Association Between Dietary Inflammatory Index and Heart Failure

Available studies have provided inconclusive results on the relation of the inflammatory potential of diet, evaluated by the dietary inflammatory index (DII), and the odds of heart failure (HF). This meta-analysis aimed to investigate whether diet-associated inflammation, as estimated by the DII, is associated with HF. A thorough literature search was carried out in PubMed [the database of the US National Library of Medicine (NLM)], Scopus, Google Scholar, and Cochrane Library up to September 2025 to obtain pertinent studies. Odds ratio (OR) and 95% CI were applied as a measure of effect size to pool the results with the use of a random effects analysis. A total of 8 publications, comprising 250,533 participants as the total sample size and 13,215 cases of HF, were included in the meta-analysis. Overall, higher DII was significantly linked to elevated odds of HF (OR: 1.15, 95% CI: 1.09-1.22), with significant heterogeneity ( I 2 =59.4%, P =0.006). The association between DII and HF was less strong in prospective cohort studies (OR: 1.08, 95% CI: 1.02-1.14) compared with case-control/cross-sectional studies (OR: 1.23, 95% CI: 1.12-1.35), with a statistically significant difference between study designs ( P =0.02). The level of adjustment for covariates influenced the strength of the association, but the association was not affected by the method of dietary assessment, obesity status, sample size, or sex and age of participants. The meta-analysis suggests that a pro-inflammatory diet is related to an elevated odds of HF.