Dietary Inflammatory Potential and Risk of Cardiovascular Disease

Quick Takes

  • A diet higher in red meat, processed meat, refined carbohydrates, and sweetened beverage is associated with higher inflammation.
  • Dietary patterns with a higher proinflammatory potential were associated with higher CVD risk.

Study Questions:

Are proinflammatory diets associated with an increased risk for cardiovascular disease (CVD)?


Data from the NHS (Nurses’ Health Study) (1984–2016), the NHSII (1991–2015), and the Health Professionals Follow-up Study (1986–2016) were used for the present study. All participants who were free of CVD and cancer at baseline were included. Diet was assessed by food frequency questionnaires every 4 years. The inflammatory potential of diet was evaluated using a food-based empirical dietary inflammatory pattern (EDIP) score that was predefined based on levels of three systemic inflammatory biomarkers. The primary outcome of interest was CVD events including coronary heart disease (CHD) events and strokes.


A total of 74,578 women from NHS, 91,656 women from NHSII, and 43,911 men from the Health Professionals Follow-up Study were included in the present study. During 5,291,518 person-years of follow-up, 15,837 incident CVD cases were identified, including 9,794 CHD cases and 6,174 strokes. A higher dietary inflammatory potential, as indicated by higher EDIP scores, was associated with an increased risk of CVD (hazard ratio [HR] comparing the highest to lowest quintiles, 1.38; 95% confidence interval [CI], 1.31-1.46; p for trend < 0.001), after adjustment for use of anti-inflammatory medications and CVD risk factors including body mass index. A similar pattern was noted for CHD (HR, 1.46; 95% CI, 1.36-1.56; p for trend < 0.001), and for stroke (HR, 1.28; 95% CI, 1.17-1.39; p for trend < 0.001). These associations were consistent across cohorts and between sexes, and they remained significant after further adjustment for other dietary quality indices. In a subset of study participants (n = 33,719), a higher EDIP score was associated with a higher circulating profile of proinflammatory biomarkers, lower levels of adiponectin, and an unfavorable blood lipid profile (p < 0.001).


The investigators concluded that dietary patterns with a higher proinflammatory potential were associated with higher CVD risk. Reducing the inflammatory potential of the diet may potentially provide an effective strategy for CVD prevention.


These data support the association between a healthy dietary pattern—including fruits, vegetables, and whole grains, with lower intake of processed and sweetened foods—and lower inflammation and lower risk for CVD.

Clinical Topics: Dyslipidemia, Prevention, Lipid Metabolism, Diet, Atherosclerotic Disease (CAD/PAD), Vascular Medicine

Keywords: Adiponectin, Anti-Inflammatory Agents, Biomarkers, Coronary Disease, Diet, Fruit, Inflammation, Lipids, Primary Prevention, Risk Factors, Stroke, Sweetening Agents, Vegetables, Vascular Diseases

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