Aim: In Traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses is frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DII®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. Methods: This Single-blind randomized controlled pilot study conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low-DII-score or standard formula at the Intensive Care Unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. Results: The trial groups did not differ significantly on baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in GCS score in the low-DII-score formula group compared to the standard formula group. Over two weeks, high sensitivity c-reactive protein (hs-CRP) values -2.73 (95% CI: -3.67, -1.79) mg/dL in the low-DII-score formula group vs. 0.65 (95% CI: -0.29, 1.58) mg/dL in controls. Moreover, the length of hospital stay was longer for the standard formula group than for the low-DII-score formula group. Conclusion: The low-DII-score formula improves inflammatory factors (serum hs-CRP) and metabolic biomarkers (LDL-c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity appear to be enhanced.

Background: Overweight, obesity and lack of sleep quality as inflammatory states are the common problems among college students and the Association of Dietary Inflammatory Index (DII) with these problems among this population is unknown. We aimed to evaluate the relationship of the DII with obesity and sleep quality among Iranian female students. Methods: The present cross-sectional study was conducted in 249 female college students. The Dietary Inflammatory Index (DII) was calculated using a valid and reliable 147-item food frequency questionnaire (FFQ). To assess sleep quality, Pittsburgh Sleep Quality Index (PSQI) was used. Odds Ratio (OR) and 95% Confidence Intervals (CIs) were estimated for anthropometric indices and sleep quality according to DII score. Linear regression was used to estimate the relationship between DII score with sleep and anthropometric indices. Results: There was a significant association evident between DII and sleep quality(> 5 is considered as poor quality of sleep); i.e., the odds ratios between DII quartile 2 vs 1 (unadjusted model: OR= 0.33 (CI: 0.14-0.74), P for trend =0.002; model 1: the fully adjusted OR= 0.31(CI: 0.12-0.78), P for trend = 0.005; model 2:OR=0.30 (CI:0.12-0.78), P for trend = 0.005) to quartile 4(unadjusted model: OR= 1.13(CI: 0.45-2.80); model 1: OR= 1.11(CI: 0.44-2.79); model 2:OR=1.13(CI:0.44-2.87), P for trend = 0.005). Also, odds ratios increased significantly from quartile 2 to quartile 4 in all models for DII and sleep quality. According to the continuous score of DII, there was a significant positive association between DII and sleep quality in all 3 models: unadjusted, model 1, and model 2 (OR= 1.21 (CI: 1.05-1.40), OR= 1.21 (CI: 1.03-1.43), and OR= 1.22 (CI: 1.03-1.44), respectively. Conclusions: In this study, after removing the effect of confounding factors, participants in the highest quartile of DII score had significantly higher PSQI global score.