Document Type
Article
Abstract
Background
Inflammatory Bowel Disease (IBD) involves genetic and environmental factors, but the relationship between disease activity, adiposity, and diet remains unclear.
Objective
To investigate the association between endoscopic/radiological activity of IBD, body adiposity, and the Dietary Inflammatory Index with or without adjustment for energy density (E-DII or DII).
Method
An observational, cross-sectional study was carried out. Endoscopic activity was defined by an endoscopic Mayo score >2, Crohn’s Disease Endoscopic Index of Severity (CDEIS) > 5, and/or the presence of a deep ulcer in any intestinal segment. Body adiposity was estimated using the body mass index, waist circumference, and waist-hip ratio (WHR). The DII and E-DII scores were calculated from a validated quantitative food frequency questionnaire. According to the DII and E-DII, the patients were divided into three groups: the first with the least pro-inflammatory diet and the third with a predominantly pro-inflammatory diet.
Results
Of the 62 patients, 58.1% (n = 36) were in remission (RD) and 41.9% (n = 26) had active disease (AD). The proportion of patients with overweight/obesity was 69.4% (n = 25) in the RD group and 50.0% (n = 13) in the AD group. Patients in remission exhibited significantly higher WHR (p < 0.05) and a greater frequency of central obesity (p < 0.01). A predominantly pro-inflammatory diet was common across both groups; 58.3% (n = 21) of RD patients and 50.0% (n = 13) of AD patients were in the highest DII tertile. Similar results were found for the E-DII.
Conclusions
Among patients with IBD, pro-inflammatory dietary patterns and excess adiposity are highly prevalent. Despite greater central adiposity in patients in remission, no significant associations were found between DII or EDII scores and endoscopic and radiological markers of disease activity.
Digital Object Identifier (DOI)
Publication Info
Published in European Journal of Clinical Nutrition, 2026.
Rights
© The Author(s) 2026 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
APA Citation
de Oliveira, R. M. V., Vasques, A. C. J., Romero, S. A., Shivappa, N., Wirth, M. D., Hébert, J. R., Reis, G. F. S. R., & Nagasako, C. K. (2026). Dietary inflammatory index and objective disease activity in IBD: no association found. European Journal of Clinical Nutrition.https://doi.org/10.1038/s41430-026-01713-6