The Dietary Inflammatory Index (DII) is a numerical score that assesses a diet for its effect on several biomarkers linked to inflammation.
The Dietary Inflammatory Index (DII) is a scoring algorithm that measures the inflammatory potential of an individual’s diet.
Negative scores are more anti-inflammatory and more positive scores are pro-inflammatory.
The DII has been linked to many chronic diseases, including arthritis, many types of cancer, cardiovascular diseases, inflammatory bowel diseases, and diabetes.
The DII 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.
The Dietary Inflammatory Index (DII) is a validated scoring system that quantifies the inflammatory potential of an individual’s diet based on how foods and nutrients influence key inflammatory biomarkers.
DII gives each food or nutrient a score derived from scientific studies on their effects on inflammation-related biomarkers like C-reactive protein (CRP), interleukins (IL-1β, IL-4, IL-6, IL-10), and tumor necrosis factor-alpha (TNF-α).
DII assigns positive values to pro-inflammatory foods and negative values to anti-inflammatory foods, giving a single score that predicts your risk of chronic inflammation.
The DII is a literature-derived scoring tool that quantifies the inflammatory potential of an individual’s overall diet.
It’s calculated based on 45 food parameters (nutrients, bioactive compounds, food groups) matched against their known effects on pro- and anti-inflammatory cytokines in the blood.
DII scores theoretically range from around -8.87 from the most anti-inflammatory to +7.98 the most pro-inflammatory.
Negative scores indicate more anti-inflammatory diets, while positive scores reflect more pro-inflammatory diets.
Foods associated with diets high in fruits, vegetables, nuts, seeds, tea, and coffee are typically more anti-inflammatory, while diets high in red meat, processed foods, refined grains, full-fat dairy, and sugar-sweetened beverages are more pro-inflammatory.
Higher, more pro-inflammatory, DII scores have been associated with increased risks of several chronic diseases, including arthritis, cardiovascular diseases, diabetes, inflammatory bowel diseases, and certain cancers.
Calculating a DII score involves comparing an individual’s intake of 37 food components to world reference values, standardizing these, weighting by inflammatory potential, and summing total scores.
There are energy-adjusted (E-DII) and children’s (C-DII) versions for specific populations.
Higher scores = more pro-inflammatory diet; lower/negative scores = anti-inflammatory.
A high, pro-inflammatory DII score is linked to a greater risk of conditions like cardiovascular disease, diabetes, and obesity.
The index calculates scores across numerous parameters by tracking the intake of macronutrients, micronutrients, and specific foods.
Key Components of the DII Anti-Inflammatory Foods (Lower the DII score): Vegetables (especially leafy greens), fruits, nuts, seeds, fatty fish (rich in Omega-3s), whole grains, and spices like turmeric or garlic.
Pro-Inflammatory Foods (Raise the DII score): Processed foods, red and processed meats, trans fats, refined carbohydrates (white bread and pasta), added sugars, and fried foods.
Condition | Effect Size / Finding |
CKD-28% higher CKD prevalence Obesity/T2DM/CVD-Consistent associations across most observational studies; some sex-specific effects Diabetes severity-Higher DII associated with worse glycemic control, especially HbA1c >9%. Dementia / AD | HR ~1.21 per DII unit increase for all-cause dementia Lung cancer-J-shaped association; IL-6 identified as central hub mediator Adverse pregnancy outcomesstillbirth risk notably elevated Asthma-Cross-sectional data do NOT support a clear association with clinical asthma outcomes
III Practical Limitations: Predominantly observational data — causality unestablished Relies on dietary recall Does not capture individual metabolic response to diet Limited interventional trial data testing DII modification as a therapeutic target
The DII is most useful as a risk stratification tool and a framework for counseling patients toward anti-inflammatory dietary patterns (Mediterranean, MIND-style diets correlate with lower DII scores).