The Anti-inflammatory Diet

But sometimes the process can go into overdrive, constantly churning out excessive inflammatory compounds. Chronic inflammation causes the inflamed lesions associated with hidradenitis suppurativa. Ongoing inflammation is also involved in other chronic diseases including asthma, rheumatoid arthritis, Celiac disease and inflammatory bowel disease (e.g. Crohn’s disease, ulcerative colitis). Heart disease, diabetes and perhaps even Alzheimer’s disease have inflammatory components as well. Obesity also triggers the release of a cascade of inflammation that can lead to health problems.

Research suggests that this type of unsaturated fat, plentiful in olive oil, almonds and avocados, reduces inflammation in the body.^1-6 Foods high in monounsaturated fat also contain antioxidants and phytochemicals that may play a role in reducing inflammation. Extra virgin olive oil, for example, is a source of polyphenols, a phytochemical that have received much attention for their anti-inflammatory effects.⁷ (Regular and light olive oil contain little or no polyphenols due to the way they are processed.) Avocados also contain anti-inflammatory polyphenols.

Cooking oils high in monounsaturated fat include olive oil, canola oil, peanut oil, sunflower oil and sesame oil. Other good sources include avocado, almonds, almond butter, cashews, pecans, peanuts, peanut butter and pistachios.

Tips to add monounsaturated fat

• Use extra virgin olive oil for salad dressings; use canola or peanut oil for sautéing and stir-frying.
• Replace butter with slices of avocado in sandwiches.
• Add cashews or peanuts to a vegetable stir-fry.
• Add chopped almonds to salads.

Omega-3 fatty acids include DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) found in oily fish oil and ALA (alpha linolenic acid) found in flax oil, flaxseeds, chai seeds, hemp seeds, walnuts, walnut oil and canola oil.

Studies have found that increasing intakes of omega-3 fats lead to less inflammation in the body.^8-11

Tips to increase omega-3’s

• Aim to include oily fish such a salmon, trout, mackerel, sardines and herring in your diet twice a week.
• If you don’t eat fish, consider taking a daily fish oil capsule that provides 500 to 600 milligrams of DHA and EPA combined. Supplements of DHA derived from algae are available for vegetarians.
• To increase ALA, add one tablespoon of ground flax or chia seeds or one teaspoon of flax oil to smoothies.
• Toss walnuts into green salads. Sprinkle with hemp seeds.

Flavonoids are a large family of phytochemicals with anti-inflammatory effects.^12-14 They’re found in fruits, vegetables, nuts, beans and lentils, cocoa, tea and red wine and are thought to be responsible, in part, for the health benefits of plant-based diets. The following foods and beverages are excellent sources of anti-inflammatory flavonoids.

Tips to increase flavonoids

• Replace coffee with black, green or white tea.
  
• Snack on an apple and small handful of walnuts or mixed nuts.
  
• Include mixed berries to breakfast – add them to oatmeal, granola and smoothies.
• Add legumes and lentils to salads, soups and stews.
  
• Stir chopped kale into soups, stir-fries and stews.

Many fruits and vegetables owe their yellow, orange and red colours to carotenoids, a group of phytochemicals. The most common carotenoids in our diet are α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, and lycopene. Beta-carotene, the best-known carotenoid found in carrots and sweet potato, has been shown to dampen inflammation in test tube and animal studies. So has lycopene, a carotenoid plentiful in tomato juice.^15-17

The anti-inflammatory effects of carotenoids have also been observed in people. Consumption of carotenoid-rich foods and drinking tomato juice have both been shown to reduce blood markers of inflammation in healthy adults.^18-20

The following fruits and vegetables are excellent sources of anti-inflammatory carotenoids.

Tips to increase anti-inflammatory carotenoids

• Instead of white potato, serve sweet potato or baked winter squash such as butternut, acorn or hubbard.
  
• Replace soft drinks and fruit juice at lunch with low sodium tomato or vegetable juice.
  
• Add spinach or kale to a fruit smoothie made with frozen mango and peaches.
  
• Replace orange juice at breakfast with ½ cup (125 ml) of unsweetened carrot juice.

Studies point to a protective role of nuts against inflammation. People who eat nuts and seeds frequently – versus rarely or not at all – have lower levels of inflammation.^21-23 Nuts contain a number of anti-inflammatory compounds including magnesium, omega-3 fatty acids (only walnuts), an amino acid called arginine and dietary fibre.

While all types of nuts are healthy, they are high in calories and easy to overeat. To prevent weight gain, substitute nuts for an equal number of calories from refined (white) starchy foods such as bread, crackers and rice. One serving of nuts is equivalent to 28 grams (1 ounce).

When buying nuts, read labels. Look for raw or dry roasted nuts and buy them unsalted.

Tips to add nuts to your diet

• Top your morning breakfast cereal with ¼ cup (50 ml) of chopped nuts.
  
• Mix chopped walnuts or pecans into muffin, pancake and waffle batters.
  
• Add ground nuts to smoothies, burger and meatloaf recipes.
  
• Toss a handful of peanuts or cashews into stir-fries and sautéed vegetables.

Ultimately, the carbohydrate-rich foods you eat – a bagel, granola bar, pasta, apple, yogurt or candy – end up in your bloodstream as glucose, the body’s primary source of energy. But not all carbohydrates raise your blood glucose in the same way. Some are digested and absorbed into the bloodstream quickly, others more slowly. The speed at which glucose enters your bloodstream can stimulate inflammation.

The glycemic index (GI) is used to indicate how much a food raises blood glucose levels. High GI foods (e.g. white bread, white rice, soda crackers, refined breakfast cereals, instant oats, baked Russet potatoes, mashed potato, raisins, watermelon, table sugar, sugary drinks) are rapidly digested and cause marked fluctuations in blood sugar levels.

In response to a fast and large spike in blood glucose, the pancreas releases a large amount of insulin, a hormone that removes glucose from the bloodstream. A diet based on high GI foods that causes elevated blood glucose and insulin has been shown to cause and worsen inflammation.^24-25

Low GI foods (e.g. 100% stoneground bread, steel-cut oats, 100% bran cereal, brown rice, quinoa, white and whole wheat pasta, sweet potatoes, apples, bananas, berries, oranges, legumes, yogurt, milk) are slowly digested and absorbed and produce gradual rises in blood sugar and insulin. Among overweight individuals, a low glycemic calorie-reduced diet has been shown to reduce inflammation.²⁶

Tips to reduce the glycemic load of your diet

• Use common sense. Unprocessed fresh foods such as whole grains, legumes, fruits and vegetables have a low GI value. High glycemic foods are usually highly processed and may have a concentrated amount of sugar.
• Include at least one low GI food per meal, or base two of your meals on low GI choices.
• Pay attention to breads and breakfast cereals since these foods contribute the most to the high glycemic load of the Western diet.
• Avoid eating high GI snacks like crackers, pretzels, corn chips and rice. Instead, opt for fresh fruit, plain yogurt, nuts or plain popcorn.

A number of studies have linked a high fibre diet to lower levels of inflammation in the body.^27-30 Fibre-rich foods might thwart inflammation in a few different ways. In the gut, fibre may absorb and eliminate inflammatory compounds. Fibre-rich foods contain phytochemicals, such as flavonoids, which dull inflammation.

A high fibre diet also helps maintain a healthy balance of microbes in the gut. An imbalanced gut microbiota – the microbe population living in our intestine – is thought to drive inflammation.

Whole grains, fruits, vegetables, legumes and nuts contain two types of fibre, soluble and insoluble. Dried peas, beans, lentils, oats, barley, psyllium husks, apples and citrus fruits are good sources of soluble fibre. Soluble fibre helps to lower blood cholesterol and prevent large rises in blood sugar. Wheat bran, whole grains, nuts and vegetables contain mainly insoluble fibre, the type that is especially effective at promoting regularity.

Women aged 19 to 50 need 25 grams of fibre each day; men require 38 grams. As we get older and our calorie requirements decrease, we need less fibre. After 50, women should aim for 21 grams, men 30 grams.

Tips to increase fibre intake

• Replace ½ cup of your usual ready-to-eat cereal with ½ cup of 100% bran cereal; use bran cereal instead of granola when making yogurt and fruit parfaits.
• Serve fibre-rich whole grain sides at dinner such as brown rice, bulgur, buckwheat, millet, and quinoa.
• Instead of potato chips or crackers, snack on air-popped popcorn, edamame, or baby carrots.
• Eat high fibre fruit for dessert such as raspberries, blackberries, apple, pears, dried apricots, mango and prunes.

The benefit of flavouring meals with herbs and spices instead of salt goes beyond reducing sodium. Certain herbs and spices have been shown to curb inflammation in the body likely due to the presence of polyphenols, phytochemicals with anti-inflammatory properties.

Anti-inflammatory herbs and spices include basil, rosemary, cayenne pepper, ginger and turmeric. The active ingredients in herbs and spices degrade over time. Be sure to store dried herbs and spices in airtight containers away from heat and direct sunlight.

Tips to flavour with anti-inflammatory herbs and spices

• Add dried basil to pasta sauces; toss chopped fresh basil into green and tomato salads; combined basil with extra virgin olive oil and garlic to make pesto for pizza, bruschetta and salmon filets.
• Season pasta sauces, pizza, chili, stews, tuna salad and cooked vegetables with dried cayenne pepper; add a dash of cayenne to hot chocolate.
• Include chopped fresh ginger root in stir-fries, whole grain pilafs, sautéed carrots and fruit salad; add ginger, fresh or dried, to baked winter squash and smoothies.
• Add ¼ teaspoon turmeric to water when cooking rice; mix into vinaigrette salad dressings; stir into olive oil and drizzle over cauliflower before roasting; add to omelettes and egg salad.

Among its many roles, vitamin D has anti-inflammatory effects in the body. Animal research has shown that vitamin D deficiency is associated with higher levels of inflammation.^31-33 In people, vitamin D deficiency has been linked to a number of inflammatory diseases, including rheumatoid arthritis, inflammatory bowel disease and type 1 diabetes. It’s thought that vitamin D deficiency may even increase levels of inflammatory markers in healthy people.

A major source of vitamin D is sunlight; your skin produces it when exposed to ultraviolet B rays. Very few foods have vitamin D naturally. Salmon and tuna are among the best sources. Eggs and cheese provide a little. Besides fortified milk and non-dairy beverages, some brands of orange juice, yogurt and breakfast cereals may also have added vitamin D.

Current vitamin D recommendations for North Americans range from 600 to 2000 IU per day. In the fall and winter, when the sun isn’t strong enough to produce vitamin D in the skin, people who live in northern latitudes are advised to supplement with 1000 to 2000 IU vitamin D per day.

Taking more vitamin D than required is not better. Safe upper daily limits are 2500 IU (aged 1-3), 3000 (aged 4-8) and 4000 IU (aged 9 and older). Excess vitamin D can cause nausea, vomiting, poor appetite, weakness, heart rhythm problems and kidney damage.