Anti-inflammatory diet

Definition

There is no one anti-inflammatory diet , rather, there are diets designed around foods that are believed to decrease inflammation and which shun foods that aggravate the inflammatory processes. Many antiinflammatory diets are based around whole grains, legumes, nuts, seeds, fresh vegetables and fruits, wild fish and seafood, grass-fed lean turkey and chicken which are thought to aid in the bodies healing of inflammation. They exclude foods that are thought to trigger inflammation such as refined grains, wheat, corn, full-fat dairy, red meat, caffeine , alcohol, peanuts, sugar, saturated and trans-saturated fats.

The common foundation of anti-inflammatory diets is the belief that low grades of inflammation are the precursor and/or antagonizer to many chronic diseases. Once removed, the body can begin healing itself.

Origins

The philosophical genesis of anti-inflammatory diets dates back to the original healers throughout history who have worked with foods, herbs, teas and other natural remedies to assist the body's own healing energy.

KEY TERMS

Chronic disease —an illness or medical condition that lasts over a long period of time and sometimes causes a long-term change in the body.

C-reactive protein (CRP) —a marker of inflammation circulating in the blood has been proposed as a method to identify persons at risk of these diseases.

Flavonoid —refers to compounds found in fruits, vegetables, and certain beverages that have diverse beneficial biochemical and antioxidant effects.

Beginning in the 1970s investigators began exploring physiological mechanisms of fever, weight loss , and acute phase responses to acute and chronic infection. Research results from these studies began to change the mainstream attitudes about disease pathogenesis. Accumulating evidence linked proteins, produced by macrophages and other immune cells, not pathogens, as formerly believed, to the cause of tissue damage and disease syndromes in experimental animals. Thus the medical profession began looking into original treatments for chronic diseases. Then in the 1980s, research showed that proteins, newly named cytokines, and hormone-like substances, named prostaglandins and leukotrienes, revealed that they possessed pleiotropic biological activities that were either beneficial or injurious to the bodies' tissues.

From this research emerged the cytokine theory of disease. The concept that cytokines produced by the immune system , can cause the signs, symptoms, and damaging after effects of chronic diseases. Change did not occur until the measurement of C-reactive protein (CRP), a marker of inflammation circulating in the blood, was proposed as a method to identify persons at risk of chronic diseases. As pioneering research began to show that higher levels of C-reactive protein was linked to heart disease , conventional thought among the medical profession began. Originally discovered by W. S. Tillett and T. Francis Jr. in 1930, C-reactive protein was discovered as a substance in the serum of patients diagnosed with acute inflammation that reacted with the C-polysaccharide of pneumoccocus.

Today, a growing consensus among medical professionals is that inflammation is believed to play a role in the pathogenesis of chronic diseases such as heart disease, stroke , diabetes, and colon cancer to name a few. Mainstream thinking is beginning to accept that treating the underlying cause may ameliorate cardiovascular disease, metabolic syndrome, hypertension , diabetes, and hyperlipidemia, inflammation caused by visceral adipose tissue.

Description

Inflammation

Inflammation is a localized reaction of tissue to injury, whether caused by bacteria or viral infection, trauma, chemicals, heat or other phenomenon that causes irritation. The ‘irritation’ causes the tissues within the body to release multiple substances that cause changes within the tissues. This complex response is called inflammation. Inflammation is characterized by such symptoms that include (1) vasodilatation of the local blood vessels resulting in excess local blood flow, (2) increases in the permeability of the capillaries with leakage of large quantities of fluid into the interstitial spaces, (3) May include clotting of the fluid in the interstitial spaces due to excess amounts of fibrinogen and other proteins leaking from the capillaries, (4) relocation of granulocytes and monocytes into the tissue in large quantities, thus (5) swelling of the tissue cells.

The common substances released from the tissues that result in inflammation are histamine, bradykinin, serotonin, prostaglandins, multiple hormonal substances called lymphokines that are released by sensitized T-cells and various other reaction products of other systems within the body. Many of these substances activate the macrophage system, which are sent out to dispose of the damaged tissue but also which further injure the still-living tissue and cells.

Conditions with chronic inflammation

Inflammation has been associated as a component of, but not limited to, arthritis, heart disease, diabetes, strokes, asthma , allergies , irritable bowel disease, Celiac disease or other digestive system diseases, obesity , chronic stress, sleep disorders such as sleep apnea, Alzheimer's disease, high blood pressure , elevated lipids such as triglycerides and cholesterol.

Medical Anti-Inflammatory Treatments

General anti-inflammatory medical treatments include relaxation , moderate exercise such as walking, weight maintenance or loss, and medications designed to reduce the inflammation and control the pain if present.

These medications may include: ibuprofen or aspirin , Non Steroidal Anti-Inflammatory Drugs (NSAIDs), or steroid medications. The NSAIDs are widely used as the initial form of therapy. Unfortunately, long-term use of these medications can irritate the stomach and lead to ulcers. And in some cases can lead to kidney, as well as other medical problems.

Function

Diet and chronic inflammation

Registered Dietitians, and Naturopathic physicians often prescribe diets to lessen the inflammatory symptoms of diseases. Although these diets have not been compared to other treatments in many formal research settings to date, it is thought that antiinflammatory diets result in a reduced amount of inflammation and a healthier response by the immune system.

Adding foods that reduce inflammation is thought to improve symptoms of chronic diseases and help decrease risk for chronic diseases. These foods help in supplying the nutrients that are needed to decrease inflammation. One example is omega-3 fatty acids. The human body uses these fats to manufacture prostaglandins, chemicals that play an important role in inflammation and a healthy immune response. Another beneficial component of fish oil that plays an important role is eicosapentaenoic acid (EPA), an essential fatty acid derived from omega-3 fatty acids. EPA promotes the production of certain forms of prostaglandins having anti-inflammatory properties by reducing inflammation and decreasing the production of inflammatory substances.

Foods that reduce Chronic Inflammation

Whole grains

Whole grains or foods made from them, whether cracked, crushed, rolled, extruded, and/or cooked, contain the essential parts and nutrients of the entire grain seed. Research has shown that diets high in whole grain products are associated with decreased concentrations of inflammatory markers and increased adiponectin levels. The protective effects of a diet high in whole grains on systemic inflammation may be explained, in part, by reduction in overproduction of oxidative stress that results in inflammation.

A whole grain will include the following parts of the grain kernel—the bran, germ and endosperm. Such whole grains are amaranth, barley, bulgur, wild rice, millet, oats, quinoa, rye, spelt, wheat berries, buck-wheat, and whole wheat.

Legumes

Diets high in legumes are inversely related to plasma concentrations of C-reactive protein (CRP). Among the many varieties of legumes are; pinto beans, lentils, kidney beans, borlotti beans, mung beans, soybeans, cannelloni beans, garbanzo or chickpeas, adzuki beans, fava beans, and black beans.

Nuts, seeds

Nuts and seeds are rich in unsaturated fat and other nutrients that may reduce inflammation. Frequent nut consumption is associated with lower levels of inflammatory markers. This may explain why there is a lower risk of cardiovascular disease and type 2 diabetes with frequent nut and seed consumption. With the exception of peanuts, be sure to add in walnuts, flax seeds and pumpkin seeds. Nuts and seeds are best eaten when unsalted and raw.

Fresh vegetabless

Green leafy vegetables, and brightly colored vegetables provide beta-carotene; vitamin C and other antioxidants have been shown to reduce cell damage and to have anti-inflammatory effects. Aim for 3 or more servings per day.

Fresh fruits

Flavonoids found in fresh fruits among other substances are thought to increase the antioxidant effects of vitamin C. research has shown that fruits have an anti-inflammatory effect. Aim for two or more servings daily. Be sure to include berries in your weekly choices of fruits such as blueberries, blackberries, and strawberries.

Wild fish and seafood

Oily fish such as Herring, Mackerel, Salmon and Trout are an excellent source of omega-3 fatty acids, as are shellfish such as mussels and clams. Including fish or seafood high in omega-3 fatty acids at least three times a week is recommended.

Lean poultry

Protein is used in the body to repair and manufacture cells, make antibodies, enzymes and hormones. Lean protein has been associated with lower levels of inflammatory biomarkers.

When choosing poultry, choose grass-fed animals, which tend to have a higher amount of essential fatty acids. Select poultry with limited amounts of, or free of, preservatives, sodium , nitrates or coloring. Also, in an ideal diet, only 10-12 percent of daily calories should come from protein. On average, an adult needs 0.36 grams of protein per pound of body weight.

Soy products

Anti-inflammatory properties of the isoflavones, a micronutrient component of soy, have been reported in several experimental models and disease conditions.

Data suggests the possibility of beneficial effects of isoflavone-rich soy foods when added to the diet. Soy products include; soybeans, edema me, tofu, tempeh, soymilk, as well as many other products made from soybeans.

Oils

Expeller pressed Canola oil and Extra Virgin Olive oil are types of oils that have been linked to reduced inflammation. Other oils thought to aid in reducing inflammation include rice bran, grape seed, evening primrose and walnut oil. It is suggested to use these oils in moderation when cooking, baking and flavoring of foods. Also, when purchasing oils, make sure they are pure oils rather than blended oils. Blended oil usually contains less healthful oils.

Water in the form of fresh drinking water free of toxic chemicals

Water is an essential substance for every function of the body. It is a medium for chemical processes; a solvent for body wastes and dilutes their toxicity and aids in their excretion. Water aids in ingestion, absorption and transport of vital nutrients that have anti-inflammatory effects. Water is also needed for basic cell functioning, repairing of body tissues and is the base of all blood and fluid secretions.

Herbs and Spices

A greater amount of research is emerging on the antioxidant properties of herbs and spices and their use in the management of chronic inflammation. Herbs and spices can be used in recipes to partially or wholly replace less desirable ingredients such as salt, sugar and added saturated fat, know for their inflammatory effects, thus reducing the damaging properties of these foods.

Precautions

Foods that irritate inflammation

Best referred to in research articles as ‘the western dietary pattern’, it credits a diet that is high in refined grains, red meat, butter, processed meats, high-fat dairy, sweets and desserts, pizza, potato, eggs, hydrogenated fats, and soft drinks. This pattern of eating is positively related to an increase in circulating blood CRP levels and higher risks for chronic diseases, obesity and cancers. These foods, termed ‘pro-inflammatory’ may increase inflammation, thus increasing a persons risk for chronic diseases as well as exacerbate symptoms from these chronic conditions.

There is some support for the belief that food sensitivities or allergens to foods may be a trigger for inflammation. Often hard to detect with common blood tests, some people have seen alleviation of symptoms of chronic diseases, such as arthritis, when the aggravating foods are removed from their diet. Common allergic foods are milk and dairy, wheat, corn, eggs, beef, yeast and soy.

Other pro-inflammatory foods have been shown to have substances that activate or support the inflammatory process. Unhealthy trans fats and saturated fats used in preparing and processing certain foods are linked to increased inflammation. Processed meats such as lunchmeats, hot dogs and sausages contain chemicals such as nitrites that are associated with increased inflammation and chronic disease.

Saturated fats naturally found in meats, dairy products and eggs contain fatty acids called arachidonic acid. While some arachidonic acid is essential for health, excess arachidonic acid in the diet has been shown to worsen inflammation.

Research supports that diets high in sugar produce acute oxidative stress within the cells, associating it with inflammation. Elimination of high sugar foods such as sodas, soft drinks, pastries, presweetened cereals and candy has been shown to be beneficial. As well as switching from refined grains to whole grains.

Benefits

The effects of the anti-inflammatory diet are unobtrusive. There is a series of research articles that demonstrate a benefit in reduction of chronic diseases such as cardiovascular disease, neurodegenerative diseases, and cancers when following a dietary pattern associated with the anti-inflammatory diet. But the benefits go beyond disease prevention. Studies have shown an alleviation of symptoms associated with chronic diseases. As well, a person may decrease or discontinue their dosage of medications prescribed to control symptoms related to inflammatory conditions, and reduce the side affects associated with anti-inflammatory agents.

It has also been documented that people who followed the anti-inflammatory diet stated they experienced loss of weight, had an elevation of energy, and reported better mental and emotional health.

QUESTIONS TO ASK YOUR DOCTOR

• May any of my medical conditions be aided by adopting an anti-inflammatory diet?
• What foods can I eat to decrease my dosage of anti-inflammatory medications?
• How might the anti-inflammatory diet help me in reducing my risks of chronic diseases?
• Would you recommend that I adopt more antiinflammatory foods into my diet?

Risks

The risks associated with following the antiinflammatory diet are limited and not supported by research. The general concern associated with following any diet without the consent of a primary physician would apply. Anyone attempting to follow the anti-inflammatory diet should discuss it with their primary care physician and get a referral to see a Registered Dietitian, educated in the diet for maximal benefit and decreased risk of following a diet that eliminates certain foods from the dietary pattern to ensure proper intake of all macro and micro-nutrients.

Research and general acceptance

As stated previously, there is no one antiinflammatory diet but rather there are foods that are thought to increase the inflammatory process and ones that are beneficial to the inflammatory processed within the body. Because of this, many medical professionals and other health providers may not support the concept of a diet that decreases the antiinflammatory response within the body.

There is substantial evidence supported through research that shows the beneficial effects on the body in reducing markers of inflammation such as CPH and reduction in chronic disease and its symptoms. Most medical professionals have an easier time accepting the Mediterranean diet which includes many of the foods found in the anti-inflammatory diet, and is the closest termed dietary eating pattern to the antiinflammatory diet.

Megan C.M. Porter RD, LD