Pro-inflammatory diet is associated with a high number of cardiovascular events and ultra-processed foods consumption in patients in secondary care.
OBJECTIVE
To evaluate the association of dietary inflammatory index (DII®) with the occurrence of cardiovascular events, cardiometabolic risk factors and with the consumption of processed, ultra-processed, unprocessed or minimally processed foods and culinary ingredients.


DESIGN
This was a cross-sectional study that analysed the baseline data from 2359 cardiac patients. Data on socio-demographic, anthropometric, clinical and food consumption were collected. Energy-adjusted food intake data were used to calculate DII, and the foods were classified according to the NOVA classification. Furthermore, the patients were grouped according to the number (1, 2 or ≥ 3) of manifested cardiovascular events. The data were analysed using linear and multinomial logistic regression.


SETTINGS
Multicentre study from Brazil.


PARTICIPANTS
Patients with established cardiovascular events from the Brazilian Cardioprotective Nutritional Program Trial evaluated at baseline.


RESULTS
Most of the patients were male (58·8 %), older adults (64·2 %) and were overweight (68·8 %). Patients in the third tertile of DII (DII > 0·91) had were more likely to have 2 (OR 1·27, 95 % CI: 1·01-1·61) and ≥ 3 (OR 1·39, 95 % CI: 1·07-1·79) cardiovascular events, with poor cardiometabolic profile. They also were more likely to consume a higher percentage of processed, ultra-processed and culinary ingredients foods consumption compared with the patients in the first DII tertile (DII ≤ 0·91).


CONCLUSION
A more pro-inflammatory diet is associated with a greater chance of having 2 and ≥ 3 cardiovascular events and cardiometabolic risk factors and were more likely to consume processed, ultra-processed and culinary ingredients compared to those with a more anti-inflammatory diet.
['da Silva|Alessandra|A|0000-0002-4188-2586', 'Felício|Matheus Brum|MB|', 'Caldas|Ana Paula Silva|APS|', 'Miranda Hermsdorff|Helen Hermana|HH|', 'Bersch-Ferreira|Ângela Cristine|ÂC|', 'Torreglosa|Camila Ragne|CR|', 'Shivappa|Nitin|N|', 'Hébert|James R|JR|', 'Weber|Bernardete|B|', 'Bressan|Josefina|J|']
D000368:Aged D002318:Cardiovascular Diseases D003430:Cross-Sectional Studies D004032:Diet D002149:Energy Intake D057140:Fast Foods D005511:Food Handling D006801:Humans D008297:Male D063127:Secondary Care
Secondary care Dietary inflammatory index NOVA classification Nutrition CVD