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The Anti-Inflammatory Diet
by Alexandra Rothwell MPH RD CSO CDN on August 26, 2015
by Alexandra Rothwell MPH RD CSO CDN on August 26, 2015
Inflammation is a popular “buzz word” in the world of nutrition and cancer. Foods and nutrients are touted for their “anti-inflammatory” properties, and we happily associate this with good health – as we should. However, it can be helpful to take a deeper look into important health concepts so that we can make informed decisions about how we eat.
Following injury or infection, acute inflammation is the normal and healthy immune system response that contributes to healing. When inflammation is chronic, however, it is related to a number of disease states. Rheumatoid arthritis, Crohn’s disease, asthma, and celiac disease are all diseases that are inflammatory in nature. Other chronic diseases, such as heart disease, diabetes, obesity, and cancer involve some level of inflammation.
The medical community does not yet have all the answers about how inflammation relates to cancer risk and development, but it is clear, at least, that inflammatory cells are a critical part of tumor progression by composing the tumor’s environment and supporting its growth and survival. Interestingly, in addition to some already existing therapies, current research is examining how to use anti-inflammatory mechanisms or the immune system to treat cancer. Even common anti-inflammatory medications, such as Advil or Aleve (known as NSAIDs), may have potential for reducing cancer risk. But an important question, of course, is ‘how can we use lifestyle to decrease inflammation?’.
One of the most impactful ways to decrease chronic inflammation is to lose weight or maintain a healthy body weight. Being overweight, obese, or having abdominal obesity are risk factors for many diseases that are associated with inflammation, such as type 2 diabetes and cancer. Adipose tissue (i.e. fat) contributes directly to an inflammatory state by producing inflammatory mediators called adipocytokines. Research has shown that with weight loss, overweight individuals can reduce inflammation. Physical activity may also contribute to a reduction in systemic inflammation, although it is unclear if this effect is independent from weight loss.
An anti-inflammatory diet includes foods in the appropriate proportions to discourage the inflammatory process. It also restricts those that may intensify it. There is no consensus for a precise anti-inflammatory diet prescription, (they vary depending on who is promoting), but generally, an anti-inflammatory diet is along the lines of a Mediterranean diet: rich in non-starchy vegetables and fruit, legumes, nuts and seeds, fish, whole grains, and moderate amounts of fermented dairy products, such as yogurt and cheese.Compounding what basically boils down to: eat more plants, less animal proteins, processed foods, fried foods, etc., there are a few relatively consistent elements to an anti-inflammatory diet. These include:
Vitamins, minerals, and phytochemicals:
Eating a rich variety of plant foods – fruit, vegetables, legumes, nuts, seeds, etc., and making these the base of the diet is the cornerstone of all anti-inflammatory models, as plants provide us with important nutrients that promote a healthier inflammatory response. Phytochemicals are the chemicals in plants that provide them with color, odor, and flavor and play a role in a number of health processes. Polyphenols, (found in green tea, grapes and berries), carotenoids, (found in sweet potatoes, apricots, and leafy greens), and flavonoids, (found in apples, citrus, soy, and coffee), are three major categories of phytochemicals that inhibit inflammation. (more info on phytochemicals…) Plants are also excellent sources of anti-inflammatory vitamins and minerals. Having low levels of magnesium, vitamin B6, vitamin C, vitamin E, or vitamin D has been associated with inflammation and inflammatory diseases. Of these nutrients, all but the vitamin D are primarily found in plant foods, including nuts, leafy greens, citrus, and legumes.
Limiting refined carbohydrates:
Sugars and other refined carbohydrates, which are ‘high glycemic index foods’, cause rapid increases in blood sugar that may be characterized as ‘high blood sugar’ or ‘hyperglycemia’. Hyperglycemia is linked with inflammation and inflammatory diseases by triggering the release of inflammatory molecules called cytokines. Carbohydrates that contain natural fibers and fat (i.e. whole grains and legumes) have a less rapid effect on blood glucose levels, resulting in fewer of these pro-inflammatory agents. Therefore, the Mediterranean diet and other anti-inflammatory diet styles typically promote a reduction or elimination of added sugars and refined flours and grains. (learn more about the connection between refined carbohydrates and cancer)
Perhaps the most characteristic aspect of anti-inflammatory diets is the promotion of anti-inflammatory fats. A typical Western diet, high in saturated and trans fats, has been associated with higher biomarkers of inflammation and chronic disease. Conversely, diets high in monounsaturated fats (e.g. nuts, olive oil, avocado) and omega-3 polyunsaturated fats (e.g. fish, flaxseeds, walnuts) are associated with decreased biomarkers of inflammation. It is thought that the ratio of omega-6 to omega-3 fatty acids in the Western diet is about 15:1, but a diet associated with an improvement in inflammatory state is about 1-3:1.
Probiotics are the beneficial bacteria found in fermented foods such as yogurt, kefir, and sauerkraut, which are the latest superstars of the medical world. In addition to playing a role in a variety of systems – from gut health to mental health, there is some evidence that probiotics can reduce systemic inflammation. **High intakes of dairy products may promote inflammation, so explore some non-dairy options (i.e. miso and fermented vegetables) when increasing probiotics in the diet.
Alexandra Rothwell is registered dietitian, with a specialization in oncology nutrition, primarily consulting with breast cancer patients throughout treatment and survivorship. Previously, she worked with patients of head and neck cancer, bone marrow transplant, gastric, colon, and prostate cancer, among other malignancies. She has completed her Masters of Public Health from Mount Sinai’s Ichan School of Medicine and received her nutrition education from New York University. She now lives in San Francisco.