{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:10:55Z","timestamp":1778735455833,"version":"3.51.4"},"reference-count":167,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>Chronic low-grade inflammation has emerged as the pivotal driver connecting metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) to neurodegenerative disorders, a pathological continuum increasingly recognized as \u201cType 3 Diabetes Mellitus\u201d (T3DM). Diet, as a primary modifiable lifestyle factor, plays a dual role as both an inflammatory trigger and a potential therapeutic target. This review systematically delineates the methodological evolution of dietary inflammatory indices, shifting from the reductionist, nutrient-centric logic of the Dietary Inflammatory Index (DII) to the systemic, \u201cfood-matrix-based\u201d logic of the recently proposed Food Inflammation Index (FII). We provide an in-depth mechanistic synthesis of the gut-metabolism-brain axis, illustrating how high-inflammatory diets initiate a malignant cascade: beginning with gut dysbiosis and barrier leakage, followed by immunometabolic reprogramming of adipose tissue, and culminating in the \u201cTrojan Horse\u201d effect at the blood\u2013brain barrier. This process facilitates amyloid-beta accumulation and bioenergetic crises, forming the molecular basis of T3DM. While the DII remains an irreplaceable tool for large-scale historical and cross-cultural epidemiological research, we argue that the FII represents an important methodological advancement toward precision nutrition. By quantifying intra-group heterogeneity and capturing whole-food effects, the FII is designed to address the clinical \u201ctranslation bottleneck\u201d of nutrient-based assessments. Furthermore, we explore the clinical integration of the Food Inflammation Scores of Individuals (FISI) with digital health platforms and artificial intelligence, proposing novel, pre-emptive tools such as Children\u2019s FISI (C-FISI) and Pregnancy FISI (P-FISI) for life-cycle management. This review bridges the gap between nutrition science and neuro-metabolic pathology, providing a novel theoretical framework and practical tools for the integrated management of MetS and the early prevention of T3DM.<\/jats:p>","DOI":"10.3389\/fnut.2026.1818219","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:30:37Z","timestamp":1778733037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["From nutrient-based to food-based assessment: the evolution of inflammatory indices and their significance for metabolic syndrome and type 3 diabetes mellitus"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Tao","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangtao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Mu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwen","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1038\/s41572-024-00563-5","article-title":"Metabolic syndrome","volume":"10","author":"Neeland","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s11906-018-0812-z","article-title":"The global epidemic of the metabolic syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr Hypertens Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.trsl.2017.01.001","article-title":"Cardiovascular consequences of metabolic syndrome","volume":"183","author":"Tune","year":"2017","journal-title":"Transla Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome\u2014a new world\u2010wide definition. 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