What is an anti-inflammatory diet?

What is an Anti-Inflammatory Diet?

An anti-inflammatory diet emphasizes fresh fruits and vegetables, monounsaturated fats (particularly olive oil), complex carbohydrates, and lean proteins while limiting ultraprocessed foods, added sugars, salt, red meat, and saturated fats. 1

Core Dietary Components to Include

Primary Food Groups

• Fruits and vegetables: Fresh, colorful, non-starchy varieties form the foundation, with a target of at least 22g of dietary fiber daily 2
• Monounsaturated fats: Primarily from olive oil, which serves as the main fat source 1
• Complex carbohydrates: Whole grains that provide fiber and nutrients supporting gut health 1
• Lean proteins: Low-fat dairy, poultry, fish, beans, and legumes without excessive saturated fat 1
• Omega-3 fatty acids: Found in fish, these demonstrate significant inverse associations with inflammatory biomarkers 1

Beneficial Compounds

• Polyphenols: Found in colorful vegetables, these inhibit nuclear factor (NF)-κB, the primary molecular target of inflammation, and activate AMP kinase 3
• Spices and herbs: Plant-based compounds with anti-inflammatory properties 4

Foods to Limit or Avoid

Pro-Inflammatory Foods

• Red and processed meats: These should be reduced to minimize inflammatory flares 1, 2
• Refined carbohydrates and added sugars: These contribute directly to inflammation 1
• Trans-unsaturated fatty acids: These elevate low-grade inflammation and should be strictly limited 1
• Ultraprocessed foods: Associated with increased risk of inflammatory conditions 2
• Saturated fats: Excessive intake promotes inflammatory pathways 1

Fatty Acid Balance

• Omega-6 fatty acids: While essential, excess omega-6 promotes inflammation through pro-inflammatory mediators 1
• Target ratio: Aim for an omega-6 to omega-3 ratio closer to 2:1 rather than the typical modern diet ratio of 11:1 1
• Supplementation: Consider 2-3g daily of EPA and DHA to achieve anti-inflammatory effects 3

Mechanisms of Action

The anti-inflammatory diet works through multiple interconnected pathways:

• Modulation of inflammatory genes: The balance of macronutrients and fatty acids alters expression of inflammatory genes 3
• Insulin stabilization: The protein-to-glycemic load ratio affects insulin and glucagon generation, reducing silent inflammation 3
• Eicosanoid formation: The omega-6 to omega-3 balance directly impacts production of inflammatory mediators 3
• Gut microbiome modulation: Dietary fiber increases short-chain fatty acid production, which provides energy for colonocytes and modulates local immune response 5
• Gene silencing: Anti-inflammatory nutrition acts as a form of gene-silencing technology, particularly for genes involved in generating silent inflammation 3

Clinical Applications

Mediterranean-Style Pattern

The Mediterranean diet serves as the practical model for anti-inflammatory eating, showing efficacy comparable to more restrictive diets for conditions like mild to moderate Crohn's disease 2. This pattern has demonstrated a 22% decrease in coronary artery disease events compared to control diets 1.

Monitoring Effectiveness

• C-reactive protein (CRP): Use as a biomarker for monitoring inflammatory status and cardiovascular disease risk 1
• Symptom improvement: Clinical improvement in inflammatory conditions indicates dietary intervention effectiveness 1
• Food diaries: For patients with inflammatory bowel disease, tracking individual food triggers provides personalized guidance 5, 2

Important Caveats

Avoid Overly Restrictive Approaches

While specific diets like the Specific Carbohydrate Diet, FODMAP, or Paleo diet are promoted in lay literature, they lack rigorous scientific evidence and present practical concerns 5. These restrictive approaches may result in:

• Unnecessary financial burden 5, 2
• Reduction in overall caloric intake in patients already at nutritional risk 5, 2
• Poor long-term adherence 2
• Potential vitamin D deficiency 5

Conflicting Internet Recommendations

Patient-targeted dietary recommendations from internet sources are frequently conflicting and may lack scientific evidence, potentially causing patient confusion 5, 2. The evidence-based approach outlined above provides clearer guidance than these variable sources.

Individual Variation

While general anti-inflammatory principles apply broadly, patients with inflammatory bowel disease may identify specific food triggers through careful monitoring 5. This personalized approach empowers patients while maintaining the core anti-inflammatory dietary framework 5.