Associations Between the Dietary Inflammatory Index, Brain Volume, Small Vessel Disease, and Global Cognitive Function

Fateme Zabetian-Targhi, Velandai K. Srikanth, Kylie J. Smith, Wendy H. Oddy, Richard Beare, Chris Moran, Wei Wang, Nitin Shivappa, James R. Hébert, Monique Breslin, Joel M. van Weel, Michele L. Callisaya

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Background: An inflammatory diet is related to poorer cognition, but the underlying brain pathways are unknown. Objective: The aim of this study was to examine associations between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and brain volume, small vessel disease, and cognition in people with and without type 2 diabetes mellitus (T2DM). Design: This is a secondary cross-sectional analysis of data from the Cognition and Diabetes in Older Tasmanians study. Participants/settings: This study included 641 participants (n = 326 with T2DM) enrolled between 2005 and 2011 from Tasmania, Australia. Main outcome measures: The E-DII was computed from the 80-item Dietary Questionnaire for Epidemiological Studies, version 2. Brain volumes (gray matter, white matter, and white matter hyperintensities), infarcts, and microbleeds were obtained from magnetic resonance imaging. Global cognition was derived from a comprehensive battery of neuropsychological tests. Statistical analysis: Logistic and linear regressions were performed to examine associations between E-DII and brain measures and a global cognitive score, adjusting for demographics, energy, T2DM, mood, ambulatory activity, and cardiovascular risk factors. An E-DII × T2DM interaction term was tested in each model. Results: The mean (standard deviation) age of participants was 69.8 (7.4) years. There were no associations between the E-DII and any of the brain structural measures or global cognitive function in fully adjusted models. There was a modification effect for T2DM on the association between E-DII and gray matter volume (T2DM: β = 1.38, 95% CI –3.03 to 5.79; without T2DM: β = –4.34, 95% CI, –8.52 to –0.16), but not with any of the other outcome measures. Conclusions: In this cross-sectional study, E-DII was not associated with brain structure or global cognition. In 1 of the 7 outcomes, a significant modification effect for T2DM was found for the associations between E-DII and gray matter. Future prospective studies are needed to clarify the associations between diet-related inflammation and brain health.

Original languageEnglish
Pages (from-to)915-924.e3
Number of pages13
JournalJournal of the Academy of Nutrition and Dietetics
Issue number5
Publication statusPublished - 1 May 2021


  • Brain MRI
  • Cognition
  • Dementia
  • Dietary inflammatory index
  • Type 2 diabetes mellitus

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