Abstract
This was an observational study based on the National Health and Nutrition Examination Survey (NHANES) and National Death Index (NDI) 2009-2014 which aimed to validate whether a proinflammatory diet may increase mortality risk in patients with diabetes mellitus. Dietary inflammatory potential was assessed by dietary inflammatory index (DII) based on 24 h dietary recall. Mortality follow-up information was accessed from NDI, which was then merged with NHANES data following the National Center for Health Statistics (NCHS) protocols. For 15,291 participants from the general population, the average DII was 0.37 ± 1.76 and the prevalence rate of diabetes was 13.26%. DII was positively associated with fasting glucose (β = 0.83, 95% CI: 0.30, 1.36, p = 0.0022), glycohemoglobin (β = 0.02, 95% CI: 0.01, 0.03, p = 0.0009), and the risk of diabetes (OR = 1.05, 95% CI: 1.01, 1.09, p = 0.0139). For 1904 participants with diabetes and a median follow-up of 45 person-months, a total of 178 participants with diabetes died from all causes (mortality rate = 9.34%). People with diabetes who adhered to a proinflammatory diet showed a higher risk of all-cause mortality (HR = 1.71, 95%CI: 1.13, 2.58, p = 0.0108). In summary, DII was positively associated with diabetes prevalence and a proinflammatory diet may increase mortality risk in patients with diabetes mellitus.