Key result
Pro-inflammatory diet shows inconsistent associations with pediatric metabolic syndrome and carotid intima-media thickness.
Why the study?
Metabolic syndrome and increased CIMT in youth warn of adult non-communicable disorders, making the evaluation of modifiable risk factors like Dietary Inflammatory Index essential for early intervention.
Does a higher Dietary Inflammatory Index increase the risk of metabolic syndrome and subclinical atherosclerosis in children and adolescents?
Systematic Review (n=13,202)
Does a higher Dietary Inflammatory Index increase the risk of metabolic syndrome and subclinical atherosclerosis in children and adolescents?
Suggestive but inconsistent evidence indicates that a pro-inflammatory diet may be associated with an increased risk of metabolic syndrome and subclinical atherosclerosis in children and adolescents, highlighting a critical gap for future prospective research.
Inconsistent evidence precludes DII-guided dietary advice in youth; leaves open whether anti-inflammatory diets affect pediatric cardiometabolic trajectories.
Context: Metabolic syndrome (MetS) and increased carotid intima-media thickness (CIMT) in children and adolescents are critical early warning signs for the development of non-communicable disorders in adulthood. Identifying modifiable risk factors such as the Dietary Inflammatory Index (DII) is therefore essential for implementing early public health interventions to prevent irreversible long-term health consequences. Objectives: This systematic review aimed to evaluate the association of DII with MetS and CIMT in children and adolescents. Data Sources: Using three literature databases (PubMed, Web of Science, and Scopus), we searched for studies published between 1 January 2000 and 1 August 2024, which assessed the association of DII with MetS or CIMT among children and adolescents. Study Selection: Two reviewers screened and assessed the quality of studies using the Newcastle-Ottawa Scale. Data Extraction: Given the heterogeneity of study designs, a narrative synthesis approach was employed (PROSPERO: CRD420250643107). Results: Out of 23,393 records identified, two prospective cohorts and five cross-sectional studies met our inclusion criteria, including four and three studies focused on MetS and CIMT as the outcome, respectively. The included studies investigated a combined population of over 13,000 participants, comprising both sexes, aged 6 to 19 years. Two studies, one cross-sectional (odds ratio: 1.20; 95% confidence interval: 1.01, 1.43) and one prospective (β: 0.12; 0.003, 0.22), showed a harmful association between DII and MetS, while two other studies did not find any statistically significant association. Regarding the association between DII and CIMT, two studies noted null associations, while another study observed a positive association with high CIMT [odds ratio = 2.46 (1.15, 5.24)]. Conclusions: In light of the inconsistent associations between the DII with MetS or CIMT reported in the literature, the suggestive evidence of harm from a small number of studies highlights a critical gap.
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Hadaegh et al. (2026) conducted a systematic review in Metabolic Syndrome (MetS) and Subclinical Atherosclerosis (CIMT) (n=13,202). Dietary Inflammatory Index (DII) vs. Lower DII/C-DII categories or per-unit/standard deviation decrease was evaluated on Metabolic Syndrome and Carotid Intima-Media Thickness (CIMT). The Dietary Inflammatory Index showed inconsistent associations with metabolic syndrome and carotid intima-media thickness in children and adolescents, with only suggestive evidence of harm in a subset of the observational studies.
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