Journal article

Randomization to 6-month Mediterranean diet compared with a low-fat diet leads to improvement in Dietary Inflammatory Index scores in patients with coronary heart disease: the AUSMED Heart Trial

Hannah L Mayr, Colleen J Thomas, Audrey C Tierney, Teagan Kucianski, Elena S George, Miguel Ruiz-Canela, James R Hebert, Nitin Shivappa, Catherine Itsiopoulos

Progress in Food & Nutrition Science | PERGAMON-ELSEVIER SCIENCE LTD | Published : 2018


A higher dietary inflammatory index (DII®) score is associated with inflammation and incidence of coronary heart disease (CHD). We hypothesized that a Mediterranean diet (MedDiet) intervention would reduce DII score. We assessed dietary data from a randomized controlled trial comparing 6-month MedDiet versus low-fat diet intervention, in patients with CHD. We aimed to determine the DII scores of the prescribed diets' model meal plans, followed by whether dietary intervention led to lower (i.e., more anti-inflammatory) DII scores and consequently lower high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (hs-IL-6). DII scores were calculated from 7-day food diaries. The MedDiet meal..

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Awarded by United States National Institute for Diabetes, Digestive and Kidney Diseases

Funding Acknowledgements

The authors are very grateful to all the participants of the study for their enthusiastic involvement and to the personnel of the affiliated hospital sites. We thank Cassandra Bendall for her assistance with data collection and entry, Jessica Radcliffe for her support during the data collection and entry process and Diana Navarro-Perez for her assistance with laboratory analyses. This work was supported by La Trobe University (Understanding Disease RFA Start-Up Grant, 2013. HLM was supported by an Australian Government Research Training Program Scholarship and a Northern Health PhD Scholarship. JRH and NS were supported by the United States National Institute for Diabetes, Digestive and Kidney Diseases (grant no. R44DK103377).The roles of the sponsors are as follows: the supplemental foods used in the study were generously donated by Cobram Estate of Boundary Bend Limited (extra virgin olive oil); the Almond Board of Australia (almonds); Jalna Dairy Foods Pty Ltd. (Greek yoghourt); Simplot Australia Pty Ltd. (canned fish and legumes); HJ Heinz Company Australia (canned fish and legumes); and Carman's (muesli bars). However, the sponsors had no role in the design, collection, analysis or writing of this article. The authors have no relevant interests to declare. However, in the spirit of full disclosure, JRH and NS make the following statement regarding their other work on DII-derived products. JRH owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. NS is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. HLM collected the presented data and analyzed the dietary intake and DII data (with support from CI, CJT and AT) and wrote the manuscript. All co-authors critically reviewed and edited the manuscript. EG and TK created the model meal plans and the Mediterranean diet and low-fat diet interventions (with support from CI and ACT). TK designed the trial protocol used herein (with support from CI and ACT). MRC assisted with design of the analyses for the manuscript. NS and JRH performed calculation of the DII from dietary intake data and provided important input in reviewing and editing drafts of the manuscript. However, they were not involved in performing statistical analyses on which the actual results are based.