Prebiotic problems for some people

An Anti-Inflammatory Diet: What makes sense?

How many times have you seen “Top 10 Foods to Fight Inflammation”? Why is it that two months later a similar list has different foods key to an anti-inflammatory diet? Did the foods first identified as “absolutely best” suddenly lose their benefits? Did research suddenly come to a whole new understanding of how to beat the chronic inflammation that’s considered a key element in development of many chronic diseases like cancer and heart disease?

Research has been progressing in identifying how eating habits and lifestyle choices can either promote or reduce chronic inflammation. In this article, you’ll get an update on our understanding of inflammation, and solid tips on how to set priorities among choices you can make to quench it.

Anti-Inflammatory Diet: Finding Net Protection

Although individual nutrients and plant compounds may show effects promoting or reducing inflammation in lab studies, when it comes to chronic inflammation in your body, it’s the net effect of how everything comes together that matters. Although that means that you can’t “undo” the damage of an overall unhealthy diet with one simple food or supplement, the good news is that you can create an anti-inflammatory diet with simple swaps. You need not feel compelled to load up on any specific food.

What turns eating habits into inflammation-busters?

1. Make vegetables and fruits a highlight each time you eat.

These are prime sources of vitamin C and beta-carotene, antioxidants that can quell the oxidative stress that can ignite inflammation. Better than getting these nutrients from a supplement or fortified food, vegetables and fruits also provide a wide range of natural compounds called flavonoids that offer the double-quenching power of turning on body antioxidant defenses and acting through other systems directly helpful in dialing down cells’ inflammatory signals. And their dietary fiber seems to play a key role, too, apparently at least in part through protective effects of a compound called butyrate that gut bacteria produce from fiber.

Making it doable:

  • You don’t have to re-do your usual meals completely. Whether mixed together in stir-fries and other combination dishes, or when each food has a place of its own on the plate, most of us will do better by doubling the usual portion of vegetables.
  • Variety matters. Potatoes and tomatoes account for more than half of Americans’ vegetable consumption. Doubling vegetables should not refer to doubling French fries and chips, the choices that account for a large portion of our potato consumption. Have fun exploring more dark green leafy vegetables, cruciferous vegetables, mushrooms and more. Apples and bananas are terrific take-and-go fruits, but move outside the box to include choices high in flavonoids and fiber by choosing berries regularly and enjoying citrus fruit rather than only its juice.
  • Make them delicious! But swap the cheese-smothered and deep-fried vegetables for choices flavored with onion and garlic (which add flavonoids of their own), lemon or lime juice, balsamic vinegar, salsa or a Greek yogurt-based dip. I grew up avoiding vegetables because they were always overcooked and mushy. I became a vegetable-lover when I learned to stir-fry, grill and oven roast them.
2. Be smart about grain choices and portions to avoid big surges in blood sugar and oxidative stress after you eat.

Whole grains boost your anti-inflammatory diet power because they provide different types of flavonoids and fiber beyond what you get from vegetables and fruits. However, as healthful as they are, keep portions appropriate for your calorie needs. Mega-calorie-burning athletes and some vegan vegetarians need more, but for many adults, one cup of cooked grains like pasta, rice or quinoa (comparable to two slices of bread) is plenty per meal.

Making it doable:

  • Swap refined grains like white bread, white rice, refined flour tortillas and regular pasta for whole grain options. Learn about quick-cooking options, if a time crunch has been the barrier for you. Transition to the heartier flavor by starting with flavorful pasta sauces or plenty of garlic and your favorite spices.
  • Don’t overdo. If you have a cup of cooked whole grains, then you probably don’t need to dip into the bread or tortilla basket that may appear on the table if you’re eating out. If the bread is a highlight, then orient the rest of your meal around non-starchy vegetables and seafood, beans, poultry, or a modest meat portion.
3. Include fat from foods linked with overall health.

Some books and articles you read may make it seem that scientists have it all figured out when it comes to fat in an anti-inflammatory diet, but that is not true. Omega-3 fats, like those found in salmon and other cold-water fish, promote production of anti-inflammatory hormone-like substances. Although the omega-3 fat found in plant foods (like soy foods, walnuts and canola oil) doesn’t promote nearly as much of these anti-inflammatory eicosanoid compounds, the net effect they have in a diet seems beneficial. And although you’ve undoubtedly heard the omega-6 polyunsaturated fats (the major fat in many vegetable oils and nuts) labeled as unhealthy promoters of inflammation, overall research is not clear on that. Studies show that these omega-6 fats form substances that stimulate inflammation and also anti-inflammatory proteins called lipoxins. Including more foods that supply omega-3 fat is clearly recommended for health. Recent studies suggest that saturated fat may promote inflammation in addition to its better-known raising of LDL cholesterol, so reducing high-fat meats is smart.

Rather than rejecting omega-6 fat, for now it’s probably more important to consider the foods in which they are found. It’s reasonable that large amounts of polyunsaturated oil in deep-fried foods, refined grain convenience foods and sweet desserts could affect inflammation and overall health quite differently than nuts and oils that contain or accompany foods rich in fiber and protective nutrients and phytochemicals. Fat included in a meal tends to slow down the rise in blood sugar that follows, benefiting insulin levels, oxidative stress and inflammatory signals. In reviewing research on nutrients and foods effects on inflammation in creating the Dietary Inflammatory Index (DII), researchers designate omega-6 polyunsaturated fat as anti-inflammatory (just not nearly as powerfully as omega-3 fat).

Making it doable:

  • Swap some of your meat-based meals for fish choices. Try salmon burgers, fish tacos, tuna or other seafood in a main dish salad, and shrimp on pasta or when grilling.
  • Choose nuts instead of croutons in salads. Keep small one-handful-size bags of nuts in your desk for a quick mid-afternoon hunger or energy saver instead of heading to the vending machine.
4. Balance calories in and out.

Excess body fat may be the single largest influence on markers of inflammation. As people become overweight, fat cells enlarge and increase production of certain proteins (such as interleukin-6 and tumor necrosis factor-alpha) that stimulate inflammation throughout the body. Fortunately, even a 6.7 percent weight loss (that could be 10 or 15 pounds) as part of a healthy lifestyle is enough to reduce a marker of inflammation called hsCRP by nearly 25 percent. Boosting physical activity makes reaching and maintaining a healthy weight easier and seems to have direct anti-inflammatory effects beyond weight, too.

Making it doable:

  • Look for a few small habit changes that could allow you to cut a few hundred calories a day without going hungry or feeling deprived. If you regularly include sugar-sweetened soft drinks, sugar-laden chai tea or coffee with sweet syrup and whipped cream, saving those for a weekly treat is an easy start.
  • When you need a stress-reducing, energy-reviving break, take a 10-minute walk instead of turning to empty-calorie food or checking your favorite social media page. Then decide if you actually need some nutrient-rich food or if the break was all you needed.
  • It’s easy to think that a daily walk “isn’t working”, since any weight loss it brings is gradual. But each time you’re active, you’re enhancing inflammation-fighting signals in your body. Find a way to include a few breaks with at least 10 minutes of walking at the start, mid-point and ending of your day.

Three Key Points on Inflammation

It’s Important. Chronic, low-grade inflammation seems to damage body tissues in ways that promote chronic diseases we often link to “aging”. Inflammatory cells have been found in the fatty plaque that builds up in blood vessels and leads to heart disease. Inflammation seems to cause cell changes that result in inability to respond to insulin appropriately, increasing risk of type 2 diabetes. Inflammation may also promote cancer development by damaging our genes, increasing cell turnover and increasing development of blood vessels that allow cancer cells to grow and spread.

It’s Complicated. As much as we might like a simple solution, inflammation is promoted by surging blood sugar levels, oxidative stress beyond what our antioxidant defenses can control, inflammatory hormones and protein from excess body fat and a lifestyle that’s too sedentary. On the flip side, healthy eating and lifestyle habits work in multiple ways to fight inflammation. Our microbiota (the health-promoting bacteria in our gut) can convert dietary fiber and certain compounds in vegetables, fruits, whole grains and beans into anti-inflammatory compounds. Plant-focused eating habits allow us to feel full on fewer calories to reach and maintain a healthy weight while supporting antioxidant defenses. It all works together.

It’s Open to Change. Numerous studies show that with changes in lifestyle, markers of inflammation can change. People with elevated markers of inflammation tend to show the greatest reductions when weight, eating habits and lifestyle changes. Of course, anti-inflammatory compounds have a limited time circulating through your body providing protection. You need to keep the balance of your choices heading in an overall anti-inflammatory protective direction.

Bottom Line:

We still have much to learn about how to best measure and avoid or dial down chronic inflammation. Doing so does seem to offer a way to a streamlined approach to lower risk of multiple health problems. Rather than pinning hopes on a few ultimate “anti-inflammatory foods”, research suggests that plant-focused eating habits including a wide variety of vegetables and fruits, combined with backing away from indulgence in sweets and other foods higher in calories than nutrients, sets us in the right direction. Lifestyle choices like keeping physically active and avoiding tobacco are other essential ingredients.

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Helpful Resources:

Need help learning to choose and prepare whole grains more often? The Whole Grains Council has everything you need from recipes to shopping tips.

Trying to simplify the wide-ranging concepts of healthy eating into some solid overall doable habits? The American Institute for Cancer Research (AICR) has an approach called the New American Plate, with tips on meal and snack ideas and finding ways to get more active.

References:

Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev. 2013; 71(8):511-527.

McArdle MA, Finucane OM, Connaughton RM, McMorrow AM, Roche HM. Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritional strategies. Front. Endocrinol. 2013 May 10;4:52.

Minihane AM, Vinoy S, Russell WR et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015 Oct 14;114(7):999-1012.

Nicklas JM, Sacks FM, Smith SR et al. Effect of Dietary Composition of Weight Loss Diets on High Sensitivity C-Reactive Protein: The Randomized POUNDS LOST Trial. Obesity (Silver Spring). 2013 Apr;21(4):681-689.

Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014 Aug;17(8):1689-1696.

Smidowicz A, Regula J.  Effect of nutritional status and dietary patterns on human serum C-reactive protein and interleukin-6 concentrations. Adv Nutr. 2015 Nov 13;6(6):738-747.

van Gemert WA, May AM, Schuit AJ et al. Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev. 2016 May;25:5 799-806.

2 Comments

  1. Dorothy Humm, MBA, RDN, CDN on March 7, 2017 at 5:25 pm

    Thank you for your info on anti-inflammatory diet. As an RDN who retired 4 years ago and is now facing many of the challenges that my clients faced, I appreciate info that is more than the general “blah-blah-blah” that doesn’t tell me anything new. I look forward to hearing you on Thursday, May 11th at Lake Placid NYSAND Centenial meeting.

    • Karen on March 10, 2017 at 8:29 pm

      Thank you for your kind words, Dorothy! I am very much looking forward to being at the NYSAND meeting. I love connecting with colleagues and helping people break through Information Overload. See you in Lake Placid! [ http://www.eatrightny.org/2017-ame ]

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Meet the author/educator

Karen Collins
MS, RDN, CDN, FAND

I Take Nutrition Science From Daunting to Doable.™

As a registered dietitian nutritionist, one of the most frequent complaints I hear from people — including health professionals — is that they are overwhelmed by the volume of sometimes-conflicting nutrition information.

I believe that when you turn nutrition from daunting to doable, you can transform people's lives.

Accurately translating nutrition science takes training, time and practice. Dietitians have the essential training and knowledge, but there’s only so much time in a day. I delight in helping them conquer “nutrition overwhelm” so they can feel capable and confident as they help others thrive.

I'm a speaker, writer, and nutrition consultant ... and I welcome you to share or comment on posts as part of this community!

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