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A recent study sheds light on one of the most common physical symptoms and how it relates to the development of type 2 diabetes: inflammation. The prospective study followed 171,094 participants over 13.5 years, with the aim of determining the association between the diet inflammatory index and the development of diabetes.

Inflammation is a biological response of the immune system that can be triggered by a variety of factors, including pathogens, damaged cells, and toxic compounds. These factors can induce acute and/or chronic inflammatory responses in the heart, pancreas, liver, kidney, lung, brain, digestive tract, and reproductive system, which can cause tissue damage or disease.

The complex interaction between diet and inflammation has become a major focus of research in recent years in different clinical environments and patient populations. In fact, inflammation has been identified as one of the key factors for:

• Malnutrition related to diseases that promote anorexia
• Development of high blood pressure
• Loss of muscle mass
• At the cellular level, insulin resistance, which can stimulate diabetes

There is solid evidence that diet impacts inflammation. Studies have looked at several single nutrients and dietary patterns with pro-inflammatory or anti-inflammatory properties, such as long-chain ω-3 fatty acids, eicosapentaenoic acid, or docosahexaenoic acid. 

The Mediterranean diet combines several of these nutrients and has been demonstrated to improve medical outcomes in the outpatient setting. What’s more, increasing evidence suggests that inflammation affects metabolism and modulates the response to nutrition support interventions.

Participants in a recent UK Biobank study did not have diabetes at the start of the study. 171,094 patients were followed until March 1, 2023 to determine type 2 diabetes incidence, and diagnostic information was obtained from linked medical records. An energy-adjusted diet inflammatory index (E-DII) was calculated based on 28 food parameters. Habitual salt intake was determined through the frequency the participants reported adding salt to foods.

The associations between E-DII, habitual salt intake, and type 2 diabetes incidence were tested with the Cox proportional hazard regression model.

Over more than a decade of follow-up, 6,216 cases of type 2 diabetes were documented. Compared to participants with a low E-DII (indicative of an anti-inflammatory diet), participants with a high E-DII (indicative of a pro-inflammatory diet) had an 18% higher risk of developing type 2 diabetes.

The study observed that the association between E-DII and type 2 diabetes tends to be linear, after adjusting to eliminate other factors. Participants with a pro-inflammatory diet who always added salt to foods had the highest risk of type 2 diabetes incidence.

The researchers concluded that these new findings support the public health promotion of an anti-inflammatory diet and reduced salt intake to prevent the onset of type 2 diabetes.
Numerous food components have been investigated for their anti-inflammatory properties and possible use in nutritional therapy. Research has not only focused on macronutrients, such as fatty acids or amino acids, and micronutrients, such as vitamin D, but has also included other food components, such as fiber and phytochemicals.

In addition to the selection of foods, some diets have been recognized to help prevent conditions. Perhaps one of the most studied diets is the Mediterranean diet, which has been demonstrated to have an anti-inflammatory and, therefore, preventive effect.

Doctors have different opinions on which foods should be included or excluded from the ideal anti-inflammatory diet. However, all versions of the ideal anti-inflammatory diet contain advice on including fats and oils high in polyunsaturated fatty acids, particularly omega-3 fatty acids (fish, canola, flax seed, sunflower). 

Additionally, they promote limiting refined carbohydrates (white sugar, brown sugar, and honey) and emphasize increased intake of seeds and nuts, which are also cornerstones of an anti-inflammatory diet. All these components reduce the glycemic load, which can impact diabetes.

This story was produced using content from original studies or reports, as well as other medical research and health and public health sources cited in links throughout the article.