Relationship between Non-Energy-Adjusted and Energy-Adjusted Dietary Inflammatory Index and the Healthy Eating Index-2015: an analysis of the National Health and Nutrition Examination Survey (NHANES) 2015-2018

• Published in: Annals of medicine (Helsinki) 2023-12, Vol.55 (2), p.2236551-2236551
• Main Authors: DiNatale, Janie C., Azarmanesh, Deniz, Hébert, James R., Wirth, Michael D., Pearlman, Jessica, Crowe-White, Kristi M.
• Format: Article
• Language: English
• Subjects: Adult; Body Mass Index; Cross-Sectional Studies; Diet; diet quality; Diet, Healthy; dietary inflammatory index; dietary patterns; energy-adjusted dietary inflammatory index; healthy eating index; Humans; inflammation; National health and nutrition examination survey; Nutrition; Nutrition Surveys
• ISSN: 0785-3890; 1365-2060
• DOI: 10.1080/07853890.2023.2236551

Significant inverse associations exist between HEI and both DII® and E-DII TM scores among a sample of American adults using NHANES 2015-2018 data. HEI scores were the highest in the first E-DII quartile compared to the first DII quartile. Use of an inflammatory index along with the HEI provides further understanding of the associations between diet quality as described by nutrient content and consumption of specific food groups on inflammation and inflammatory-related chronic diseases. Acknowledging the association between diet and systemic inflammation, the Dietary Inflammatory Index (DII ® ) and the Energy-Adjusted DII (E-DII TM ) were developed to categorize diet from anti- to pro-inflammatory. The purpose of this study was to evaluate differences in the relationship between DII and E-DII against the Healthy Eating Index (HEI) to assess the use of energy-adjustment when analyzing the inflammatory potential of the diet. This cross-sectional secondary data analysis included 5289 adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2018. DII and E-DII scores were calculated and grouped into quartiles. Multivariable linear regression was used to evaluate the association between HEI with DII and E-DII separately, adjusting for age, gender, race/ethnicity, education, family-to-poverty ratio and body mass index. Bootstrap methods were used to estimate the difference between coefficients for E-DII and DII from their respective models. Results suggest that HEI scores were significantly lower between quartile 2 and quartile 1 of DII scores (Q2 vs. Q1: β(SE) = −7.45(0.54), p