What is an anti-inflammatory diet?

What is the best diet for chronic fatigue syndrome and fibromyalgia? What constitutes an anti-inflammatory diet? What foods are best to reduce inflammation?

Far too many diets are named and trademarked for the purpose of selling books and products. Because of this, it can be easy to lose sight of what these diets are truly comprised of. An anti-inflammatory diet is one such example. So what is it exactly?

First, let us describe the opposite—an inflammatory diet. This is defined in the literature as food that has a high inflammatory potential. These foods promote the release of inflammatory molecules—cytokines—from cells and tissues. With chronic consumption, a smoldering ensues which has been linked to everything from heart disease, fatty liver, diabetes, and depression.

Foods with a high inflammatory potential are not surprisingly those that are heavily processed—commonly referred to as “industrial foods.” Foods high in refined sugars, artificial flavorings, shelf stabilizing fats, processed cooking oils, and made-to-look-like-real-food vegan/vegetarian items.

Specific examples include sodas, vegetable oil, cookies, chips, pre-made desserts, dinners, and snacks. It goes without saying that if the ingredients list is a mile long and unpronounceable, it is a processed highly inflammatory food.

This you likely already know, and it is one of the few things all nutritionists can agree on. But what an anti-inflammatory diet is, is less clear.

One common thought about anti-inflammatory diets is centered on the ratio of omega fats in foods. Though rather simplistic, we are taught that omega-3 fats are anti-inflammatory, while omega-6 fats are pro-inflammatory. Some authors suggest a ratio of omega 6 to omega 3 in the range of 3:1. Comparatively, the standard Western diet is estimated to be in the range of up to 20:1, resulting in a high inflammatory potential.

We commonly take medications to block the inflammatory effects of omega fat metabolism. These include ibuprofen and the like, which block enzymes that produce inflammatory molecules. A better solution is to consume fewer fats which initiate this inflammatory pathway.

Foods High in Omega-3

Fish, eggs, shellfish, walnuts, chia, flax, hemp seed, and Brussels sprouts

Another way to define an anti-inflammatory diet is one that is rich in nutrients that have the ability to block or reduce inflammatory cytokines. This includes foods containing phytonutrients and certain amino acid-like nutrients.

Phytonutrients are abundant in colorful foods and culinary spices. Eat color and spice and everything nice. Many of these act like anti-oxidants, reducing inflammation by stabilizing reactive oxygen species.

Keep in mind that many phytonutrients are fat soluble. This means that these foods should be prepared and consumed in the presence of cooking fats in order to be utilized for cellular processes.

Foods High in Phytonutrients

Carrots, blueberries, capsaicin, ginger root, beets, leafy greens, tomatoes, garlic, onions, dark chocolate, red wine, and green tea

Culinary Spices High in Phytonutrients

Curcumin (turmeric), black pepper, cloves, cinnamon, oregano, thyme, sage, rosemary, saffron, and tarragon

The amino acid betaine (trimethlyglycine, TMG) and nutrient choline are considered anti-inflammatory. While the body synthesizes these compounds on its own, consuming foods high in both are associated with positive outcomes. In the ATTICA study, which comprised 1514 Greek men and 1528 Greek women, those with the highest dietary intakes of choline and betaine also had the best health outcomes based on blood markers of inflammation.

Foods High in Betaine

Spinach, shrimp, wheat bread, and raw mushrooms

Foods High in Choline

Liver, eggs, pork, beef, cod, shrimp, salmon, oat bran, Brussels sprouts, broccoli, and cauliflower

How can I tell if my diet is anti-inflammatory?

Routine blood tests are the best for assessing the inflammatory potential of your diet. Ask your doctor to measure C-reactive protein (hsCRP) and homocysteine. Those with ME/CFS, may also consider adding blood measures for interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-a). More specific testing can also be measured via specialty lab by doing a blood spot analysis of omega fats to determine your ratio.

Should I supplement with these in addition to, or in lieu of, eating them?

That depends. Generally speaking, nutrients are better absorbed and utilized in the body when consumed in their natural state in foods. In some instances, based on lab work and health condition, addition of the above in supplement form may be necessary. Those with the highest degree of inflammation such as inflammatory arthritis and ME/CFS, would likely benefit from supplemental anti-inflammatory support.

Tolkien K, Bradburn S, Murgatroyd C (2018) An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis. Clin Nutr. pii: S0261-5614(18)32540-8.

Detopoulou P, et al (2008) Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study. The American Journal of Clinical Nutrition, Vol 87, Issue 2:424–430.

Ingvild Paur, Monica H. Carlsen, Bente Lise Halvorsen, and Rune Blomhoff. Ch 2: Antioxidants in Herbs and Spices: Roles in Oxidative Stress and Redox Signaling. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Benzie IFF, Wachtel-Galor S, editors. Boca Raton (FL): CRC Press/Taylor & Francis; 2011.

dietDr. Craigdiet, inflammation