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. 2025 Feb 3;25(1):74.
doi: 10.1186/s12872-025-04515-z.

Relationship between the dietary inflammation index and hypertension in American children and adolescents: findings from the national health and nutrition examination survey 1999-2018

Lanfei Du  1 , Jinxia Hao  2 , Kai Yu  3 , Peihong Su  4 , Jie Pu  5 , Zhiguo Tang  5 , Fuqiang Liu  5 , Jie Zhou  6
Affiliations

Relationship between the dietary inflammation index and hypertension in American children and adolescents: findings from the national health and nutrition examination survey 1999-2018

Lanfei Du et al. BMC Cardiovasc Disord. .

Abstract

This study aimed to examine the relationship between the dietary inflammatory index (DII) and hypertension in children and adolescents using data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. The analysis included 18,460 participants aged 8 to 17 years, with 2,070 diagnosed with youth hypertension, defined as blood pressure above the 95th percentile for their age and gender. Dietary information was collected to calculate the DII, which was initially treated as a continuous variable and later categorized into tertiles. Multivariable weighted logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DII and youth hypertension. The results revealed a positive relationship between higher DII scores and increased likelihood of hypertension in youth, with both regression and RCS analyses showing a linear positive correlation after adjusting for potential confounders. The findings suggest that managing dietary inflammation may be an important strategy for preventing hypertension in children and adolescents.

Keywords: Adolescents; Cross-sectional study; DII; Hypertension; NHANES.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The NHANES protocol adheres to the Policy for the Protection of Human Research Subjects set forth by the U.S. Department of Health and Human Services. The protocol numbers for NCHS IRB/ERC are: NHANES 2017–2018: Protocol #2018-01 (Effective beginning October 26, 2017), Continuation of Protocol #2011-17 (Effective through October 26, 2017); NHANES 2015–2016: Continuation of Protocol #2011-17; NHANES 2013–2014: Continuation of Protocol #2011-17; NHANES 2011–2012: Protocol #2011-17; NHANES 2009–2010: Continuation of Protocol #2005-06; NHANES 2007–2008: Continuation of Protocol #2005-06; NHANES 2005–2006: Protocol #2005-06; NHANES 1999–2004: Protocol #98 − 12. Consent for publication: Not Applicable. Informed consent: was obtained from all subjects involved in the NHANES. Clinical trial number: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of children and adolescents enrollment
Fig. 2
Fig. 2
RCS analysis of the association between DII and risk of youth hypertension among all enrolled children and adolescents. RCS was adjusted for age, sex, and race/ethnicity, family income, total energy intake, BMI, eGFR, DM. DII, dietary inflammation index; RCS, restricted cubic spline; BMI, body mass index; OR, odds ratio
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