iranian trend of household dietary inflammatory index from 1991 to 2020: analyzing for policies - study protocol

Background and objectives: systemic inflammation has gained increasing attention in the literature due to its critical role in health and the rising prevalence of its risk factors, such as unhealthy diets in middle- and low-income countries. this study aims to calculate the trend of the modified empirical dietary inflammatory index (edii) for the iranian population over the past three decades and analyze for policies related to this index.materials and methods: this study analyzes the dii trend using household food expenditure data in iran. the data on household food purchases were extracted from the annual household income and expenditure survey conducted by the iranian statistics center between 1991 and 2020. to estimate food intake, adjustments will be made for unpurchased, wasted, lost, and cooked food using specific coefficients.the dii calculation involves determining the average daily food expenditure for 15 predefined food groups categorized into two main categories: anti-inflammatory and pro-inflammatory foods. the edii score is calculated by multiplying the amounts of each food group by its respective scores and weights. additionally, the edii will be adapted to iranian dietary patterns, as investigated in esmaillzadeh’s study.for the qualitative phase, a one-page graphic questionnaire will be designed to raise awareness among policymakers about the issue. stakeholder analysis will be conducted using brugha's stakeholder analysis method. policy documents, articles, and relevant texts will be reviewed to identify key concepts and themes. to determine policy components, the walt and gilson health policy framework and shiffman and smith policy making frameworks will be applied.