Author: Michael Bernstein, MS, IFNCP
Date: April 2025
Inflammation is a key part of the immune system and part of the body’s natural defense. There are two types of inflammation, acute and chronic. Acute inflammation is usually in response to an injury, infection, or irritant, and is usually short-term. In contrast, chronic inflammation is usually lower grade and takes place long-term. If left unchecked, it can progress and lead to non-communicable diseases (NCD), such as obesity, type 2 diabetes (T2D), cardiovascular disease (CVD), and certain cancers. It can also contribute to many other conditions not limited to autoimmune disorders such as rheumatoid arthritis, as well as asthma, COPD, CKD, and IBD. In general, inflammation underlies the pathology of so many health conditions. A poor diet can promote low grade chronic inflammation whereas a healthy diet can help mitigate it. One of the key inflammatory pathways in the body is the arachidonic acid cascade. Arachidonic acid is an omega-6 fatty acid. The arachidonic acid cascade is stimulated by consuming foods high in omega-6 fatty acids, which includes linoleic acid and arachidonic acid, the main omega-6 fatty acids. When the arachidonic acid cascade is stimulated, COX and LOX enzymes produce pro-inflammatory eicosanoids, which are inflammatory mediators. On the other hand, consumption of omega-3 fatty acids competes with the arachidonic acid cascade, and COX and LOX enzymes produce less inflammatory or anti-inflammatory eicosanoids from omega-3 consumption. Prostaglandins and leukotrienes are types of eicosanoids that can be either pro-inflammatory or anti-inflammatory, and resolvins and protectins are specific types of anti-inflammatory eicosanoids produced from omega-3s. Excessive dietary consumption of omega-6s in relation to omega-3s contributes to a pro-inflammatory state. Also, there is a type of omega-6 fatty acid called DGLA (dihomo-gamma-linolenic acid) that is also anti-inflammatory. It can be found in high amounts in borage oil, evening primrose oil, as well as blackcurrant seed oil. Seed oils, such as soybean and corn oil, which are used in cooking, are very high in omega-6 fatty acids. Also, grain-fed beef is higher in omega-6s compared to grass-fed beef. Omega-3 fatty acids include ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). ALA is a short-chain omega 3 fatty acid, and comes mainly from nuts and seeds including walnuts, flaxseed, and chia seed. EPA and DHA are long-chain omega 3s, and come mainly from fatty fish including as salmon, other seafood, or fish oil supplements. The body can convert ALA to EPA and DHA, but not very efficiently. Both omega-3s and omega-6s are essential, meaning that the body cannot synthesize them and they must be obtained from diet. In the standard American Diet, the ratio can be as high as 25:1 (omega-6 to omega-3). When this ratio is excessively high, it can contribute to chronic inflammation. A ratio of 2:1 or 1:1 is more favorable. Also, omega-3s were shown to lower inflammatory biomarkers including TNF-alpha, CRP, and IL-6 (Chavda et al., 2024; Johnston C, 2009; Institute for Quality and Efficiency in Health Care, 2021; Pahwa et al., 2023; van Zonneveld et al., 2024; Yu et al., 2024).
Dietary strategies to reduce inflammation involve following an anti-inflammatory diet. Eliminating meat, poultry, and eggs can help lower the intake of arachidonic acid, which can lower inflammation. Animal proteins may promote inflammation through heme iron, and also through cooking meat at high temperatures, which releases advanced glycation end products. Plant proteins, including soy products such as edamame, tofu, and tempeh, are considered anti-inflammatory. Their phytoestrogens, specifically daidzein and genistein, may contribute to these beneficial effects. In general, a balanced vegetarian diet may be better at reducing inflammation. A pesco-vegetarian diet, which includes fish and other seafood, can help to lower arachidonic acid levels and increase EPA and DHA through seafood. One of the most studied and recommended diets for lowering inflammation is the Mediterranean diet (MedDiet). The MedDiet includes fruits, vegetables, whole grains, beans, nuts, seeds, olive oil, and low to moderate amounts of dairy, poultry, and fish. The DASH diet (Dietary Approaches to Stop Hypertension), which shares similarities with the Mediterranean diet, has also been shown to lower inflammation. Both diets emphasize fruits and vegetables, which have anti-inflammatory effects. This is attributable to multiple mechanisms including vitamins, minerals, phytochemicals, and fiber. Vitamins A, C, E, D, and minerals including magnesium and zinc, as well as phytochemicals such as polyphenols and carotenoids are antioxidants that can help neutralize free radicals and lower oxidative stress and inflammation. Oxidative stress occurs when there is an imbalance of ROS (reactive oxygen species) to antioxidants. Consuming antioxidants can lower ROS, and this can help reduce inflammation, since ROS can trigger inflammatory pathways. In terms of phytochemicals, polyphenols in fruits and vegetables have antioxidant properties, which lowers oxidative stress, and can inhibit inflammatory pathways. Brussels sprouts, cabbage, broccoli, and cauliflower are high in polyphenols and other anti-inflammatory compounds. Onions, asparagus, and broccoli, aside from their vitamin and fiber content also contain the flavonoids kaempferol and quercetin, which have antioxidant properties, which can lower inflammation. Carotenoids, specifically lycopene and beta-carotene, which are found in carrots, tomatoes, as well as dark green vegetables such as kale, spinach, and collard greens, can also reduce oxidative stress and inflammation. In terms of fruit, citrus fruits, berries, and cherries are anti-inflammatory. Berries have flavonoids, which are a type of phytochemical, specifically anthocyanin, which can inhibit the expression of inflammatory cytokines (Chavda et al., 2024; Johnston C, 2009; Institute for Quality and Efficiency in Health Care, 2021; Pahwa et al., 2023; van Zonneveld et al., 2024; Yu et al., 2024).
Other components of an anti-inflammatory diet include dietary fiber, which is only found in plant foods. Dietary fiber helps the gut produce beneficial short-chain fatty acids (SCFAs), which can help lower inflammation. Prebiotic and dietary fiber contained in fruits and vegetables can help promote gut health through improving diversity of the gut microbiome, alleviating dysbiosis, which can lower inflammation. Also, consumption of probiotic containing foods including miso, kombucha, yogurt, sauerkraut, kimchi, etc. may help improve the integrity of the gut barrier, which can help prevent leaky gut and antigens from leaking through the gut lining into the bloodstream. It is also good to focus on low glycemic foods such as whole grains, legumes, and non-starchy vegetables, which not only help regulate blood sugar, but also lower oxidative stress, which can lower inflammation. Foods containing monounsaturated fatty acids including olive oil, avocados, nuts and seeds, such as almonds, cashews, peanuts, and sesame seeds may result in a less inflammatory state. The consumption of nuts and seeds is linked to lower oxidative stress. Walnuts are particularly beneficial, as they contain more polyphenols than any other nuts and are anti-inflammatory. Olive oil, specifically extra virgin olive oil, has many polyphenols, which are anti-inflammatory. Regular olive oil is highly refined and should be avoided. Coffee, as well as green and black tea, contain polyphenols which are anti-inflammatory. Herbs and spices including ginger, garlic, cinnamon, and turmeric have antioxidant properties, which can lower inflammation. Foods that should be avoided as much as possible include processed foods. They usually contain unhealthy fats, starches, sugar, sodium, and additives. They also contain empty calories since they are void of vitamins and minerals. Additionally, they can have adverse effects on the gut microbiome, which may lead to gut dysbiosis. Also, sugar sweetened beverages should be avoided as much as possible. By following an anti-inflammatory diet, such as the MedDiet, and avoiding processed foods, individuals that are overweight can lose weight, and losing weight can lower inflammation. Fat tissue releases adipokines, which are inflammatory cytokines, and can promote systemic inflammation. Having less fat tissue can lower the amount of adipokines released. In order to test for systemic inflammation, a few biomarkers that can be assessed inexpensively include C-reactive protein (CRP), fibrinogen, and serum protein electrophoresis (SPE). There are tests that can measure inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1beta), interleukin-6 (IL-6), and interleukin-8 (IL-8), however, these tests aren’t standardized and can be expensive. Following an anti-inflammatory diet, such as the MedDiet, can help lower CRP, TNF-alpha, and IL-6 (Chavda et al., 2024; Johnston C, 2009; Institute for Quality and Efficiency in Health Care, 2021; Pahwa et al., 2023; van Zonneveld et al., 2024; Yu et al., 2024).
References:
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Institute for Quality and Efficiency in Health Care. (2021, May 18). What Is an inflammation? National Library of Medicine; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK279298/
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Nelson, B., & Faquin, W. (2025). How pro-inflammatory diets may create the right recipe for cancer: In this second of a two-part series on how nutrition can influence cancer, recent studies linking some foods and additives to higher cancer risks have zeroed in on the contributing role of unresolved inflammation. Cancer cytopathology, 133(4), e70007. https://doi.org/10.1002/cncy.70007
van Zonneveld, S. M., van den Oever, E. J., Haarman, B. C. M., Grandjean, E. L., Nuninga, J. O., van de Rest, O., & Sommer, I. E. C. (2024). An Anti-Inflammatory Diet and Its Potential Benefit for Individuals with Mental Disorders and Neurodegenerative Diseases-A Narrative Review. Nutrients, 16(16), 2646. https://doi.org/10.3390/nu16162646
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* The content provided by this article is for informational purposes only. These statements are not intended to diagnose, treat, cure, or prevent any disease. This article is not intended to provide personal medical advice, which should be obtained from a medical professional.
