• Mohamed A Mostafa, Travis Milan Skipina, Omaima A Shalash, and Elsayed Z Soliman.
• Epidemiological Cardiology Research Center (EPICARE), Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: moh.adel.mostafa@gmail.com.
• Am. J. Med. Sci. 2023 Jul 1; 366 (1): 444844-48.

BackgroundInflammation plays an important role in developing myocardial infarction (MI). This study examined whether a proinflammatory diet is associated with increased risk of myocardial infarction.MethodsThis analysis included 7,134 participants (60.3 ± 13.6 years; 51.8% females) from the third National Health and Nutrition Examination (NHANES-III). The proinflammatory diet was assessed using the empirical dietary inflammatory potential (EDIP) score, calculated from the Food Frequency Questionnaire. MI was defined from electrocardiograms (ECGs) using the Minnesota ECG Classification. The cross-sectional association between levels of EDIP modeled as tertiles and per 1-standard deviation (1-SD) increase in separate models with the risk of MI using multivariable logistic regression analysis.ResultsParticipants with MI (n=230 (3.2%)) had higher levels of EDIP scores compared to those without MI (0.148 ± 0.241 score units vs. 0.106 ± 0.256 score units, respectively; p=0.01). In multivariable-adjusted models, each 1-SD (0.256 score unit) increase in EDIP was associated with 20% increased odds of MI (OR (95% CI); 1.20 (1.05 to 1.38)). Odds of MI increased as the levels of EDIP tertiles increased, indicating a dose-response relationship (OR (95% CI); 1,41 (1.0 to 1.99) and 1.48 (1.05 to 2.09), respectively). These results were consistent among subgroups of the participants stratified by hypertension, obesity, diabetes, and hyperlipidemia, but effect modification by smoking status was observed (interaction p-value=0.04).ConclusionsDietary patterns with high proinflammatory properties are associated with an increased risk of MI. Advocating for low proinflammatory dietary patterns could be an approach for preventing coronary heart disease.Copyright © 2023 Southern Society for Clinical Investigation. All rights reserved.

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