Dietary Inflammatory Index Chart: Foods to Eat & Avoid

The Dietary Inflammatory Index is a scoring system that rates your overall diet on a scale from strongly anti-inflammatory (around −8.9) to strongly pro-inflammatory (around +8.0), based on how 45 different food components are known to affect inflammatory markers in your blood. It was built from nearly 2,000 qualifying research articles and validated against real populations across multiple countries, giving it more scientific grounding than most “eat this, not that” lists you’ll find online.¹ The practical question most people have, though, is simpler: which foods push your score in the wrong direction, and which ones pull it back?

How the DII Score Actually Works

Researchers built the DII by reviewing roughly 6,500 published studies on how specific dietary components affect six inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6, and tumor necrosis factor-alpha. Each of the 45 food parameters received a weighted score reflecting how consistently the literature showed it raised or lowered these markers. Your personal DII score depends on how much of each parameter you consume relative to a global reference database drawn from eleven countries.¹ In that global database, the median score landed at +0.23, meaning the average diet worldwide leans very slightly pro-inflammatory.

The 45 parameters are not all whole foods. They include macronutrients like total fat and protein, specific fatty acid types, individual vitamins and minerals, and a handful of whole food categories like garlic, onion, green and black tea, and certain spices. So when people talk about a “DII chart,” they’re really talking about the composite effect of the nutrients and bioactive compounds inside foods, not a simple food-by-food list. That said, translating from nutrients to groceries is straightforward enough once you know which components matter most.

Foods That Lower Your Score

The strongest anti-inflammatory contributors in the DII are fiber, omega-3 fatty acids, magnesium, vitamins A, C, D, and E, beta-carotene, zinc, selenium, and several polyphenol-rich compounds like flavonoids and anthocyanidins. In practical grocery terms, that translates to a diet heavy in vegetables, fruits, whole grains, nuts, seeds, and fatty fish.

Omega-3 fatty acids deserve special attention because they are among the most consistently anti-inflammatory nutrients in the literature. Food sources like salmon, sardines, walnuts, and flax seeds have been linked to lower levels of inflammatory markers and reduced risk of chronic disease.² That said, when researchers looked specifically at diabetic and cardiovascular patients in a systematic review, the benefits for inflammatory biomarkers were less clear-cut, suggesting that omega-3s may be more helpful for prevention than for reversing established disease.³

Herbs and spices also carry outsized anti-inflammatory weight relative to the small amounts you actually eat. Turmeric, ginger, garlic, saffron, pepper, and rosemary all contain compounds that the DII literature scores as anti-inflammatory. Epidemiological comparisons have noted that populations with high daily spice consumption tend to have lower rates of certain chronic diseases, though many confounders make it hard to credit spices alone.⁴ Still, adding turmeric to a stir-fry or ginger to tea is one of the easiest ways to nudge a DII score downward without overhauling your entire diet.

A practical anti-inflammatory grocery list, grouped by what they contribute:

Omega-3 sources: salmon, sardines, mackerel, walnuts, flax seeds, chia seeds
Fiber and polyphenols: berries, leafy greens, broccoli, onions, whole oats, beans, lentils
Vitamin- and mineral-rich produce: sweet potatoes, bell peppers, citrus fruits, tomatoes, spinach
Herbs and spices: turmeric, ginger, garlic, rosemary, oregano, saffron, black pepper
Beverages: green tea, black tea (both scored as anti-inflammatory in the DII)

Foods That Raise Your Score

On the pro-inflammatory side, the DII flags saturated fat, trans fat, cholesterol, refined carbohydrates, and high-glycemic-index foods as the primary dietary drivers of inflammation. In grocery-store terms, that means red meat (especially processed varieties like bacon and sausage), full-fat dairy, partially hydrogenated oils, sugary snacks, sodas, and white bread or other highly refined grain products all push your score upward.⁵

Ultra-processed foods are worth calling out separately because their inflammatory effects go beyond just their nutrient profiles. Research has found that characteristics unique to ultra-processed foods, including non-nutritive additives and their effects on gut health, can promote low-grade chronic inflammation independently of the fat, sugar, or sodium they contain.⁶ So a frozen dinner that technically matches the macronutrient profile of a home-cooked meal may still be more inflammatory because of what was done to the food during manufacturing.

Foods most consistently associated with higher DII scores:

Processed meats: bacon, hot dogs, deli meats, sausage
Refined carbohydrates: white bread, pastries, most breakfast cereals, sugary drinks
Fried foods: especially those cooked in partially hydrogenated or repeatedly reused oils
High-sugar items: candy, sweetened beverages, many packaged snacks
Certain fats: margarine with trans fats, lard, palm oil in excess

How Cooking Methods Change the Picture

The same ingredient can be more or less inflammatory depending on how you prepare it. One well-studied mechanism involves advanced glycation end products, or AGEs, which are compounds that form when proteins and fats are exposed to high, dry heat. Grilling, frying, roasting, and broiling can increase AGE levels by 10 to 100 times compared to the uncooked food.⁷ These compounds contribute to oxidative stress and inflammation once absorbed.⁸

The same research found that animal-derived foods high in fat and protein are most prone to forming new AGEs during cooking, while carbohydrate-rich foods like vegetables, fruits, and whole grains produce relatively few even after cooking. Cooking with moist heat (steaming, poaching, stewing), using lower temperatures, keeping cooking times shorter, and adding acidic ingredients like lemon juice or vinegar all significantly reduced AGE formation.⁷ So a chicken breast poached with lemon is a meaningfully different inflammatory exposure than the same chicken breast charred on a grill.

Does the DII Actually Predict Disease?

The strongest reason to care about DII scores is the growing body of evidence connecting higher scores to worse health outcomes. These are not small effects confined to a single study, and they span several major disease categories.

In cardiovascular disease, a prospective cohort study of older Chinese adults found that those in the highest third of DII scores had roughly 43% higher risk of developing cardiovascular disease and 45% higher risk of dying from it compared to those in the lowest third.⁹ The fact that this was a prospective study, meaning researchers tracked people forward in time rather than looking backward, makes the association more convincing than a simple snapshot.

For colorectal cancer, a meta-analysis combining multiple studies found that people eating the most pro-inflammatory diets had about 40% higher risk of colorectal cancer compared to those eating the most anti-inflammatory diets. Every one-point increase in the DII score was associated with a 7% increase in risk.¹⁰ A separate case-control study in a Chinese population found an identical 40% increased risk in the highest DII quartile.¹¹

Type 2 diabetes risk also tracks with DII. A meta-analysis found that pro-inflammatory diets are directly related to all the standard markers of diabetes risk, including fasting blood sugar, insulin resistance, and hemoglobin A1c. The proposed mechanism is that pro-inflammatory nutrients elevate circulating inflammatory molecules, which in turn drive insulin resistance.⁵

Inflammation, the Gut, and Why It Goes Beyond Nutrients

One reason the DII picks up health signals that go beyond simple nutrient tallies may be its connection to the gut microbiome. In older adults, a pro-inflammatory diet was associated with reduced microbial diversity and distinct shifts in the types of bacteria present in the gut.¹² A separate cross-sectional study found that people eating the most pro-inflammatory diets had higher levels of specific bacterial species linked to inflammation, while those eating anti-inflammatory diets were enriched in Akkermansia muciniphila, a microbe associated with better metabolic health.¹³

The microbiome connection matters because it suggests that the DII isn’t just measuring direct chemical effects of food on blood markers. Your diet also shapes the bacterial community in your gut, and that community independently influences systemic inflammation. This is part of why ultra-processed foods can be more inflammatory than their nutrient profiles would predict: they may disrupt the microbial ecosystem in ways that a simple tally of saturated fat and sugar wouldn’t capture.

Mental Health and Brain Disorders

Some of the more surprising DII research involves the brain. A large prospective cohort study found that people with the highest DII scores had roughly 14–18% higher risks of depression, anxiety, sleep disorders, and stroke compared to those with the lowest scores. The researchers demonstrated that inflammation mediated part of this relationship, meaning the pro-inflammatory diet appeared to affect the brain at least partly through elevated systemic inflammation.¹⁴

Cross-sectional data paints a starker picture for depression specifically. One analysis found that people in the highest DII quartile had 82% higher odds of depression compared to those in the lowest quartile, with a clear dose-response pattern: more inflammatory diets, more depression, step by step up the scale.¹⁵ The proposed pathway involves inflammatory molecules crossing into the brain and affecting neuronal function. Anti-inflammatory diets combined with exercise have even been shown to upregulate genes involved in brain plasticity in animal studies.¹⁶

This doesn’t mean eating salmon will cure clinical depression. But it does suggest that chronic dietary inflammation is one contributor to mood and cognitive risk, alongside genetics, stress, sleep, and everything else. For someone already managing depression, cleaning up dietary inflammation is a lever worth knowing about.

Rheumatoid Arthritis and Autoimmune Conditions

Because rheumatoid arthritis is itself an inflammatory disease, the DII-RA connection is a natural area of study. Patients with RA tend to have higher DII scores than healthy controls, and the relationship runs in both directions: more inflammatory diets are linked to higher disease activity scores. In one study, each one-unit increase in DII raised the standard disease activity measure (DAS-28) by 1.11 times, and patients with the most inflammatory diets had significantly higher levels of CRP and TNF.¹⁷ A separate study confirmed a modest but statistically significant relationship between DII and disease activity, with dietary inflammation explaining about 12% of the variation in DAS-28 scores.¹⁸

Twelve percent might sound modest, and it is. Diet is one of many factors affecting RA flares, and no amount of turmeric replaces disease-modifying medications. But for patients already optimizing their treatment, shifting toward an anti-inflammatory diet represents a modifiable factor that may reduce flare severity at the margins.

Who Ends Up With Pro-Inflammatory Diets

DII scores aren’t evenly distributed across the population. Using data from the U.S. National Health and Nutrition Examination Survey, researchers found that food insecurity was significantly associated with higher DII scores even after accounting for demographics and income. People with very low food security had DII scores about 0.31 points higher than food-secure individuals.¹⁹ That gap may sound small on a scale that ranges from roughly −9 to +8, but across years of eating, even fractional shifts compound into meaningfully different inflammatory exposure.

The reason is straightforward: fresh produce, fatty fish, nuts, and spices are more expensive and less accessible than processed foods high in refined carbohydrates and saturated fat. Anti-inflammatory eating isn’t just a knowledge problem. For many people, it’s a cost and access problem. Telling someone on a tight budget to eat more wild-caught salmon and fresh berries isn’t realistic advice. Frozen vegetables, canned beans, dried lentils, and basic spices like turmeric and ginger are more practical anti-inflammatory staples that are affordable and shelf-stable.

What the DII Does Not Tell You

For all its research backing, the DII has real limitations. It was designed to capture the overall inflammatory potential of a diet across a population, not to give any individual a precise inflammation reading. There are no established clinical reference values, meaning there’s no agreed-upon score that marks “healthy” versus “unhealthy.” There’s also no minimal clinically important difference, so it’s hard to say how much of a DII change matters for any one person.²⁰

The DII also doesn’t account for everything in food that might drive or reduce inflammation. Sodium, nitrite-based preservatives, and food additives are not included in its 45 parameters because they don’t appear reliably in standard food composition databases. For conditions like asthma, where these substances may be particularly harmful, the DII could miss important dietary triggers.²⁰ And the method you use to assess your diet in the first place, whether a food diary, a recall interview, or a questionnaire, can change the resulting DII score.

There’s also the question of how well the DII aligns with established diet quality measures. Comparing the energy-adjusted DII against the Healthy Eating Index (a standard U.S. measure of diet quality), researchers found substantial overlap: about half the variation in HEI scores was explained by the energy-adjusted DII.²¹ That’s a lot of overlap, and it raises a fair question: does the DII give you meaningfully different guidance from “just eat well”? The honest answer is that for most people, a Mediterranean-style diet rich in produce, fish, olive oil, and whole grains will produce a low DII score without you ever calculating one. The DII is more useful as a research instrument that validates why those diets work than as a daily tracking tool for individuals.

Pregnancy and Early Life

One area where the DII evidence is more nuanced than headlines suggest is maternal diet during pregnancy. A study examining whether a mother’s DII score during pregnancy predicted allergic diseases in her child at 18 months found no significant associations with food allergy, eczema, wheeze, asthma, or immune sensitization.²² That doesn’t mean maternal diet is unimportant for child health broadly, but it does caution against assuming that the DII framework automatically extends to every inflammation-adjacent outcome. The inflammatory processes driving adult chronic diseases and those influencing infant immune development may respond to different dietary signals, or operate on timescales the DII wasn’t built to capture.

This is a healthy reminder that the DII is a tool, not a universal law. It works well for the outcomes it was validated against, primarily chronic diseases in adults where long-term low-grade inflammation is a known driver. Stretching it into every context where inflammation plays some role is tempting but premature.

Validating the Score Against Blood Markers

The DII wouldn’t be worth discussing if higher scores didn’t actually correspond to measurable inflammation in people’s blood. Validation studies have confirmed that the link exists, though it varies by marker. In one study, each one-unit increase in DII was associated with 19% higher odds of elevated interleukin-6 and 56% higher odds of elevated homocysteine, though no significant link was found with CRP or fibrinogen in that particular population.²³ Another validation study did find a significant association between higher DII scores and CRP levels above 3 mg/L.²⁴ A Brazilian cross-sectional study echoed the CRP finding, particularly when energy-adjusted versions of the DII were used, while noting that associations with individual cytokines were more mixed.²⁵

The takeaway from these validation studies is that CRP appears to be the most consistently responsive blood marker to chronic dietary patterns, which makes sense given that CRP reflects sustained, systemic inflammation rather than short-term immune responses. If you wanted a single blood test to check whether your dietary habits are inflammatory, CRP would be the one your doctor could order. But the DII captures something broader than any single marker, which is precisely why it was built from six markers rather than one.

1
PubMed Central. Designing and developing a literature-derived, population-based dietary inflammatory index
2
PubMed Central. Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health
3
Scientific Reports. Omega-3 Fatty Acids Effects on Inflammatory Biomarkers and Lipid Profiles among Diabetic and Cardiovascular Disease Patients: A Systematic Review and Meta-Analysis
4
PubMed Central. Chronic diseases, inflammation, and spices: how are they linked?
5
PubMed Central. Dietary Inflammatory Index in relation to Type 2 Diabetes: A Meta-Analysis
6
PubMed Central. Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review
7
PubMed Central. Advanced glycation end products in foods and a practical guide to their reduction in the diet
8
PubMed Central. Plant-Based Approaches for Inhibition of Advanced Glycation End Products Formation: Dietary Polyphenols
9
The Journal of nutrition, health and aging. Dietary inflammatory index and the risk of cardiovascular disease and mortality: A prospective cohort study of Chinese community-dwelling older adults
10
PubMed Central. Dietary Inflammatory Index and Colorectal Cancer Risk—A Meta-Analysis
11
PubMed Central. The Dietary Inflammatory Index Is Positively Associated with Colorectal Cancer Risk in a Chinese Case-Control Study
12
PubMed Central. Association Between the Dietary Inflammatory Index and Life’s Essential 8 in Older Adults Based on Gut Microbiota Profiles
13
British Journal of Nutrition. Dietary inflammatory potential in relation to the gut microbiome: Results from a cross-sectional study
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Translational Psychiatry. Dietary inflammatory index and brain disorders: a Large Prospective Cohort study
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PubMed Central. The association between dietary inflammation index and depression
16
PubMed Central. Dietary inflammatory potential and the incidence of depression and anxiety: a meta-analysis
17
PubMed. Association of Dietary Inflammatory Index (DII) with disease activity and inflammatory cytokines in the patients with rheumatoid arthritis
18
PubMed. The relationship between dietary inflammatory index scores and rheumatoid arthritis disease activity
19
PubMed Central. Associations between Food Security Status and Dietary Inflammatory Potential within Lower-Income Adults from the United States National Health and Nutrition Examination Survey, Cycles 2007 to 2014
20
The Journal of Allergy and Clinical Immunology: In Practice. Dietary Inflammatory Index and Clinical Outcome Measures in Adults With Moderate-to-Severe Asthma
21
PubMed Central. Relationship between Non-Energy-Adjusted and Energy-Adjusted Dietary Inflammatory Index and the Healthy Eating Index-2015: an analysis of the National Health and Nutrition Examination Survey (NHANES) 2015-2018
22
PubMed Central. Maternal dietary inflammatory index during pregnancy and the risk of offspring allergic disease
23
PubMed Central. Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study
24
PubMed Central. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS)
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Nutrition Research. Dietary Inflammatory Index is positively associated with hs-CRP and inversely associated with IL-8 in Brazilian adults: a cross-sectional study