**5. Conclusions**

In participants with current AN, we identified significantly lower intake of cholesterol, protein, and zinc, compared to HCs and MUFAs and PUFAs compared to participants recovered from AN. The DII score did not significantly differ between groups. Therefore, the findings from this study suggest that it is unlikely that a pro-inflammatory diet accounts for the alterations in cytokines and other inflammatory markers that have been observed

in people with current AN. As this is the first study to assess dietary inflammation in AN, future research should further explore the use of the DII in samples with current and recovered AN, using multiple 24-h dietary recalls (to avoid problems associated with averaging intake over a long period of time).

**Author Contributions:** Conceptualisation, H.H., O.P. and B.D.; methodology, H.H., O.P. and B.D.; formal analysis, O.P.; investigation, O.P. and B.D.; data curation, O.P., C.K. and B.D.; writing original draft preparation, O.P.; writing—review and editing, B.D., H.H., U.S., C.K., N.S., J.F. and J.R.H.; visualisation, O.P.; supervision, H.H. and B.D.; project administration, O.P. and B.D.; funding acquisition, H.H. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of London City and East (Reference: 17/LO/2017).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author. The data are not publicly available as they are still being used for analysis and manuscript writing.

**Acknowledgments:** O.P., U.S. and H.H. receive salary support from the National Institute of Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London (KCL). B.D. was supported by a studentship awarded by the Department of Psychological Medicine, King's College London (KCL) and the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), KCL. U.S. is also supported by an NIHR Senior Investigator Award. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health. J.F. is supported by a University of Manchester Presidential Fellowship (P123958) and a UK Research and Innovation Future Leaders Fellowship (MR/T021780/1) and has received honoraria/consultancy fees from Atheneum, Parachute and Nirakara, independent of this work.

**Conflicts of Interest:** James R. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII®) from the University of South Carolina in order to develop computer and smart phone applications for patient counselling and dietary intervention in clinical settings. Nitin Shivappa is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
