Document Type : Original Article


1 Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

3 Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences


Obesity, as a chronic inflammation, is one of the most important health problems in the world. Increased central obesity is associated with increased inflammation. Diet plays a major role in regulating inflammation. The aim of this study was to investigate the relationship between dietary inflammatory index (DII) and obesity in Tehranian women. This cross-sectional study was performed on 199 women living in District 7 of Tehran. Food intake obtained through a food frequency questionnaire (FFQ) and DII was calculated. Weight, height, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were measured or calculated. In the final analysis, the effect of age, level of education, smoking status, and physical activity was controlled. The mean age of the subjects was 37.03 years, and the mean BMI was 27.6 kg/m2. The odds of high WC increased with increasing DII score in the crude model (p=0.01) and decreased significantly in the adjusted model (p=0.04). But there was no significant relationship between DII and other variables of abdominal obesity and general obesity (p>0.05). The study states that by increasing the inflammatory index score of the diet, the chance of developing abdominal obesity (waist circumference) decreases. But this result is not true for other variables of abdominal obesity and general obesity.


  1. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet (London, England). 2004;363(9403):157.
  2. Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiological Reviews. 1994;74(4):761-811.
  3. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9(1):88.
  4. Jones-Smith JC, Gordon-Larsen P, Siddiqi A, Popkin BM. Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989–2007. American Journal of Epidemiology. 2011;173(6):667–75.
  5. Jones-Smith JC, Gordon-Larsen P, Siddiqi A, Popkin BM. Is the burden of overweight shifting to the poor across the globe? Time trends among women in 39 low-and middle-income countries (1991–2008). International Journal of Obesity. 2012; 36(8):1114-20.
  6. Caro JF, Sinha MK, Kolaczynski JW, Zhang PL, Considine RV. Leptin: the tale of an obesity gene. Diabetes. 1996;45(11):1455-62.
  7. Frayling TM, Timpson NJ, Weedon MN, Zeggini E, Freathy RM, Lindgren CM, et al. A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science. 2007;316(5826):889-94.
  8. Maddah M. The Factors associated with adult obesity in Iran: A review. Iranian Journal of Nutrition Sciences & Food Technology. 2012;7(1):0-.
  9. Hermsdorff HHM, Zulet MÁ, Puchau B, Martínez JA. Central adiposity rather than total adiposity measurements are specifically involved in the inflammatory status from healthy young adults. Inflammation. 2011;34(3):161-70.
  10. Fogarty AW, Glancy C, Jones S, Lewis SA, McKeever TM, Britton JR. A prospective study of weight change and systemic inflammation over 9 y. The American Journal of Clinical Nutrition. 2008;87(1):30-5.
  11. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutrition. 2014;17(8):1689-96.
  12. Wirth MD, Hébert JR, Shivappa N, Hand GA, Hurley TG, Drenowatz C, et al. Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices. Nutrition Research. 2016;36(3):214-9.
  13. Ramallal R, Toledo E, Martínez JA, Shivappa N, Hébert JR, Martínez‐González MA, et al. Inflammatory potential of diet, weight gain, and incidence of overweight/obesity: The SUN cohort. Obesity. 2017;25(6):997-1005.
  14. Duncan BB, Chor D, Aquino EM, Bensenor IM, Mill JG, Schmidt MI, et al. Chronic non-communicable diseases in Brazil: priorities for disease management and research. Revista de Saude Publica. 2012;1:126-34.
  15. Neufcourt L, Assmann K, Fezeu L, Touvier M, Graffouillere L, Shivappa N, et al. Prospective association between the dietary inflammatory index and metabolic syndrome: Findings from the SU. VI. MAX study. Nutrition, Metabolism and Cardiovascular Diseases.2015;25(11):988-96.
  16. Corley J, Shivappa N, Hébert J, Starr J, Deary I. Associations between dietary inflammatory index scores and inflammatory biomarkers among older adults in the Lothian birth cohort 1936 study. The Journal of Nutrition, Health & Aging. 2019;23(7):628-36.
  17. Rahmani A, Sayehmiri K, Asadollahi K, Sarokhani D, Islami F, Sarokhani M. Investigation of the prevalence of obesity in Iran: a systematic review and meta-analysis study. Acta Medica Iranica. 2015:596-607.
  18. Baker P, Friel S.  Processed foods and the nutrition transition:  evidence from Asia. Obesity Reviews. 2014;15(7):564-77.
  19. Bishwajit G. Nutrition transition in South Asia: the emergence of non-communicable chronic diseases. F1000Research. 2015;4.
  20. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns and markers of systemic inflammation among Iranian women. The Journal of Nutrition. 2007;137(4):992-8.
  21. Ramezankhani A, Kabir A, Pournik O, Azizi F, Hadaegh F. Classification-based data mining for identification of risk patterns associated with hypertension in Middle Eastern population: A 12-year longitudinal study. Medicine. 2016;95(35):e4143.
  22. Kord Varkaneh HKV, Rahmani J, Tajik S, Zarezadeh M, Nazari A, Fatahi S. Association between dietary inflammatory index with obesity in Women who referred to health centers affiliated to Tehran University of Medical Sciences. Razi Journal of Medical Sciences.2017;24(161):21-30.
  23. Tabung FK, Steck SE, Zhang J, Ma Y, Liese AD, Agalliu I, et al. Construct   validation    of   the   dietary    inflammatory    index    among postmenopausal women. Annals of Epidemiology. 2015;25(6):398-405.
  24. Haghighatdoost F, Najafabadi MM, Bellissimo N, Azadbakht L. Association of dietary acid load with cardiovascular disease risk factors in patients with diabetic nephropathy. Nutrition. 2015;31(5):697-702.
  25. Neufcourt L, Assmann KE, Fezeu LK, Touvier M, Graffouillere L, Shivappa N, et al. Prospective association between the dietary inflammatory index and cardiovascular diseases in the SUpplémentation en VItamines et Minéraux AntioXydants (SU. VI. MAX) cohort. Journal of the American Heart Association. 2016;5(3):e002735.
  26. WHO. Obesity: preventing and managing the global epidemic: World Health Organization; 2000.
  27. Ruiz-Canela M, Zazpe I, Shivappa N, Hébert JR, Sánchez-Tainta A, Corella D, et al. Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvencion con DIeta MEDiterranea) trial. British journal of Nutrition. 2015;113(6):984-95.
  28. Muhammad HFL, van Baak MA, Mariman EC, Sulistyoningrum DC, Huriyati E, Lee YY, et al. Dietary inflammatory index score and its association with body weight, blood pressure, lipid profile, and leptin in Indonesian adults. Nutrients. 2019;11(1):148.
  29. Burkhauser RV, Cawley J. Beyond BMI: the value of more accurate measures of fatness and obesity in social science research.  Journal of Health Economics. 2008;27(2):519-29.
  30. Festa A, D'Agostino Jr R, Williams K, Karter A, Mayer-Davis E, Tracy R, et al. The relation of body fat mass and distribution to markers of chronic inflammation. International Journal of Obesity. 2001;25(10):1407-15.
  31. Varkaneh K, Varkaneh HK, Rahmani J, Tajik S, Zarezadeh M, Nazari A, et al. Association between dietary inflammatory index with obesity in Women who referred to health centers affiliated to Tehran University of Medical Sciences. Razi Journal of Medical Sciences. 2017;24(161):21-30.
  32. Qi Q, Chu AY, Kang JH, Huang J, Rose LM, Jensen MK, et al. Fried food consumption, genetic risk, and body mass index: gene-diet interaction analysis in three US cohort studies. BMJ. 2014; 348:g1610.
  33. Power C, Miller SK, Alpert PT. Promising new causal explanations for obesity and obesity-related diseases. Biological Research for Nursing. 2007;8(3):223-33.
  34. Corica F, Allegra A, Corsonello A, Buemi M, Calapai G, Ruello A, et al. Relationship between plasma leptin levels and the tumor necrosis factor-α system in obese subjects. International Journal of Obesity. 1999; 23(4):355.
  35. Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. The Journal of Clinical Investigation. 1995; 95(5):2409-15.
  36. Finck BN, Kelley KW, Dantzer R, Johnson RW. In vivo and in vitro evidence for the involvement of tumor necrosis factor-α in the induction of leptin by lipopolysaccharide. Endocrinology. 1998; 139(5):2278-83.
  37. Sarraf P, Frederich RC, Turner EM, Ma G, Jaskowiak NT, Rivet DJ, et al. Multiple cytokines and acute inflammation raise mouse leptin levels: potential role in inflammatory anorexia. Journal of Experimental Medicine. 1997;185(1):171-6.
  38. Shivappa N, Hebert JR, Marcos A, Diaz LE, Gomez S, Nova E, et al. Association between dietary inflammatory index and inflammatory markers in the HELENA study. Molecular Nutrition & Food Research. 2017;61(6):1600707.