Inflammatory potential of the diet and mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC‐Spain)

Scope Low‐grade chronic inflammation is associated with several chronic conditions, and diet is known to play a role in chronic inflammation. We aimed to evaluate the association between the inflammatory potential of the diet and mortality in the Spanish population from the European Prospective Investigation into Cancer and Nutrition (EPIC‐Spain). Methods and results The study included 41 199 participants (62% female) aged 29–69 years from five Spanish regions. During 18 years of follow‐up 3316 deaths were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 30 dietetic components and their corresponding inflammatory scores (weights). The association between the ISD and mortality was analyzed by multivariate Cox regression models. There was a significant association between ISD and mortality: subjects classified in the fifth quintile of the ISD (more proinflammatory diets) had a hazard ratio of 1.42 (95%‐confidence interval 1.25–1.60) as compared with those in the first quintile; the corresponding figures were 1.89 (1.48–2.40) for cardiovascular diseases mortality and 1.44 (1.22–1.69) for death by cancer. Conclusion Consuming more proinflammatory diets, expressed by means of the ISD, is associated with higher mortality; this effect seems to be stronger for deaths by cardiovascular diseases. An inflammatory score is calculated to assess the inflammatory potential of the usual diet of about 41 000 Spanish adults. The study analyzes the impact on mortality of the inflammatory potential of diet together with body composition and physical activity. Inactive subjects with proinflammatory diets and abdominal obesity have 46% higher risk of death than nonobese and active subjects with more anti‐inflammatory diets.