Association of novel dietary and lifestyle inflammation scores with the incidence of diabetes, hypertension and chronic kidney disease among adults: results from a large US cohort with 12-year follow-up

Objectives To examine the associations between the inflammatory potentials of diet and lifestyle, as measured by the Dietary Inflammation Score (DIS) and Lifestyle Inflammation Score (LIS), with the risk of type 2 diabetes mellitus (T2DM), hypertension and chronic kidney disease (CKD). Design, setting This retrospective cohort study used data collected between 2000 and 2012 from the Multi-Ethnic Study of Atherosclerosis cohort, which was conducted across six US communities. Participants The study sample included 4736 participants for the analysis of T2DM, 2149 participants for hypertension and 4631 participants for CKD. Outcome measures The primary outcomes were the incidence of T2DM, hypertension and CKD during follow-up. Results During a median follow-up of 9.0 years, 537 participants developed T2DM, 1019 developed hypertension and 1067 developed CKD. DIS was not associated with T2DM in the overall population; however, women in the third quartile of DIS had a 52% higher risk of developing T2DM (HR 1.52; 95% CI 1.07 to 2.15). Also, individuals in the third quartile of DIS had a 22% higher risk of hypertension (1.22; 95% CI 1.02 to 1.47) in the overall population; however, no significant linear trend was observed across the quartiles (P-trend=0.397). Individuals in the fourth quartile of LIS had over twice the risk of developing T2DM (2.15; 95% CI 1.57 to 2.95), although no significant linear trend was observed across quartiles (P-trend <0.001). Additionally, the fourth quartile of LIS was associated with a 39% higher risk of hypertension (1.39; 95% CI 1.16 to 1.66) with a significant trend across quartiles (P-trend=0.001). The significant association between LIS and DIS and the risk of CKD was attenuated after adjusting for study confounders. Conclusion This study highlights the role of diet and lifestyle-related inflammation in the development of hypertension and T2DM risk, providing novel evidence from a large, multiethnic US cohort. The findings underscore the potential of dietary and lifestyle strategies that target inflammation to reduce cardiometabolic disease risk.