What is an anti-inflammatory diet and could it improve your health?

Inflammation can be triggered by various health conditions or lifestyle factors and cause serious threat to our bodies. But are there foods we can eat to prevent unnecessary inflammation, allowing us to manage symptoms and lower our risk of disease?

What is inflammation?

Inflammation is your body’s natural and healthy response to harm, such as infection, injury or toxin.

When something damages your cells, your immune system kicks in, often causing short-term symptoms. Say you get a splinter – the swelling you’ll likely experience is your white blood cells protecting you against the foreign body and potential infection.

You wouldn’t want to prevent this from happening – it’s a critical mechanism that protects our health. In that case, what is the anti-inflammatory diet actually for and why would we want to use it to discourage inflammation?

Inflammation becomes unhealthy when it sticks around long term. This is a common issue.

“Some researchers suggest elements of modern living can drive chronic inflammation,” says dietitian Sophie Medlin. Factors believed to promote it include smoking, being overweight, a sedentary lifestyle and drinking alcohol excessively.

Chronic inflammation has also been identified as a risk factor for a number of diseases, including heart disease, diabetes, some cancers and neurodegenerative conditions.

The anti-inflammatory diet could have direct benefits – for instance, certain foods can have a direct impact on inflammation levels – as well as indirect, as what you eat affects your weight and health, which in turn can be linked to inflammation.

It could, then, help lower your risk of certain diseases, as well as be a way to manage symptoms of inflammatory conditions.

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What is the anti-inflammatory diet?

The anti-inflammatory diet isn’t a set regime, but more about simply choosing foods believed to fight inflammation and limiting those thought to contribute to it. Luckily, lots of foods are thought to contain anti-inflammatory properties.

Harvard University has come up with a list of anti-inflammatory foods, which includes tomatoes, olive oil, green leafy vegetables, nuts, oily fish and fruits.

Meanwhile, “Foods on the pro-inflammatory list include fried foods, sugary drinks, refined carbohydrates, animal fats and processed meats,” says Medlin.

Not getting enough of particular nutrients and micronutrients has been linked to inflammation. Foods high in refined carbohydrates, sugar, saturated fat and trans fatty acids – for instance some ultra-processed foods – and a diet low in fibre, natural antioxidants and omega 3, have also been linked to inflammation. (Use the BBC Food nutrition calculator to find out how likely you are to be lacking in nutrients, based on your age and sex.)

Some bacteria living in our gut are “known to produce anti-inflammatory properties,” says Medlin, so it is worth looking after your gut health by eating a varied diet with a focus on plants. Swap white breads, pasta and rice for wholegrain, fibre-filled alternatives for your gut bacteria to ‘feed’ on. Beans, pulses, legumes and many other vegetables are also high in fibre.

Numerous spices, including black pepper, ginger and turmeric, as well as garlic, have been linked to fighting inflammation. But more research is needed, as “very few studies were performed with actual foods,” instead using extracts or capsules.

“Many would question the link between the [list of foods by Harvard] and chronic inflammation in the otherwise healthy population,” says Medlin. But, she continues, “a balanced diet that includes plenty of the foods on the anti-inflammatory list and not too many of the pro-inflammatory foods is good healthy eating advice.”

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Do we all have the same inflammatory response to foods?

Inflammation triggered by the food we eat can vary considerably from person to person, according to results from a 2020 study.

The study identified “a wide range of metabolic responses after eating in apparently healthy adults,” and linked a poor metabolic response (where the body needs to work longer and harder to clear fat and sugar) to food with “increased risk of conditions such as low-grade inflammatory diseases including heart disease, type 2 diabetes and obesity.”

Senior researcher on the study professor Tim Spector says, “The metabolic response to food was so different between people in identical conditions. So, if they were given an identical muffin, for example, how much their sugar, insulin and blood fats went up varied about eight-fold between people. There was no average response.”

Is the Mediterranean diet anti-inflammatory?

The Mediterranean diet, which has a focus on vegetables, fruits, wholegrains and lean protein, has been linked to lower levels of inflammatory-causing proteins. It encourages eating oily fish, such as salmon and sardines, which contain omega 3 and are linked to reducing inflammation.

It has also been found to be effective for weight loss, which is significant because obesity is reported to make us predisposed to problematic inflammation.

The diet limits refined starches, sugar and saturated fat – all foods that are thought to encourage inflammation.

There is evidence that any anti-inflammatory effect of the Mediterranean diet can be felt within three months, but the greatest impact is achieved after a year.

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Will an anti-inflammatory diet help with arthritis?

A 2023 study, which followed 45 people with rheumatoid issues (including arthritis), examined if following an anti-inflammatory diet could reduce the chronic pain patients suffered with and it showed promising results.

However, Arthritis Action is clear no diet or type of food is proven to make arthritis better or worse, and states, “The aim should be to eat a well-balanced diet and to keep to a healthy weight.”

Dietitian Martin Lau, spokesperson for Arthritis Action, says, “A healthy diet which promotes anti-inflammation (such as the Mediterranean diet) and not carrying too much body weight, combined with specialist anti-rheumatic medications could promote remission [in those with rheumatoid arthritis].”

Some people believe nightshade vegetables, including tomatoes (which are on the Harvard list of anti-inflammatory foods), aggravate arthritis pain due to a chemical they contain called solanine.

“There are no scientific studies to prove that they actually cause inflammation or make symptoms worse,” says Kim Larson, a Seattle-based dietitian and Academy of Nutrition and Dietetics spokesperson.

If you think they may be worsening your pain, the Arthritis Foundation recommends you “eliminate nightshades from your diet for a couple weeks and slowly reintroduce them. If you find that adding nightshades triggers arthritis pain, don’t eat them.” Other nightshade vegetables include aubergine, red bell peppers and potatoes.

The anti-inflammatory diet is not for everyone

The anti-inflammatory diet may not reduce inflammation for everyone, and may even exacerbate symptoms for some.

“If my inflammatory bowel disease patients or those with gut disorders followed Harvard’s anti-inflammatory diet, their problems may get worse, not better,” warns Medlin.

If you have a medical condition, always consult your doctor or dietitian before altering your diet.

Originally published November 2020