Scores to monitor inflammatory effects of a diet: a useful concept?

The Dietary Inflammatory Index (DII) was developed to quantify the inflammatory potential of dietary patterns based on their effects on inflammatory biomarkers. Growing evidence links low-grade inflammation to chronic diseases such as obesity, cardiovascular disease, diabetes, and cancer. This review summarizes current evidence regarding the clinical and epidemiological relevance of the DII and evaluates its potential as a tool for nutritional assessment and disease prevention.

Recent studies demonstrate consistent associations between higher DII scores and adverse cardiometabolic outcomes, including atherosclerosis, metabolic liver disease, obesity, and increased cardiovascular mortality. Anti-inflammatory dietary patterns, particularly the Mediterranean diet, are associated with lower DII scores, reduced inflammatory markers, and improvements in metabolic parameters and quality of life. Emerging evidence also suggests benefits in cancer survivors, patients with depression, and individuals with chronic inflammatory conditions. Methodological advances, including the energy-adjusted DII (E-DII) and the pediatric C-DII, have improved the applicability and predictive value of the index.

The DII provides a useful framework for assessing the relationship between diet and inflammation across populations and clinical settings. Current evidence supports its value in identifying dietary patterns associated with chronic inflammation and related diseases. Although causal relationships remain to be fully established, the DII may contribute to personalized nutrition strategies and support prevention and management approaches for inflammation-related disorders. Further long-term interventional studies are needed to strengthen its clinical utility and prognostic significance.