Longitudinal Changes in the Dietary Inflammatory Index: An Assessment of the Inflammatory Potential of Diet over Time in Postmenopausal Women

Abstract

Background/objective The dietary inflammatory index (DII) measured at one time point is associated with risk of several chronic diseases but disease risk may change with longitudinal changes in DII scores. Data are lacking regarding changes in DII scores over time, therefore we assessed changes in the DII in the Women's Health Initiative (WHI). Methods: DII scores were calculated using data from repeated food frequency questionnaires in the WHI Observational Study (OS; n=76,671) at baseline and Year 3, and the WHI Dietary Modification trial (DM; n=48,482) at three time points. Lower DII scores represent more anti-inflammatory diets. We used generalized estimating equations to compare mean changes in DII over time, adjusting for multiple comparisons; and multivariable linear regression to determine predictors of DII change. Results: In the OS, mean DII decreased modestly from −1.14 at baseline to −1.50 at Year 3. In the DM, DII was −1.32 in Year 1, −1.60 in Year 3, and −1.48 in Year 6 in the intervention arm, and was −0.65 in Year 1, −0.94 in Year 3 and −0.96 in Year 6 in the control arm. These changes were modified by BMI, education, and race/ethnicity. A prediction model explained 22% of the variance in the change in DII scores in the OS. Conclusion: In this prospective investigation of postmenopausal women, reported dietary inflammatory potential decreased modestly over time. Largest reductions were observed in normal weight, highly educated women. Future research is warranted to examine whether reductions in DII are associated with decreased chronic disease risk.