Dietary inflammatory index

The Dietary Inflammatory Index (DII) is a numerical score that assesses a diet for its effect on several biomarkers linked to inflammation. Its theoretical bounds are −8.87 to +7.98, and it is oriented such that negative scores are more anti-inflammatory and more positive scores are pro-inflammatory. The DII has been linked to many chronic diseases, including arthritis, cardiovascular diseases, inflammatory bowel diseases, diabetes, and many types of cancer (such as esophageal cancer).[1] Variants include an energy-adjusted E-DII and a children's C-DII.[2]

History and development

The development of the DII began in 2004,[2] and the first version of the DII debuted in December 2009.[3] However, this older version was never used in a published paper. It had several drawbacks, such as being statistically biased, omitting the impact of flavonoids, and being reversed (scoring inflammatory diets as negative).[2] A new, revised DII was released in 2014.[4] This version quickly gained favor as a research tool for the study of diet-associated inflammation and health-related outcomes, and is the version commonly referred to as the DII. The E-DII was developed later. At the request of the USDA, a children's DII was developed in 2018.[2]

Validation

The DII has been subjected to construct validation. It is correlated with several inflammatory markers, including interleukin 1 beta, interleukin 4, interleukin 6, interleukin 10, tumor necrosis factor TNFα-R2, C-reactive protein, and homocysteine, both individually and as a combined inflammatory biomarker score.[2]

Availability

The weights of the DII are published in the 2014 paper.[4] However, computing DII scores requires a nutrition database and normalizing dietary scores relative to the world standard food intake, and the original authors observed significant errors in the published literature. The E-DII and C-DII require unique comparative databases which are products of Connecting Health Innovations and are not publicly available.[2]

References

  1. ^ Yarahmadi, A.; et al. (2025). "Dietary inflammatory index and the risk of esophageal cancer: a systematic review and meta-analysis". BMC Cancer. 25 (1) 826. doi:10.1186/s12885-025-14199-5. PMC 12048919. PMID 40319274.
  2. ^ a b c d e f Hébert, JR; Shivappa, N; Wirth, MD; Hussey, JR; Hurley, TG (1 March 2019). "Perspective: The Dietary Inflammatory Index (DII)-Lessons Learned, Improvements Made, and Future Directions". Advances in Nutrition. 10 (2): 185–195. doi:10.1093/advances/nmy071. PMC 6416047. PMID 30615051.
  3. ^ Cavicchia, PP; Steck, SE; Hurley, TG; Hussey, JR; Ma, Y; Ockene, IS; Hébert, JR (December 2009). "A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein". The Journal of Nutrition. 139 (12): 2365–72. doi:10.3945/jn.109.114025. PMC 2777480. PMID 19864399.
  4. ^ a b Shivappa, N; Steck, SE; Hurley, TG; Hussey, JR; Hébert, JR (August 2014). "Designing and developing a literature-derived, population-based dietary inflammatory index". Public Health Nutrition. 17 (8): 1689–96. doi:10.1017/S1368980013002115. PMC 3925198. PMID 23941862.
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