Table 2 Characteristics of studies examined the association of Dietary Inflammatory Index with cardiometabolic diseases
Reference | First author (year) | Study design | Country | Age range/mean age | Gender | Sample size | Diet assessment tool | Number of subjects with CMDs | Duration of follow-up (years) | Number of used dietary factors in DII calculation | Outcome variable | Measure of outcome | Comparison | Type of DII variable (categorical/continuous) | Type of effect size measure | Effect size measure (95% CI) | Study quality | Confounders | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
15 | Bodén et al. 2017 | Case–control | Sweden | 30–73 | F/M | 6944 F (NR) M (NR) | FFQ | 1389 | 6.4 | 30 | MI | Morbidity | Quartile 4 (NR) vs. Quartile 1 (NR) | Categorical | OR | 1.37 (1.07, 1.73) | 8 | 1, 2, 3, 4, 5, 6, 7, 8 | ||
29 | Bondonno et al. 2017 | Cohort | Western Australia | ≥ 70 | F | 1304 | FFQ | 269 | 15 | 31 | ASVD | Mortality | Quartile 4 (1.72, 5.80) vs. Quartile 1 (− 6.14, − 1.37) | Categorical | HR | 2.02 (1.30, 3.13) | 8 | 1, 2, 7, 9, 10, 11, 12, 13, 14, 15, 16 | ||
– | Continues (per one SD (2.13 units)) | 1.36 (1.15, 1.60) | ||||||||||||||||||
150 | IHD | Quartile 4 (1.72, 5.80) vs. Quartile 1 (− 6.14, − 1.37) | Categorical | 2.51 (1.37, 4.62) | ||||||||||||||||
– | Continues (per one SD (2.13 units)) | 1.40 (1.13, 1.75) | ||||||||||||||||||
107 | Ischaemic cerebrovascular disease | Quartile 4 (1.72, 5.80) vs. Quartile 1 (− 6.14, − 1.37) | Categorical | 1.76 (0.92, 3.40) | ||||||||||||||||
– | Continues (per one SD (2.13 units)) | 1.30 (1.00, 1.69) | ||||||||||||||||||
511 | Deng et al. 2017 | Cohort | USA | 20–90 | F/M | 9631 F (5164) M (4467) | 24-h dietary recall | 676 | 18 | 27 | CVD | Mortality | Tertile 3 (> 2.0) vs. Tertile 1 (< − 0.20) | Categorical | HR | 1.52 (1.18, 1.96) | 9 | 2, 3, 4, 7, 9, 17, 18, 19 | ||
2681 F (1,264) M (1417) | 412 | 1.44 (1.02, 2.04) | ||||||||||||||||||
968 F (451) M (517) | 240 | 0.98 (0.57, 1.67) | ||||||||||||||||||
16 | Garcia-Arellano et al. 2015 | Cohort | Spain | 67.0 | F/M | 7216 | FFQ | 277 | Median follow-up of 4.8 | 32 | CVD | Morbidity | Quartile 4 (median = 1.17) vs. Quartile 1 (median = − 2.46) | Categorical | HR | 1.73 (1.15, 2.60) | 7 | 1, 3, 4, 6, 7, 9, 17, 20, 21, 22, 23, 24, 25, 26 | ||
– | Continues (per one SD) | 1.22 (1.06, 1.40) | ||||||||||||||||||
52 | Neufcourt et al. 2016 | Cohort | France | 35–60 | F/M | 7743 F (4546) M (3197) | At least 3 valid 24-h dietary records | 292 | 13 | 36 | Overall CVD | Morbidity | Quartile 4 (mean(IQR) (3.1 (1.3)) vs. Quartile 1 (− 1.7 (1.1)) | Categorical | HR | 1.16 (0.79, 1.69) | 7 | 1, 2, 3, 7, 9, 17, 25, 27, 28, 29, 30 | ||
– | Continues (per one unit) | 1.03 (0.96, 1.11) | ||||||||||||||||||
93 | MI | Quartile 4 (mean(IQR) (3.1 (1.3)) vs. Quartile 1 (− 1.7 (1.1)) | Categorical | 2.26 (1.08, 4.71) | ||||||||||||||||
– | Continues (per one unit) | 1.12 (0.98, 1.28) | ||||||||||||||||||
Quartile 4 (mean (IQR)2.41 (1.00))vs. Quartile 1 (− 1.86 (1.20)) | Categorical | 1.62 (0.88, 2.97) | ||||||||||||||||||
– | Continues (per one unit) | 1.12 (0.98, 1.27) | ||||||||||||||||||
58 | Stroke | Quartile 4 (mean (IQR) (3.1 (1.3))vs. Quartile 1 (− 1.7 (1.1)) | Categorical | 1.22 (0.56, 2.65) | ||||||||||||||||
– | Continues (per one unit) | 1.05 (0.89, 1.24) | ||||||||||||||||||
128 | AP/RI | Quartile 4 (mean (IQR) (3.1 (1.3)) vs. Quartile 1 (− 1.7 (1.1)) | Categorical | 0.73 (0.41, 1.30) | ||||||||||||||||
– | Continuous (per one unit) | 0.97 (0.87, 1.09) | ||||||||||||||||||
13 | Sudden deaths | Quartile 4 (mean (IQR) (3.1 (1.3))vs. Quartile 1 (− 1.7 (1.1)) | Categorical | NR | NR | |||||||||||||||
– | Continuous (per one unit) | |||||||||||||||||||
53 | O’Neil et al. 2015 | Cohort | Australia | 20–97 | M | 1363 | FFQ | 76 | 5 | 22 | CVD | Morbidity | Pro-inflammatory (positive DII) vs. anti- inflammatory (negative DII) | Categorical | OR | 2.00 (1.01, 3.96) | 7 | 1, 3, 4, 6, 7, 9, 31, 32 | ||
17 | Ramallal et al. 2015 | Cohort | Spain | 38 | F/M | 18,794 F (NR) M (NR) | FFQ | 117 | Median (8.9) | 28 | CVD | Morbidity | Quartile 4 (− 0.74, 3.97) vs. Quartile 1 (− 5.14, − 2.68) | Categorical | HR | 2.03 (1.06, 3.88) | 7 | 1, 2, 3, 6, 7, 9, 17, 22, 23, 24, 25, 33, 34, 35, 36 | ||
54 | Shivappa et al. 2016 | Cohort | USA | 55–69 | F | 28,677 | FFQ | 6528 | Mean ± SD (20.7 ± 7.0) | NR | CVD | Mortality | Quartile 4 (0.64, 4.65) vs. Quartile 1 (− 5.75, − 2.50) | Categorical | HR | 1.09 (1.01, 1.18) | 8 | 1, 2, 6, 7, 9, 22, 25, 33, 37, 38 | ||
– | Continuous (per one unit) | 1.04 (1.01, 1.07) | ||||||||||||||||||
3381 | CHD | Quartile 4 (0.64, 4.65) vs. Quartile 1 (− 5.75, − 2.50) | Categorical | 1.17 (1.05, 1.30) | ||||||||||||||||
– | Continuous (per one unit) | 1.07 (1.03, 1.11) | ||||||||||||||||||
1439 | Stroke | Quartile 4 (0.64, 4.65) vs. Quartile 1 (− 5.75, − 2.50) | Categorical | 1.04 (0.88, 1.22) | ||||||||||||||||
– | Continuous (per one unit) | 1.01 (0.95, 1.08) | ||||||||||||||||||
417 | 0–4.99 | CVD | 1.06 (0.95, 1.19) | |||||||||||||||||
736 | 5–9.99 | 1.14 (1.05, 1.24) | ||||||||||||||||||
1177 | 10.00–14.99 | 1.01 (0.94, 1.07) | ||||||||||||||||||
1825 | 15.00–19.99 | 1.07 (1.01, 1.13) | ||||||||||||||||||
2373 | 20.00–25.00 | 1.00 (0.96, 1.05) | ||||||||||||||||||
260 | 0–4.99 | CHD | 1.13 (0.68, 1.31) | |||||||||||||||||
447 | 5–9.99 | 1.15 (1.03, 1.28) | ||||||||||||||||||
681 | 10.00–14.99) | 0.98 (0.90, 1.07) | ||||||||||||||||||
918 | 15.00–19.99 | 1.12 (1.04–1.20) | ||||||||||||||||||
1075 | 20.00–25.00 | 1.03 (0.96, 1.11) | ||||||||||||||||||
54 | 0–4.99 | Stroke | 1.05 (0.77, 1.42) | |||||||||||||||||
129 | 5–9.99 | 1.07 (0.87, 1.32) | ||||||||||||||||||
233 | 10.00–14.99) | 1.06 (0.92, 1.23) | ||||||||||||||||||
441 | 15.00–19.99 | 1.04 (0.93, 1.16) | ||||||||||||||||||
582 | 20.00–25.00 | 0.96 (0.87, 1.06) | ||||||||||||||||||
55 | Shivappa et al. 2016 | Cohort | Sweden | NR | F | 33,747 | FFQ | 2399 | 15 | 27 | CVD | Mortality | Quintile 5 (≥ 1.91) vs. Quintile 1 (≤ − 0.67) | Categorical | HR | 1.26 (0.93, 1.70) | 8 | 1, 2, 3, 7, 9, 25, 39 | ||
– | Continues (per one unit) | 1.04 (0.98, 1.12) | ||||||||||||||||||
30 | Shivappa et al. 2017 | Cohort | Germany | 45–64 | M | 1297 | 7-day dietary record | 244 | Survey1: median follow-up = 25.8 Survey 3: median follow-up = 16.7 | NR | CVD | Mortality | Quartile 4 (median (2.507)) vs. Quartile 1 (median (− 0.803)) | Categorical | HR | 1.19 (0.76, 1.86) | 7 | 1, 2, 3, 6, 7, 9, 22, 25, 40, 41, 42 | ||
– | Continues (per one unit) | 1.05 (0.92, 1.20) | ||||||||||||||||||
155 | CHD | Quartile 4 (median (2.507)) vs. Quartile 1 (median (− 0.803)) | Categorical | 1.02 (0.57, 1.82) | ||||||||||||||||
– | Continues (per one unit) | 1.01 (0.86, 1.18) | ||||||||||||||||||
1252 | 213 | CHD | Morbidity | Quartile 4 (median (2.507)) vs. Quartile 1 (median (− 0.803)) | Categorical | 1.53 (0.93, 2.53) | ||||||||||||||
– | Continues (per one unit) | 1.11 (0.97, 1.27) | ||||||||||||||||||
56 | Shivappa et al. 2017 | Cohort | USA | > 19 | F/M | 12,366 F (NR) M (NR) | One in-person 24-h dietary recall | 1235 | Mean ± SD (13.5 ± 4.0) | 27 | CVD | Mortality | Tertile 3 (2.03, 4.83) vs. Tertile 1 (− 5.60, − 0.22) | Categorical | HR | 1.46 (1.18, 1.81) | 8 | 2, 3, 6, 7, 9, 17, 18, 22, 33, 43 | ||
– | Continuous (1-unit increment in DII (corresponding to 0.5 standard deviation increase)) | 1.06 (1.02, 1.09) | ||||||||||||||||||
57 | Shivappa et al. 2017 | Case–control | Italy | Case (19–79) Control (16–79) | F/M | 1442 F (423) M (1019) | FFQ | 760 | – | 30 | AMI | Morbidity | Quartile 4 (1.10, 5.45) vs. Quartile 1 (− 4.46, − 1.38) | Categorical | OR | 1.60 (1.06, 2.41) | 7 | 1, 2, 3, 6, 7, 9, 17, 22, 23, 24, 25, 44 | ||
– | Continuous (one unit increase in DII equals to ~ 9% range of DII in this study (− 6.22 to + 5.45) | 1.14 (1.05, 1.24) | ||||||||||||||||||
31 | Vissers et al. 2016 | Cohort | Australia | 52 (1) | F | 6,972 | FFQ | 335 | Mean ± SD (11 ± 1.6) | 25 | CVD | Morbidity | (DII ≥ 0) vs. (DII < 0) | Categorical | HR | 1.03 (0.76, 1.42) | 8 | 1, 2, 3, 6, 7, 9, 22, 25, 37, 39, 45 | ||
– | Continuous (per one SD) | 0.98 (0.84, 1.15) | ||||||||||||||||||
191 | IHD | (DII ≥ 0) vs. (DII < 0) | Categorical | 1.33 (0.86, 2.06) | 1, 6, 7, 9, 22 | |||||||||||||||
– | Continuous (per one SD) | 1.08 (0.88, 1.33) | ||||||||||||||||||
69 | MI | (DII ≥ 0) vs. (DII < 0) | Categorical | 1.59 (0.72, 3.52) | ||||||||||||||||
– | Continuous (per one SD) | 1.40 (0.97, 2.01) | ||||||||||||||||||
59 | Cerebrovascular disease | (DII ≥ 0) vs. (DII < 0) | Categorical | 0.57 (0.29, 1.15) | ||||||||||||||||
– | Continuous (per one SD) | 0.72 (0.50, 1.02) | ||||||||||||||||||
40 | Stroke | (DII ≥ 0) vs. (DII < 0) | Categorical | 0.55 (0.24, 1.26) | ||||||||||||||||
– | Continuous (per one SD) | 0.77 (0.51, 1.18) | ||||||||||||||||||
19 | Wirth et al. 2016 | Cross-sectional | USA | 20–80 | F/M | 15,613 F (8047) M (7566) | 24-h dietary recall | 1734 | – | 27 | Combined circulatory disorders | Morbidity | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | POR | 1.30 (1.06, 1.58) | 5 | 2, 7, 9, 46 | ||
– | Continuous (per one unit) | 1.05 (1.01, 1.08) | ||||||||||||||||||
15,622 | 501 | Congestive heart failure | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | 1.38 (1.09, 1.74) | |||||||||||||||
– | Continuous (per one unit) | 1.06 (1.02, 1.10) | ||||||||||||||||||
15,623 | 634 | CHD | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | 0.96 (0.72, 1.28) | |||||||||||||||
– | Continuous (per one unit) | 0.99 (0.94, 1.05) | ||||||||||||||||||
15,643 | 423 | AP | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | 0.83 (0.54, 1.28) | |||||||||||||||
– | Continuous (per one unit) | 0.95 (0.89, 1.02) | ||||||||||||||||||
15,664 | 685 | Heart Attack | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | 1.48 (1.12, 1.97) | |||||||||||||||
– | Continuous (per one unit) | 1.06 (1.01, 1.12) | ||||||||||||||||||
15,666 | 604 | Stroke | Quartile 4 (1.94, 4.83) vs. Quartile 1 (− 5.81, − 0.81) | Categorical | 1.56 (1.21, 2.01) | |||||||||||||||
– | Continuous (per one unit) | 1.09 (1.04, 1.15) | ||||||||||||||||||
32 | Shivappa et al. 2017 | Cohort | England | 35–55 | F/M | 7627 F (2319) M (5308) | FFQ | 264 | 22 | 27 | CVD | Mortality | Tertile 3 (0.74–3.82) vs. Tertile 1 (− 3.08–0.39) | Categorical | HR | 1·46 (1·00, 2·13) | 7 | 1, 2, 3, 6, 9, 7, 17, 18, 22, 29, 33, 39, 47, 48, 49, 50 | ||
– | Continuous (per one SD (1.3 units)) | 1.23 (1.04, 1.47) | ||||||||||||||||||
77 | Hodge et al. 2018 | Cohort | Australia | 40–69 | F/M | 39,532 F (16,051) M (23,481) | FFQ | 2,081 | 19 | 29 | CVD | Mortality | Quintile 5 (0.7, 4.9) vs. Quintile 1 (− 5.0, − 2.4) | Categorical | HR | 1.16 (1.01, 1.33) | 8 | 6, 17, 24, 33, 39, 51, 52 | ||
78 | Mark Park et al. 2018 | Cohort | USA | 20–90 | F/M | 3733 F (1553) M (2180) | 24-h dietary recall | 252 | 18.5 | 27 | CVD | Mortality | Tertile 3 (1.97, 4.55) vs. Tertile1 (− 5.08, − 0.24) | Categorical | HR | 2.50 (1.60, 3.91) | 8 | 2, 3, 7, 9, 17, 18, 25, 53 | ||
– | Continuous (per one SD) | 1.32 (1.10, 1.58) | ||||||||||||||||||
79 | Park et al. 2018 | Cohort | USA | 45–75 | F | 83,054 | FFQ | 7811 | 18.2 ± 4.9 | 28 | CVD | Mortality | Quintile 5 (− 0.06, 4.95) vs. Quintile 1) − 6.64, − 3.91) | Categorical | HR | 1.29 (1.17–1.42) | 8 | 1, 2, 3, 6, 7, 9, 18, 25, 29, 37, 39 | ||
– | Continues (per one unit) | 1.04 (1.03,1.06) | ||||||||||||||||||
M | 67,351 | 8401 | Quintile 5 (− 0.06, 4.95) vs. Quintile 1 (− 6.64, − 3.91) | Categorical | 1.13 (1.03, 1.23) | |||||||||||||||
– | Continues (per one unit) | 1.03 (1.01, 1.04) | ||||||||||||||||||