Dietary factors play a role in modulating chronic inflammation and in the development of cardiovascular disease. We aimed to investigate the association between the dietary inflammatory index (DII) and cardiometabolic risk factors among adolescents.A total of 31,684 Brazilian adolescents (12–17 years), from the Study of Cardiovascular Risks in Adolescents (ERICA) were included. Dietary intake was assessed using a 24-hour dietary recall. The E-DII (energy-adjusted)score was calculated based on data for 25available nutrients. The anthropometric profile, blood pressure, lipid profile, glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and glycated hemoglobin were measured. Poisson regression models were used to examine the associations between sex-specific quartiles of the E-DII and cardiometabolic risk factors. In the energy-adjusted models, when comparing a high pro-inflammatory diet (quartile 4) withananti-inflammatory diet (quartile 1), there was a positive association with high HOMA-IR among boys(prevalence ratios (PR)Q4=1.37, 95%CI: 1.04–1.79); and with high fasting glucose (PRQ4 = 1.96, 95%CI: 1.02–3.78), high triglycerides (PRQ4 = 1.92, 95%CI: 1.06–3.46),low HDL-c (PRQ4 = 1.16, 95%CI: 1.02–1.32) and high LDL-c (PRQ4 = 1.93, 95%CI: 1.12–3.33) among girls. Additionally, a moderately pro-inflammatory diet was positively associated with high HOMA-IR (PRQ2 = 1.14, 95%CI: 1.02–1.29) among girls, and high total cholesterol (PRQ3 = 1.56, 95%CI: 1.20–2.01) among boys.In conclusion, this study provides new evidence on the association between inflammatory diets with cardiometabolic risk factors among adolescents.

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