• Nitin Shivappa, Marialaura Bonaccio, James R Hebert, Augusto Di Castelnuovo, Simona Costanzo, Emilia Ruggiero, George Pounis, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, and Moli-sani study Investigators.
• Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA; Connecting Health Innovations LLC, Columbia, South Carolina, USA. Electronic address: Shivappa@mailbox.sc.edu.
• Nutrition. 2018 Oct 1; 54: 182-188.

ObjectivesThe association between diet and inflammation is well documented. Yet, no evidence exists on the relationship between the inflammatory potential of the diet and low-grade inflammation (LGI) as measured by a composite score of plasma and cellular biomarkers. The aim of this study was to assess the association between the Dietary Inflammatory Index (DII®) and LGI in a large population-based cohort.MethodsCross-sectional analyses were conducted on data from 20 823 adults (age ≥35 y; 48% male) without acute inflammation, who were recruited within the general population of the Moli-sani study from 2005 to 2010. LGI was measured by using a composite score (INFLA-score) including platelet and leukocyte counts, the granulocyte to lymphocyte ratio, and C-reactive protein. DII scores were computed based on dietary intake assessed by the EPIC food frequency questionnaire. Multivariable linear regression models were fit to produce adjusted regression coefficients and 95% confidence intervals (CIs).ResultsHigher DII scores were associated with increased LGI (β = 0.131; 95% CI, 0.089-0.174 for the highest versus lowest quintile of DII) after adjusting for age, sex, lifestyle, prevalence of chronic diseases, and health conditions. A higher DII score also was positively associated with each single biomarker of inflammation included in the INFLA-score, unhealthy behaviors (smoking, sedentary lifestyle), and insulin.ConclusionsHigher DII scores, indicating greater inflammatory potential of the diet, were directly associated with LGI, as measured by a composite score of plasma and cellular biomarkers of inflammation. These findings are consistent with the contributing role of diet-mediated inflammation in increasing risk for inflammation-related chronic diseases.Copyright © 2018 Elsevier Inc. All rights reserved.

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