Obesity · Journal article

Association between dietary inflammatory index and sarcopenia in overweight or obese adults: a cross-sectional study.

Journal of Diabetes and Metabolic Disorders · August 17, 2026

Promising Why this matters to you Expert discussion

Encouraging direction, but not yet definitive.

AI Summary

This cross-sectional study of 2,432 overweight or obese US adults found that higher dietary inflammatory index (DII) and energy-adjusted DII (E-DII) were independently associated with increased odds of sarcopenia, with inflammatory-lipid composite markers identified as potential mediators. The findings suggest a link between anti-inflammatory diet quality and muscle mass preservation in this population, but do not establish causality or demonstrate clinical benefit of dietary intervention.

What was studied

Cross-sectional analysis. Overweight or obese adults from NHANES 2011–2018. Intervention: Dietary inflammatory index (DII) and energy-adjusted DII (E-DII) as continuous exposures. Compared with: No explicit comparator; associations modelled per unit increase in DII/E-DII. n = 2,432. United States (NHANES).

Key findings

Each 1-unit increase in DII associated with 25% higher odds of sarcopenia (OR = 1.25; 95% CI: 1.13-1.38; P < 0.001) Each 1-unit increase in E-DII associated with 29% higher odds of sarcopenia (OR = 1.29; 95% CI: 1.00-1.67; P = 0.048) DII showed linear relationship with sarcopenia (P for nonlinearity = 0.553)

Safety

Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.

Who this may help

Clinicians may consider dietary inflammatory quality as a modifiable factor associated with sarcopenia risk in overweight or obese patients, but evidence remains observational and does not yet support a change in practice. Prospective and intervention trials are needed to establish whether lowering dietary inflammatory index prevents or improves sarcopenia.

Plain-language summary

Cross-sectional analysis of a large national sample showing independent associations between dietary inflammatory indices and sarcopenia odds, with identified mediators, but lacking longitudinal design, causality, or intervention evidence to guide practice change.

Study design

As stated by the source record.

MethodsWeighted logistic regression, restricted cubic spline (RCS), and mediation analyses applied to NHANES 2011–2018 data to examine associations between DII and E-DII with sarcopenia, and to test mediation by four inflammatory-lipid composite markers (NHR, PHR, MHR, LHR).

DesignCross-sectional analysis

PopulationOverweight or obese adults from NHANES 2011–2018

Sample size2,432

InterventionDietary inflammatory index (DII) and energy-adjusted DII (E-DII) as continuous exposures

ComparatorNo explicit comparator; associations modelled per unit increase in DII/E-DII

SettingUnited States (NHANES)

Reported figures

Quoted from the source exactly as published.

Sample size2432

DII odds ratio1.25

DII 95% confidence interval1.13-1.38

DII p-value< 0.001

E-DII odds ratio1.29

E-DII 95% confidence interval1.00-1.67

E-DII p-value0.048

DII nonlinearity p-value0.553

Clinical bottom line

Caveats

Cross-sectional design prevents inference of temporal sequence or causality; reverse causation possible
Unmeasured or residual confounding not ruled out; fully adjusted model covariates not enumerated in abstract
E-DII 95% CI includes 1.00, indicating borderline statistical significance
Generalizability limited to US overweight or obese population; applicability to normal weight or other ethnic groups unknown

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

moderate

Cross-sectional NHANES analysis; observational, no randomization or intervention

Directness

strong

Directly measures DII/E-DII against sarcopenia in target population

Consistency

moderate

Both DII and E-DII show associations; E-DII non-linear but direction consistent

Risk of bias

moderate

Cross-sectional design precludes temporal precedence; unmeasured confounding possible

Sample adequacy

strong

2,432 overweight or obese adults from national survey; adequate for weighted regression

Source abstract

Objective. To examine the associations of DII and E‑DII with sarcopenia in overweight or obese adults and the mediating role of inflammatory‑lipid composite markers.Methods. We analyzed 2,432 overweight or obese adults from NHANES 2011-2018 using weighted logistic regression, RCS, and mediation analyses for four inflammatory‑lipid composite markers (NHR, PHR, MHR, LHR).Results. In fully adjusted models, each 1‑unit increase in DII was associated with a 25% higher odds of sarcopenia (OR = 1.25; 95% CI: 1.13-1.38; P < 0.001), while E‑DII showed a 29% higher odds (OR = 1.29; 95% CI: 1.00-1.67; P = 0.048). RCS analysis revealed a linear relationship for DII (P for nonlinearity = 0.553) but a non‑linear relationship for E‑DII (P for nonlinearity = 0.004). Mediation analyses identified NHR and PHR as significant mediators, with higher mediation proportions in the E‑DII models.Conclusion. Higher DII and E‑DII were independently associated with higher odds of sarcopenia in overweight or obese adults. Early dietary anti‑inflammatory interventions for sarcopenia should also target overweight individuals, not only those with obesity.

Follow from this

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Qi ShenHong CaoObesityYanping XiaFeng ZhangMengmeng Wu