An Evidence-Based Anti-Inflammatory Diet
An anti-inflammatory diet is a highly effective lifestyle tool to stop inflammation in its tracks and change the course of an autoimmune disease. You can literally make or break inflammation by how you eat. You probably know this already, and that’s why you’re here – because you’re interested in a food-first approach to de-inflame your body.
But what does this mean exactly? What is an anti-inflammatory diet? You may be confused by the information that’s out there, which is oftentimes contradictory. Or you may feel overwhelmed, naturally so because doing a complete dietary overhaul on your own from a book can be a daunting task. It’s hard to change eating habits, especially if you’re not sure what’s right for you.
Here we present what the evidence says about anti-inflammatory eating. Some of it is general and some of it is personal. Truth be told, there is no one-size-fits-all anti-inflammatory eating plan that fits everyone. After all, your immune system is unique to you. Foods that aggravate or quell inflammation are unique to you. There’s no reason to follow a rigid diet or restrict foods based on a dietary theory if they aren’t proven to be a problem for you. An anti-inflammatory diet is personal and should be customized to you, especially when it comes to identifying your problematic foods.
Hopefully, this information will demystify how to go about eating to de-inflame your body and mind. Please don’t be overwhelmed when you read this! We distill the information into a step-by-step actionable guide called Dr. Laura’s Guide to Eat Your Way Out of Inflammation.
What are anti-inflammatory foods to add?
Often anti-inflammatory diets focus on what to avoid, but that’s only half the picture. Knowing what to include is equally important. This is all about fatty acids and deeply pigmented vegetables – two game changers to significantly change your inflammation profile for the better.
1. Anti-inflammatory Fatty Acids (EPA, DHA, GLA, and ALA)
Fatty acids are the most important inflammation-regulating component of our diet. You can literally control your inflammation by the types of fats you eat! How does this work? It’s all about the balance and types of Omega-3 fats and Omega-6 fats. These fats go through metabolic pathways that result in hormone-like messengers called prostaglandins (PG), which raise or resolve inflammation:
- Omega-6 fats make prostaglandin 2 (PG2) which causes inflammation
- Omega-3 fats make prostaglandin 3 (PG3) which resolves inflammation
By the way, when you take a nonsteroidal anti-inflammatory drug (NSAID), it reduces PG2. You can actually do this with your fatty acid intake!
The ideal balance in our diets is four parts Omega-6 to four parts Omega-3, or 4:1. The typical diet has a ratio of 20:1 or even higher! Lowering this ratio will significantly change the inflammation in your body. This generally means increasing Omega-3 fats and decreasing Omega-6 fats:
- To get Omega-3 fats, take fish oil for EPA and DHA (or algae for a plant source), and eat flax seeds which can convert to EPA and then DHA if conditions are right.
- To lower Omega-6 fats, use olive or avocado oils and nix seed and vegetable oils (corn, canola, sunflower, safflower, etc). Also choose meat, dairy, and eggs that are 100% grass-fed, wild, or pastured, because the conventional versions are high in a particularly inflammatory Omega-6 fat called AA (arachidonic acid).
There’s one caveat here, and that is that there is a very special Omega-6 fat called GLA (gamma-linolenic acid), which is in borage, evening primrose, and black currant seed oils. GLA is special because it creates PG1, which like PG3, also reduces inflammation. So the real project is to increase Omega-3 fats and GLA and to decrease Omega-6 fats.
2. Deeply pigmented fruits and vegetables are anti-inflammatory
Purple, blue, dark green, red, orange, and yellow foods moderate inflammation in a myriad of ways. Firstly, they provide plentiful antioxidants to quench free radicals that create oxidative stress, which is a source of inflammation. Deeply pigmented fruits and vegetables are helpful for blood sugar regulation, which supports the anti-inflammatory prostaglandin pathways. They are a great source of fiber to feed your beneficial gut microbes, which in turn make a highly anti-inflammatory short-chain fatty acid called butyrate. Lastly, they provide a plethora of phytonutrients, including enzymes used as co-factors needed to activate beneficial fatty acids.
What are inflammatory foods to reduce or eliminate?
There are generalizations we can make about foods that cause inflammation, based on metabolic pathways. Then there are specific foods that cause inflammation in individual people.
1. Inflammatory foods for everyone
White flour, sugar, alcohol, and transfats cause inflammation in many ways. They block enzymes that make the anti-inflammatory prostaglandins work. White flour and sugar raise blood sugar and insulin, which directs fatty acids down the undesirable PG2 pathway. Alcohol and transfats are both damaging to cells and a significant cause of oxidative stress. These foods are devoid of nutrients and fiber and provide poor sources of energy. They are commonly called “empty calories,” and cause you to eat less nutrient-dense anti-inflammatory foods. All in all, these four “foods” will increase inflammation for everyone.
2. Inflammatory foods for the individual
This is the most complex part of an anti-inflammatory diet because it is so personal (yes, gluten is not a problem for everyone). You can react to foods in different ways, including allergies, sensitivities, and intolerances. These are three different things. It’s important to find out which foods you actually react to so that you aren’t restricting anything unnecessarily.
The tried and true way to identify food reactions is to do a targeted elimination/provocation diet, where you eliminate suspect foods for a designated period of time and then re-introduce them one by one to see how your body reacts. This method can reveal both food sensitivities and intolerances. Learn more about how to do an elimination diet here. There are different types, and it’s important to choose one that is realistic for you, with supervision and guidance.
In our practice, we design a customized elimination diet that fits the individual. We target foods we suspect are a problem. For example, nightshades may contribute to osteoarthritis, gluten is a common problem with autoimmunity, and high-histamine foods may be a culprit of puffiness and swelling. Then we do a Food Inflammation Test (FIT), which is a blood test for IgG antibodies and an inflammatory marker called complement factor. This information helps us hone in on the elimination diet that’s right for you.
Your preferences and capacity for change matter. Some people like to make big changes overnight, and others need slow and gradual changes. We can customize the approach based on where you are coming from and what works for you. It’s even possible to eliminate and then test one food at a time if that’s the right pace for you.
Do you want some help creating a personalized anti-inflammatory diet that is doable? Or would you like to download Dr. Laura’s Guide to Eat Your Way Out of Inflammation? Please reach out!
Dr. Laura Paris, DACM is an Institute for Functional Medicine certified practitioner who specializes in the intersection of autoimmunity, inflammation, and female hormones. She helps women take charge of their immune health, reverse chronic inflammation, and get into remission and stay there.