The Role of Dietary Inflammatory Index on the Association Between Sleep Quality and Long-Term Cardiovascular Risk: A Mediation Analysis Based on NHANES (2005-2008).

People with poor sleep quality have higher risk of cardiovascular disease (CVD), and one potential mechanism of CVD is chronic inflammation. The aim of this study was to investigate the role of dietary inflammation in the relationship between sleep quality and CVD risk. This study involved 5594 participants from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008. Sleep quality, dietary inflammation, and 10-year CVD risk were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Energy-adjusted Dietary Inflammatory Index (E-DII), and the Framingham Risk Score (FRS), respectively. We used generalized additive model (GAM) and mediation analysis to investigate the relationship among sleep quality, 10-year CVD risk, and E-DII. PSQI had a non-linear relationship with 10-year CVD risk (P < 0.001). Meanwhile, among the participants with poor sleep quality, PSQI was positively associated with increased 10-year CVD risk (P < 0.001) and E-DII (P < 0.001). Furthermore, the association between sleep quality and CVD risk was partially mediated by E-DII, and the mediated proportion was 14.6%, and the mediating effect of E-DII varied in different gender and age groups. However, in the subjects with good sleep quality, the association among PSQI, E-DII, and 10-year CVD risk was not existed. Ten-year CVD risk could be reduced by controlling the intake of inflammatory food, especially for whom with sleep disorders. In general, the reduction of inflammatory diet could weaken the effect of sleep disorders on the CVD risk.

Wang L ，Sun M ，Guo Y ，Yan S ，Li X ，Wang X ，Hu W ，Yang Y ，Li J ，Li B ... -  《Nature and Science of Sleep》

Mediation of 10-Year Cardiovascular Disease Risk between Inflammatory Diet and Handgrip Strength: Base on NHANES 2011-2014.

Xie Z ，Wang L ，Sun M ，Wang R ，Li J ，Wang X ，Guo R ，Dong Y ，Wang Y ，Li B ... -  《Nutrients》

Oral health and 10-year cardiovascular risk in US adults: mediating role of inflammatory diet and vitamin D.

To investigate whether E-DII or vitamin D mediates the relationship between oral health and cardiovascular disease (CVD) risk. This study involved 6616 participants aged over 30 years old from the National Health and Nutrition Examination Survey (NHANES) in 2009-2014. Dietary inflammation and 10-year CVD risk were evaluated via the Energy-adjusted Dietary Inflammatory Index (E-DII) and the Framingham Risk Score (FRS), respectively. We used correlation analysis and mediation analysis to investigate the role of dietary inflammation and vitamin D in the relationship between oral health and CVD risk. Oral health indicators and CVD risk were positively correlated with E-DII (r > 0, P < 0.001) and negatively correlated with vitamin D levels (r < 0, P < 0.001). The estimated mediating role of E-DII and vitamin D in the overall association between oral health and 10-year risk of CVD ranged from 4.9 to 7.5% and 6.6 to 11.6%, respectively. Furthermore, the mediation proportion of E-DII and vitamin D levels in the total association between oral health indicators and FRS were increased in participants without periodontitis. Both E-DII and serum vitamin D were mediated the association between oral problems and 10-year CVD risk, especially in participants without periodontitis. Among them, E-DII played a positive mediating role, and serum vitamin D levels was a negative mediator. Anti-inflammatory diet and prevention of vitamin D deficiency might reduce the impact of oral problems on cardiovascular disease risk to some extent. The study highlights the important role of oral health and dietary inflammation and vitamin D in primary prevention of cardiovascular disease.

Wang L ，Wang X ，Sun M ，Wang X ，Li X ，Hu W ，Yang Y ，Li J ，Dong Y ，Li B ... -  《-》

Higher dietary inflammation is associated with increased odds of depression independent of Framingham Risk Score in the National Health and Nutrition Examination Survey.

Cardiovascular disease (CVD) may increase depression risk. Risk for future CVD, which can be estimated by the Framingham Risk Score (FRS), and depression risk are both linked to systemic inflammation. Dietary consumption of proinflammatory food can be measured using the Dietary Inflammatory Index (DII) score. We examined the potential impact of DII on depression and whether this effect is independent of FRS. We hypothesized that (1) both FRS and DII would be associated with depression (Patient Health Questionnaire-9 ≥ 10) and (2) associations between DII and depressive symptoms (continuous) would be mediated by FRS. Data were included from adults without CVD who were participants of the 2007-2012 National Health and Nutrition Examination Survey (n = 11 624). Using logistic regression, we tested cross-sectional associations of FRS, DII (adjusting for FRS), and joint effects of FRS and DII with depression. Finally, using the Sobel method, we tested whether FRS mediates the relationship between DII and depressive symptoms. Individuals with FRS or DII scores in the top 2 quartiles had higher odds of depressive symptoms than those in the bottom quartile. The association of DII with depressive symptoms remained after FRS adjustment. The joint effects of elevated DII and FRS were additive. There was no evidence for mediation by FRS between DII and depressive symptoms. Thus, higher DII remained associated with increased odds of depressive symptoms net CVD risk. Collectively, the joint effects of CVD risk and DII indicate that a proinflammatory diet could add to risk for depressive symptoms even in those with a high FRS.

Jorgensen D ，White GE ，Sekikawa A ，Gianaros P ... -  《-》

Inflammatory properties of diet mediate the effect of depressive symptoms on Framingham risk score in men and women: Results from the National Health and Nutrition Examination Survey (2007-2014).

Depression is common in patients with cardiovascular disease (CVD) and associated with inflammation. Inflammation contributes to the development of CVD and can be modulated by diet. However, the role of inflammatory properties of diet in the relationship between depressive symptoms and CVD risk is not well understood. We hypothesized that the inflammatory properties of diet mediate the relationship between depressive symptoms and CVD risk in men and women. Cross-sectional data collected by the National Health and Nutrition Examination Survey (2007-2014) were used for the study. Depressive symptoms scores, inflammatory properties of diet, and CVD risk were measured by the Patient Health Questionnaire-9 (PHQ-9), the Dietary Inflammatory Index (DII), and the Framingham risk score (FRS), respectively. Generalized linear models were used for the mediation analysis. There were significant differences in the proportions of men and women in the depressed group (PHQ-9 ≥ 10; 5.24 ± 0.65% vs 9.36 ± 0.87%, P < .001) and high CVD risk group (FRS >20%; 16.47 ± 0.79% vs 6.03 ± 0.32%, P < .001). The DII partially mediated the relationship between depressive symptoms and CVD risk in men (indirect effect: 0.06, P = .010) but fully mediated the relationship between depressive symptoms and CVD risk in women (indirect effect: 0.10, P < .001). These findings confirmed our hypothesis that inflammatory properties of diet at least partially mediate the relationship between depressive symptoms and CVD risk in men and women. Our findings suggest that interventions designed to reduce depressive symptoms should contain strategies to reduce pro-inflammatory and increase anti-inflammatory properties of diet to decrease CVD risk.

Kang J ，Moser DK ，Biddle MJ ，Lennie TA ，Smyth SS ，Vsevolozhskaya OA ... -  《-》