When you’re aiming to be less inflamed, it can be worthwhile to look beyond regular foods to supplements and what I’m calling “add-ins” – foods/condiments to intentionally put on or in your food because of their anti-inflammatory benefits. Check out all the options:

1. Brightly-Colored Spices (like ginger, cinnamon, turmeric, etc)

Brightly-colored spices have high antioxidant content that can be powerfully anti-inflammatory. Several have specifically been researched and tested for efficacy in managing blood sugar in diabetes, though their anti-inflammatory properties can be beneficial for muscle soreness, recovery after exercise, and metabolic syndrome.^1-4

You can take these supplements in concentrated capsules (stick to the recommended dosage) or make a concerted effort to add brightly-colored spices to your food regularly.

2. Fish Oil/Omega-3s/Borage Oil

Increasing intakes of omega-3 fatty acids have been demonstrated to reduce inflammation. They are currently being researched and tested for treatment of many health factors, from prevention of dementia (dementia rates decreased in 19 out of 22 reported studies in a review)⁵ and cancer to lower cholesterol.^6-7

To increase your intake of omega-3s, you can eat more fish, walnuts, flax seed, and chia seeds. Chia is one of my personal favorites because it contains a high concentration of omega-3s and has nearly no flavor. I mix them into oatmeal, smoothies, and yogurt. If you take a capsule supplement, be sure to find one that states it is “burpless” or “enteric-coated.” That ensures the capsules go alllllll the way into your intestines before dissolving, preventing unpleasantly fishy-tasting burps/breath.

3. Tart Cherries

These tart little guys are becoming big news in the anti-inflammatory scene, largely for treatment of inflammatory joint pain caused by conditions like arthritis and gout. Some research with dosing tart cherry has shown similar decreases in pain to leading medications for arthritis and gout.^8-10

You can eat them canned, dried, in supplement form, or drink 100% tart cherry juice.

4. Vitamin D

Vitamin D has been shown to be important not only for preventing cardiovascular disease, osteoporosis, and many types of cancers, but also plays a role in improving depression.⁵

We get a lot less vitamin D these days than we used to. Our primary sources are sunlight (15-20 minutes of sunlight helps our skin make its own vitamin D!) and fortified foods like milk, other dairy, and fruit juices. Supplements are also an option. Ask your doctor to check your vitamin D levels and if they are low, consider working on boosting your intake with food or supplementation.

1. http://journals.sagepub.com/doi/abs/10.3181/0902-MR-78

2. http://journals.sagepub.com/doi/abs/10.1177/193229681000400324

3. http://www.sciencedirect.com/science/article/pii/S2225411016300670

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665015/

5. Pawlak, Laura. The Hungry Brain. 2012. Biomed Books. p. 177.

6. http://europepmc.org/abstract/med/2836574

7. http://www.tandfonline.com/doi/abs/10.1080/07315724.2002.10719248

8. http://www.sciencedirect.com/science/article/pii/S1756464614002886

9. http://www.sciencedirect.com/science/article/pii/S0166432803004650

10. http://www.tandfonline.com/doi/abs/10.1080/03009740600704155

The short answer? Just about everybody. The average person is wandering around with more inflammation going on than is healthy.¹ There are certain conditions, though, that can really see improvement by following an anti-inflammatory lifestyle. In fact, depending on the condition and severity, dietary changes have led to improvements greater or equal to those of medications. Here’s a list of conditions that are related to inflammation and can be improved by incorporating some anti-inflammatory changes to your diet and lifestyle:

• Obesity – high levels of excess fat, especially fat around the waist, are associated with an increase in overall inflammation in the body, which can lead to insulin resistance (diabetes’ slightly less ugly cousin) and heart disease¹
• Diabetes – insulin resistance (mentioned above) is the precursor to diabetes, and is caused largely by inflammation¹
• Heart Disease – atherosclerosis is an inflammatory condition in the arteries that can lead to heart attack, stroke, or clots^{2, 3}

• Arthritis, Gout, and Chronic Pain – these conditions obviously lead to painful joints, and it’s not always true, but in this case, pain = inflammation^4,5
• Frequent Headaches – again, usually (but not always), pain = inflammation⁶
• Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Celiac Disease – these conditions are all linked to inflammation in the gut, which then leads to, well…you don’t want to know
• Dementia (prevention) – there are quite a few connections between chronic inflammation and the progression of dementia, unfortunately it seems we have to nip this one in the bud before it happens⁷

• Endometriosis, PCOS, PMS/Cramps, and other Reproductive Health Issues – each of these has a different link to inflammation, but it typically boils down to either pain or, in the case of PCOS, insulin resistance.⁸ Not based on any research, I can say from personal experience that eating the anti-inflammatory diet made a significant decrease in my cramps (and I’ve seen this for several clients and friends as well).

If you have one of these conditions or just hope to be a happy, healthy human – click here to learn more about anti-inflammatory eating!

Disclaimer: To be clear, I do not recommend that you cease taking medications prescribed by your doctor without his or her approval. Dietary changes do not always replace medication, particularly in severe cases or with specific conditions. Discuss your goals with your doctor and find a Registered Dietitian to assist you in improving your overall health. If you live in Washington state, come see me!

1. https://www.jci.org/articles/view/19451
2. https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis
3. http://circ.ahajournals.org/content/105/9/1135
4. http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/anti-inflammatory-diet.php
5. http://www.sciencedirect.com/science/article/pii/S0166432803004650
6. http://www.sciencedirect.com/science/article/pii/S0304395913003965
7. Pawlak, L. The Hungry Brain. 2012. Biomed books.
8. http://www.sciencedirect.com/science/article/pii/S0015028207002026

Sorry for the delay in posting – I’ve been experiencing technical difficulties. And by “technical difficulties” I mean that my work tablet took a brief swim and is now resting in a pan of rice. 🙁 Pray for dry insides!

Anyhoo, as you may know, eating out and eating well can be a challenge. My favorite mantra for eating out:

You can make a “bad” choice just about everywhere, you can make a “good” choice pretty much anywhere, but you can always make the best choice for where you are.

Life happens. Food is a (wonderful!) part of life. By all means, eat out and enjoy it! Making choices when eating out depends a lot on how frequently you eat out. If you mostly cook at home and eat out once or twice a month or only on special occasions, ignore this post. Go out on your date night, anniversary, or family fun night and enjoy it. Don’t worry about this – it’s not a big enough portion of your whole eating picture to matter that much. I’m not advocating an all-out binge, but you should order what you want and move on.

On the other hand, if eating out is more frequent for you – maybe you travel or life is just busy – the story is different. You will have to tailor your eating out for your health goals if you ever hope to meet them. If you’re hoping to eat well with an eye towards decreasing inflammation, here are some tips from my experiences in the last few weeks:

Asian

We’ve eaten Asian food out twice since I started anti-inflammatory. Once we went to a new (to us) local Asian fusion restaurant that essentially offers a Subway-style, build-your-own sushi wrap, bowl, or salad. When eating out along these lines, choose foods without too much carbohydrate and get lots of veggies. Choose fish (especially salmon) – it’s high in anti-inflammatory omega-3s! If you’re up for spicy, add in brightly-colored spicy sauces, but go easy on those with sugar like teriyaki or sweet chili sauce. The seaweed in sushi is loaded with antioxidants too. I really wanted a sushi wrap so I asked for a light layer of rice, got miso soup on the side, and only ate half of the wrap.

Another day we went to a Korean restaurant. This one was easy – I love bibimbap! If you aren’t familiar, it’s a crackly, delicious cauldron of rice, tons of veggies, a meat of your choice, and an egg. I chose chicken and added loads of the optional veggie add-ins at the table (especially kimchi, which not only has colorful spices but also contains probiotics). Again, I saved half for later.

Italian

This one was tricky because (by far) my favorite type of Italian food is pasta, and most pasta dishes are just that – a giant plate of carbohydrates with a creamy, buttery inflammatory sauce. Hmph. I had to do a little finagling for this one. I decided I would still get pasta but choose a lean meat, an olive-oil based vinaigrette sauce, and lots of colorful vegetables. In this case, I picked a seafood pasta (to up the omega-3s) with tomatoes, onions, and asparagus. To prevent eating too many carbs I only ate half (are you noticing a pattern?). A vegetable-based sauce (like marinara) would have worked nicely too. Watch out for too much cheese or the absurd amount of delicious carbohydrates like breadsticks with pasta, pasta, and more pasta!

If you weren’t so much a pasta person, a salad with Italian vinaigrette or a chicken breast with marinara sauce could be a less inflammatory choice.

Seafood

A friend’s birthday dinner took us to a seafood restaurant. Seafood is anti-inflammatory as long as it’s not covered in butter or alfredo sauce (darn it), so you can choose a fillet of salmon or whitefish with veggies and a starch any time. I opted for a cioppino – basically seafood stewed in a tomato-based sauce with herbs and spices. High in antioxidants and omega-3s! It came with one slice of bread (plus in the spirit of full disclosure, I ate a slice of sourdough as an appetizer too). I skipped a drink and opted for water instead. Since my entree wasn’t inflammatory and it was delicious and reasonably portioned, I ate the whole thing!

Indian

We didn’t actually go out to an Indian restaurant in the last three weeks, but it could be a great place to go for an anti-inflammatory meal because of all of the beautiful spices they use! Keep your rice/naan portion reasonable, choose a sauce that is brightly-colored but not creamy, like curry, and get a brightly-colored veggie for a side (like palak paneer). This is a great opportunity to go meatless and choose a lentil- or garbanzo-based dish as well!

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Eating Out on a Mediterranean Diet

As I’ve continued with anti-inflammatory eating, I’ve frequently found myself at BBQs – summer is starting! Depending on the context, anti-inflammatory eating can be tricky at BBQs because there may not be very many options, other people are bringing the foods, and sometimes the sides are just junk food. Tough anti-inflammatory noogies for Becki.

.

So, I’ve had to be creative: eat small at the BBQ and fill in the gaps with fruits or veggies at home after or bring a fruit or veggie to the BBQ.

Fruit has become my go-to anti-inflammatory snack, and that is fine with me. I’m sprinkling chia seeds on nearly any edible object that will allow it and using lots and lots of spices, which is so fun! I’ve really enjoyed the food I’ve been eating and it’s anything but bland. The anti-inflammatory diet definitely makes for colorful, visually pleasing, and delicious healthful eating.

Tune in later this week for tips on eating out while on an anti-inflammatory diet.

Depending on who you ask, you might find anti-inflammatory recommendations that encourage complete elimination of sugar and carbohydrates to decrease inflammation. As is frequently the case, though, those recommendations are likely unnecessary extremes and everything is case-by-case. For one thing, you can probably achieve the anti-inflammatory benefits you’re looking for while still including well chosen, nutrient dense complex carbohydrates. Secondly, why over-restrict if we can still enjoy some tasty treats in moderation? That’s how we balance meeting health goals and living a life we love! So what does the research actually say about carbs and inflammation?

Multiple studies have linked consumption of concentrated sugar and simple carbohydrate consumption with increased levels of inflammation.^1-2 A long time ago I talked in this post about what happens when we eat carbs and how we break them down into blood sugar to use as fuel. Those fuels are stuck in the blood until insulin comes around to let them in to our cells. High blood sugars, especially over the long term, correlate with inflammation in several types of tissue in the body, including fat cells.³

A strong link has been drawn between chronic inflammation and insulin resistance.⁴ This is a vicious cycle because (as you may remember from this post) insulin resistance means that blood sugars get stuck in the blood without a way out, causing fat storage and inflammation. Stored fat then produces inflammatory factors which make insulin resistance worse! Not fair.

So what can we do about it? Well, we can aim to cut inflammation off at the pass by changing parts of our lifestyle and the foods we eat to combat inflammation and give our cells a helping hand with that blood sugar. With regard to carbohydrates, we can do a couple of things specifically:

1. Focus on eating more complex carbohydrates than simple carbohydrates like sugar. What does that mean? Well, complex carbohydrates are long chains of sugars that take much longer to digest, break down, and enter our blood, thus making our blood sugar much more stable (and preventing inflammation from blood sugar spikes). Simple carbohydrates are individual sugars or tiny chains of sugars that break down very quickly and enter the blood rapidly, causing a sharp spike in blood sugar that is inflammatory. Complex carbohydrates like whole grains, beans, and vegetables are connected with lower levels of inflammation.⁵ Same goes for high-fiber carbohydrates like fruit.

2. Avoid eating too much carbohydrate at once. Just like with diabetes, the key to preventing carbohydrate-induced inflammation is keeping the blood sugar from going too high. Eating controlled amounts of carbohydrate throughout the day can help keep your energy up and your inflammation down.

1. http://ajcn.nutrition.org/content/94/2/479.short
2. https://www.hindawi.com/journals/mi/2013/509502/abs/
3. http://www.jbc.org/content/280/6/4617.short
4. https://www.jci.org/articles/view/19451
5. https://www.ncbi.nlm.nih.gov/pubmed/17391554