Designing and developing a literature-derived, population-based dietary inflammatory index
Open accessAbstract
Objective: To design and develop a literature-derived, population-based dietary inflammatory index (DII) to compare diverse populations on the inflammatory potential of their diets. Design: Peer-reviewed primary research articles published through December 2010 on the effect of diet on inflammation were screened for possible inclusion in the DII scoring algorithm. Qualifying articles were scored according to whether each dietary parameter increased (+1), decreased (−1) or had no (0) effect on six inflammatory biomarkers: IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein. Setting: The Dietary Inflammatory Index Development Study was conducted in the Cancer Prevention and Control Program of the University of South Carolina in Columbia, SC, USA from 2011 to 2012. Results: A total of ≈6500 articles published through December 2010 on the effect of dietary parameters on the six inflammatory markers were screened for inclusion in the DII scoring algorithm. Eleven food consumption data sets from countries around the world were identified that allowed individuals’ intakes to be expressed relative to the range of intakes of the forty-five food parameters observed across these diverse populations. Qualifying articles ( n 1943) were read and scored based on the forty-five pro- and anti-inflammatory food parameters identified in the search. When fit to this composite global database, the DII score of the maximally pro-inflammatory diet was +7·98, the maximally anti-inflammatory DII score was −8·87 and the median was +0·23. Conclusions: The DII reflects both a robust literature base and standardization of individual intakes to global referent values. The success of this first-of-a-kind attempt at relating intakes of inflammation-modulating foods relative to global norms sets the stage for use of the DII in a wide variety of epidemiological and clinical studies.
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Different assessment methods to measure biomarkers via different kits with varying inter- and intra-assay coefficients of variability influence the overall accuracy of the reported effect estimates.
“Different assessment methods to measure these biomarkers via different kits with varying inter- and intra-assay coefficients of variability further influence the overall accuracy of the reported effect estimates [176,177].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [177]
The Materials and methods sections discuss which inflammatory biomarkers were included and describe different methods for assessing dietary intake, not methods for measuring the biomarkers. Searches for assay kits, inter- and intra-assay variability, and effects on the accuracy of effect estimates found no passage addressing the claim. (LLM, conf=0.76)
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“The assessment of the diet’s inflammatory potential involved the computation of DII scores 35 .”
- Authors
- Shivappa, N., Steck, S. E., Hurley, T. G., Hussey, J. R., & Hébert, J. R.
- Affiliations
- University of South Carolina (US)
- Corresponding author
- Hébert, James R
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-08-14
- Volume
- 17
- Issue
- 8
- Pages
- 1689-1696
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC3925198
- OpenAlex
- W2121076832
- Cited by
- 2,731
- References
- 2
- Citations by year
- 2026: 328 · 2025: 460 · 2024: 421 · 2023: 335 · 2022: 278 · 2021: 255 · 2020: 167 · 2019: 151 · 2018: 151 · 2017: 80 · 2016: 54 · 2015: 31 · 2014: 17 · 2013: 2
- FWCI
- 35.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (K05CA136975)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- Dietary Inflammatory Index, dietary inflammatory potential, diet and inflammation, inflammatory markers, cytokines, C-reactive protein
- MeSH terms
- Algorithms, C-Reactive Protein, Diet, Feeding Behavior, Humans, Inflammation, Interleukins, Nutritional Status, Tumor Necrosis Factor-alpha, Biomarkers, Nutrition Assessment, Inflammation Mediators
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