What is an anti-inflammatory diet?
Our expert nutritionist explains whether the foods we eat can help counter inflammation-related health conditions
This article is not intended as medical advice. If you are concerned about symptoms, speak to your GP about your treatment plan before making any changes to your diet.
What is inflammation?
We tend to think of it as something to be avoided at all costs, but inflammation is a natural response actioned by our immune system. In certain circumstances, inflammation helps keep us well and protects us from infection and tissue damage following injury. This is when inflammation is short-term and in response to something that our body interprets as harmful, whether that’s a bacteria or virus, an injury from a cut or burn, or exposure to a toxin. Inflammation involves a series of complex chemical reactions that result in the classic signs of inflammation – swelling, redness, heat, pain and possible loss of tissue function at the wound site or injury.
It is when our immune system fails to switch off the inflammatory process that problems may occur. What should have been an acute, fast-acting reaction is at risk of becoming a chronic, long-term condition with a damaging impact on our health and wellbeing. Our lifestyle may also be a risk factor for some inflammatory conditions – obesity and being overweight in particular puts you at a greater risk. Other inflammatory conditions have a hereditary connection; these atopic conditions include asthma, allergy and skin conditions such as eczema and psoriasis.
What is an anti-inflammatory diet?
Following an anti-inflammatory eating plan may help manage symptoms by reducing the effects of inflammation. The 'diet' advises the restriction of certain foods while encouraging others, and may recommend eating at specific times to influence the inflammatory process.
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An anti-inflammatory diet focuses on foods that are rich in healthy fats, lean proteins and plant compounds – so whole plant-based foods and oily fish are key. The diet also aims to stabilise blood sugar, and by so doing regulate insulin response. This is important because insulin may influence the control mechanisms that manage the inflammatory process.
How does the anti-inflammatory diet work?
Inflammation is thought to be at the root of a number of chronic diseases, including auto-immune diseases such as lupus and rheumatoid arthritis, as well as cancer, heart disease, diabetes, bowel diseases, depression and Alzheimer’s. The anti-inflammatory diet works by reducing the intake of pro-inflammatory foods whilst promoting those that may help reduce inflammation. Some of the components of the diet, like oily fish and unsalted nuts contain omega-3 fatty acids that may partly inhibit aspects of inflammation, while others are high in protective compounds, called antioxidants, that help prevent the inflammatory effects of an everyday process, called oxidation.
How to follow an anti-inflammatory diet
Rather than being a strict ‘diet’, the anti-inflammatory diet is more a set of guiding principles that influences how you select, prepare and eat food. Typically, fast and processed foods that are high in fat, sugar and salt are eliminated (or at least minimised) and replaced with whole foods with an emphasis on colourful fruit and vegetables, fish and other lean proteins and wholegrains.
Most experts advocate a Mediterranean-style of eating, because it is thought that the variety of whole foods typical in a traditional Mediterranean diet work together to promote the desired anti-inflammatory effects, rather than one specific food being the answer. However, it’s worth remembering that the ideal composition of your diet may vary depending on the inflammatory process involved. For example, if you carry a lot of extra weight, you may benefit from more protein in your diet, because protein promotes a process called thermogenesis which helps with weight management and hormonal control. Similarly, a food that may typically work to reduce inflammatory symptoms for most people may have the opposite effect if you happen to have an intolerance or allergy to it.
There is also the question of meal timing; the very action of eating is pro-inflammatory, so allowing the gut time to rest by adopting the approach of an eating window may prove helpful.
Foods that may reduce inflammation
Olive oil is a key component of the Mediterranean diet and a rich source of beneficial mono-unsaturated fats. The oil described as extra-virgin is minimally processed and retains more protective plant compounds known as polyphenols, which may be effective against inflammation and pain. As a guide, aim to include 1-2 tbsp oil in your diet daily.
Fatty fish including salmon, trout and sardines
Fatty varieties of fish, such as salmon, trout and sardines, supply long-chain omega-3 fatty acids that have potent anti-inflammatory properties. Aim for at least two portions (140g cooked weight) weekly.
These are a source of omega-3 fatty acids, although in the less active short chain form. Walnuts are an especially good source.
Colourful fruit and vegetables
Leafy greens, berries and avocado contribute beneficial plant compounds, which help lessen the effects of inflammation. Include at least five portions of different fruit and vegetables in your diet daily, and choose from a variety of colours like dark green, orange, yellow, red and purple.
Non-starchy vegetables and wholegrains
These provide fibre and slow-releasing energy that help stabilise blood sugar and insulin response. We describe these foods as having a low glycaemic index (GI). Combining these with healthy fats and lean protein reduces the glycaemic load of a meal.
Foods to avoid with an anti-inflammatory diet
Highly processed or refined foods
These are easily broken down by the body and rapidly absorbed, which means they may cause spikes in blood sugar and as a result trigger insulin. They are also typically of low nutritional value and easy to overeat. Examples include white rice, bread, pasta and processed foods, all of which have a high glycaemic load.
Sugary food and drinks
Cakes, biscuits and fizzy drinks disrupt blood sugar and promote the release of inflammatory chemicals, called cytokines.
Foods high in fat and sugar
These are associated with reduced gut health and can disrupt the beneficial bacteria that live there. This can lead to compounds known as endotoxins passing into the bloodstream and triggering an inflammatory response.
Processed seed and vegetable oils
These are rich in omega-6 fatty acids. Early research suggested that too many of these omega-6 fats may have a pro-inflammatory effect. However, more recent findings suggest this is not quite as clear-cut as was originally thought, but because our modern diets contain such a lot of them we should try to minimise our intake, and focus instead on foods rich in omega-3 fatty acids.
Higher consumption of meats such as bacon, sausages and salami is associated with increased inflammation, especially for those who are overweight.
Although low to moderate consumption of alcohol, most notably red wine may offer benefits, consistent higher levels triggers inflammation.
Does the anti-inflammatory diet work for weight loss?
Obesity is a silent inflammatory condition, where the excess fat causes over-production of inflammatory chemicals. It is referred to as 'silent' because it takes place without pain. In time, this may lead to systemic inflammation, metabolic syndrome and eventually type 2 diabetes. Following a calorie restricted, anti-inflammatory diet comprising low GI foods, whole-grains, legumes, nuts, seeds, fish, olive oil and colourful fruit and vegetables may be effective both for weight loss and for reducing the more problematic weight around the middle, known as belly fat.
Are anti-inflammatory diets effective?
We all have a unique immune system that responds to circumstances differently, so the effects of any dietary protocol will vary from person to person. Other factors include the level of compliance with the diet and your commitment to make positive change. With this in mind it is important that any ‘diet’ take account of your personal likes and dislikes, as well as your lifestyle, because to be effective long-term, you will need to be compliant for life.
The complexity of the inflammatory process explains why many people find a multi-pronged approach best for helping manage their symptoms. An anti-inflammatory diet may form part of this approach, but may not switch off inflammation on its own. That said, evidence supports that for some people, the right diet may well ease symptoms or act as a valuable complement to medical or physical interventions, making day-to-day symptoms more manageable.
Does an anti-inflammatory diet work? A nutritionist’s view…
Generally speaking, the healthy principles on which an anti-inflammatory diet is founded makes this way of eating beneficial for everyone, regardless of whether or not they suffer from an inflammatory condition. This is because the diet promotes blood sugar control, includes adequate dietary fibre, promotes beneficial fats, lean protein and supplies protective plant compounds.
However, you should remember that diet alone is unlikely to be the answer for all people and, in such cases, it is worth considering other influences on the immune system. One factor to consider is light exposure – 80% of our immune system is under the influence of the circadian rhythm, and with modern lifestyles exposing us to more artificial light, including increased screen time, it may be worth reviewing your daily habits. Aspects to consider include access to the outdoors during daylight hours, especially in the morning, as well as screen use during the evening. Stress, insufficient physical activity, smoking, excess alcohol and lack of sleep also promote inflammation.
Although diet may be effective in easing symptoms and aiding day-to-day management, it is important for anyone with a chronic inflammatory condition to follow a comprehensive treatment plan that's been approved and is overseen by a GP or registered health practitioner.
A note on ‘anti-inflammatory’ claims
In both Great Britain and the European Union the term ‘anti-inflammatory’ is not an authorised health claim; this means no commercially sold food may carry this claim on its food label.
Kerry Torrens is a qualified Nutritionist (MBANT) with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food.
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