/10.1038/s41430-022-01198-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41430-022-01198-z

Search

Quick links