DII was a risk factor for CVD among individuals with diabetes, with BMI and SII each partially mediating this relationship, suggesting that monitoring dietary inflammation, body weight, and systemic immune-inflammation may help reduce CVD risk in diabetic patients.
Higher dietary inflammatory index (DII) was significantly associated with increased risk of cardiovascular disease (CVD) among individuals with diabetes.
Among 5068 diabetic participants, 1243 (24.53%) had comorbid cardiovascular disease.
Body mass index (BMI) partially mediated the relationship between DII and CVD in adults with diabetes.
Systemic immune-inflammation index (SII) partially mediated the relationship between DII and CVD in adults with diabetes.
Both BMI and SII serve as mediating pathways through which dietary inflammation contributes to CVD risk in diabetic individuals.
This research suggests that eating a more pro-inflammatory diet — measured by the Dietary Inflammatory Index (DII) — is associated with a higher risk of heart and vascular disease (CVD) among people who have diabetes. Using data from nearly 5,100 diabetic adults surveyed between 2009 and 2023 as part of the U.S. National Health and Nutrition Examination Survey, the researchers found that about 1 in 4 diabetic participants already had CVD, and that a higher DII score meaningfully increased the odds of having CVD. The study also explored why this link exists by testing whether body weight (BMI) and a blood marker of whole-body inflammation (the systemic immune-inflammation index, or SII) help explain the connection. Both did: higher DII was associated with higher BMI and higher SII, and both of those in turn were associated with greater CVD risk. In other words, pro-inflammatory diets may raise CVD risk partly by increasing body weight and partly by stoking systemic inflammation, though diet also appears to affect CVD risk through additional pathways not captured by these two factors. This research suggests that for people living with diabetes, paying attention to the inflammatory quality of their diet — not just calorie content — could matter for heart health. Tracking body weight and inflammation markers like SII may help identify diabetic individuals at elevated CVD risk, particularly those whose diets tend to be more pro-inflammatory. The findings point to diet, body weight, and inflammation as interconnected targets worth considering in efforts to reduce heart disease burden in people with diabetes.
Tang S, Li H, Wang Z, Wang B, Li Z, Li Y, et al.. (2026). Mediating roles of systemic immune-inflammation index and body mass index in the association between dietary inflammatory index and cardiovascular disease in diabetes.. Medicine. https://doi.org/10.1097/MD.0000000000050622