Abstract
Purpose
Chronic inflammation plays a role in the pathogenesis of age-related renal disease and the diet can moderate systemic inflammation. The primary objective of this study was to examine the associations between a dietary inflammatory index (DII®) score and renal function, the trajectory of renal function decline, and renal disease-related hospitalizations and/or mortality over 10 years.
Methods
The study was conducted in 1422 Western Australian women without prevalent chronic kidney disease and aged ≥ 70 years. Baseline dietary data, obtained from a validated food frequency questionnaire, were used to calculate a DII score for each individual.
Results
In this cohort, the mean [range] DII score was 0.19 [− 6.14 to 6.39]. A higher DII score was associated with poorer renal function at baseline and a greater renal function decline over 10 years; after multivariable adjustments, a one-unit higher DII score was associated with a 0.55 mL/min/1.73 m2 lower eGFR at baseline (p = 0.01) and a 0.06 mL/min/1.73 m2 greater annual decline in eGFR over 10 years (p = 0.05). Restricted cubic splines provide evidence of a non-linear association between baseline DII score and risk of a renal disease-related event. Compared to participants in the lowest quintile, those in the highest quintile of DII score were at a higher risk of experiencing a renal disease-related event (adjusted HR 2.06, 95% CI 0.97, 4.37).
Conclusion
Recommending an increased consumption of foods with a higher anti-inflammatory potential could form part of a multifaceted approach to reduce the risk of renal disease through diet and lifestyle changes.
Similar content being viewed by others
References
Vlassara H, Cai W, Chen X, Serrano EJ, Shobha MS, Uribarri J, Woodward M, Striker GE (2012) Managing chronic inflammation in the aging diabetic patient with CKD by diet or sevelamer carbonate: a modern paradigm shift. J Gerontol A Biol Sci Med Sci 67(12):1410–1416
Kidney Health Australia (2016) Kidney fast facts. Kidney Health Australia, Melbourne
Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, Hobbs FDR (2016) Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PLoS One 11(7):e0158765
Lim WH, Lewis JR, Wong G, Teo R, Lim EM, Byrnes E, Prince RL (2015) Plasma neutrophil gelatinase-associated lipocalin and kidney function decline and kidney disease-related clinical events in older women. Am J Nephrol 41(2):156. https://doi.org/10.1159/000380831
Silverstein D (2009) Inflammation in chronic kidney disease: role in the progression of renal and cardiovascular disease. Pediatr Nephrol 24(8):1445–1452. https://doi.org/10.1007/s00467-008-1046-0
Xu H, Sjögren P, Ärnlöv J, Banerjee T, Cederholm T, Risérus U, Lindholm B, Lind L, Carrero JJ (2015) A proinflammatory diet is associated with systemic inflammation and reduced kidney function in elderly adults. J Nutr 145(4):729. https://doi.org/10.3945/jn.114.205187
Cui X, Jin Y, Singh UP, Chumanevich AA, Harmon B, Cavicchia P, Hofseth AB, Kotakadi V, Poudyal D, Stroud B, Volate SR, Hurley TG, Hebert JR, Hofseth LJ (2012) Suppression of DNA damage in human peripheral blood lymphocytes by a juice concentrate: a randomized, double-blind, placebo-controlled trial. Mol Nutr Food Res 56(4):666–670. https://doi.org/10.1002/mnfr.201100496
Cavicchia PP, Steck SE, Hurley TG, Hussey JR, Ma Y, Ockene IS, Hébert JR (2009) New dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr 139(12):2365–2372. https://doi.org/10.3945/jn.109.114025
Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L (2006) Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 84(6):1489–1497
Johansson-Persson A, Ulmius M, Cloetens L, Karhu T, Herzig K-H, Önning G (2014) A high intake of dietary fiber influences C-reactive protein and fibrinogen, but not glucose and lipid metabolism, in mildly hypercholesterolemic subjects. Eur J Nutr 53(1):39–48. https://doi.org/10.1007/s00394-013-0496-8
Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, Hu FB (2004) Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 80(4):1029–1035
Odermatt A (2011) The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. Am J Physiol Renal Physiol 301(5):F919–F931
Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17(8):1689–1696. https://doi.org/10.1017/S1368980013002115
Wood LG, Shivappa N, Berthon BS, Gibson PG, Hebert JR (2015) Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma. Clin Exp Allergy 45(1):177–183. https://doi.org/10.1111/cea.12323
Garcia-Arellano A, Ramallal R, Ruiz-Canela M, Salas-Salvadó J, Corella D, Shivappa N, Schröder H, Hebert J, Ros E, Gómez-Garcia E, Estruch R, Lapetra J, Arós F, Fiol M, Serra-Majem L, Pintó X, Babio N, Gonzalez J, Fitó M, Martínez J, Martínez-Gonzalez M, Investigators t (2015) Dietary inflammatory index and incidence of cardiovascular disease in the PREDIMED study. Nutrients 7(6):4124–4138. https://doi.org/10.3390/nu7064124
van Woudenbergh GJ, Theofylaktopoulou D, Kuijsten A, Ferreira I, van Greevenbroek MM, van der Kallen CJ, Schalkwijk CG, Stehouwer CDA, Ocké MC, Nijpels G (2013) Adapted dietary inflammatory index and its association with a summary score for low-grade inflammation and markers of glucose metabolism: the Cohort study on Diabetes and Atherosclerosis Maastricht (CODAM) and the Hoorn study. Am J Clin Nutr 98(6):1533–1542
Wirth MD, Shivappa N, Steck SE, Hurley TG, Hébert JR (2015) The dietary inflammatory index is associated with colorectal cancer in the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Br J Nutr 113(11):1819–1827. https://doi.org/10.1017/S000711451500104X
Lu Y, Shivappa N, Lin Y, Lagergren J, Hébert J (2016) Diet-related inflammation and oesophageal cancer by histological type: a nationwide case-control study in Sweden. Eur J Nutr 55(4):1683–1694. https://doi.org/10.1007/s00394-015-0987-x
Zamora-Ros R, Shivappa N, Steck S, Canzian F, Landi S, Alonso M, Hébert J, Moreno V (2015) Dietary inflammatory index and inflammatory gene interactions in relation to colorectal cancer risk in the Bellvitge colorectal cancer case–control study. Genes Nutr 10(1):1–9. https://doi.org/10.1007/s12263-014-0447-x
Shivappa N, Bosetti C, Zucchetto A, Serraino D, La Vecchia C, Hébert JR (2015) Dietary inflammatory index and risk of pancreatic cancer in an Italian case–control study. Br J Nutr 113(2):292–298. https://doi.org/10.1017/S0007114514003626
Shivappa N, Hébert JR, Rietzschel ER, De Buyzere ML, Langlois M, Debruyne E, Marcos A, Huybrechts I (2015) Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr 113(4):665–671. https://doi.org/10.1017/S000711451400395X
Prince RL, Devine A, Dhaliwal SS, Dick IM (2006) Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med 166(8):869–875
Bondonno NP, Lewis JR, Blekkenhorst LC, Shivappa N, Woodman RJ, Bondonno CP, Ward NC, Hébert JR, Thompson PL, Prince RL (2017) Dietary inflammatory index in relation to sub-clinical atherosclerosis and atherosclerotic vascular disease mortality in older women. Br J Nutr 117(11):1577–1586
Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G (2000) The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Aust N Z J Public Health 24(6):576
Ireland P, Jolley D, Giles G, O’Dea K, Powles J, Rutishauser I, Wahlqvist ML, Williams J (1994) Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr 3(1):19–31
Lewis J, Lim W, Zhu K, Wong G, Dhaliwal S, Lim E, Ueland T, Bollerslev J, Prince R (2014) Elevated osteoprotegerin predicts declining renal function in elderly women: a 10-year prospective cohort study. Am J Nephrol 39(1):66–74. https://doi.org/10.1159/000357787
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612
Hodgson JM, Devine A, Puddey IB, Beilby J, Prince RL (2006) Drinking tea is associated with lower plasma total homocysteine in older women. Asia Pacific J Clin Nutr 15(2):253
World Health Organization (1977) International classification of diseases; manual of the international statistical classification of diseases, injuries, and causes of death, 1975th edn. World Health Organization, Geneva
World Health Organization (1988) The International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM), 1st edn. National Centre for Classification in Health, Sydney
Holman CDAJ, Bass JA, Rosman DL, Smith MB, Semmens JB, Glasson EJ, Brook EL, Trutwein B, Rouse IL, Watson CR, de Klerk NH, Stanley FJ (2008) A decade of data linkage in Western Australia: strategic design, applications and benefits of the WA data linkage system. Aust Health Rev 32(4):766–777. https://doi.org/10.1071/AH080766
Devine A, Dhaliwal SS, Dick IM, Bollerslev J, Prince RL (2004) Physical activity and calcium consumption are important determinants of lower limb bone mass in older women. J Bone Miner Res 19(10):1634–1639
McArdle W, Katch F, Katch V (1991) Energy, nutrition and human performance. Lea Febiger, Philadelphia
Britt H (1997) A new coding tool for computerised clinical systems in primary care–ICPC plus. Aust Fam Physician 26:S79–S82
Willett WC, Sampson L, Browne ML, Stampfer MJ, Rosner B, Hennekens CH, Speizer FE (1988) The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol 127(1):188–199
Noordzij M, Leffondré K, van Stralen KJ, Zoccali C, Dekker FW, Jager KJ (2013) When do we need competing risks methods for survival analysis in nephrology? Nephrol Dial Transpl 28(11):2670–2677
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG (2013) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 380(9859):2224–2260
Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292(12):1440–1446
Huang X, Jiménez-Moleón JJ, Lindholm B, Cederholm T, Ärnlöv J, Risérus U, Sjögren P, Carrero JJ (2013) Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrol 8:1548–1555
Stenvinkel P (2010) Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease. J Intern Med 268:456–467. https://doi.org/10.1111/j.1365-2796.2010.02269.x
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu C-y (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351(13):1296–1305
Shlipak MG, Fried LF, Crump C, Bleyer AJ, Manolio TA, Tracy RP, Furberg CD, Psaty BM (2003) Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency. Circulation 107(1):87–92
Muntner P, Hamm LL, Kusek JW, Chen J, Whelton PK, He J (2004) The prevalence of nontraditional risk factors for coronary heart disease in patients with chronic kidney disease. Ann Intern Med 140(1):9–17
Wirth MD, Burch J, Shivappa N, Violanti JM, Burchfiel CM, Fekedulegn D, Andrew ME, Hartley TA, Miller DB, Mnatsakanova A (2014) Association of a dietary inflammatory index with inflammatory indices and metabolic syndrome among police officers. J Occup Environ Med 56(9):986–989
Mazidi M, Shivappa N, Wirth MD, Hebert JR, Kengne AP (2018) Greater Dietary Inflammatory Index score is associated with higher likelihood of chronic kidney disease. Br J Nutr 120(2):204–209
Rouhani MH, Najafabadi MM, Surkan PJ, Esmaillzadeh A, Feizi A, Azadbakht L (2019) Dietary inflammatory index and its association with renal function and progression of chronic kidney disease. Clin Nutr ESPEN 29:237–241
Hébert JR, Shivappa N, Wirth MD, Hussey JR, Hurley TG (2019) Perspective: the dietary inflammatory index (DII)—Lessons learned, improvements made, and future directions. Adv Nutr 10(2):185–195
Rifkin DE, Shlipak MG, Katz R, Fried LF, Siscovick D, Chonchol M, Newman AB, Sarnak MJ (2008) Rapid kidney function decline and mortality risk in older adults. Arch Intern Med 168(20):2212–2218
Lin J, Fung TT, Hu FB, Curhan GC (2011) Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses’ Health Study. Am J Kidney Dis 57(2):245–254
Inker LA, Schmid CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, Kusek JW, Manzi J, Van Lente F, Zhang YL (2012) Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 367(1):20–29
Acknowledgements
The authors wish to thank the staff at the Data Linkage Branch, Hospital Morbidity Data Collection and Registry of Births, Deaths and Marriages for their work on providing data for this study.
Funding
The study was supported by Kidney Health Australia grant S07 10, Healthway Health Promotion Foundation of Western Australia, Sir Charles Gairdner Hospital Research Advisory Committee Grant and by project grants 254,627, 303169 and 572604 from the National Health and Medical Research Council of Australia. The salary of JRL is supported by a National Health and Medical Research Council of Australia Career Development Fellowship (ID: 1107474). NPB is funded by a National Health and Medical Research Council Early Career Fellowship (Grant number APP1159914), Australia. The salary of JMH is supported by a National Health and Medical Research Council of Australia Senior Research Fellowship, Australia (Grant number APP1116937). WL is supported by the Raine/University of Western Australia clinical fellowship. NS and JRH were supported by the United States National Institute for Diabetes, Digestive and Kidney Diseases (grant no. R44DK103377). None of the funding agencies had any role in the conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
Author information
Authors and Affiliations
Contributions
W.H.L., J.R.L., D.A.K., and R.L.P. were responsible for the project conception; J.R.L., R.L.P. collected the data; W.H.L., J.R.L., D.A.K., R.L.P., and J.M.H. developed the research plan; N.S. and J.R.H. contributed expertise and algorithms to calculate the DII scores and consulted on DII-related analyses. N.P.B. analyzed the data; N.P.B., L.C.B., and A.L.B. prepared the manuscript; all authors critically reviewed the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest. Dr. James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII®) from the University of South Carolina to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Bondonno, N.P., Blekkenhorst, L.C., Bird, A.L. et al. Dietary inflammatory index and the aging kidney in older women: a 10-year prospective cohort study. Eur J Nutr 59, 3201–3211 (2020). https://doi.org/10.1007/s00394-019-02160-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00394-019-02160-9