The association of dietary inflammation index (DII) and health-related outcomes: an umbrella review of systematic reviews.

Authors

Vasiliki Gkesou, Xenophon Theodoridis, Androniki Papaemmanouil, Niki Papageorgiou, Michael Chourdakis, Alexandra Michaelidou, Stamatia Kokkali, Anna-Bettina Haidich

Published in

Clinical nutrition ESPEN. Pages 103590. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

Accumulating evidence suggests that adherence to pro-inflammatory dietary patterns, as reflected by elevated Dietary Inflammatory Index (DII) scores, is associated with adverse health outcomes. This umbrella review investigated the association between the DII and health-related outcomes.
A comprehensive search was performed through PubMed, Scopus, Web of Science Core Collection and epistemonikos.org databases to identify related systematic reviews and/or meta-analyses published until July 2024. The identification of relevant studies, data extraction and critical appraisal of the included studies were performed independently by two investigators. The methodological quality was appraised using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) tool.
The findings are presented using a narrative analysis. A total of 90 systematic reviews and/or meta-analyses were identified, evaluating associations between DII and various health outcomes: cancer (n = 32), mortality (n = 12), metabolic disorders (n = 8), cardiovascular diseases (CVDs) (n = 5), neurocognitive and mental health outcomes (n = 18), alterations in body composition (n = 6), bone disorders (n = 4), neurological disorders (n = 1), and pregnancy and maternal health outcomes (n = 3). Our findings suggest that high scores of DII have an adverse effect on various health outcomes compared to lower scores. However, the overall certainty of evidence is limited, as most included reviews were rated as having low or critically low methodological quality.
The findings suggest that diets with high inflammatory load may represent a significant health risk factor, reinforcing the need for preventive interventions that promote anti-inflammatory dietary patterns. Future randomized controlled trials are warranted to confirm the potential benefits of anti-inflammatory diet patterns on health-related outcomes.
Registered on the International Prospective Register of Systematic Reviews; PROSPERO (CRD42024555761).

PMID:
42435895
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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