Inflammation: the Good, the Bad and the Diet
by Linda Samuels, MS, RD, CSSD, LDN – Board Certified Sports Dietitian
Inflammation…we see news features on TV: “The Inflamed Brain”; we hear about it on podcasts: “Inflammation Nation”; if you Google it, you’ll have 260,000,000 results to read all about it. But what IS inflammation and why should we pay attention to how it affects us? As a sports dietitian who works with athletes in sport performance and wellness, inflammation has become a focus that many of my clients are interested in learning more about. So here is a deeper dive into the Good, the Bad and the Anti-Inflammation Diet.
The definition of “Inflammation”, in the past, was focused on a localized physical condition, such as a reaction to injury or infection. You could actually see that the body was showing symptoms of inflammation because it would become reddened, swollen, hot and/or painful. More recently, inflammation has become a buzz-word for a much broader and complex set of root causes. And, because of the complexity of each of these causes, there has also been some controversy. A more current definition of inflammation is: Inflammation is a normal process in the body that is critical to survival. It is a highly coordinated physiological process in response to a foreign exposure or injury. Well, “normal process” sounds Good!
Unfortunately, there can be a down-side to inflammation if it becomes chronic or systemic. Researchers have linked chronic inflammation to quite a few medical conditions and diseases. The severity and progression of these diseases/conditions can be exacerbated by inflammation, so it becomes important for the individual to pay attention to the factors affecting their inflammation. Some of the diseases linked to chronic inflammation include: cardiovascular disease, hypertension, osteoarthritis, irritable bowel syndrome, asthma, psoriasis, celiac disease and rheumatoid arthritis. So, chronic inflammation is not so good…in fact, it can be Bad if you look at that list of potential outcomes.
We are able to take measures to positively affect inflammation, though, so we do have some control over its potential consequences. When you look at the factors and causes of inflammation, they include:
Environmental – toxins, pollutants and allergens.
Lifestyle – obesity, or high body fat, is the #1 cause of chronic, low grade inflammation.
Physical Activity – inactivity and overtraining.
Sleep – 6 hours or less, chronically.
Gut Health – antibiotic exposure, degree of hygiene, and infections.
Psychological – stress, anxiety, depression and even negative thoughts.
Nutrition – low fiber, excessive amount of processed and high sugar foods, not enough fruits/vegetables, and high in saturated and trans fats.
A few of these factors we can somewhat control. And I’d like to think that with planning, the nutrition factor can be controlled so that a significant amount of any negative effects could be mitigated. There are two distinct aspects of an Anti-Inflammatory Diet: foods that cause inflammation and foods that reduce inflammation.
First the foods which may cause inflammation. Food allergies or intolerances are highly individual in both symptoms and intensity. Symptoms can include skin reactions like hives/dermatitis or gastrointestinal reactions like stomach aches or diarrhea. There are also more serious immune mediated symptoms such as anaphylaxis or celiac disease. The most common foods contributing to 90% of food allergies are:
Eggs, Peanuts, Tree Nuts (almonds, cashews, walnuts), Fish, Shellfish, Soy, Wheat and Cow’s Milk
The most common food additive intolerances contributing to about 1-2% of food allergies are:
Sulfites, Tartrazine (yellow 5), Benzoic Acid, Monosodium Glutamate
The tricky part to these allergies and intolerances is that there can be thresholds for which intake just over, an individual would experience a reaction, but just under, no apparent reaction at all would occur. Some testing, such as blood tests or skin prick tests, can pinpoint some of these trigger foods. Some individuals may have to undertake a food challenge, or food elimination test, which can dial in where their threshold of tolerance lies. Working with a medical doctor and Registered Dietitian who specializes in food allergies/intolerances is key to clarifying an individual’s trigger foods.
There are some other food categories which increase inflammation, and they include: highly processed and sugary foods, and foods high in saturated and/or trans fats…the typical American Diet. Alcohol and caffeine in excess can also cause inflammation, so should be avoided.
The great news about the Anti-Inflammatory Diet is that we do know quite a bit about foods that can decrease inflammation and positively affect our overall health. The following are at the top of the list to help fight inflammation, and would be appropriate for just about any athlete in training.
Cold Water Fish (Salmon, Tuna, Trout, Mackerel) are all high in Omega 3 fatty acids, and research has shown that Omega 3s help relieve tender joints and help ease morning stiffness.
Fruits and Vegetables increase the fiber in your diet, and has been shown to reduce C-reactive protein (CRP) levels, which is a marker of inflammation.
The Mediterranean-style diet of fish, olive oil, fruits, vegetables, nuts/seeds and beans has been shown to be anti-inflammatory.
Spices such as ginger, turmeric and cinnamon have potent anti-inflammatory effects. Additionally, “synbiotics” such as pre-biotics and pro-biotics, which alter the gut microbiome, have shown benefits in reduction of pro-inflammatory cytokines.
Tart Cherry research showed a reduction of biomarkers of inflammation (CRP).
Recommended anti-inflammatory food chart includes:
Fruits - dried plums, grapefruit, grapes, blueberries, pomegranate, mango, banana, peaches, apples, tart cherries and citrus fruits
Vegetables - all of them, but especially cruciferous such as broccoli, cauliflower, cabbage, greens and brussels sprouts
Whole Grains - oatmeal, whole wheat bread, brown rice, corn, rye, barley, millet, sorghum
Legumes - navy beans, black beans, pinto beans, kidney beans, lentils
Spices - ginger, turmeric
Oils - olive oil, fish oil
Fatty Fish - salmon, trout, tuna, mackerel
Misc - yogurt, green tea, nuts/seeds, dark chocolate, red wine
To review what we all can do to decrease the factors which contribute to inflammation, we should:
- Attempt to decrease environmental toxin exposure of pollutants and dangerous chemicals
- Enjoy moderate exercise, and avoid overtraining or other physical stressors
- Decrease psychological stressors
- Increase fresh fruits/vegetables, legumes, nuts/seeds, herbs/spices
- Adjust quantity and quality of fats by increasing Omega 3 fatty acid rich foods such as fish, and decreasing saturated fats and trans fats
- Optimize gut health by increasing fiber and including pre-biotics and pro-biotic foods
- Limit alcohol and caffeine
- Decrease refined foods and sugary foods
- Prevent weight gain above personal ideal body weight
For two cookbook recommendations to get you started, check out these two, which focus on the Mediterranean Diet:
The Complete Mediterranean Cookbook: 500 Vibrant, Kitchen-Tested Recipes for Living and Eating Well Every Day Paperback – December 27, 2016 – by American’s Test Kitchen
The 30-Minute Mediterranean Diet Cookbook: 101 Easy, Flavorful Recipes for Lifelong Health – October 2018 – by Deanna Segrave-Daly RD, and Serena Ball RD