The Dish: Anti-Inflammatory Diets

Client Question of the Week: “What’s with all the talk about an anti-inflammatory diet? Is that something I should be following?” 

There is SO much information floating around about inflammation and anti-inflammatory food/supplements, and it’s often hard to distinguish fact from fiction. Unfortunately, strategic marketing and the misrepresentation of products and research have interfered with the integrity of many food and health claims. 

So let me break it down for you…

What is inflammation?

In general, inflammation is part of the natural immune response our body has to damaged cells and harmful stimuli like bacteria, toxins and viruses. This allows our bodies to heal from intense exercise or injury and helps to remove disease-causing organisms and foreign invaders. Sounds like inflammation is on our side, right? 

Well, I should probably distinguish between the two kinds of inflammation: acute and chronic. 

With acute, think ‘short-term’. Acute inflammation describes the healthy immune response your body has to damaged cells, allergens, or other harmful stimuli. Your body responds by sending out an army of chemicals/substances to fight the foreign invaders, protect the affected area and promote healing. When you are healed, the inflammation is no longer present. Problem solved! 

But… 

Chronic inflammation can develop when this immune response is not alleviated and becomes exhausted. While many inflammatory conditions create discomfort and are therefore detectable and treatable, such as arthritis, heart burn or inflammatory bowel disease (Chron’s or ulcerative colitis), we can’t actually feel chronic low-grade inflammation. And when this inflammation persists undetected for many years, we are at increased risk for many health conditions such as diabetes, heart disease, autoimmune disorders, kidney disease, dementia and cancer(1).

Why do dietitians and other health professionals talk so much about anti-inflammatory foods?

Because the typical American diet and obesity both promote inflammation. However, adopting more plant-based dietary patterns(which doesn’t necessarily mean vegetarian or vegan!) may help prevent chronic inflammation from evolving.

Well, how do I know if I have chronic inflammation?

Your healthcare provider can offer a blood test to test for markers of inflammation. Common markers include C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) among others. Although we know a lot, there is still much more to learn about detecting and treating low-grade chronic inflammation.

What does the research have to say about diet and inflammation?

Research on this topic often involves measuring how certain foods, diets or lifestyle factors impact inflammatory blood markers. It is important to note that most of this research is done on laboratory animals. 

There are 2 diets that have been named “anti-inflammatory diets”, because they have been proven to help reduce inflammatory markers, namely C-reactive protein. These include the Mediterranean diet and the DASH diet. Whole30 calls itself “anti-inflammatory”, but because it is only a 30-day plan AND because it bans essentials food groups (grains, beans/legumes, dairy), I do not recommend adopting whole30 as a lifelong anti-inflammatory food guide.

So do you need to strictly adopt one of these diets to reduce inflammation?

Not necessarily! Instead, let’s take a look at what these two diets have in common and discuss practical changes you can make to help protect your cells!

1.    Focus on fruits, vegetables and whole grains. A higher intake of fruits and vegetables leads to a decrease in inflammatory markets C-reactice protein and TNA-alpha(2). In unhealthy individuals, markers of inflammation have improved with higher intakes of whole grains(3). It is therefore suspected that the many vitamins, minerals, fiber and phytonutrients in these plant foods work together to ward off chronic inflammation(4).

2.    Choose healthy fats. Replacing solid fats with healthy oils is a great first step to promote overall health and longevity. Specifically, olive oil intake has been shown to decrease the inflammatory markers CRP and IL-6(5). In a review of studies that tested the effects of omega-3 fats on inflammatory markers, results were surprisingly inconclusive(6). More important than omega-3 fatty acid intake alone seems to be maintaining a high RATIO of omega-3 to omega-6(6). While omega-6 fatty acids are also essential, meaning our bodies can’t make them and need them from foods, they can actually CONTRIBUTE to inflammation. More research needs to be done on this topic. What you CAN do is continue choosing foods rich in omega-3s, like cold-water fish, fresh ground flax and walnuts. You may want to try a fish oil supplement that is rich in both EPA and DHA. These are the building blocks for hormones that control immune function, blood, clotting, cell growth and structure. 

What are the main sources of omega-6 fats in the American diet? 

The refined oils often used in snack foods, fast foods, cookies, crackers, and sweets. Think corn oil, sunflower oil, safflower oil, soybean oil. Do you choose these foods often? Try snacking on whole foods instead of processed options. You can also make your own snacks using olive oil.

3.    INCLUDE dairy! Dairy foods offer lots of protein, calcium, and other nutrients that may actually help reduce chronic inflammation. In a recent meta-analysis, higher dairy intake compared with low or no intake reduced CRP, TNF-alpha, and IL-6 inflammatory markers (7).

4.    Reduce your sodium intake. Processed and restaurant foods are often very high in sodium. When we eat these foods in excess, our cells retain water, which can cause them to swell and increase blood pressure among other things. Try to choose foods high in other minerals like potassium, calcium and magnesium. Fruits, grains, vegetables, legumes, nuts and seeds with minimal added salt/sodium are all great options!

5.    Consider reducing your meat intake, especially options high in saturated fat and sodium. As a whole, plant-based foods are greatly associated with overall improvement in inflammatory markers when compared to other diet patterns (4). You don’t have to cut meat out entirely, but simply reduce! : ) 

6.    Maintain healthy habits. Alcohol, smoking, stress, lack of sleep, lack of physical activity and obesity can all contribute to chronic inflammation. Work towards making healthier choices. Don’t know where to start? Let’s talk about it! 

Can’t I use over-the-counter drugs and supplements for inflammation?

Many rely on nonsteroidal anti-inflammatory drugs (NSAIDs) like Aspirin to reduce inflammation. Additionally, there are several herbal/spice products marketed as anti-inflammatory like matcha/green tea, ginger, turmeric/curcumin, antioxidants powders, etc. While many compounds in herbs and spices HAVE been shown to help combat inflammation, the dose and frequency needed to achieve the desired outcome is often very high. It is also important to recognize that none of these options negate the damage of poor diet and lifestyle choices. Unfortunately, there is no crutch or quick-fix when it comes to physical and mental health.

The bottom line: Eating with inflammation in mind doesn't have to be complicated or restrictive. In fact, the foods that are anti-inflammatory are typically the same foods that can help support your overall health! 

Next week, I’ll be releasing a blog post about inflammation, diet and supplementation as it relates to sport and exercise.

* These recommendations are generalized. Please consult your primary care doctor or a registered dietitian for individualized guidance! You can schedule a consult with me by pressing the button at the bottom of this page.

-Kylie

References

1.    Furman, D., Campisi, J., Verdin, E. et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 25, 1822–1832 (2019). https://doi.org/10.1038/s41591-019-0675-0

2.    Banafshe Hosseini, Bronwyn S Berthon, Ahmad Saedisomeolia, Malcolm R Starkey, Adam Collison, Peter A B Wark, Lisa G Wood, Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis, The American Journal of Clinical Nutrition, Volume 108, Issue 1, July 2018, Pages 136–155, https://doi.org/10.1093/ajcn/nqy082

3.    Rahmani, S., Sadeghi, O., Sadeghian, M., Sadeghi, N., Larijani, B., & Esmaillzadeh, A. (2020). The effect of whole-grain intake on biomarkers of subclinical inflammation: a comprehensive meta-analysis of randomized controlled trials. Advances in Nutrition, 11(1), 52-65.

4.    Eichelmann, F., Schwingshackl, L., Fedirko, V., & Aleksandrova, K. (2016). Effect of plant‐based diets on obesity‐related inflammatory profiles: a systematic review and meta‐analysis of intervention trials. obesity reviews, 17(11), 1067-1079.

5.    Schwingshackl, L., Christoph, M., & Hoffmann, G. (2015). Effects of olive oil on markers of inflammation and endothelial function—a systematic review and meta-analysis. Nutrients, 7(9), 7651-7675.

6.    Natto, Z. S., Yaghmoor, W., Alshaeri, H. K., & Van Dyke, T. E. (2019). Omega-3 Fatty Acids Effects on Inflammatory Biomarkers and Lipid Profiles among Diabetic and Cardiovascular Disease Patients: A Systematic Review and Meta-Analysis. Scientific reports, 9(1), 1-10.

7.    Moosavian, S. P., Rahimlou, M., Saneei, P., & Esmaillzadeh, A. (2020). Effects of dairy products consumption on inflammatory biomarkers among adults: A systematic review and meta-analysis of randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases.