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The Dietary Inflammatory Index is Lower Among Healthy Older Adults Consuming a Walnut-Supplemented Diet. Ancillary
Lynnley Huey Stern1, Jayme Brisco2, Karen Jaceldo-Siegl3
1Alzheimer's Disease Program, Chronic Disease Control Branch, Center for Healthy Communities, California Department of Public Health, Sacramento, CA, 95814, USA; School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA.
Background:
Walnuts may lower diet-related inflammation by providing anti-inflammatory compounds and displacing pro-inflammatory nutrients.
Objective:
To explore the association between daily walnut consumption or abstention for 2 years and the Dietary Inflammatory Index (DII®).
Design:
The Walnuts and Healthy Aging (WAHA) study is a dual-center (Loma Linda, California, USA and Barcelona, Spain), randomized trial, comparing a walnut-rich diet with a control diet over 2 years between May 2012 to May 2016, for age-related outcomes in healthy, free-living older adults aged 63-79 y. This ancillary study concerned only the Loma Linda cohort.
Participants/Setting:
A total of 319 older adults (mean age 69 y, 66% women) from Loma Linda, Ca were randomly assigned to walnut (n = 166) or control (n = 153) diets.
Intervention:
The walnut group consumed 1-2 oz walnuts/day (30-60 g/day, ∼15% of energy), while the control group abstained from walnuts and limited other nuts to <2 servings/week. Both groups followed their usual background diet.
Main Outcome Measures:
DII scores were calculated from five 24-hour dietary recalls taken at random during the 2-year period.
Statistical Analyses Performed:
Linear mixed models tested DII differences between the walnut and control groups, adjusting for sex, age, BMI, race, energy intake, smoking status, physical activity, and educational attainment.
Results:
The mean DII (SE) score was -0.025 (0.14) in the walnut group and 0.615 (0.14) in the control diet group (p<0.01). At the nutrient level, n-3 PUFAs (ß=-0.291; 95%CI: -0.450, -0.132; p<0.01), magnesium (ß=-0.014; 95%CI: -0.015, -0.013; p<0.01), carbohydrate (ß=-0.009; 95%CI: -0.014, -0.005; p<0.01), fiber (ß=-0.120; 95%CI: -0.133, -0.106; p=0.05), and protein (ß=-0.020; 95% CI: -0.031, -0.008; p<0.01), were associated with a more anti-inflammatory DII score, while intake of total and saturated fat were associated with a higher, more proinflammatory, DII score (ß=0.033; 95%CI: 0.020, 0.045; p<0.01 and ß=0.102; 95%CI: 0.080, 0.125; p<0.01 respectively).
Conclusion:
Incorporating walnuts into the habitual diet was associated with more anti-inflammatory DII scores compared with a walnut-free control diet. These findings suggest that adding a single whole food may be a feasible complementary strategy for favorably improving the inflammatory potential of a diet.
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