Journal
BMC INFECTIOUS DISEASES
Volume 15, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12879-015-0981-1
Keywords
Diet patterns; Sepsis; Epidemiology
Categories
Funding
- National Institute for Nursing Research [R01NR012726]
- National Center for Research Resources [UL1RR025777]
- Center for Clinical and Translational Science
- Lister Hill Center for Health Policy of the University of Alabama at Birmingham
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services [U01NS041588]
- National Institutes of Health [R03DK095005, R01NS080850]
- Amgen Corporation
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Background: Sepsis is the syndrome of body-wide inflammation triggered by infection and is a major public health problem. Diet plays a vital role in immune health but its association with sepsis in humans is unclear. Methods: We examined 21,404 participants with available dietary data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of 30,239 black and white adults >= 45 years of age living in the US. The primary exposures of interest were five empirically derived diet patterns identified via factor analysis within REGARDS participants: Convenience (Chinese and Mexican foods, pasta, pizza, other mixed dishes), Plant-based (fruits, vegetables), Southern (added fats, fried foods, organ meats, sugar-sweetened beverages), Sweets/Fats (sugary foods) and Alcohol/Salads (alcohol, green-leafy vegetables, salad dressing). The main outcome of interest was investigator-adjudicated first hospitalized sepsis events. Results: A total of 970 first sepsis events were observed over similar to 6 years of follow-up. In unadjusted analyses, greater adherence to Sweets/Fats and Southern patterns was associated with higher cumulative incidence of sepsis, whereas greater adherence to the Plant-based pattern was associated with lower incidence. After adjustment for sociodemographic, lifestyle and clinical factors, greater adherence to the Southern pattern remained associated with higher risk of sepsis (hazard ratio [HR] comparing the fourth to first quartile, HR 1.39, 95 % CI 1.11,1.73). Race modified the association of the Southern diet pattern with sepsis (P-interaction = 0.01), with the Southern pattern being associated with modestly higher adjusted risk of sepsis in black as compared to white participants (HR comparing fourth vs. first quartile HR 1.42, 95 % CI 0.75,2.67 vs. 1.21, 95 % CI 0.93,1.57, respectively). Conclusion: A Southern pattern of eating was associated with higher risk of sepsis, particularly among black participants. Determining reasons for these findings may help to devise strategies to reduce sepsis risk.
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