Abstract 3287: Associations of whole food and lifestyle-based inflammation scores with all-cause, cancer- and cardiovascular disease-specific mortality
Authors: Byrd Doratha , Holmes Ashley , Judd Suzanne , Flanders W Dana , Bostick Roberd M. 
Published: July 2017

Chronically higher levels of inflammation have been implicated in the etiology of cancer and other major chronic diseases. Contributors to chronic inflammation likely include diet, physical activity, obesity, and smoking. We developed dietary (DIS), lifestyle (LIS), and overall (OIS) inflammation scores to characterize the aggregate of pro- and anti-inflammatory exposures, and investigated associations of the scores with all-cause, cancer- and cardiovascular disease (CVD)-specific mortality in the prospective Reasons for Geographic and Racial Differences in Stroke Study (REGARDS) (n=21,426). The components of the scores were selected based on biological plausibility and previous literature. The dietary components included processed meats, red meat, white meat, fish, nuts, legumes, coffee, tea, dairy products, refined and whole grains, and nine other botanical categories. The lifestyle components included body mass index, smoking status, alcohol intake, and exercise level. Associations of each score component with a panel of biomarkers of inflammation in a subset of 577 male and female, black and white, chronic disease-free participants in REGARDS were assessed using multivariable linear regression, and the resulting beta coefficients were used to weight each score component. For each study participant, the weighted score components were summed to produce the scores such that a higher score was more pro-inflammatory. The scores were categorized according to quintiles of their distributions among all REGARDS participants at baseline, and their associations with mortality were assessed using multivariable Cox proportional hazards regression. Over an average of 7.89 years follow-up, 2,964 individuals died, including 854 from cancer. With increasing levels of each score, there was increasing risk for all-cause, cancer- and CVD-specific mortalities. For those in the highest relative to the lowest quintiles of the OIS, DIS, and LIS, the multivariable-adjusted hazard ratios (95% confidence intervals) for all-cause mortality were: 2.16 (1.87, 2.49; Ptrend&lt;0.0001), 1.25 (1.10, 1.41; Ptrend&lt;0.0001), and 1.94 (1.69, 2.24; Ptrend&lt;0.0001), respectively. The corresponding findings for cancer mortality were 1.79 (1.38, 2.32; Ptrend&lt;0.0001), 1.20 (0.95, 1.50; Ptrend=0.10), and 1.83 (1.42, 2.37; Ptrend&lt;0.0001), respectively, and for CVD mortality 2.38 (1.83, 3.09; Ptrend&lt;0.0001), 1.28 (1.02, 1.61; Ptrend=0.03), and 1.90 (1.49, 2.42; Ptrend&lt;0.0001). These results suggest that pro-inflammatory diets and lifestyles may be associated with higher risk for all-cause, cancer- and CVD-specific mortality.

Citation Format: Doratha Byrd, Ashley Holmes, Suzanne Judd, W Dana Flanders, Roberd M. Bostick. Associations of whole food and lifestyle-based inflammation scores with all-cause, cancer- and cardiovascular disease-specific mortality [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3287. doi:10.1158/1538-7445.AM2017-3287