Diets high in red and processed meat, refined grains and sugary beverages – which have been associated with increased inflammation in the body – may increase subsequent risk of cardiovascular disease and stroke compared to diets filled with anti-inflammatory foods, according to a study published Nov. 2 in the Journal of the American College of Cardiology (JACC).

Jun Li, MD, PhD, et al., used the men and women from the Nurses' Health Studies I and II starting from 1986 and included up to 32 years of follow up. After excluding participants with missing diet information or previously diagnosed cardiovascular disease, stroke or cancer, over 210,000 participants were included in the analysis. The participants completed a survey every four years to ascertain dietary intake.

The researchers used an empirically-developed, food-based dietary index to evaluate levels of inflammation associated with dietary intake that was based off 18 predefined food groups that together showed the strongest associations with an increase in inflammatory biomarkers. After controlling for other risk factors such as BMI, physical activity, family history of cardiovascular disease and multivitamin use, results showed the participants consuming proinflammatory diets had a 46% higher risk of cardiovascular disease and 28% higher risk of stroke, compared to those consuming anti-inflammatory diets.

Based on results, the researchers suggest consuming foods with higher levels of antioxidants and fiber to help combat inflammation: green leafy vegetables (kale, spinach, cabbage, arugula), yellow vegetables (pumpkin, yellow peppers, beans, carrots), whole grains, coffee, tea and wine. The researchers also suggested limiting intake of refined sugars and grains, fried foods, sodas, and restricting processed, red and organ meat as these foods are among the major contributors to the proinflammatory dietary index.

"We found that dietary patterns with higher inflammatory potential were associated with an increased rate of cardiovascular disease," said Li, lead author of the study and research scientist in the department of nutrition at Harvard T.H. Chan School of Public Health. "Our study is among the first to link a food-based dietary inflammatory index with long-term risk of cardiovascular disease."

Meanwhile, a separate JACC study assessed how incorporating walnuts, an anti-inflammatory food, into an individual's usual diet would improve inflammatory biomarkers.

A total of 634 participants were assigned either a diet without walnuts or a diet with regularly incorporated walnuts (about 30-60 grams per day). After a follow up period of two years, results showed those who ate a diet with walnuts had significantly reduced levels of inflammation in the body in six out of 10 of the inflammatory biomarkers tested.

"The anti-inflammatory effect of long-term consumption of walnuts demonstrated in this study provides novel mechanistic insight for the benefit of walnut consumption on cardiovascular disease risk beyond that of lipid lowering," said Montserrat Cofán, PhD, lead author of the study.

In an editorial comment on both of the studies, Ramon Estruch, MD, PhD, et al., note, "a better knowledge of the mechanisms of health protection by the different foods and dietary patterns, mainly their anti-inflammatory properties as gleaned from the two reports ... should provide the basis for designing healthier dietary patterns and upgrading their protective effects against cardiovascular disease."

Clinical Topics: Prevention

Keywords: Primary Prevention, Vegetables, Antioxidants, Risk Factors, Cardiovascular Diseases, Wine, Public Health, Body Mass Index

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