Associations of novel dietary and lifestyle inflammation scores with all-cause, all-cancer, and all-cardiovascular disease mortality among older woman Open Access

Li, Zhuoyun (Spring 2020)

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Background:  Exogenous exposures that may contribute to chronic, low-grade inflammation collectively may increase chronic disease and mortality risks.  We investigated associations of novel questionnaire-based dietary (DIS) and lifestyle (LIS) inflammation scores with all-cause, all-cancer, and cardiovascular disease (CVD) mortality in the prospective Iowa Women’s Health Study (IWHS; 1986 – 2012; = 33,155, of whom 17,431 died during follow up).

Methods:  The previously reported weights for the components of the 19-component DIS and 4-component LIS were calculated based on their strengths of associations with a panel of inflammation biomarkers in a diverse subset of participants in the Reasons for Geographic and Racial Differences in Stroke study (REGARDS).  In the IWHS, we summed each study participant’s weighted components to yield their inflammation scores; a higher score was considered more pro-inflammatory.  We assessed DIS- and LIS-mortality associations using multivariable Cox proportional hazards regression. 

Results:  Among participants in the highest relative to the lowest DIS and LIS quintiles, the adjusted hazards ratios (HR) and their 95% confidence intervals [CI], were, respectively, for all-cause mortality, 1.11 (1.05-1.16;) and 1.59 (1.51-1.67); for all-cancer mortality, 1.06 (0.96-1.17) and 1.51 (1.37-1.66); and for CVD mortality, 1.11 (1.03-1.20) and 1.78 (1.65-1.93) (all Ptrend<0.01).  Among those in the highest relative to the lowest joint LIS/DIS quintile, the HRs (95% CIs) for all-cause, all-cancer, and all-CVD mortality were 1.88 (1.71-2.08;Pinteraction=0.02), 1.83 (1.50-2.21;Pinteraction=0.97), and 1.90 (1.63-2.22; Pinteraction=0.05), respectively.  

Conclusions:  These results suggest that more pro-inflammatory diets and lifestyles may be associated with higher all-cause, all-cancer, and all-CVD mortality risks.

Table of Contents



Study population

Data collection

Summary of the development and validation of the dietary (DIS) and lifestyle (LIS) inflammation scores

Calculation of the DIS and LIS in the IWHS

Statistical analyses





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