The study presents the development of a dietary inflammatory index (DII), a tool to assess the inflammatory potential of diets based on a literature review. The DII was designed to compare diverse populations on the inflammatory effects of their diets. The process involved screening peer-reviewed articles published through December 2010 to identify the effects of dietary parameters on six inflammatory biomarkers: IL-1β, IL-4, IL-6, IL-10, TNF-α, and C-reactive protein. Eleven food consumption data sets from around the world were used to standardize individual intakes relative to global referent values. The DII scoring algorithm was refined to account for the robustness of the literature and to relate individual intakes to global norms. The final DII score ranges from -8.87 (maximally anti-inflammatory) to +7.98 (maximally pro-inflammatory), with a median of +0.23. The DII reflects both a robust literature base and standardized individual intakes to global referent values. The new DII is improved by using a more comprehensive literature review, a global referent database, and a percentile scoring system. The DII is calculated by linking dietary intake data to a global database that provides a robust estimate of mean and standard deviation for each parameter. This allows for the calculation of a Z-score, which is then converted to a percentile score. The percentile score is multiplied by the food parameter-specific inflammatory effect score to obtain the food parameter-specific DII score. These scores are summed to create the overall DII score for an individual. The DII can be used in various epidemiological and clinical studies to assess the inflammatory potential of diets. It is based on a comprehensive review of the literature and incorporates a wide range of dietary parameters, including whole foods, nutrients, and bioactive compounds. The DII is not dependent on specific population means or recommendations but is based on results published in the scientific literature. This distinguishes the DII from other indices that are often simple counts of foods. The DII provides a standardized way to compare dietary intakes across different populations and is a valuable tool for assessing the inflammatory potential of diets.The study presents the development of a dietary inflammatory index (DII), a tool to assess the inflammatory potential of diets based on a literature review. The DII was designed to compare diverse populations on the inflammatory effects of their diets. The process involved screening peer-reviewed articles published through December 2010 to identify the effects of dietary parameters on six inflammatory biomarkers: IL-1β, IL-4, IL-6, IL-10, TNF-α, and C-reactive protein. Eleven food consumption data sets from around the world were used to standardize individual intakes relative to global referent values. The DII scoring algorithm was refined to account for the robustness of the literature and to relate individual intakes to global norms. The final DII score ranges from -8.87 (maximally anti-inflammatory) to +7.98 (maximally pro-inflammatory), with a median of +0.23. The DII reflects both a robust literature base and standardized individual intakes to global referent values. The new DII is improved by using a more comprehensive literature review, a global referent database, and a percentile scoring system. The DII is calculated by linking dietary intake data to a global database that provides a robust estimate of mean and standard deviation for each parameter. This allows for the calculation of a Z-score, which is then converted to a percentile score. The percentile score is multiplied by the food parameter-specific inflammatory effect score to obtain the food parameter-specific DII score. These scores are summed to create the overall DII score for an individual. The DII can be used in various epidemiological and clinical studies to assess the inflammatory potential of diets. It is based on a comprehensive review of the literature and incorporates a wide range of dietary parameters, including whole foods, nutrients, and bioactive compounds. The DII is not dependent on specific population means or recommendations but is based on results published in the scientific literature. This distinguishes the DII from other indices that are often simple counts of foods. The DII provides a standardized way to compare dietary intakes across different populations and is a valuable tool for assessing the inflammatory potential of diets.