{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T21:37:09Z","timestamp":1791754629116,"version":"4.3.4"},"reference-count":66,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T00:00:00Z","timestamp":1518393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R44DK103377"],"award-info":[{"award-number":["R44DK103377"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII\u00ae) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and CVD. Individuals in the highest versus the lowest (reference) DII category showed a 36% increased risk of CVD incidence and mortality, with moderate evidence of heterogeneity (relative risk (RR) = 1.36, 95% confidence interval (CI): 1.19, 1.57; heterogeneity index I2 = 69%, p &lt; 0.001). When analyzed as a continuous variable, results showed an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score. Results remained unchanged when analyses were restricted to the prospective studies. Results of our meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality. In conclusion, a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality. These results further substantiate the utility of DII as tool to characterize the inflammatory potential of diet and to predict CVD incidence and mortality.<\/jats:p>","DOI":"10.3390\/nu10020200","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T10:50:38Z","timestamp":1518432638000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":305,"title":["Dietary Inflammatory Index and Cardiovascular Risk and Mortality\u2014A Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"given":"Nitin","family":"Shivappa","sequence":"first","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Connecting Health Innovations, LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5809-5706","authenticated-orcid":false,"given":"Justyna","family":"Godos","sequence":"additional","affiliation":[{"name":"NNEdPro Global Centre for Nutrition and Health, St John\u2019s Innovation Centre, Cambridge CB4 0WS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Connecting Health Innovations, LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wirth","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Connecting Health Innovations, LLC, Columbia, SC 29201, USA"},{"name":"College of Nursing, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Piuri","sequence":"additional","affiliation":[{"name":"Inflammation Society, 18 Woodlands Park, Bexley DA52EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3712-9428","authenticated-orcid":false,"given":"Attilio","family":"Speciani","sequence":"additional","affiliation":[{"name":"Inflammation Society, 18 Woodlands Park, Bexley DA52EL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-5285","authenticated-orcid":false,"given":"Giuseppe","family":"Grosso","sequence":"additional","affiliation":[{"name":"NNEdPro Global Centre for Nutrition and Health, St John\u2019s Innovation Centre, Cambridge CB4 0WS, UK"},{"name":"Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Universitaria Policlinico Vittorio Emanuele, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.2174\/138161209788453167","article-title":"Inflammation, microenvironment, and the immune system in cancer progression","volume":"15","author":"Keibel","year":"2009","journal-title":"Curr. 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