Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

Abstract

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children’s DII (C-DII) scores and new avenues of investigation in this field of nutritional research.

Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

“…A higher DII score indicates a more pro-inflammatory diet, whereas a lower DII score indicates an anti-inflammatory diet [15]. An association between the DII and the inflammatory biomarkers have been reported in 25 studies [15][16][17][18]. While most articles that have examined the relationship between the DII and CVD outcomes have detected a positive association [18][19][20][21], some have not [22].…”

“…An association between the DII and the inflammatory biomarkers have been reported in 25 studies [15][16][17][18]. While most articles that have examined the relationship between the DII and CVD outcomes have detected a positive association [18][19][20][21], some have not [22]. Therefore, there is a need to deepen our understanding of whether a more pro-inflammatory diet, as measured by DII score, could be associated with higher risk of CVD and its subtypes, MI and strokes.…”

Proinflammatory Dietary Intake is Associated with Increased Risk of Metabolic Syndrome and Its Components: Results from the Population-Based Prospective Study

“…The DII has been shown to be associated with a number of health outcomes including cancer, CVD, adverse mental health and musculoskeletal disorders [15][16][17][18][19]. However, the association between DII and MetS has been inconsistent across studies.…”

Intergenerational associations of dietary inflammatory index with birth outcomes and weight status at age 5 and 9: Results from the Lifeways cross‐generation cohort study

“…The literature‐derived Dietary Inflammation Index (DII®) was developed to characterize the inflammatory potential of an individual's diet on a spectrum from anti‐ to pro‐inflammatory . The DII, which is validated against several inflammatory biomarkers in numerous populations, including an Irish adult cohort, has been associated with a range of health outcomes including cancer, asthma, anthropometric measures, cardiometabolic health, metabolic syndrome (MetS) and adverse mental health outcomes . Although less well‐studied in pregnancy, the DII score positively correlates with interval changes in high‐sensitivity CRP during pregnancy .…”

“…10 The DII, which is validated against several inflammatory biomarkers in numerous populations, 11,12 including an Irish adult cohort, 13 has been associated with a range of health outcomes including cancer, asthma, anthropometric measures, cardiometabolic health, metabolic syndrome (MetS) and adverse mental health outcomes. [14][15][16] Although less well-studied in pregnancy, the DII score positively correlates with interval changes in high-sensitivity CRP during pregnancy. 16,17 Recently, a more pro-inflammatory maternal diet during pregnancy has been associated with adverse birth outcomes 12 and obesity and metabolic risk markers in mid-childhood.…”