Article Text

Download PDFPDF
Original research
Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts
  1. Joanna Kaluza1,2,
  2. Otto Stackelberg2,3,
  3. Holly Ruth Harris4,5,
  4. Martin Björck6,
  5. Alicja Wolk2,6
  1. 1 Nutrition Research Laboratory, Department of Human Nutrition, Warsaw University of Life Sciences – SGGW, Warsaw, Poland
  2. 2 Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3 Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden
  4. 4 Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  5. 5 Department of Epidemiology, University of Washington, Seattle, Washington, USA
  6. 6 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Joanna Kaluza, Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw 02-776, Poland; joanna_kaluza{at}


Objective The relationship between dietary patterns and development of abdominal aortic aneurysm (AAA) is not well understood. Thus, we prospectively evaluated the association between the anti-inflammatory potential of diet and risk of AAA.

Methods The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 633 women), aged 45–83 years at baseline. The anti-inflammatory potential of diet was estimated using Anti-inflammatory Diet Index (AIDI) based on 11 foods with anti-inflammatory potential and 5 with proinflammatory potential (maximum 16 points) that was validated againsthigh sensitivity C reactive protein (hsCRP). Cox proportional hazard regression models were used to estimate HRs and 95% CIs. During the 14.9 years of follow-up (1 217 263 person-years), 1528 AAA cases (277 (18%) ruptured, 1251 non-ruptured) were ascertained via the Swedish Inpatient Register, the National Cause of Death Register and the Register for Vascular Surgery (Swedvasc).

Results We observed an inverse association between the AIDI and AAA risk in women and men; HRs between extreme quartiles of the AIDI (≥8 vs ≤5 points) were 0.55 (95% CI 0.36 to 0.83) in women and 0.81 (95% CI 0.68 to 0.98) in men. The AIDI was inversely associated with both ruptured and non-ruptured AAA incidence; the HR of participants in the highest quartile of AIDI compared with those in the lowest quartile was 0.61 (95% CI 0.41 to 0.90) for ruptured AAA and 0.79 (95% CI 0.65 to 0.95) for non-ruptured AAA.

Conclusion Adherence to diet with a high anti-inflammatory potential was associated with a reduced AAA risk, an association that was even more pronounced for AAA rupture.

  • aortic aneurysm
  • cardiac risk factors and prevention
  • epidemiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All authors have participated in the work. JK and OS had full access to all data in the study and take responsibility for the integrity of the data analysis. JK and AW study concept and design. JK and OS performed the statistical analysis. All authors have reviewed critically and edited the final version.

  • Funding The study was supported by a research grants from the Swedish Research Council Medicine (VR 2015- 02302), the Swedish Research Council for Health, Working Life and Welfare (FORTE 2015-00778) and the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas 2016-00308) and grant (VR 2017-00644) for the Swedish Infrastructure for Medical Population-based Life-course Environmental Research (SIMPLER).

  • Competing interests None declared.

  • Ethics approval The study was approved by the Regional Ethical Review Board, Stockholm, Sweden.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.