Association between the Dietary Inflammatory Index and All-Cause Mortality in Adults with Obesity

Introduction: The dietary inflammatory index (DII) is associated with numerous chronic noncommunicable diseases. Previous studies have shown that the pro-inflammatory DII categories are associated with abdominal and simple obesity. However, the association between DII and mortality in patients with abdominal obesity and simple overweight or obesity remains unclear. Methods: We used data from the US National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A DII >0 (positive DII) was defined as a pro-inflammatory diet. A restricted cubic spline curve was used to describe the trend between DII and all-cause mortality. We then examined the association between DII and all-cause mortality in different body types using a Cox regression analysis and investigated the differences between sexes. Finally, the mediating effects of systemic inflammation were explored. Results: A pro-inflammatory diet increased all-cause mortality in adults with abdominal obesity (aHR: 1.31, 95% confidence interval [CI]: 1.11–1.54; p < 0.001) and with simple overweight or obesity (aHR: 1.30, 95% CI: 1.11–1.53; p < 0.001). In addition, the most pro-inflammatory DII increased the risk of mortality by 43% (hazard ratio [HR]: Q4 vs. Q1 = 1.43, 95% CI = 1.14–1.79; p = 0.002; p for trend = 0.003) and 39% (HR: Q4 vs. Q1 = 1.39, 95% CI = 1.13–1.74; p = 0.003; p for trend = 0.009) in participants with abdominal obesity and with simple overweight or obesity, respectively. However, this association was not present in normal-sized participants. Compared with men, women resisted the effects of a pro-inflammatory diet. Mediation analysis showed that white blood cell and neutrophil were mediators of the association between DII and all-cause mortality (p < 0.001). Conclusion: A pro-inflammatory diet is associated with all-cause mortality in adults with abdominal obesity and simple overweight or obesity, and this effect differs between men and women. Systemic inflammation may mediate the association between DII and all-cause mortality.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Association between the Dietary Inflammatory Index and All-Cause Mortality in Adults with Obesity ; volume:79 ; number:5 ; year:2023 ; pages:434-447 ; extent:14 ; Annals of nutrition & metabolism ; 79, Heft 5 (2023), 434-447 (gesamt 14)

Contributors, Places and Time

• Creator: Zheng, Xin ; Ge, Yi-Zhong ; Ruan, Guo-Tian ; Lin, Shi-Qi ; Chen, Yue ; Liu, Chen-An ; Xie, Hai-Lun ; Song, Meng-Meng ; Liu, Tong ; Wang, Zi-Wen ; Shi, Jin-Yu ; Zhang, He-Yang ; Yang, Ming ; Liu, Xiao-Yue ; Deng, Li ; Shi, Han-Ping

Further information

• DOI: 10.1159/000533380
• URN: urn:nbn:de:101:1-2023121323132424200615
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:25 AM CEST