Aim: The impact of the anti-inflammatory potential of diet on risk of heart failure (HF) and the potential modification of this association by smoking, a trigger of systemic inflammation, has not been previously investigated. We examined the association between anti-inflammatory potential of diet and risk of HF taking into account smoking status.
Methods and results: The study population included the Cohort of Swedish Men (40 514 men) and the Swedish Mammography Cohort (34 809 women), age 45-83 years, without HF, ischaemic heart disease, or cancer at baseline. Anti-inflammatory potential of diet was estimated using an anti-inflammatory diet index (AIDI; 0-16 scores). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for HF risk factors. Over a mean follow-up of 14.9 years (1 119 110 person-years, 1998-2014), 8161 new HF diagnoses (4443 in men, 3718 in women) were identified. Compared to the lowest quintile of the AIDI (scores ≤4), the HRs for men and women in the highest quintile (scores ≥8) were 0.92 (95% CI 0.84-1.02; P-trend = 0.02) and 0.86 (95% CI 0.78-0.96; P-trend = 0.001), respectively. An inverse association between the AIDI and HF incidence was observed in current and ex-smokers but not in never-smokers (P-interaction = 0.046). Comparing extreme quintiles, the HRs were 0.86 (95% CI 0.74-1.00; P-trend = 0.007) in current smokers, 0.81 (95% CI 0.71-0.92; P-trend = 0.001) in ex-smokers, and 0.95 (95% CI 0.86-1.06; P-trend = 0.10) in never-smokers.
Conclusion: These results suggest that adherence to a diet with high anti-inflammatory potential may be associated with lower HF incidence in current and ex-smokers.
Keywords: Anti-inflammatory index; Diet; Heart failure; Inflammation; Prospective study.
© 2020 European Society of Cardiology.