Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HR_quartile2 = 1.42 (95%CI = 0.97–2.09); HR_quartile3 = 1.85 (1.27–2.71); and HR_quartile4 = 1.73 (1.15–2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06–1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.

Fiber and fiber-rich foods have been inversely associated with cardiovascular disease (CVD), but the evidence is scarce in young and Mediterranean cohorts. We used Cox regression models to assess the association between quintiles of total fiber and fiber from different sources, and the risk of CVD adjusted for the principal confounding factors in a Mediterranean cohort of young adults, the SUN (Seguimiento Universidad de Navarra, Follow-up) cohort. After a median follow-up of 10.3 years, we observed 112 cases of CVD among 17,007 participants (61% female, mean age 38 years). We observed an inverse association between fiber intake and CVD events (p for trend = 0.024) and also between the highest quintile of fruit consumption (hazard ratio (HR) 0.51, 95% confidence interval (CI) 0.27–0.95) or whole grains consumption (HR 0.43 95% CI 0.20–0.93) and CVD compared to the lowest quintile, and also a HR of 0.58 (95% CI 0.37–0.90) for the participants who ate at least 175 g/day of fruit. Only the participants in the highest quintile of fruit-derived fiber intake had a significantly lower risk of CVD (HR 0.52, 95% CI 0.28–0.97). The participants who ate at least one serving per week of cruciferous vegetables had a lower risk than those who did not (HR 0.52, 95% CI 0.30–0.89). In conclusion, high fruit consumption, whole grain consumption, or consumption of at least one serving/week of cruciferous vegetables may be protective against CVD in young Mediterranean populations.

We aimed to assess the effects of the antioxidant-rich Mediterranean diet (MedDiet) on white blood cell count. Our study population included participants in the PREvención con DIeta MEDiterránea study (average age 67 years old, 58% women, high cardiovascular risk). We assessed whether a MedDiet intervention enriched in extra-virgin olive oil or nuts, versus a low-fat control diet, modified the incidence of leukocytosis (>11 × 10⁹ leukocytes/L), mild leukopenia (<4.5 × 10⁹ leukocytes/L), or severe leukopenia (<3.5 × 10⁹ leukocytes/L) in individuals without the condition at baseline (n = 3190, n = 2925, and n = 3190, respectively). We also examined whether MedDiet modified the association between leukocyte count alterations and all-cause mortality. Both MedDiet interventions were associated with a lower risk of developing leukopenia (incidence rates: 5.06% in control diet, 3.29% in MedDiet groups combined; hazard ratio [95% confidence interval]: 0.54 [0.36–0.80]) and severe leukopenia (incidence rates: 1.26% in control diet, 0.46% in MedDiet groups combined; hazard ratio: 0.25 [0.10–0.60]). High cumulative adherence to a MedDiet was linked to lower risk of leukocytosis (incidence rates: 2.08% in quartile 1, 0.65% in quartile 4; HR_Q4-Q1: 0.29 [0.085–0.99]) and attenuated the association between leukopenia and all-cause mortality (P-interaction = 0.032). In brief, MedDiet decreased the incidence of white blood cell count-related alterations in high cardiovascular risk individuals.