Inflammation and Diet
(*Click on the many links provided in this article to take you to evidence-based videos to learn more about the role of diet in inflammation, and to examine the supporting evidence.)
The Role Of Diet in Inflammation
Inflammation is the root cause of many of the conditions that I treat as a massage therapist. Any condition that ends in the suffix ‘itis’ is an inflammatory condition; for example, tendonitis, bursitis, arthritis (both rheumatoid and osteoarthritis), tenonosinovitis (seen in carpal tunnel syndrome), plantar fasciitis, or frozen shoulder (adhesive capsulitis) is an inflammatory condition.
As well, it is worth noting that inflammation is involved in most pathological processes in the body, but is especially evident with asthma, premature aging, mental health issues, periodontal disease, obesity, skin aging, diabetes, multiple sclerosis, cancer, arthritis, irritable bowel syndrome, and inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. Coronary artery disease (America’s number one cause of death) is a direct manifestation of inflamed and clogged arteries. Oxidized LDL cholesterol may trigger the inflammatory response in artery walls which can eventually lead to a heart attack and death. Furthermore aging research is finding that the primary marker driving the aging process is low grade inflammation((Arai Y, Martin-Ruiz CM, Takayama M, Abe Y, Takebayashi T, Koyasu S, Suematsu M, Hirose N, von Zglinicki T. Inflammation, But Not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians. EBioMedicine. 2015 Jul 29;2(10):1549-58.)) and that body inflammation appears to be inversely related to longevity (healthspan). This is how far the topic of inflammation reaches.
There are several ways to battle inflammation, but one of the most effective approaches is to examine and improve our diet. Much of the inflammation in the body actually begins and occurs in the gut. This is because our gut is the area of our body containing the most bacteria, and it also has the highest concentration of immune cells (cells capable of mounting an immune response). Generally speaking, foods that we eat tend to either contribute to, or battle inflammation. An anti-inflammatory diet may help combat many soft tissue complaints that are inflammatory in nature. The great news is that the same diet that can help to minimize localized soft tissue inflammation can also reduce your chance of heart attack, stroke, diabetes and other previously mentioned diseases.
Foods that can Cause/Promote Inflammation
As mentioned, many factors cause or contribute to systemic body-wide inflammation, but food is likely the single-most important factor, and it is also highly modifiable. What foods cause inflammation? With few exceptions, foods that cause inflammation are either of animal origin, or are heavily processed.((Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review.
Nutr Rev. 2013 Aug;71(8):511-27.)) Animal products, including eggs, dairy, meat, and animal protein tend to increase inflammation. A single meal of meat, eggs, or dairy may cause a spike of inflammation within hours of consumption. The following eight substances are found in animal-based foods, and they are all implicated in systemic (body-wide) inflammation:
- Heme iron (the type of iron found in animal products) is believed to act as a pro-oxidant contributing to the development of atherosclerosis by oxidizing cholesterol with free radicals. The risk has been quantified as a 27% increase in coronary heart disease risk for every one milligram of heme iron consumed daily.((Yang W, Li B, Dong X, Zhang XQ, Zeng Y, Zhou JL, Tang YH, Xu JJ. Is heme iron intake associated with risk of coronary heart disease? A meta-analysis of prospective studies. Eur J Nutr. 2014;53(2):395-400))
- Exogenous endotoxins are the load of dead bacteria that are found in all animal products. These bacteria release heat-resistant endotoxins that are absorbed into our cardiovascular system, leading to the endotoxemic inflammation that peaks about two hours after a meal and then slowly tapers off over a period of several hours. Given the normal spacing of meals, this can leave one’s body in a mild inflammatory state for the entire day if one is eating the standard American diet.
- Saturated fat increases oxidative stress and the production of free radicals and inflammation, establishing a vicious cycle of events leading to mitochondrial dysfunction. This, in turn causes impairment of insulin signaling in muscle cells, which can eventually lead to insulin resistance and glucose uptake issues (prediabetes and type 2 diabetes).
- Choline and carnatine- Gut bacteria metabolize carnitine (found in red meat) and choline (found in eggs, milk, liver, red meat, poultry, shell fish, and fish) to a toxic substance called trimethylamine. This is then oxidized in our liver to TMAO (trimethylamine-n-oxide) which then circulates throughout our bloodstream. TMAO may increase the risk of buildup of cholesterol in the inflammatory cells in the atherosclerotic plaques in our arteries, increasing our risk of heart attack, stroke, and death.
- Advanced glycation end products (AGEs)- Of 549 foods tested for AGE content, the top most contaminated foods were chicken, bacon, hot dog, beef, turkey, and fish. As food is heated, more AGEs are generated. Moist heat produces fewer AGEs than dry heat, and animal foods contain substantially many more AGEs than plant foods. These glycation end products cross-link proteins together, causing tissue stiffness, oxidative stress, and inflammation. In the brain, they may contribute to dementia; in the eye, cataracts and macular degeneration. In the arteries and heart, hypertension, atherosclerosis, heart failure, and stroke; then anemia, kidney disease, osteoporosis, and muscle loss.
- Arachidonic Acid- Animal fats contain arachidonic acid, a compound that our body uses to produce inflammatory compounds such as prostaglandins.
- Neu5Gc is a foreign meat molecule not found in plants.This molecule incorporates itself into our cells, leading to chronic inflammation directly, and to the formation of antibodies—which can then lead back to more inflammation.
As well, there are other compounds found in food that can cause inflammation:
- Excessive exposure to plastics with BPA may be linked with liver inflammation,
- Acrylamide, which can be formed from deep-fried carbohydrate-rich food,
- Large doses of vitamin supplements,
- Titanium dioxide, a whitening agent in some processed foods,
- And Carrageenan, a red algae used as a food additive in dairy and non-dairy food products.
Foods that can Fight Inflammation
So, now that we know what foods to avoid or minimize to reduce inflammation, the next obvious question is, “What foods actively reduce inflammation?” Well, we have learned that animal-based foods and some processed foods are implicated in inflammation, so it should come as no surprise to learn that whole (unprocessed) plant foods tend to be anti-inflammatory. It is most likely the symphony of nutrients in whole plant foods that help minimize inflammation in our bodies, however, since everyone is always looking for the magic bullet, let’s look at the individual nutrients that have been found to fight inflammation:
- Fibre: present in virtually all whole plant foods, removed from many processed foods, a not present in any animal foods.
- Dietary magnesium: Present in animal foods, but abundant in greens, beans, whole grains, nuts, and seeds.
- Phytates: Found in beans, grains, nuts, and seeds. The average daily intake of phytate in vegetarian diets is about twice that of those eating mixed diets of plant and animal foods.((R. Greiner, U. Konietzny, K. D. Jany. Phytate – an undesirable constituent of plant-based foods? Journal fur Ernahrungsmedizin 2006 8(3):18 – 28.))
A diet that includes a variety of whole plant foods, fruits and vegetables with the highest antioxidant levels seems to reduce inflammation the most. The higher the antioxidant level of the food, the more likely it is that it will have an anti-inflammatory effect in the gut. Other specific plant foods identified as being highly anti-inflammatory include turmeric, cloves, ginger, rosemary, cherries, rose hips, apples, black pepper, broccoli, broccoli sprouts, Ceylon cinnamon, cilantro, citrus fruits, ginger, cloves, rosemary; chamomile, dragon’s blood, dried apples and dried plums, berries, crimini, oyster, maitake, and white button mushrooms, nutritional yeast, ground flaxseed, green leafy vegetables, tomato juice, legumes, purple potatoes, amla (Indian gooseberries), nuts in general, and specifically English walnuts; which may be so effective that the equivalent of eating a single walnut half per day may cut the risk of dying from inflammatory disease in about half!
Eating to minimize inflammation is actually fairly straightforward. It involves avoiding processed foods and animal foods as much as possible, and eating a varied diet of whole fruits, vegetables and plant-based foods.
Since some fruits and vegetables are more potent than others at fighting inflammation, eating a variety might be more important than the actual quantity consumed.
Comparing Plant-Based Foods to Anti-Inflammatory Drugs
Eating a strictly plant-based diet may be as anti-inflammatory as taking aspirin as you will see in this video, but without the side effects. Sweet cherries, turmeric, rose hips, and watermelon specifically may be good NSAID alternatives. However, despite what you might have heard, multiple studies now show that fish oil has not been shown to reduce inflammation, possibly due to the presence of industrial pollutants.
Caution Concerning Supplements
While many of us are often looking for a quick fix to our health problems in a pill or a dietary supplement, the answer to inflammation lies in lifestyle and diet; not in a pill. The overall theme emerging from decades of nutrition research suggests that it is not one magic ingredient in the food that will contribute to our health or fight inflammation; it is actually the symphony of nutrients found in whole, plant-based foods that creates the most powerful effects. This is why one should always be wary of supplements, because as good as they might sound when advertised, they are not whole foods. Furthermore, very few supplements that were being promoted a few decades ago have stood up to scientific scrutiny. Some have actually been shown to be detrimental to our health.
Eating to minimize inflammation is actually fairly straightforward. It involves avoiding processed foods and animal foods as much as possible, and eating a varied diet of whole fruits, vegetables and plant-based foods. Some of the particularly potent plant-based foods listed above such as cherry juice, turmeric and rose hips might be strategies worth trying if you have persistent inflammation. The beauty of this manner of eating is that not only does it fight inflammation; it has also been shown by Dr. Dean Ornish and by Dr. Caldwell Esselstyn to arrest, and even sometimes reverse North America’s number one killer- heart disease.
* Legal Waiver- All content on this website is provided for informational purposes only. Always consult your primary care provider before making major dietary changes. Much of the content of this article was adapted from an article at www.nutritionfacts.org on inflammation. Their non-profit website is dedicated to providing free, unbiased, high quality, evidence-based nutritional information.