Simple dietary changes for patients to reduce inflammation

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By Avery St. Onge

The American diet is filled with inflammatory foods. When eaten in excess, these foods can lead to chronic inflammation that manifests throughout the body contributing to conditions like cardiovascular disease, and type 2 diabetes, according to Victoria Eaton, RDN, LDN, IFNCP, dietitian for the biotech company, NutriSense, based in Chicago. Yet, with inflammatory foods being so widespread and common in the American diet, they can be hard for patients to identify and even more difficult to avoid.

The inflammatory response begins as a way for the body to protect itself. When the immune system encounters a threat, like a virus, bacteria, or physical injury, the immune system deploys inflammatory cells to help heal damage tissue and attack foreign invaders, said Eaton.

“Getting a splinter or paper cut is an example of a healthy inflammatory response: the injured area gets red and perhaps a little puffy and painful,” said Eaton. “This type of response is short-lived and is called “acute inflammation.” It’s essential for healing and trapping outside “offenders.”

However, according to Lora Jody, RDN, holistic nutritionist, founder of Advanced Nutrition Therapy, in greater Lexington, Ky., overtime inflammatory foods and environmental toxins can lead to chronic low-grade inflammation, which happens in the absence of injury or insult to the body.

The more processed the food, the more inflammatory it is, said Jody. Compared to other diets around the world, the American diet is particularly processed. The Mediterranean diet, eaten in countries like Spain, Italy, and Greece, are made up of whole foods like fruit and vegetables, whole grains, beans, olive oil, fish, and chicken, according to Danica Cowen, MS, RD, an integrative dietitian at the University of California San Francisco Osher Center for Integrative Health. Eating a less inflammatory diet, like the Mediterranean diet can have several health benefits, according to Stacie Stephenson, DC, CNS, founder, and chief executive of the health and wellness media company, VibrantDoc, based in Chicago and Phoenix.

“Inflammation is an important concern because it likely underlies, at least to some extent, just about every common chronic disease of the 21st century,” said Stephenson. “An anti-inflammatory diet is both healing and preventive. There is no downside.”

Processed wheat flour

Inflammatory ingredients are often found in American comfort foods, the number one ingredient being wheat flour. According to Jody, 35 percent of the average American diet comes from processed flour. She said foods like crackers, breaded or batter foods, bread, and pasta are usually made with processed wheat flour. With such a significant amount of the American diet made up of wheat, Jody explained, Americans are filling up on calories that are not only inflammatory but lacking in nutrients. Even whole wheat, Jody said, which is commonly believed to be healthy, lacks in nutrient value.

According to Eaton, refined carbohydrates like processed flour, are often the source of what causes inflammation in foods.

“Inflammatory foods are typically ultra-processed, high in calories, and low in important nutrients like fiber, antioxidants, vitamins, and minerals,” said Eaton.

Although wheat can cause inflammation, Jody said practitioners can suggest alternative flours made from whole ingredients. For baked goods, Jody said cassava flour, oat flour, and almond flour can substitute wheat flour. Additionally, Jody said pastas made of chickpeas and lentils are readily available and far more nutritious than traditional pasta made with white flour.

As for grains, Stephenson said they should be eaten in moderation. She said whole, intact grains like brown rice and quinoa are more nutritious options than refined carbs, but vegetables and legumes are even better substitutes.

“If you want to eat an anti-inflammatory diet, I have two words for you – whole foods,” said Stephenson. “When you eat foods in their natural form, the body knows what to do with those foods, and they will encourage the growth and proliferation of the beneficial bacteria in your microbiome that contribute in so many ways to good health.”

Refined sugar

Another common ingredient that can cause inflammation, according to Jody, is sugar. Jody explained that sugar is inherently inflammatory and lacking in nutrients. In the United States, high amounts of refined sugar are found in many processed food and drink items like candy, donuts, soda, cereal, and coffee, said Eaton. 

There are several theories as to why foods cause inflammation, Stephenson explained. Because inflammatory foods are often low in nutrients, some theorize that the body does not recognize them as a food, triggering an immune response. Others believe the inflammation is a result of how the foods interact with the gut.

“Some people think that highly processed foods are inflammatory because of the way they change the gut microbiome, feeding the microbes that tend to trigger inflammatory processes rather than the beneficial microbes,” said Stephenson.

Sweet foods, Jody said, should be avoided as much as possible, however, some forms of sweeteners tend to be less inflammatory than others. Instead of highly processed sugar, Jody suggested small amounts of maple syrup and honey. She said these substitutes are purer and contain more nutritional value than things like cane sugar and high fructose corn syrup.

Dairy

Dairy can also be a source of inflammation, according to Jody. She explained that most adults have an intolerance to dairy to some extent and it gets worse as people age. Whey, a protein found in dairy, does not metabolize, or absorb as well in the body as plant protein, according to Jody.

 “The type of protein and sugar that’s in dairy humans are not necessarily meant to process,” she said.

Jody said the level of inflammation due to dairy is based on one’s intolerance to it and the level of gut dysfunction it’s causing. She said in functional medicine, practitioners often apply an elimination diet to determine a patient’s intolerance to dairy.

If a patient does show signs of a dairy intolerance, Jody said there are several dairy alternatives. Instead of cow’s milk, Jody said unsweetened almond milk, oat milk, and coconut milk are good substitutes. To make sure their milk is completely pure and unsweetened, patients can even make plant-based milks at home she said, with water filtered with nuts or oats.

Vegetable oil

Highly processed oils rich in omega-6 like vegetable oil, often promote inflammation, explained Eaton. Vegetable oil can be found in foods like potato chips, French fries, and donuts all cornerstones of the American diet. The Standard American Diet (SAD), according to Cowen, is filled with calorie dense foods such as these with high levels of saturated fat, which can contribute to cardiovascular disease and death.

Olive oil, accord to Cowen, is a healthier alternative to vegetable oil as it’s high in monounsaturated fatty acids and polyphenols. Eaton also suggested coconut oil while cooking at low heat levels and avocado oil for higher temperature cooking as a substitute.

Alcohol

To prevent chronic, low-grade inflammation, according to Jody, patients should also limit alcohol consumption. Jody said inflammation can result from the way in which the liver processes alcohol but also, alcoholic drinks often contain high amounts of sugar. Like all inflammatory foods, Jody said while ideally, they should be cut out of people’s diet completely, that’s not always manageable. She said drinks high in sugar like margaritas and daiquiris should be completely avoided, but more simple drinks with lower amounts of sugar can be okay in moderation.

In general, said Stephenson, the more processed the food, and the farther it is from its natural state, the more inflammatory it will be.

“There is a whole food equivalent for just about any processed food, and while the taste may be less exciting at first for those who eat a lot of processed food, it’s good to train your palate back to appreciating the taste of real whole food,” said Stephenson.

Eaton suggested that preparing meals at home is always better than eating out, so patients know exactly what is in their meals.

“While this isn’t novel advice, it’s still pertinent: a diet rich in antioxidants and whole, unprocessed foods is the best remedy for inflammation,” said Eaton