The Mediating Role of Body Mass Index in the Association between Dietary Inflammatory Index and 10-year risk of CVD: a counterfactual mediation analysis

Abstract

AbstractIntroductionDietary with higher inflammatory potential are associated with cardiovascular disease (CVD) risk over the next decade, while studies have shown body mass index (BMI) to be one of the mediators between dietary inflammatory index (DII) and multiple diseases such as depression and diabetes. However, the role of BMI in the association between DII and 10-year risk of CVD is unclear.MethodsStudy based on 14,355 adults from the National Health and Nutrition Examination Survey (NHANES). Participants’ diet, obesity level and CVD risk were assessed using the DII, BMI and Framingham Risk Score (FRS). Linear regression and counterfactual model were used to analyze this relationship.ResultsParticipants on a pro-inflammatory diet had a higher risk of CVD over the next ten years compared to participants on an anti-inflammatory diet. Counterfactual models showed a 34.0% partial mediating role of BMI in this relationship, most particularly in males (17.3%) and non-elderly (28.6%-100%).ConclusionInflammatory diet adversely affects cardiovascular risk, a large part of which operates through BMI, especially in males and non-elderly populations. These findings are beneficial in facilitating research on the mechanisms of diet-related inflammation on CVD.