Dietary Inflammatory Index and Cardiovascular Diseases Outcomes in Adults: A Systemic Review

This registration describes a systematic literature review, conducted and reported according to PRISMA 2020, on the association between the inflammatory potential of the diet and cardiovascular disease (CVD) among adults. Purpose. The review synthesises recent evidence (2022–2026) on whether diets with higher inflammatory potential, measured by the Dietary Inflammatory Index (DII), its energy-adjusted version (E-DII), or the Empirical Dietary Inflammatory Pattern (EDIP), are associated with CVD incidence or prevalence, CVD-specific mortality, specific CVD outcomes (coronary heart disease, myocardial infarction, stroke, heart failure, atherosclerotic CVD) and all-cause mortality. The question was framed using PECO: adults aged ≥18 years (Population); inflammatory diet (Exposure); lower or reference levels of inflammatory dietary exposure (Comparator); and CVD outcomes (Outcome). Methods. Scopus and Web of Science were searched, with Google Scholar as a supplementary source (last search 31 July 2026), limited to English-language research articles published 2022–2026. Of 1888 records identified, 778 remained after search limits and 56 studies were included after screening and full-text assessment. Study quality was appraised with the six-criterion framework of Abouzahra et al. (2020). Data were extracted with a standardised form (index used, design, sample, dietary assessment, outcomes, effect estimates, covariates). Findings were synthesised narratively, grouped by index and outcome and organised into themes; no meta-analysis was performed. A published meta-analysis was used only as an external benchmark and is not counted among the 56 studies. Outputs. The review reports the direction, magnitude and statistical significance of associations by index and outcome, how they vary by population characteristics and methodological factors, and the limitations of the evidence base. Registration status. This registration was completed retrospectively, after data extraction was finished. No protocol was published in advance.