What is inflammation?
Inflammation, a crucial biological process (1) regulated by our innate immune system, is most commonly associated with symptoms such as pain, swelling, redness, and heat resulting from injury or cell damage. However, the inflammatory response and healing process actually involves a balance between pro-inflammatory and anti-inflammatory mechanisms that allow our bodies to repair and recover.
The pro-inflammatory response, known as classical inflammation, is an acute mechanism characterized by cellular destruction and common symptoms of pain, swelling, redness, and heat. The anti-inflammatory mechanism, on the other hand, is responsible for the repair and regeneration of cells, helping the body return to homeostasis. (14)
While the acute inflammatory response is normal and essential to the healing process, chronic or “silent” inflammation, in which the pro-inflammatory response persists at a low level below the pain threshold, has been associated with several chronic health conditions, such as cardiovascular disease, inflammatory bowel conditions, arthritis, cancer, and type 2 diabetes. (3)(5).
Anti-inflammatory nutrition: the role of diet in the inflammatory response
In the past several years, we have seen changes in dietary patterns that may contribute to inflammation and an increase in inflammatory conditions. Three specific dietary trends linked to the increase in silent inflammation include:
- An increased intake of refined carbohydrates;
- Increased consumption of omega-6 fatty acids; and
- A decreased consumption of omega-3 fatty acids (14)
Furthermore, research focusing on the role of diet in inflammation and disease has identified foods and nutrients that affect inflammatory pathways and therefore, modulate levels of inflammation in the body. (9)(13)
This has led to the belief that an anti-inflammatory diet, incorporating an abundance of anti-inflammatory foods and restricting the intake of pro-inflammatory foods, may be a promising approach to targeting inflammation in the body.
Components of an anti-inflammatory diet
The anti-inflammatory diet focuses on the consumption of anti-inflammatory nutrients, including omega-3 fatty acids and an abundance of phytonutrient-rich plant-based foods, such as vegetables, fruits, nuts, and whole grains. The diet also restricts the intake of potentially pro-inflammatory foods, such as refined carbohydrates and saturated or trans-fats. (6)
In addition, the glycemic load (GL) and the composition of omega fatty acids in the diet can impact inflammation. Therefore, two of the most important aspects of the anti-inflammatory diet include maintaining a stable glycemic response and a healthy ratio of omega-3 to omega-6 fatty acids. (5)(11)
Plant-based foods
The effects of an anti-inflammatory diet may be attributed in part to a high intake of plant-based foods, such as fruits, vegetables, and whole grains, which are associated with a lower risk of inflammation. Certain bioactive plant compounds, such as carotenoids and flavonoids, appear to be involved in the modulation of inflammatory and immune processes. (9)(16) In particular, flavonoids, found primarily in plant-based foods such as fruits, vegetables, cocoa, and wine, may target inflammation in a number of ways and are shown to have modulatory effects on inflammatory cytokines and C-reactive protein (CRP) concentrations. (9)Carbohydrates
The quality of dietary carbohydrates appears to be a determinant of their inflammatory potential. While the consumption of whole grains is a component of the anti-inflammatory diet, refined carbohydrates, such as white flours and sugars, have been associated with increased levels of inflammation. This greater inflammatory potential may be a result of their effect on the glycemic response. Ingestion of refined carbohydrates, typically lower in nutrients and fiber, results in an increased glycemic response, classifying them as high glycemic index (GI) foods. High GI foods are a significant dietary factor contributing to inflammation. (8)(14) One study of individuals with type 2 diabetes examined the effects of the glycemic index on body composition, inflammation, and metabolic markers. Reductions in body fat and prevention of negative metabolic and inflammatory markers were noted in individuals following a low GI diet when compared to baseline and individuals following a high GI diet. (7) As high GI carbohydrates appear to contribute to inflammation, carbohydrates included in an anti-inflammatory diet should be composed of non-starchy, low-glycemic vegetables, fruit, and whole grains. These foods provide a high content of polyphenols and help to maintain stable blood sugar and insulin levels between meals. In addition, overeating should be avoided as excess calories in a meal can also raise blood glucose and insulin levels. (14)
Fat
Research has shown that the composition of dietary fat in an individual’s diet can also promote or prevent inflammation in the body. There is some evidence that saturated fats, primarily found in animal products, may promote inflammation by binding to the transmembrane protein TLR-4, leading to the activation of the NF-κB pathway and production of inflammatory cytokines. (14) While saturated fats may play a part in inflammation, much of the research focuses on the role of omega fatty acids, specifically the ratio of omega-3 and omega-6 fatty acids. It was found that the balance of omega-3 and omega-6 fatty acids can affect the eicosanoid formation and the expression of inflammatory genes. (13) Eicosanoids are bioactive signaling lipids involved in the inflammatory response. They are typically produced from arachidonic acid (4), a polyunsaturated fatty acid primarily found in animal foods such as meat, fish, and eggs. (15) Arachidonic acid can also be produced from linoleic acid (12), which is the primary fatty acid found in vegetable oils, such as corn, soy, and sunflower oil. (14) While omega-6 fatty acids are essential to body functions, the ratio between omega-3 and omega-6 is imperative as research has shown higher blood ratios of AA/EPA is correlated with greater levels of silent inflammation in the body. (5) Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), omega-3 fatty acids, well-known for their anti-inflammatory effects, have been shown to partly inhibit inflammatory mechanisms, including the production of eicosanoids derived from arachidonic acid. These omega-3 fatty acids also produce eicosanoids with lower biological potency and anti-inflammatory resolvins and protectins. (2) EPA and DHA are primarily found in seafood, particularly fatty fish, such as mackerel, salmon, sardines, and anchovies. Other plant-based foods like flax seeds and walnuts provide ALA, which can be converted to small amounts of EPA and DHA in the body. (10)Protein
An anti-inflammatory diet is also characterized by reductions of inflammatory arachidonic acid-rich animal proteins. However, even individuals adhering to a vegetarian diet may produce excess AA if they are consuming large amounts of omega-6 fatty acids and carbohydrates with high glycemic indexes. (14) Furthermore, as the insulin response is largely connected to inflammation, the balance of protein and the glycemic load of a meal is essential to preventing unhealthy fluctuations in blood glucose. (13)
Anti-inflammatory foods
Outlined below are the foods to enjoy, moderate, and avoid while following the anti-inflammatory diet.Enjoy
- Beans and legumes
- Fatty fish
- Fruits
- Healthy fats and oils (e.g., extra virgin olive oil, avocado oil)
- Herbs and spices
- Nuts and seeds
- Vegetables
- Whole grains
Moderate
- Eggs
- Dairy
- Meat
- Vegetable oils (unprocessed)
Avoid
- Refined carbohydrates (e.g., white rice, white bread, pasta)
- Processed fats and oils (e.g., margarine, soybean oil, sunflower oil, corn oil)
- Processed foods (e.g., chips, crackers, cookies, pastries)
The bottom line
The key to a successful anti-inflammatory diet is to regulate blood glucose levels and focus your diet on anti-inflammatory plant-based foods and omega-3 fatty acids. To learn more about the anti-inflammatory diet and find out if it’s right for you, be sure to consult an integrative healthcare practitioner for guidance.Help more patients.
right in your Fullscript account!
New to Fullscript? Sign up now.
- Bordoni, A., Danesi, F., Dardevet, D., Dupont, D., Fernandez, A.S., Gille, D., … Vergères, G. (2017). Dairy products and inflammation: A review of the clinical evidence. Critical Reviews in Food Science and Nutrition, 57(12), 2497-2525.
- Calder, P.C. (2013). Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? British Journal of Clinical Pharmacology, 75(3), 645-62.
- Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., … Zhao, L. (2018). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget, 9(6), 7204–7218.
- Dennis, E.A., & Norris, P.C. (2015). Eicosanoid storm in infection and inflammation. Nature Reviews Immunology, 15(8), 511–523.
- Galland, L. (2010). Diet and inflammation. Nutrition in Clinical Practice, 25, 634-640.
- Giugliano, D., Ceriello , A., & Esposito, K. (2006). The effects of diet on inflammation: Emphasis on the metabolic syndrome. Journal of the American College of Cardiology, 48(4).
- Gomes, J.M.G., Fabrini, S.P., & Alfenas, R.C.G. (2017). Low glycemic index diet reduces body fat and attenuates inflammatory and metabolic responses in patients with type 2 diabetes. The Archives of Endocrinology and Metabolism, 61(2),137-144.
- Kim, Y., Chen, J., Wirth, M.D., Shivappa, N., & Hebert, J.R. (2018). Lower dietary inflammatory index scores are associated with lower glycemic index scores among college students. Nutrients, 10(2), 182.
- Minihane, A.M., Vinoy, S., Russell, W.R., Baka, A., Roche, H.M., Tuohy, K.M., … Calder, P.C. (2015). Low-grade inflammation, diet composition and health: current research evidence and its translation. British Journal of Nutrition, 114(7), 999–1012.
- National Institute of Health. (2018). Omega-3 fatty acids. Retrieved from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
- Ricker, M. A., & Haas, W. C. (2017). Anti-inflammatory diet in clinical practice: A review. Nutrition in Clinical Practice, 32(3), 318-325.
- Sanders, T.A.B. (2016). Introduction: The role of fats in human diet. Functional Dietary Lipids, 2016, 1-20.
- Sears, B. (2010). Anti-inflammatory diets. Journal of the American College of Nutrition, 34(Suppl 1),14-21.
- Sears, B., & Ricordi, C. (2011). Anti-inflammatory nutrition as a pharmacological approach to treat obesity. Journal of Obesity, 2011, 1-14.
- Taber, L., Chiu, C.H., & Whelan, J. (1998). Assessment of the arachidonic acid content in foods commonly consumed in the American diet. Lipids, 33(12), 1151-7.
- Watzl, B. (2008). Anti-inflammatory effects of plant-based foods and of their constituents. International Journal for Vitamin and Nutrition Research, 78(6), 293-8.
