Joint association of anti-inflammatory diet and vigorous leisure-time physical activity on all-cause and cardiovascular disease mortality in U.S. adults: findings from NHANES, 2007–2014

Balanced dietary patterns, sufficient physical activity, and other healthy lifestyle behaviors are increasingly recognized as a complimentary strategy for the prevention of cardiovascular disease (CVD). We aim to explore the joint association of anti-inflammatory diet and vigorous leisure-time physical activity (LTPA) on all-cause and CVD mortality.

This retrospective cohort study included 16,068 adults from the National Health and Nutrition Examination Survey (2007–2014). Participants were categorized into four lifestyle patterns based on the inflammatory properties of the diet and the degree of vigorous LTPA: pro-inflammatory diet and insufficient vigorous LTPA (pattern 1), anti-inflammatory diet and insufficient vigorous LTPA (pattern 2), pro-inflammatory diet and sufficient vigorous LTPA (pattern 3), anti-inflammatory diet and sufficient vigorous LTPA (pattern 4). Multivariable Cox proportional hazards models were used to estimate the hazards ratio (HR) and 95% confidence intervals (CI).

Compared to pattern 1, pattern 4 showed an obvious lower risk of all-cause (HR, 0.51; 95% CI 0.32–0.81) and CVD mortality (HR, 0.31; 95% CI 0.12–0.80). In addition, pattern 2 also had a significantly decreased all-cause (0.80; 0.69–0.92) and CVD mortality risk (0.71; 0.53–0.95). However, t there was no significant reduction in all‐cause mortality (0.75; 0.54–1.06) and CVD mortality (0.60; 0.32–1.13) among pattern 3. Consistent results were obtained in subgroup and sensitivity analyses.

Adhering to the anti-inflammatory diet and sufficient vigorous LTPA was associated with lowest all-cause and CVD mortality. Anti-inflammatory diet can counteract the hazards caused by insufficient vigorous LTPA, while sufficient vigorous LTPA fails to offset the detrimental effect of pro-inflammatory diet.