The dietary inflammatory index and cardiometabolic parameters in US firefighters

Andria Christodoulou; Costas A Christophi; Mercedes Sotos-Prieto; Steven Moffatt; Longgang Zhao; Stefanos N Kales; James R Hébert

doi:10.3389/fnut.2024.1382306

The dietary inflammatory index and cardiometabolic parameters in US firefighters

Front Nutr. 2024 Jun 13:11:1382306. doi: 10.3389/fnut.2024.1382306. eCollection 2024.

Authors

Andria Christodoulou¹, Costas A Christophi^{1

2}, Mercedes Sotos-Prieto^{2

3

4

5}, Steven Moffatt⁶, Longgang Zhao^{7

8

9}, Stefanos N Kales^{2

10}, James R Hébert^{7

8

9}

Affiliations

¹ Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
² Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
³ Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
⁴ Biomedical Research Network Centre of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.
⁵ IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain.
⁶ National Institute for Public Safety Health, Indianapolis, IN, United States.
⁷ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
⁸ Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
⁹ Connecting Health Innovations LLC, Columbia, SC, United States.
¹⁰ Department of Occupational Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA, United States.

Abstract

Introduction: Dietary choices play a crucial role in influencing systemic inflammation and the eventual development of cardiovascular diseases (CVD). The Dietary Inflammatory Index (DII®) is a novel tool designed to assess the inflammatory potential of one's diet. Firefighting, which is characterized by high-stress environments and elevated CVD risk, represents an interesting context for exploring the dietary inflammatory-CVD connection.

Aim: This study aims to investigate the associations between Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and cardiometabolic risk parameters among US firefighters.

Methods: The study analyzed 413 participants from the Indianapolis Fire Department who took part in a Federal Emergency Management Agency (FEMA)-sponsored Mediterranean diet intervention trial. Thorough medical evaluations, encompassing physical examinations, standard laboratory tests, resting electrocardiograms, and submaximal treadmill exercise testing, were carried out. Participants also completed a detailed food frequency questionnaire to evaluate dietary patterns, and E-DII scores were subsequently computed based on the gathered information.

Results: Participants had a mean body mass index (BMI) of 30.0 ± 4.5 kg/m² and an average body fat percentage of 28.1 ± 6.6%. Regression analyses, adjusted for sex, BMI, maximal oxygen consumption (VO₂ max), max metabolic equivalents (METS), age, and body fat percentage, revealed significant associations between high vs. low E-DII scores and total cholesterol (β = 10.37, p = 0.04). When comparing low Vs median E-DII scores there is an increase in glucose (β = 0.91, p = 0.72) and total cholesterol (β = 5.51, p = 0.26).

Conclusion: Our findings support an association between higher E-DII scores and increasing adiposity, as well as worse lipid profiles.

Keywords: DII scores; US firefighters; cardiovascular disease; inflammatory index; nutrition.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was funded by EMW-2014-FP-00612, US Department of Homeland Security, Ohio University OURC grant, CHSP Research Innovation grant, and the 2018 Southeast Center for Integrated Metabolomics Pilot and Feasibility Project. MS-P holds a Ramón y Cajal contract (RYC-2018-025069-I) from the Ministry of Science, Innovation and Universities and FEDER/FSE and FIS grant PI20/00896. The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation or in the decision to submit this manuscript for publication.