Construct Validation of the Dietary Inflammatory Index (DII) among Young College-Aged Women

Abstract

The Dietary Inflammatory Index (DII) is designed to assess the inflammatory potential of the diet. While previous research has utilized DII among college-aged women, no study to date has validated it in this population. We conducted a construct validation of DII among 393 healthy women aged 18–31 years against a robust panel of 14 inflammatory biomarkers, including CRP, IL-1β, IL-4, IL-6, IL-10, and TNF-α, which were used in the development of DII. Three linear regression models were constructed: (1) an age-adjusted model, (2) the most parsimonious model based on likelihood ratio tests, and (3) a fully adjusted model for age, race, body mass index, waist circumference, physical activity, smoking status, and nonsteroidal anti-inflammatory drug use. DII was derived from the Harvard food frequency questionnaire and categorized into quartiles. Consistent with our hypothesis, DII was negatively and significantly associated with back-transformed IL-10 levels, confirming that a more pro-inflammatory diet was associated with lower levels of an anti-inflammatory cytokine (Model 3: Q4 vs. Q1 β = 0.62; 95% CI: 0.42, 0.93; p-trend = 0.04). While validated in other populations, DII may not be a suitable tool for assessing the inflammatory potential of the diet among college-aged women.