Dietary inflammatory index and anthropometric measures of XXXX in a population sample at high cardiovascular risk from the PREDIMED (PREvenci  n con DIeta MEDiterr  nea) trial.

@entity1 @entity32 @entity28
The dietary inflammatory index (DII) is a new tool to assess the inflammatory potential of the diet. In the present study, we aimed to determine the association between the DII and BMI, waist circumference and waist:height ratio (WHtR). We conducted a cross-sectional study of 7236 @entity1 recruited into the PREvenci  n con DIeta MEDiterr  nea trial. Information from a validated 137-item FFQ was used to calculate energy, food and nutrient intakes. A fourteen-item dietary screener was used to assess adherence to the Mediterranean diet (MeDiet). Sex-specific multivariable linear regression models were fitted to estimate differences (and 95 % CI) in BMI, waist circumference and WHtR across the quintiles of the DII. All nutrient intakes, healthy foods and adherence to the MeDiet were higher in the quintile with the lowest DII score (more anti-inflammatory values) except for intakes of animal protein, saturated fat and monounsaturated fat. Although an inverse association between the DII and total energy was apparent, the DII was associated with higher average BMI, waist circumference and WHtR after adjusting for known risk factors. The adjusted difference in the WHtR for @entity1 and @entity1 between the highest and lowest quintiles of the DII was 1  60 % (95 % CI 0  87, 2  33) and 1  04 % (95 % CI 0  35, 1  74), respectively. Pro-inflammatory scores remained associated with @entity28 after controlling for the effect that adherence to a MeDiet had on @entity32 . In conclusion, the present study shows a direct association between the DII and indices of @entity28 , and supports the hypothesis that diet may have a role in the development of @entity28 through inflammatory modulation mechanisms.
