Diet has a huge influence on our health. Here is how it can enhance your way of life. Photo / 123rf
Chronic inflammation can lead to heart disease and cancer. We asked the experts which foods to eat — and avoid — to help tackle it.
Ignore chronic inflammation at your peril. Recognised as a contributor to many deaths globally, half of these are partly attributable to inflammation-related diseases such as heart disease, stroke, cancer, and type 2 diabetes.
“Whilst helpful in the short term as part of the body’s healing process in response to injury or an infection, inflammation becomes harmful if it becomes chronic,” says Dr Sammie Gill, a dietitian and irritable bowel syndrome (IBS) specialist.
“And it can cause damage to tissue and cause disease.”
Diet is a huge influence. “Some foods such as the highly processed Western-style diet, with high levels of saturated fat, fuel inflammation. Others, such as a Mediterranean-style diet with its plant-based healthy fats and lean protein content, have an anti-inflammatory effect, which can be helpful in preventing and managing chronic diseases.”
Chronic inflammation is low grade (most people won’t know they have it), but persistent and can cause long-term collateral damage to tissue and organs, as well as affect immune function, leading to increased susceptibility to infections and tumours.
“Chronic inflammation can be silently damaging your body and the effects will only become noticeable over time,” says Gill.
Conditions associated with chronic inflammation include:
Inflammatory bowel diseases such as Crohn’s and ulcerative colitis.
Mental illnesses such as depression.
What is the anti-inflammatory diet?
“An anti-inflammatory diet is not one diet per se, more of an umbrella term for an approach to eating a largely plant-based diet, with wholegrains, legumes and lean proteins such as fish, including oily fish such as salmon and mackerel, and poultry, and only a small amount of saturated fat,” says Gill.
“This approach is the foundation of the Mediterranean diet, the dietary approach to stopping hypertension (Dash) diet and the Nordic diet, which all focus on plant-based foods, healthy fats such as oily fish, nuts and avocados, rather than red or processed meat.”
Gill says diet has been shown to be a good predictor of C-reactive protein (CRP) levels in the blood. High levels are a marker for inflammation in the body. “Studies have consistently shown that higher intakes for fruit, vegetables and fish are linked with lower levels of CRP. Saturated fat, red and processed meats are linked with higher CRP levels.”
Inflammatory foods include those high in saturated fats such as meat, including processed meat, and butter, as well as processed foods such as cakes and biscuits, which contain palm oil.
Marcela Fiuza, a registered dietitian at Marcela Nutrition, says in her practice she uses a Med-style anti-inflammatory diet because it’s easy to follow and has the best evidence base.
“As well as metabolic health it’s very beneficial for your joints, reducing your risk of certain types of cancer, and it’s important for brain health and cognitive function. There are also benefits for your emotional health including reducing the risk of depression and improving mood.”
Foods to include
Anti-inflammatory foods include:
Green leafy vegetables: “Broccoli, kale and spinach are all anti-inflammatory,” says Ursula Arens, a nutrition writer and former registered dietitian. “Try to eat them regularly (it doesn’t have to be every day) as they contain plant chemicals including polyphenols which reduce inflammation.”
Pulses and legumes such as chickpeas, beans and lentils.
Unsalted nuts and seeds.
Fruits, including blueberries, cherries, strawberries, apples, bananas, oranges and grapes are all rich sources of antioxidants that have anti-inflammatory effects. “Don’t get fixated on eating particular ones, eat the ones you enjoy and aim for a variety,” Arens advises. “The recommended intake is five a day in the UK, but seven in Australia (five vegetables and two fruits). Most people in the UK are only averaging 3.5 a day. All types of fruit count, including fresh, frozen and tinned.”
Oily fish: “These include salmon, sardines, mackerel, herring and fresh tuna (but not tinned),” says Arens. “They are rich sources of long-chain omega fatty acids, which have a strong evidence base for reducing inflammation, particularly in arthritis. The UK government recommends eating two portions a week of fish, one of which would be oily. This probably wouldn’t be enough on its own to help with something like arthritis, though, you would need to take fish oil supplements as well and medication. Large amounts of omega-3s will help, but won’t cure the condition.”
Olive oil and rapeseed oil.
Wholegrains including wholemeal bread, pasta and rice.
Tea, including black tea and green tea. “Tea has a high anti-inflammatory index score, it doesn’t matter whether it’s black or green, although there’s some evidence adding milk might reduce the effects,” says Arens.
Coffee is also anti-inflammatory because it contains polyphenols (but doesn’t score as highly as tea).
Lean protein such as chicken or turkey, or vegetarian alternatives such as tofu.
Dark chocolate (look for 70 per cent cocoa and above and stick to a few squares).
Herbs and spices such as garlic, ginger and turmeric are anti-inflammatory agents. Use to flavour food instead of salt.
Red wine: although it is anti-inflammatory due to its high content of resveratrol, experts don’t advocate drinking too much alcohol. Whole grapes and berries are better sources of resveratrol.
Foods to avoid or limit
As a general rule avoid or cut down on foods high in saturated fat and sugar.
Red meats such as burgers and steaks and processed ready meals containing red meat have high levels of saturated fat, which is pro-inflammatory, so eat only small amounts.
Processed meats such as salami, ham, sausages, bacon and chorizo.
Deep-fried foods such as chips and takeaways.
Sweets and milk chocolate.
Baked goods including shop-bought cakes and biscuits.
Sugary drinks.
Foods containing trans fats such as processed ready meals and some margarines.
Crisps.
Alcohol.
Takeaway and processed pizzas.
Coconut oil and butter.
Full-fat milk and hard cheese.
Health benefits
Following an anti-inflammatory diet can help with several conditions where inflammation is the main driver, although you may also need medication and have to make lifestyle changes such as being more active, giving up smoking, managing stress, cutting down on alcohol, and getting better sleep.
Heart health
Most evidence for the health benefits of the anti-inflammatory diet lies in the heart health field. Going back to the 1950s, the Seven Countries Study by the American physiologist Ancel Keys found dietary patterns in the Mediterranean were associated with lower rates of heart disease and death.
The Lyon Diet Heart Study, built on these findings, showed the Mediterranean anti-inflammatory diet had a striking protective effect on heart attack recurrence. “Since then, large-scale epidemiological and intervention trials have consistently shown compelling evidence on cardiovascular health including lowering hypertension (high blood pressure) and blood lipids (cholesterol and triglycerides),” says Gill.
Type 2 diabetes and weight management
The anti-inflammatory diet has shown promise in metabolic health with previous studies showing improvements in glycaemic (blood sugar) control.
A study published last year found the Mediterranean diet was effective in helping to control blood sugar in people with type 2 diabetes. An anti-inflammatory diet is also linked to a lower body weight and body mass index (BMI), as well as a lower risk of gaining weight over time.
Mental health
The Smiles trial found people with moderate-to-severe depression who followed a Med-style anti-inflammatory diet, eating 50g of fibre a day, had a 32 per cent reduction in depression symptoms compared with 8 per cent in a control group. Since then, other studies have reported similar findings.
Tips for starting an anti-inflammatory diet
Start gradually: “Some people like to change everything overnight in an all-or-nothing sort of way,” says Fiuza. “But I generally find people stick to it more if they make small changes gradually — adding lentils to a bolognese sauce for instance to replace half the meat, using olive oil for cooking or cutting out white bread for wholemeal or white rice or pasta for brown.”
Cook meals from scratch: “That way you will avoid trans fats and a lot of the saturated fats and sugars that are added to goods to improve taste and extend shelf life,” Fiuza explains. “It gives you much more control over the ingredients.”
Go for variety: “Instead of buying a tin of red kidney beans or a packet of frozen peas, choose a tin of mixed beans or mixed vegetables instead to benefit your gut microbes,” says Dr Gill. “Same with nuts and dried fruit, opt for a mixed bag of different varieties.”
Batch cook: “Not everyone has the time and energy to cook a meal every night after work, so try batch cooking and freezing meals which you can defrost when convenient.”
Think apples, onions, and tea: “One study found that apples, tea, and onions were the foods with the most anti-inflammatory effects, so that might be a good place to start,” says Arens.
Seven-day meal plan
Weekly menu
Monday
Breakfast: Smashed avocado on wholegrain bread with a poached egg