Increased premature mortality risk associated with inflammation-promoting diet may be counteracted by antioxidant supplementation

Tuesday, March 15, 2016

An article published online on February 10, 2016 in the American Journal of Clinical Nutrition reports an association between a higher Dietary Inflammatory Index (DII) score and a significantly increased risk of mortality from cardiovascular disease and cancer over a median of 12.4 years. 

The current investigation included 8,089 men and women enrolled in the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study which compared the effects of a placebo to supplementation with ascorbic acid, vitamin E, beta-carotene, selenium, and zinc from 1994 to 2002. Participants' dietary records were utilized to calculate each subject's Dietary Inflammatory Index score, which rates total calories, carbohydrates and other components as proinflammatory, and such items as monounsaturated and polyunsaturated fatty acids, vitamins, and other nutrients as anti-inflammatory factors.

Over a 12.4 year median, 41 deaths caused by cardiovascular disease, 123 cancer deaths and 43 deaths due to other causes occurred. Participants whose Dietary Inflammatory Index scores were among the top one-third of subjects had a risk of dying from cancer or cardiovascular disease that was 53% higher than those whose scores were among the lowest third. For cancer alone, the risk of death was 83% higher in the highest DII group. Subjects in the placebo group whose scores were among the top third had over twice the risk of death from all causes over follow-up compared to those whose scores were among the lowest third, however this effect was not observed among those who received antioxidant supplements.

"To our knowledge, this study was the first to investigate the prospective association between the DII and mortality in a large population-based French cohort including both men and women," authors Laurie Graffouillère and colleagues announce. "In line with results from laboratory studies, our findings suggest that antioxidants may contribute to counteract some of the potential deleterious effects of a proinflammatory diet on mortality."

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Selenium plus CoQ10 supplementation associated with reduced age-related increase in inflammatory biomarkers
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A secondary analysis of a randomized trial reported on September 16, 2015 in PLOS One found a reduction in C-reactive protein (CRP) and a lower rate of increase in sP-selectin in men and women supplemented with coenzyme Q10 (CoQ10) and selenium in comparison with those who received a placebo. C-reactive protein is a marker of systemic inflammation and cardiovascular risk. SP-selectin is a cell adhesion molecule that is also involved in inflammation and is a biomarker for atherosclerosis as well.

The trial included 443 participants between the ages of 70 to 88 years who enrolled from 2003-2010. Two hundred twenty-one subjects received 200 micrograms selenium plus 200 milligrams CoQ10 per day, and 222 subjects received a placebo for 48 months. Blood samples collected at the beginning and end of the treatment period were analyzed for CRP and sP-selectin. Participants were followed for an average of 5.2 years, during which any deaths were recorded.

Among those who received a placebo, CRP levels averaged 4.8 nanograms per milliliter (ng/mL) at the beginning of the treatment period and 5.1 ng/mL at the study's conclusion, while CRP declined from an average of 4.15 ng/mL to 2.1 ng/mL among those who received selenium and CoQ10. SP-selectin increased from 56.6 milligrams per milliliter (mg/mL) to 72.3 mg/mL in the placebo group, in contrast with an increase of 55.9 mg/mL to just 58.0 mg/mL in the selenium/CoQ10 group. Cardiovascular deaths in the supplemented group were approximately half the number of those that occurred in the placebo group.

"The mechanism behind this effect is probably the antioxidative effects of both selenium and coenzyme Q10," authors Urban Alehagen and colleagues write. "As previously reported, reduced cardiovascular mortality has been demonstrated, which is probably associated with the decreased oxidative state in those receiving active supplementation."

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Health Concern

Inflammation (Chronic)

A diet high in saturated fat is associated with higher pro-inflammatory markers, particularly in diabetic or overweight individuals (Nappo et al. 2002) (Peairs et al. 2011). This effect was absent in healthy individuals (Myhrstad et al. 2011, Poppitt et al. 2008, Payette et al. 2009). Diets high in synthetic trans-fats (such as those produced by hydrogenation) have been associated with increases in inflammatory markers (IL-6, TNF-α, IL-8, CRP) in some studies (Mozaffarian et al. 2004) (Lopez-Garcia et al. 2005), but had no effect in others (Nielsen et al. 2011, Bendsen et al. 2011). The increases in markers of inflammation due to synthetic trans-fats may be more pronounced in individuals that are also overweight (Nielsen et al. 2011).

General dietary over-consumption is a major contributor to inflammation and other detrimental age-related processes in the modern world. Therefore, eating a calorie-restricted diet is an effective means of relieving physiologic stressors. Indeed, several studies show that calorie restriction provides powerful protection against inflammation (Ahmadi 2011; González 2012).

As an aging human, you face a daily onslaught of excess glucose that poses a grave risk to your health and longevity. Surplus glucose relentlessly reacts with your body's proteins, causing damaging glycation reactions while fueling the fires of chronic inflammation and inciting the production of destructive free radicals (Basta 2004; Uribarri 2005; Toma 2009).

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