The dietary inflammatory index is associated with diabetes severity

Abstract

Objective: The Dietary Inflammatory Index (DII) is a recently developed dietary inflammation assessment tool. The current study examined the association between DII and the presence and severity of diabetes in adults age >20 years. Research Design and Methods: Cross-sectional analysis of 4434 adult participants in the National Health and Nutrition Examination Survey (NHANES 2013 to 2014). The DII was calculated based on 24-hour dietary recall data. Linear and logistic regression models were used to estimate the relationship and control for possible confounding factors. Results: Among 4434 participants, mean age was 49.4 years, mean BMI (body mass index) was 29.3 kg/ m2, and mean DII (higher is more inflammatory) was 0.65 (range, -3.41 to +9.05). The mean DII scores in participants with and without diabetes were 0.79 and 0.50, respectively (P = .0098). Participants with Hemoglobin A1c (HgbA1c) >9% had higher DII scores than those with 6.5% to 9% HgbA1c (1.37 vs 0.54, P = .0002) and those with <6.5% HgbA1c (1.37 vs 0.50, P < .0001). With 1 point increase in the DII score, odds of having diabetes increased by 13% (95% CI, 1.02 to 1.24). Among the individuals with diabetes, we also observed a significant association between severity of diabetes and DII scores; with 1 point increase in DII score, the odds of having HgbA1c higher than 9% increased by 43% (95% CI, 1.21 to 1.68). Conclusions: The DII had a significant association with diabetes and a stronger association when HgbA1c >9%. Further research will help clarify the association between inflammation and diet and the utility of the DII as a tool in risk assessment and management of patients with diabetes.