Inflammation is a familiar health concept, but it can be hard to understand how it connects to what we eat.
Eating to avoid inflammation isn’t a strict “diet” – it’s simply about eating healthy, in a Mediterranean style that emphasizes whole grains, vegetables and heart-healthy fats, says Julia Zumpano, a registered dietitian with the Cleveland Clinic who specializes in disease prevention and management. “It’s just replacing processed foods with whole foods,” she says.
The principle is simple, but I wondered whether it would be hard to avoid inflammatory foods in practice. What stumbling blocks and questions do people encounter? I decided to spend a week figuring it out.
What is inflammation?
In the case of injury, acute inflammation is a protective response – the body’s way of dispatching resources to a threatened area, like emergency vehicles arriving on scene. This is a healthy reaction intended to promote healing; as a result, we might see swelling at the site of a mosquito bite or feel it in our throats when we have a cold.
But over the past decade, researchers have increasingly drawn attention to chronic, systemic inflammation – a state in which the body remains in a perpetual emergency mode. Chronic inflammation is associated with, though not necessarily the cause of, many major chronic diseases, including autoimmune disorders like rheumatoid arthritis, cardiovascular conditions, neurodegenerative diseases such as Parkinson’s, and cancer.
Chronic inflammation often accompanies ageing, but it can affect people of all ages. In the US, for instance, rates of inflammatory bowel disease have risen sharply, especially among younger populations. “We’re even finding that inflammation is rising in children,” says Zumpano. Many people may not even know they’re experiencing chronic inflammation, as symptoms can be hard to pinpoint. A blood test for inflammatory biomarkers can help, and signs include migraines, brain fog, joint pain and mood disorders like depression.
While some are genetically predisposed to chronic inflammation, Zumpano tells me most people have some level of it. It can be caused or exacerbated by stress, insufficient sleep and exercise. Environmental factors, such as air pollution and chemical exposure and microplastic ingestion, can also contribute.
How can diet affect inflammation?
Diet is one significant factor influencing chronic inflammation, says the Washington-based gastroenterologist Dr Christopher Damman. Sugar, trans and saturated fats, alcohol, refined carbs and ultra-processed foods are all inflammatory. Ultra-processed foods – which comprise about 60% of the American diet, often pack a cocktail of inflammatory preservatives and additives – are a significant source of microplastics and, as Damman points out, usually lack healthy components like fiber that help slow the body’s absorption of sugar.
Eating these foods can lead to spikes in blood sugar, which increases inflammation in immune cells in particular, Damman says, and causes the body to release inflammatory molecules called cytokines. Sugar also “feeds inflammatory microbes in the gut” – essentially “bad” gut bacteria – says Damman, gradually imbalancing our gut microbiome and leading to more inflammation.
Research often supports the potential health benefits of a diet high in anti-inflammatory and antioxidant-rich foods. But studies on supplementation and specific outcomes have been inconsistent, with results varying based on individual health and the form of intake, like food v supplements.
What does an anti-inflammatory diet look like?
I’m pretty familiar with the Mediterranean diet and I assume I can dive right into a week of anti-inflammatory eating. I work from home, I like cooking, I’m not responsible for any picky kids. Easy! But this can-do attitude lasts about 1 minute. Is my oatmeal anti-inflammatory because it’s high-fiber? Or does adding banana and a drizzle of maple syrup make it too sugary?
“A diet that has anti-inflammatory qualities would specifically focus on foods that are high in fiber,” says Dr Qianzhi Jiang, a Boston-based doctor of nutrition and registered dietitian. Prebiotic fiber, an indigestible carb that feeds your good gut bacteria, aiding digestion and slowing the body’s absorption of sugars, is particularly good. Whole grains, beans and many fruits and vegetables are reliable sources. Jiang recommends 25 to 30g of fiber in total and no more than 25g of sugar a day (the US Food and Drug Administration recommends adults consume no more than 50g of added sugar per day).
I estimate my breakfast has 9g of fiber and 16g of sugar. I could do better if I omitted added sweeteners, used lower-sugar fruits like blueberries or raspberries, or did a savory oatmeal with some greens and egg on top.
Jiang suggests I focus on probiotics like those found in yogurt (dairy is not inherently inflammatory unless you have a sensitivity to it) and fermented foods; omega-3 fatty acids, found in oily fish like salmon and sardines, and walnuts, flax and chia seeds; as well as antioxidants, a broad term for compounds that protect against oxidative stress, including phytochemicals such as polyphenols, which are abundant in foods like berries, apples, coffee, cocoa and olives.
“Antioxidant” is essentially just another way of saying “anti-inflammatory”, says Damman – research continues to uncover how antioxidants combat inflammation in powerful and multifaceted ways that should not be underestimated. “They’re best taken in the context of whole foods, whole plants,” he says.
Eggs, rich in omega-3, are a good choice, plus vegetables like spinach and mushrooms. One day, I do a Japanese-inspired breakfast: a boiled egg, tofu, kimchi, and a scoop of cucumber and avocado salad with umeboshi dressing that contains polyphenol-rich preserved plums, olive oil, rice vinegar and soy sauce.
Is salt inflammatory?
My mid-morning snacks consist of roasted, salted edamame beans and extremely salty oil-cured black olives. I also have antioxidant-rich pomegranate seeds, but mostly I indulge my goat-like craving for a salt-lick.
Unfortunately, “excessive salt intake can be inflammatory”, says Jiang. “Studies have found increased levels of inflammation in animal models and humans, especially patients with hypertension and heart failure.”
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What’s the relationship between meat and inflammation?
Over the weekend, I’d made a huge batch of bolognese sauce. Generally, anti-inflammatory eaters are advised to avoid red meat. But the problem isn’t meat itself – it’s saturated fat, which in excess both triggers and aggravates pre-existing inflammation, says Jiang.
My bolognese contains ground bison, which is lower in saturated fat than beef. Not the worst outcome.
Processed meat like salami or hot dogs are the biggest no-nos due to their high saturated fat content and additives like nitrates and preservatives, which can trigger inflammation. But moderate portions of unprocessed meats like chicken breast or lean cuts of steak you buy from the butcher and cook at home are not inherently inflammatory.
However, cooking methods can affect how inflammatory they are. High temperature cooking like grilling or frying creates pro-inflammatory compounds called advanced glycation end products (AGEs), whereas water-based methods like poaching or stewing do not.
I consider my bison bolognese a stew and eat it with steamed sweet potatoes.
How much of your food intake should be anti-inflammatory?
I feel like I’m doing pretty well with the challenge. One night, I make a soba noodle salad loaded with veggies and edamame. On another, I make a poke bowl with wild salmon, an omega-3 powerhouse, over greens and mixed-grain rice.
Then, one evening, friends come over for a movie night. I’d originally pictured it as a pizza-type affair, but instead I get on my high horse and make soup with roasted squash, ginger, cilantro and lime. I’m proud of my resolve … until people arrive bearing microwave popcorn, Doritos and my favorite Haribo peaches. I have a sweet tooth and have mostly been able to rein it in – but now I fold like a lawn chair. Have I thrown off my whole week?
According to Zumpano, my hiccup will not “necessarily undo” my other efforts. “Think of your body as a bucket,” she says. “Processed foods, environment toxins, stress and lack of sleep all contribute to filling your inflammation bucket. When you changed your diet to reduce inflammation you emptied a good amount from the bucket. If you have a pro-inflammatory meal, but you get back on track, you’re not going to suddenly overfill it.”
Sticking to an 80/20 rule, in which 80% of your diet is anti-inflammatory and 20% is on the less healthy side, can still help keep an otherwise healthy person’s inflammation in check, Zumpano says.
What are the best anti-inflammatory drinks?
An anti-inflammatory diet avoids alcohol, sugar and artificial sweeteners. This means limiting juice, soda, energy drinks, fruit-based smoothies and more.
I drink many cups of unsweetened green tea (high in polyphenols), mint tea (antioxidant and stomach-soothing) and ginger tea. I make the latter myself by blending fresh ginger, an especially potent anti-inflammatory, and freezing it into cubes. I also have lots of coffee, which is actually one of the top dietary sources of antioxidants for Americans.
Golden milk, made with ginger, turmeric and plant-based milk with a dash of black pepper and cinnamon, is a good way to combine anti-inflammatory ingredients. Data shows that ginger and turmeric can be anti-inflammatory, says Zumpano, though she notes that research tends to look at high dosage supplements v dietary inclusions.
Is it easy to follow an anti-inflammatory eating plan?
Overall, anti-inflammatory eating is a long-haul practice requiring a fairly consistent level of self-awareness and commitment; a lifestyle, not a diet. But it’s fundamentally simple: eat lots of plants, avoid refined and ultra-processed options and if you hoover up a bunch of Haribo, well, there’s always tomorrow.