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1. Introduction
Low-grade chronic inflammation has been established as a relevant factor in the development of cardiovascular disease (CVD) [1]. It is characterized by increased circulating levels of cytokines with inflammatory activity and acute-phase proteins (C-Reactive Protein; CRP), interleukins (IL-1, IL-6), and tumor necrosis factor alpha (TNF-α), among others-as well as by increased infiltration of macrophages in peripheral tissue [2]. Evidence has shown that lifestyles, especially dietary factors, may modulate this process [3,4,5]. Thus, nutrition plays an important role in the development of atherogenesis and cardiovascular events [3,6].
In this context, it has been indicated that dietary patterns characterized by a high intake of saturated and trans unsaturated fatty acids may lead to alterations in endothelial function [7,8]. The “Western” diet, rich in red meats, fats, and carbohydrates, has been positively associated with markers of low-grade subclinical inflammation, while dietary patterns based on fruits, vegetables, olive oil, and whole grains have shown an inverse relationship [3,4,9]. In addition, the Mediterranean food pattern, which is a well-known anti-inflammatory diet, exerts a protective effect against free radicals and oxidants [10].
A dietary pattern comprising high amounts of fish, yogurt, vegetables, pasta, greens, fruit, and wine also has the potential to reduce circulating levels of inflammatory markers [3]. Diet-based anti-inflammatory components, including omega-3 fatty acids, vitamins B1 (thiamine), B2 (riboflavin) and B3 (niacin), folic acid, vitamin A, vitamin C, vitamin E, beta-carotene, magnesium, and zinc, have been identified [11].
On this basis, researchers from the University of South Carolina in the United States designed the dietary inflammatory index (DII), a tool for assessing the inflammatory diet profile based on 45 nutritional parameters. Due to their anti-inflammatory or pro-inflammatory properties, these nutritional factors were associated with markers of inflammation including CRP, interleukins IL-1β, IL-4, IL-6 and IL-10, and TNF-α [12]. The DII has been reported to be associated with several inflammatory processes, such as obesity, insulin resistance, cardiovascular risk, and several types of cancer [13,14,15,16]. However, to the best of our knowledge, the DII has not been used to evaluate inflammatory properties of diet in Latin Americans, characterized by increasing total fat, animal products, and sugar intakes [14], particularly in the Colombian population. Since Latin Americans have different dietary habits and morbidity and mortality indicators, it is of particular...