The anti-inflammatory diet continues to show that it is a valuable tool in the fight against dangerous and disease-causing inflammation. Using the guidance in this blog post will help you to reduce your levels of chronic inflammation.
While I talk about a variety of chronic health conditions, I will focus on inflammation’s affect on cancer risk. Because inflammation is strongly linked to cancer, reducing chronic inflammation is one of my 3 Keys to Cancer Risk Reduction.
Use the table of contents below to help navigate this comprehensive post on the Anti-inflammatory Diet, afterwards, download and print the Anti-Inflammatory Diet PDF to keep a summary of this article.
Anti-Inflammatory Diet Table of Contents
What is inflammation?
I think the best way to understand inflammation is with this analogy that I created: Let’s say, you get up in the morning and look out your window. You see a car accident on your street, so you pick up the phone and call 9-1-1.
The first responders all arrive – the paramedics take care of the injured parties, the firefighters clean up any spilled fuel and put out any fires, the tow truck takes away the damaged vehicle and the police get the traffic moving again. In a few hours, you look out your window and your street is back to normal. Think of this as acute inflammation, acute means ‘short term’.
Let’s think of how this works in your body. If you cut your finger, your body calls cellular 9-1-1 and all the cellular first responders come to the scene. You know they are there because you see the signs of inflammation – heat, pain, redness, swelling and loss of function.
After the injury heals with the help of those cellular first responders, they die or go to other areas of the body and don’t hang around. After a week or so, your finger is back to normal. This is acute inflammation – it’s a normal, healthy functioning system and its part two in the four-part wound healing process.
Now let’s go back to that scenario in the street. There is a car accident in front of your house, and you called 9-1-1. This time the first responders arrive but they don’t leave. Now what happens? The pedestrians slow down to look and the sidewalk becomes congested. It’s the same with cars that slow down to see what is going on and traffic starts to back-up. Some drivers start honking which creates new problems.
When it’s garbage day, the residents put their garbage out, but because of all the congestion with the first responders that haven’t left, the garbage truck can’t get down the street to pick it up. Then that garbage starts to smell and you’re getting more cockroaches, rats and raccoons on the street.
What was once a healthy functioning system, just by having responders stay too long, has become a breeding ground for dysfunction and disease. Think of this as chronic inflammation – chronic means ‘long term’.
You may have an injury or invader somewhere in your body – it could be a sunburn, a cut, or a virus and your body calls cellular 9-1-1. But if those cellular first responders come to the scene and don’t leave, it creates an environment called chronic inflammation.
Chronic Low-Grade Inflammation Creates Disease
Chronic inflammation creates an environment that cancer cells love. It is also an environment that allows heart disease, Alzheimer’s and other chronic diseases to take hold and it is involved in lymphedema, which is a chronic swelling condition. By definition, chronic low-grade inflammation is a persistent condition resulting in tissue destruction and repair occurring simultaneously over a long period of time (8).
Inflammation I Can Feel in My Body
Some inflammatory conditions are very painful or at least uncomfortable, and you can feel “inflamed” or feel the painful inflammation in your body. Conditions such as heart burn, colitis, and arthritis are all examples.
Because my work as a registered dietitian focuses on cancer, I want to review some evidence for chronic inflammatory conditions and cancer. Let’s talk about inflammation you can feel first.
Arthritis and Inflammation
In a review paper published in 2008 researchers explored whether arthritis is linked to cancer, they found that people with rheumatoid arthritis were at increased risk of developing both lymphoma and lung cancer compared to the general population (1). The risk for lymphoma was double that of the general population (3.29 times higher for Hodgkin’s lymphoma and 1.95 times higher for non-Hodgkin’s lymphoma).
The authors summarize this meta-analysis of 21 publications that examined relative risk of cancer for individuals with rheumatoid arthritis “the findings among the studies which included a variety of medications are consistent…it is the underlying inflammation rather than the mediations for treatment that contributes to the risk [of cancer]” (1). Arthritis is not the only inflammatory condition linked to cancer
COPD and Inflammation
Chronic obstructive lung disease (COPD), a lung disease with long-standing inflammation, is a risk factor for lung cancer and inflammation in the lungs contributes to both the susceptibility and progression to lung cancer (2).
GERD and Inflammation
Gastro esophageal, reflux disease (GERD), commonly known as “heart burn” and Barrett’s esophagus are two inflammatory conditions of the esophagus. Both of these are associated with a higher risk of esophageal cancer and inflammation is thought to be the driving force behind the risk (3).
Inflammatory Bowel Disease and Inflammation
Children who are diagnosed with either Crohn’s disease or ulcerative colitis, (collectively called Inflammatory bowel disease) have a greater risk of developing cancer, especially a GI cancer, both in childhood and later in life. “The extent and duration of chronic inflammation might be the main driving mechanism of the increased risk of cancer” (4).
Lymphedema and Inflammation
Chronic Low-Grade Inflammation and Cancer
It’s important to know, that arthritis, GERD, Crohn’s disease and lymphedema are all examples of inflammation you can feel in your body. However, you don’t have to feel inflammation for it to be doing damage.
Chronic low-grade inflammation can be just as dangerous, and perhaps even more so, because, you don’t feel it and don’t know you have it and therefore, are not taking steps to reduce your risk.
Let’s talk about some strategies you have to reduce your risk including how to measure inflammation and how to reduce it.
How Do I Measure Inflammation?
Since inflammation is a response by the body’s immune cells, it is possible to take a blood test to measure the level of these cells to gauge the amount of chronic inflammation in your body. The most common blood test for this is called high sensitivity C-reactive protein (hs-CRP) (5).
- C-Reactive Protein (CRP)
- Erythrocyte sedimentation rate (ESR)
- Plasma viscosity (PV)
- TNF-alpha (tumor necrosis factor-alpha)
- Interleukin biomarkers;
These tests are used in research on inflammation but are not necessarily done in routine blood work or even by specialists . You would need to request a blood test from your doctor. But regardless of whether you have the blood results or not, I recommend you implement anti-inflammatory strategies.
How Do I Reduce Inflammation?
Consuming an anti-inflammatory diet has been shown to reduce inflammation. The specific eating pattern, that has been found to reduce the hs-CRP level is a plant-based diet high in fruits, vegetables, and whole grains with little red meat (7).
An example of an eating pattern that is anti-inflammatory is the Mediterranean diet (also called the traditional Mediterranean diet). The main aspects of this diet are high amounts of monounsaturated fat (mostly from olives and olive oil), omega-3 and 6 fatty acids fruits, vegetables and whole grains.
While in North American and Northern Europe a typical source of omega-3 is from cold water fish, mainly salmon, in the Mediterranean, the omega-3 comes from olive oil, nuts, fish (sardines and anchovies are two examples of Mediterranean fish that have omega-3), spinach, purslane and wild onion (10).
What Foods Are Anti-Inflammatory?
- Antioxidant rich fruits and vegetables (typically those that are bright coloured), including;
- Sweet potato
- Green leafy vegetables
- Fruits, vegetables
- Whole grains
- Omega-3 Fatty Acids
- Cold water fishes (salmon, herring, sardines, anchovies, rainbow trout)
- Flax oil and seeds
- Green and black tea
- Vitamins A, C, D and E
- B Vitamins Niacin and Riboflavin
- Minerals Zinc and Magnesium
- Low Glycemic Index (GI) and Low Glycemic Load (GL) (9)
What Foods Are Inflammatory?
- Foods that contain trans fats
- Deep fried foods and other foods cooked in oil at high temperatures or for a long time
- Saturated fat
- Animal fat
- Tropical oils (coconut, palm and palm kernel)
- High glycemic index (GI) or high glycemic load (GL)(9)
- Foods high in sugar
- Processed carbohydrate foods
- White/refined breads and cereals
In addition to these specific foods, eating too much food and carrying extra body fat (especially if you carry the fat around your waist) are inflammatory.
Anti-Inflammatory Diet and Cancer
Can Following an Anti-Inflammatory Diet Reduce My Cancer Risk?
The Dietary Inflammatory Index and Cancer
- A higher DII (an inflammatory diet) was associated with:
- A higher incidence of cancer (the increased odds of developing cancer ranged from 16% to 216%)
- A higher risk of death from cancer (67% increase in risk, range 13% – 248%)
- A 12% higher incidence of breast cancer, a 33% higher incidence of colorectal cancer and a 30% higher incidence of lung cancer
How Does Inflammation Contribute to Cancer Risk?
- Inflammation is linked to oxidative damage to DNA and a mutation of tumor suppressor genes
- Inflammation can negatively influence the microbiome
- A pro-inflammatory diet may change the expression of certain genes by turning them on or off (epigenetic changes) that promote tumor growth (9)
Summary:Reducing Inflammation and Decreasing Cancer Risk
- Make changes to your diet to become more plant based
- Include spices in your cooking especially garlic, ginger, turmeric and onion
- Take steps to lose weight especially if you carry excess weight around your waist
- Participate in regular exercise
Anti-Inflammatory Diet PDF
Download and print the Anti-Inflammatory Diet PDF.
Anti-Inflammatory Diet Webinar
To watch a webinar on the Anti-Inflammatory diet and earn 1 CEU for dietitians go to Dietitian Central
References for Anti-Inflammatory Diet
1. Smitten, A.L., Simon, T.A., Hochberg, M.C. et al. A meta-analysis of the incidence of malignancy in adult patients with rheumatoid arthritis. Arthritis Res Ther 10, R45 (2008) doi:10.1186/ar2404
2. Bozinovski S, Vlahos R, Anthony D et al. COPD and squamous cell lung cancer: aberrant inflammation and immunity is the common link. Br J Pharmacol. 2016 Feb;173(4):635-48.
3. Abdel-Latif MM1, Duggan S, Reynolds JV, et al. Inflammation and esophageal carcinogenesis. Curr Opin Pharmacol. 2009 Aug;9(4):396-404. doi: 10.1016/j.coph.2009.06.010. Epub 2009 Jul 10.
4. Olén O, Askling J, Sachs MC, et al. Childhood onset inflammatory bowel disease and risk of cancer: a Swedish nationwide cohort study 1964-2014. 2017 Sep 20;358:j3951. doi: 10.1136/bmj.j3951.
5. Collins, K. Inflammation: How to Measure it and Reduce it. July 17, 2019.
6. Tidy, C, Bonsall A. Blood Tests to Detect Inflammation. July 28, 2018.
7. Neale EP, Batterham MJ, Tapsell LC. Consumption of a healthy dietary pattern results in significant reductions in C-reactive protein levels in adults: a meta-analysis. Nutr Res. 2016 May;36(5):391-401. doi: 10.1016/j.nutres.2016.02.009. Epub 2016 Feb 22.
8. Shivappa, N, Miao Q, Walker, M et al. Association Between a Dietary Inflammatory Index and Prostate Cancer Risk in Ontario, Canada. Nutr Cancer. 2017 Aug-Sep; 69(6): 825–832.
9. Fowler ME, Akinyemiju TF. Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. Int J Cancer. 2017 Dec 1;141(11):2215-2227.
10. Galli C, Marangoni F. N-3 fatty acids in the Mediterranean diet. Prostaglandins, Leukotrienes and Essential Fatty Acids 75. 2006., 129-133.
11. Ricker MA and Haas WC. Anti-Inflammatory Diet in Clinical Practice: A Review.Nutr Clin Prakt. 2017;32:318-325.
12. Shivappa N, Steck S, Hurley TG et al. Designing and developing a literature-derived, population-based inflammatory index. Public Health Nutr. 2014 Aug;17 (8): 1689-1696.
13. Dimitrov S, Hulteng E and Hong S. Inflammation and exercise: inhibition of monocytic TNF production by acute exercise via Beta2-adrenergic activation. Brain Behav Immun. 2017 Mar;61: 60-68.
14. Pinto A, Di Raimondo D and Tuttolomondo A et al. Effects of physical exercise on inflammatory markers of atherosclerosis. Curr Pharm Des. 2012; 18(28):4326-49.
15. Nimmo MA, Leggate M, and Viana JL et al. The effect of physical activity on mediators of inflammation. Diabetes Obes Metabl. 2013. Sept;15 Suppler 3:51-60.
16. Liang Y, Jiao H, Qu L et al. Positive association between dietary inflammatory index and gastric cancer risk: A systematic review and meta-analysis. Nutritionists Cancer. 2019 Nov 24;1-7.