Predictors and associations of childhood dietary inflammation ​with obesity


Better understanding of the relationship between dietary inflammation and adiposity in childhood may be important in the context of identifying modifiable behaviours for early prevention of childhood obesity. In this project we characterised childhood dietary inflammation using the recently described child dietary inflammatory index (C-DII).

We conducted pooled analyses of individual participant data across 6 cohorts and 4 European countries, describing the inflammatory potential of children’s diets (n=13,978) in early, mid and late childhood and investigating cross-sectional associations of C-DII with childhood adiposity (Study 1) as well as predictors of C-DII (Study 2).

Progress & Results

Several achievements have been made towards finalising the aims of the project

Study 1

Study 1 investigated cross-sectional dietary inflammation associations with childhood weight status and is in the write-up and dissemination stage.  We conducted a two-stage randomeffects individual participant data meta-analysis with linear and logistic regression adjusted models using multiple imputation for missing covariates. Quantile regression examined childhood dietary inflammatory index (C-DII) associations with percentiles of BMI z-score, with cohort interactions. The study found that the associations between childhood dietary inflammatory potential and adiposity were inconsistent, by cohort and quantile. Contrary to our hypothesis, exposure to a more pro-inflammatory diet was associated with lower latechildhood BMI, potentially explained by adiposity rebound. Preliminary results have been accepted for poster presentation at the 30th European Congress of Obesity 17-20 May 2023 (see attached) and a manuscript for publication is being prepared for the Lancet Child and Adolescent Health.

Study 2

Study 2 examined socio-ecological predictors of childhood dietary inflammation with analysis expected to be finalised in May 2023. We conducted a two-stage random-effects individual participant data meta-analysis with linear and logistic regression adjusted models using multiple imputation for missing covariates, with predictors identified from the literature and matched to available cohort data.  On completion of analysis the manuscript will be prepared for submission to a high-quality/impact target journal, e.g. JAMA Pediatrics.

In addition to the original proposal, we also started a rapid scoping review; the findings of which will support and contextualise the results of our 2 main studies. The scoping review protocol is currently under review at PLOS ONE and the scoping review is in progress.


In summary, results thus far suggest childhood dietary inflammation associations with adiposity vary by cohort and quantile. Further studies are warranted in other cohorts. Building on previous research and expanding the knowledge and evidence base may help inform early intervention strategies and future paediatric obesity clinical practice guidelines. Reducing the health burdens related to childhood obesity using dietary interventions in turn may lead to significant savings in healthcare expenditure and improved quality of life for children and their families.

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