Obesity and Its Relationship with Dietary Inflammatory Index (DII): A Systematic Review

Sruthi Satheesan; Jeeva George; Sitara Pani

Obesity and Its Relationship with Dietary Inflammatory Index (DII): A Systematic Review

Author(s)	Ms. Sruthi Satheesan, Jeeva George, Sitara Pani
Country	India
Abstract	Abstract Background: The Dietary Inflammatory Index (DII) estimates the inflammatory potential of habitual diet; higher scores indicate a more pro-inflammatory pattern. Obesity is associated with chronic low-grade inflammation, and diet-related inflammation may influence body weight, fat distribution, and cardiometabolic risk. Objectives: To systematically review the association between DII (or energy-adjusted DII) and obesity-related outcomes like body mass index (BMI), overweight/obesity, waist circumference, body fat percentage, visceral adiposity, obesity phenotypes, and obesity-related metabolic and inflammatory markers — among adults and adolescents. Methods: This review followed a PRISMA 2020-informed structure. Eligible studies included human participants and reported DII or E-DII in relation to anthropometric, body-composition, obesity-phenotype, metabolic, or inflammatory outcomes. Twenty studies meeting these criteria were retained after removing duplicate, incomplete, and non-primary entries from an earlier draft. Data were synthesised narratively owing to substantial heterogeneity in population, dietary assessment method, DII calculation, and outcome definition; a study-selection flow diagram is presented, and formal risk-of-bias tools (Newcastle-Ottawa Scale for cohort/case-control studies, AXIS for cross-sectional studies) are proposed for completion. Results: The 20 included studies were cross-sectional, cohort, secondary-survey, or clinical designs from Europe, Asia, North America, Latin America, and the Middle East. Most studies reported that higher DII was associated with higher BMI, waist circumference, body fat, central obesity, obesity phenotypes, metabolic syndrome, or inflammatory biomarkers (CRP, IL-6, TNF-α, leptin). Two studies reported null findings for BMI or body fat, and one clinical (pre-surgical) sample showed an inverse DII–BMI association. Conclusions: A more pro-inflammatory dietary pattern is consistently associated with adverse obesity-related anthropometric and metabolic outcomes, but the predominantly cross-sectional evidence base does not establish causation. Prospective cohort studies and randomised dietary interventions using standardised DII and obesity definitions are needed.
Keywords	Dietary Inflammatory Index; obesity; body mass index; central obesity; inflammation; systematic review.
Field	Medical / Pharmacy
Published In	Volume 8, Issue 5, September-October 2026
Published On	2026-10-04

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Obesity and Its Relationship with Dietary Inflammatory Index (DII): A Systematic Review

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