Anti-inflammatory diet
Cohort meta-analyses link the most pro-inflammatory diets on the Dietary Inflammatory Index to about 23% to 36% more heart disease and 40% to 53% higher odds of depression than the most anti-inflammatory diets. These links are observational. In a rheumatoid arthritis trial, disease activity did not differ in the main analysis. No harms were sourced.
- Status
- A dietary pattern, not a regulated product.
- Also called
- anti inflammatory diet, anti-inflammatory eating, Dietary Inflammatory Index, DII, low-inflammatory diet, AID, ADIRA diet, inflammation diet
- Followed for
- inflammation, C-reactive protein, heart health, depression, cancer prevention, rheumatoid arthritis, ulcerative colitis
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help5
- ModerateLinked to lower heart disease risk: the most pro-inflammatory diet scores carried 23% to 36% higher risk than the most anti-inflammatory scores in cohort studies.
- ModerateLinked to lower odds of depression: pro-inflammatory diets carried 40% to 53% higher odds than anti-inflammatory diets in observational studies.
- ModerateLinked to lower cancer risk: the most pro-inflammatory scores carried 25% higher cancer incidence and 67% higher cancer mortality in one meta-analysis.
- ModerateLinked to lower odds of elevated C-reactive protein, about 10% for each point lower on the Dietary Inflammatory Index.
- LimitedOne trial in mild to moderate ulcerative colitis found more remission with fecal transplant plus an anti-inflammatory diet, then the diet alone, than with standard therapy.
Reported risks0
No risks sourced yet.
What people follow it for, and what was found
Shown to help5
Heart disease and death
Linked to lower heart disease risk: the most pro-inflammatory diet scores carried 23% to 36% higher risk than the most anti-inflammatory scores in cohort studies.
Compared with people whose diets scored in the highest (most pro-inflammatory) Dietary Inflammatory Index category [1], [2]
The numbers and sources
- Effect
- Across 30 cohort studies (669,205 participants), the highest Dietary Inflammatory Index category was linked to more cardiovascular disease (HR 1.23, 95% CI 1.14 to 1.33, I² 54%) and cardiovascular death (HR 1.29, 95% CI 1.24 to 1.35) than the lowest, and to myocardial infarction (HR 1.41) [1]. An earlier meta-analysis of 14 studies found a relative risk of 1.36 (95% CI 1.19 to 1.57, I² 69%), and 8% higher risk for each one-point rise in the index [2].
- Population
- Adults in cohorts from 9 countries [1]; 11 cohort, 2 case-control and 1 cross-sectional study [2]. Observational.
- Sources
- [1], [2]
- Caveats
- Observational. These compare people's usual diets by score, not a prescribed diet. Heterogeneity was moderate in both reviews [1][2].
Depression
Linked to lower odds of depression: pro-inflammatory diets carried 40% to 53% higher odds than anti-inflammatory diets in observational studies.
Compared with people on a pro-inflammatory diet [3]; people with higher (more pro-inflammatory) Dietary Inflammatory Index scores [4]
The numbers and sources
- Effect
- In 11 studies (101,950 participants), a pro-inflammatory diet was linked to higher risk of depression or depressive symptoms than an anti-inflammatory diet (OR 1.40, 95% CI 1.21 to 1.62, I² 63%) [3]. In 43 studies, higher index scores were linked to depression (OR 1.53, 95% CI 1.42 to 1.66, I² 81.5%), with no link at scores below 0 and rising risk above 0 [4].
- Population
- People aged 16 to 72 in cross-sectional and longitudinal studies [3]; 43 observational studies [4].
- Sources
- [3], [4]
- Caveats
- Observational, with high heterogeneity, partly from mixing cross-sectional and longitudinal designs [3][4].
Cancer
Linked to lower cancer risk: the most pro-inflammatory scores carried 25% higher cancer incidence and 67% higher cancer mortality in one meta-analysis.
Compared with people whose diets scored in the highest (most pro-inflammatory) Dietary Inflammatory Index category [5]
The numbers and sources
- Effect
- Against the lowest index category, the highest had higher overall cancer incidence (RR 1.25, 95% CI 1.16 to 1.35), higher odds of cancer (OR 1.75, 95% CI 1.43 to 2.16) and higher cancer mortality (RR 1.67, 95% CI 1.13 to 2.48). Links held for breast (RR 1.12), colorectal (RR 1.33) and lung cancer (RR 1.30) [5].
- Population
- 24 studies: 13 case-control, 7 cohort, 3 RCTs and 1 unspecified [5].
- Sources
- [5]
- Caveats
- Mostly case-control studies. Index scores came from study-specific food frequency questionnaires [5].
C-reactive protein
Linked to lower odds of elevated C-reactive protein, about 10% for each point lower on the Dietary Inflammatory Index.
Compared with people with higher (more pro-inflammatory) Dietary Inflammatory Index scores, per point [6]
The numbers and sources
- Effect
- In 14 studies (59,941 people), each one-unit rise in the index was linked to 10% higher odds of elevated C-reactive protein (OR 1.10, 95% CI 1.06 to 1.14, I² 0%) [6].
- Population
- Adults in observational studies [6].
- Sources
- [6]
- Caveats
- Observational. The abstract's confidence interval for the highest against lowest category (OR 1.39) does not contain the estimate, so only the per-unit figure is reported here [6].
Ulcerative colitis
One trial in mild to moderate ulcerative colitis found more remission with fecal transplant plus an anti-inflammatory diet, then the diet alone, than with standard therapy.
Compared with optimized standard medical therapy [8]
The numbers and sources
- Effect
- At 8 weeks, fecal transplant with an anti-inflammatory diet led to remission in 60% against 32.3% on optimized standard therapy (OR 3.2, 95% CI 1.1 to 8.7), and deep remission in 36.4% against 8.7%. Among responders, deep remission held to 48 weeks in 6 of 24 on the diet alone and 0 of 27 on standard therapy (p = 0.007) [8].
- Population
- 73 adults with mild to moderate ulcerative colitis randomized, 66 analyzed [8].
- Sources
- [8]
- Caveats
- Open-label. During the first 8 weeks the diet was combined with seven fecal transplants, so its own effect cannot be separated [8].
Not shown to help1
Rheumatoid arthritis
One crossover trial in rheumatoid arthritis found no difference in disease activity in its main analysis, with a small difference among people who finished both diets.
Compared with a control diet similar to the general dietary intake in Sweden, eaten by the same people in turn [7]
The numbers and sources
- Effect
- In the main analysis of 47 participants, DAS28-ESR did not differ between the anti-inflammatory and control diets (P = 0.116). Among the 44 who completed both periods, DAS28-ESR was lower after the anti-inflammatory diet (median 3.05 against 3.27, P = 0.04). Tender and swollen joints, ESR and general health ratings did not differ [7].
- Population
- 50 adults with rheumatoid arthritis [7].
- Sources
- [7]
- Caveats
- Ten weeks per diet. The completer result was an unadjusted analysis [7].
How trials defined it
The Dietary Inflammatory Index scores how pro- or anti-inflammatory a diet is, and the meta-analyses compared people in the highest and lowest categories of their usual diets [1][2][5]. In the cancer studies, scores were calculated from study-specific food frequency questionnaires [5]. In the rheumatoid arthritis trial, participants ate a portfolio of suggested anti-inflammatory foods or a control diet like the usual Swedish diet for 10 weeks each, with a 4-month washout. Food covering about half of energy needs was delivered weekly [7]. The ulcerative colitis trial paired the diet with seven weekly colonoscopic fecal transplants for 8 weeks, then continued the diet alone to 48 weeks [8].
Claims tested and not found
- That an anti-inflammatory diet lowers rheumatoid arthritis disease activity. In the main analysis, DAS28-ESR did not differ from a control diet, and none of its components differed [7].
Sources
- Ni Y, Yao Q, Xu T, et al. Dietary inflammatory index and cardiovascular risk and mortality: an updated systematic review and meta-analysis. Frontiers in Cardiovascular Medicine. 2025. https://doi.org/10.3389/fcvm.2025.1626523
- Shivappa N, Godos J, Hébert JR, et al. Dietary Inflammatory Index and Cardiovascular Risk and Mortality: A Meta-Analysis. Nutrients. 2018. https://doi.org/10.3390/nu10020200
- Tolkien K, Bradburn S, Murgatroyd C. An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis. Clinical Nutrition. 2019. https://doi.org/10.1016/j.clnu.2018.11.007
- Yu L, Bian L, Ren L, et al. Nonlinear dose-response relationship between dietary inflammatory index and risk of depression: a systematic review and meta-analysis. Frontiers in Nutrition. 2025. https://doi.org/10.3389/fnut.2025.1645789
- Fowler ME, Akinyemiju TF. Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. International Journal of Cancer. 2017. https://doi.org/10.1002/ijc.30922
- Mohammadi S, Hosseinikia M, Ghaffarian-Bahraman A, et al. Dietary inflammatory index and elevated serum C-reactive protein: A systematic review and meta-analysis. Food Science & Nutrition. 2023. https://doi.org/10.1002/fsn3.3553
- Vadell AKE, Bärebring L, Hulander E, et al. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA): a randomized, controlled crossover trial indicating effects on disease activity. The American Journal of Clinical Nutrition. 2020. https://doi.org/10.1093/ajcn/nqaa019
- Kedia S, Virmani S, K Vuyyuru S, et al. Faecal microbiota transplantation with anti-inflammatory diet (FMT-AID) followed by anti-inflammatory diet alone is effective in inducing and maintaining remission over 1 year in mild to moderate ulcerative colitis: a randomised controlled trial. Gut. 2022. https://doi.org/10.1136/gutjnl-2022-327811