# The association between the Dietary Inflammatory Index and breast cancer risk: an updated systematic review and meta-analysis

**Authors:** Chaoyang Wang, Qian Zhou, Liang Chen, Chao Zhai

PMC · DOI: 10.3389/fnut.2026.1735685 · Frontiers in Nutrition · 2026-02-04

## TL;DR

This study finds that pro-inflammatory diets increase breast cancer risk, suggesting anti-inflammatory eating could help prevent it.

## Contribution

An updated meta-analysis linking the Dietary Inflammatory Index to breast cancer risk using recent observational studies.

## Key findings

- Higher Dietary Inflammatory Index scores are associated with a 91% increased breast cancer risk in case-control studies.
- Cohort studies show a 8% higher breast cancer risk per one-unit increase in Dietary Inflammatory Index.
- Promoting anti-inflammatory diets may aid in breast cancer prevention and management.

## Abstract

This meta-analysis aimed to clarify the relationship between the Dietary Inflammatory Index (DII) and the risk of breast cancer (BC), thereby providing an evidence-based foundation for the primary prevention and secondary management of BC.

A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies published up to September 30, 2025. Observational studies (case-control and cohort) reporting effect estimates (OR/HR with 95% CI) for the association of DII/E-DII with BC risk or prognostic outcomes were included. Effect sizes were pooled using a random-effects model. Heterogeneity was assessed, and subgroup analyses along with publication bias evaluation were performed.

Nineteen studies (14 case-control, 5 cohort) were included. Case-control studies demonstrated a significant positive association between a higher DII and increased BC risk (pooled OR = 1.91, 95% CI: 1.50–2.42), a trend consistently observed in both premenopausal and postmenopausal women. Cohort studies further confirmed that elevated DII scores were associated with a higher risk of BC (pooled HR = 1.08, 95% CI: 1.01–1.15). Each one-unit increase in the DII was correlated with an approximate 2% rise in BC risk. Moderate heterogeneity was detected among the studies, primarily attributable to variations in DII categorization methods and population characteristics.

The current evidence suggests that the DII is associated with BC risk, with pro-inflammatory dietary patterns linked to a higher risk of breast cancer. Promoting anti-inflammatory dietary habits, characterized by abundant consumption of fruits, vegetables, whole grains, and healthy fats, holds substantial public health importance for the prevention and management of BC.

## Linked entities

- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Genes:** PRKAA1 (protein kinase AMP-activated catalytic subunit alpha 1) [NCBI Gene 5562] {aka AMPK, AMPK alpha 1, AMPKa1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, NOS1 (nitric oxide synthase 1) [NCBI Gene 4842] {aka IHPS1, N-NOS, NC-NOS, NOS, bNOS, nNOS}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, LEP (leptin) [NCBI Gene 3952] {aka LEPD, OB, OBS}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, MYD88 (MYD88 innate immune signal transduction adaptor) [NCBI Gene 4615] {aka IMD68, MYD88D, WM1}
- **Diseases:** cancer (MESH:D009369), insulin resistance (MESH:D007333), Chronic inflammation (MESH:D007249), node (MESH:D012804), obese (MESH:D009765), BC (MESH:D001943), tumorigenesis (MESH:D063646)
- **Chemicals:** Saturated fatty acids (MESH:D005227), carbohydrates (MESH:D002241), acetone (MESH:D000096), omega-3 polyunsaturated fatty acids (-), caffeine (MESH:D002110), alcohol (MESH:D000438), ketone bodies (MESH:D007657), flavonoids (MESH:D005419), ROS (MESH:D017382)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12913110/full.md

## References

36 references — full list in the complete paper: https://tomesphere.com/paper/PMC12913110/full.md

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Source: https://tomesphere.com/paper/PMC12913110