What are the best foods to lower Erythrocyte Sedimentation Rate (ESR)?

Best Foods to Lower Erythrocyte Sedimentation Rate (ESR)

There are no specific foods that have been clinically proven to directly lower ESR values, as ESR is primarily elevated due to underlying inflammatory conditions that should be addressed through proper medical treatment rather than diet alone. 1, 2

Understanding ESR and Its Clinical Significance

• ESR is a non-specific marker of inflammation that measures how quickly red blood cells settle in a test tube over one hour 2
• Normal ESR values are typically below 20 mm/h in men and below 30 mm/h in women, with higher values suggesting underlying inflammation 2
• ESR is not always reliable as a standalone test for disease presence, especially in elderly patients where approximately 25% of patients with actual disease may have ESR values within normal range 3
• A markedly elevated ESR (≥70 mm/h) is often associated with specific pathologies such as infections (42%), malignancies (27%), or inflammatory conditions (20%) 4

Anti-Inflammatory Diet Principles for Potentially Influencing ESR

While no foods directly lower ESR, an anti-inflammatory diet may help address underlying inflammation that contributes to elevated ESR:

Recommended Foods:

• Whole grains (30-90g daily) can reduce risk of cardiovascular disease and type 2 diabetes, which are associated with chronic inflammation 1
• Pulses (legumes) consumption of 50-150g daily or 4 servings (400g/week) provides good sources of protein and minerals while potentially reducing inflammatory conditions 1
• Nuts and seeds (15-35g daily) increase antioxidant blood concentrations such as vitamins E and A, which may help combat oxidative stress 1
• Fruits and vegetables (200-300g daily) are high in vitamins and minerals with anti-inflammatory properties 1
• Plant-based oils, particularly virgin olive oil (10g daily), may help reduce inflammation associated with cardiovascular disease 1
• Fermented foods, especially dairy products, may help improve gut health and reduce inflammatory markers 1

Foods to Limit or Avoid:

• Processed foods containing phosphate additives should be avoided as they may contribute to inflammation 1
• Sugar consumption should be limited to <10% of total daily energy intake to lower risk of obesity and inflammatory conditions 1
• Processed meats should be limited to 50g daily due to their potential inflammatory effects 1
• Salt intake should be restricted to <2g of sodium per day (equivalent to 5g of salt) to help manage blood pressure and reduce cardiovascular risk 1

Clinical Approach to Elevated ESR

• ESR is most useful for monitoring conditions like giant cell arteritis, polymyalgia rheumatica, and certain inflammatory disorders rather than as a screening test 2, 5
• An unexplained increase in ESR is generally transitory and seldom due to serious disease, but persistent elevation warrants investigation 5
• Elevated ESR has been identified as an independent prognostic factor for mortality, even after adjusting for age and comorbidities 6

Important Considerations

• Diet alone cannot replace appropriate medical treatment for conditions causing elevated ESR 1
• The relationship between ESR and diet is indirect - diet may influence underlying inflammation rather than directly affecting the ESR measurement 7
• In patients with kidney disease, nutritional management should be tailored to their specific condition, as they may have different dietary requirements 1
• L-carnitine supplementation may be considered in specific clinical scenarios like dialysis patients with symptoms such as malaise and muscle weakness, but there is insufficient evidence for routine use 8

Remember that elevated ESR is a sign of an underlying condition that requires proper medical diagnosis and treatment. Dietary modifications should be part of a comprehensive treatment plan developed with healthcare providers.