Association between dietary inflammatory index with metabolic syndrome and inflammation in middle-aged and older adults: A cross-sectional study

ABSTRACT Background and aim Dietary patterns play a significant role in the development of chronic metabolic diseases. The dietary inflammatory index (DII) is a tool utilized to evaluate the inflammatory potential of a diet. This study aimed to examine the association of DII with metabolic syndrome and inflammation in middle-aged and older adults in Semarang, Indonesia. Methods A cross-sectional study included participants aged 40 or older residing in Semarang. The DII score was calculated from data on 29 nutrients and food components. Anthropometric data, blood pressure, lipid profile, blood glucose, and C-reactive protein (CRP) were evaluated. Multivariate logistic regression was employed to examine the association of DII, metabolic syndrome, and inflammation. Results We found that 67.57% of subjects consumed a more pro-inflammatory diet. The prevalence of metabolic syndrome in this study was 18.8%. The highest DII tertile (T3) was significantly correlated with the escalation of metabolic syndrome (OR: 1.701; 95% CI: 1.128-2.565), high waist circumference (OR: 1.775; 95% CI: 1.229-2.564), high fasting blood glucose (FBG) (OR: 1.651; 95% CI: 1.124-2.425), low high-density lipoprotein (HDL) (OR: 1.410; 95% CI: 1.090-1.920), and high CRP (adjusted OR: 1.780; 95% CI: 1.260-2.516) compared to the lowest tertile (T1). Conclusion The DII is positively associated with metabolic syndrome and inflammation among middle-aged and older adults. Higher DII scores are linked to increased metabolic syndrome, increased waist circumference, elevated fasting blood glucose, reduced HDL cholesterol levels, and increased CRP. These findings underscore the potential utility of DII as a screening tool in primary care settings and highlight the need for dietary interventions to reduce pro-inflammatory diets among Indonesian adults.