The Anti-Inflammation Diet
Experts now believe there's a common culprit behind our most
deadly diseases, including cancer, heart disease, and
diabetes. The best defense is right on your dinner plate--and
may be the only diet you'll ever need.
By Catherine Guthrie
As the CEO of a supplement company in Los Angeles, Andy Pham
eats, breathes, and dreams nutritional supplements. In fact,
he downs roughly 80 pills a day. Pham knows he's far from the
norm. Heck, most people pat themselves on the back if they
remember to swallow a single dietary booster, much less six
dozen. So when asked to think like the average time-pressed
American and choose just one nutrient to take every day, he
doesn't hesitate. "Fish oil," he declares. "I take it for the
omega-3 fatty acids. They're a great all-around inflammation
Whether he realizes it or not, Pham's advice is in lockstep
with the latest medical buzz. Researchers are uncovering an
insidious new medical reality: Inflammation, the body's most
primitive weapon against infection and injury, may be at the
root of some of the deadliest diseases of the 21st century,
including heart disease, diabetes, cancer, and Alzheimer's.
The typical 65-year-old with arthritis, an ulcer, and heart
disease goes to see three different doctors: a rheumatologist,
a gastroenterologist, and a cardiologist, says Jack Challem,
author of The Inflammation Syndrome. And he may walk out with
three different treatment plans. "No one stops long enough to
connect the dots and see the underlying inflammatory current,"
Challem says. As a result, what's missing is a unified voice
offering patients nuts-and-bolts advice about how to stamp out
inflammation before it burns out of control.
That's where the alternative approach comes in. Many
practitioners say they've been connecting the dots between
inflammation and disease for years, only to have their
warnings go unheeded. They've been particularly ahead of the
curve in suggesting what they claim is the best defense
against inflammation-related diseases: eating the right foods.
Leo Galland, an internist and founder of the Foundation for
Integrated Medicine in New York City, says he's been writing
and lecturing about the benefits of anti-inflammatory foods
since the early 1980s. "Things I talked about 20 years ago
that were considered out in left field are now so mainstream
they're almost boring," he says. "I feel vindicated on a daily
Here's how the inflammatory cycle can go awry. Under normal
circumstances, inflammation is part of the immune reaction
that helps the body heal when injured. When you slice your
finger cutting onions, for example, blood vessels near the
accident scene expand. That clears the way for the entrance of
white blood cells, good guys who annihilate any bacteria that
sneak in on the knife blade. They also mend ragged tissue by
ordering in new cells to seal the cut. By the time the signs
of inflammation kick in--heat, soreness, and swelling--the
wound is well on its way to healing.
Still, like an inconsiderate houseguest, inflammation can
overstay its welcome. Medical researchers discovered long ago
that certain diseases, such as lupus, Graves' disease, and
fibromyalgia, emerge when the immune system flips on and
refuses to turn off. And a new theory paints an even broader
picture of how other killers gain a foothold when inflammation
It all started with the heart. Until the early 1990s, experts
believed that heart disease, specifically atherosclerosis
(hardening of the arteries), resulted when sticky plaque
glommed on to smooth artery walls, causing the arterial
passageway to narrow. A heart attack was thought to be the
end-case scenario, a blood clot finally plugging the last
remaining opening in the dam. But as it turns out, the process
is more complex than that.
Experts now know that arteries aren't smooth pipes lined with
white globs of gluey fat. Instead they are dynamic,
multilayered tissue structures. Arteries do absorb LDL (bad)
cholesterol from the bloodstream. But instead of sticking to
the artery wall, LDL seeps between the tissue layers and
festers, like an angry plaque-filled blister. The body
triggers an inflammatory response to contain the damage and
the artery swells, constricting blood flow to the heart.
Disaster finally strikes when the plaque bursts and debris
barricades the artery.
With Alzheimer's, a backward glance uncovered the inflammation
connection. Numerous studies show that people who use
ibuprofen, a popular anti-inflammatory, lower their risk of
acquiring the disease. Although the mechanism isn't fully
understood, neurologists believe the brain's immune cells
rally to attack a form of plaque that signals Alzheimer's. The
ensuing skirmish creates inflammation that may spur
progression of the disease.
As for diabetes, it's often related to how much fat a person
carries around on his or her frame. Fat cells ooze
inflammation-boosting proteins called cytokines, so more fat
equals more inflammation. Over time, too many circulating
cytokines dampen the body's ability to monitor insulin
production. Eventually the body's efforts falter, and the gate
swings open for Type 2 diabetes. (It's no coincidence that
rates of the disease are nudging upward in unison with
America's belt size.) Chronic inflammation in the body also
causes cells to oxidize, which may trigger a cascade of
cancerous mutations. In fact, Bruce Ames, a biochemist at the
University of California at Berkeley and former board member
of the National Cancer Institute, thinks inflammation is
responsible for up to 30 percent of all cancers.
Scary stuff for sure, but fortunately, experts are also
learning more about some simple, even pleasurable, ways to
reduce inflammation. Exercise and stress relief are important,
but the best defense, most researchers agree, is through diet.
Most foods either fuel the fires of inflammation or tamp them
down, Galland explains. And fat is the crux of the issue. The
goal is to eat a good balance of inflammatory fats (mainly
omega-6s, as found in safflower, sunflower, and corn oil) and
anti-inflammatory fats (like omega-3s, found in fish, and
omega-9s, which olive oil has). But most people chow down on
up to 30 times more inflammatory fats than anti. "The typical
American diet is priming people for inflammation," says
Challem. "It's like sitting in a parked car with your foot on
the gas. Eventually you'll overheat."
The good news is that dozens of foods, herbs, and spices are
proven to rev up the body's ability to stomp out inflammatory
hot spots. For evidence, one need look no further than studies
of Rheumatoid Arthritis . In one published last January in
Rheumatology International, patients who followed an
anti-inflammatory diet had a 14 percent decrease in joint
tenderness and swelling compared to those who ate a typical
Western diet. Fish oil supplements goosed the results even
further, bringing the final tally of those feeling an
improvement up to 31 percent.
Small studies suggest that an anti-inflammatory diet may also
hold Alzheimer's disease at bay. In a French study of
cognitive decline, scientists followed the diets of 1,600
seniors for seven years. In the end, those who ate fish at
least once a week were less likely to develop the disease.
Because the concept of eating to curb inflammation is still
relatively new, most of the existing evidence is anecdotal.
Jacob Farin, a naturopath in Portland, Oregon, has seen
patients with everything from chronic back pain to
pancreatitis improve after adopting an anti-inflammatory diet.
The bottom line? This new eating plan, laid out in these
pages, may be the most efficient diet you've ever seen. In one
fell swoop, you'll hedge your bets against some of the biggest
health threats facing Americans today.
1. Get Friendly With Fish
Eat fish at least twice a week. Why? Because it overflows with
two key omega-3 fatty acids--eicosapentaenoic and
docosahexaenoic (EPA and DHA for short)--that are potent
anti-inflammatories. Good sources are fatty fish such as
mackerel, salmon, trout, sardines, and tuna. Canned tuna is
fine, but make sure it's packed in water. Otherwise, the
omega-3s leach into the surrounding oil.
You do need to watch out for toxins in fish, though,
especially if you're in a high-risk category. Women who are
either pregnant or hoping to be should avoid shark, swordfish,
king mackerel (a different species from regular mackerel), and
tilefish, all of which harbor potentially dangerous levels of
mercury, which can be damaging to their developing fetus.
(Nursing mothers and young children should avoid these fish,
If you don't want to mess with mercury, you're not so fond of
fish, or you just want to hedge your bets, try fish oil
supplements. Look for a supplement with EPA and DHA and take
2,000 milligrams every day.
Whatever fish-oil delivery system you choose--fresh, canned,
or supplement--don't let this one get away. "There is an
absolute need for fish oil if you're going to quell
inflammation," says Jim LaValle, an integrative physician and
clinical nutritionist at the Longer Living Institute in
There are options for vegetarians, too, though they're not
perfect. The body can make its own EPA and DHA from the
omega-3 fat found in plant sources such as flaxseed, wheat
germ, and walnuts. But the body's mechanism for converting
plant-based omega-3s isn't particularly effective.
Although flaxseed is often touted as a substitute for fish
oil, it just can't compete, says LaValle. "That's one of the
biggest misconceptions in the natural products industry."
One solution is to take flaxseed supplements, but you'll need
to down four times as many of these as you would of fish oil
2. Choose Fats Wisely
Replace trans fats with those high in omega-3s. Good fats
include fatty fish, extra-virgin olive oil, canola oil
(expeller-pressed), walnuts and their oil, hemp oil, and
flaxseed or flaxseed oil.
Trans fats are the worst offenders because they're high in
omega-6s, fatty acids that gum up the body's ability to
regulate inflammation. "If your diet is rich in trans fats,
you're going to drive your body to make more inflammatory
chemicals," says LaValle. The worst culprits are vegetable
shortenings and hard margarines, but most processed foods
house a trans fatty acid or two, usually in the form of
partially hydrogenated oil. (Soon, trans fats will be easier
to spot thanks to new legislation requiring food makers to
list them on ingredient labels by 2006.) Other fats to avoid
(also because of their omega-6s) include safflower oil,
sunflower oil, and corn oil.
3. Embrace Your Inner Herbivore
Load your plate with fruits and vegetables--the more colorful
the better. Brightly pigmented produce such as blueberries,
peppers, and spinach have the most anti-inflammatory
For a simple way to make sure you're eating enough plant-based
foods, Melanie Polk, a registered dietitian at the American
Institute for Cancer Research in Washington, D.C., suggests
using your dinner plate as a measuring tool. Ideally,
two-thirds of the plate or more should be covered with fruit,
vegetables, whole grains, and/or beans, she explains. The
remaining one-third can be filled with lean animal protein,
like a chicken breast or fish fillet, or tofu.
How to Find Out If You're Inflamed
Take the test. Inflammation is measured by a marker
called C-reactive protein or CRP. As inflammation creeps
up, so do CRP levels in the blood. A blood test to
measure levels of CRP is inexpensive ($25 to $30) and
extremely reliable. Patients with autoimmune disease and
cancer often have high CRP levels, but the test is
making headlines for its ability to suss out heart
disease in otherwise healthy-looking people. Those who
have the most to gain from being tested are people at
moderate risk (poor diet plus a lack of exercise) with
otherwise healthy-looking cholesterol levels. (If you
already know you're at high risk for heart disease, the
test probably won't tell you anything new.)
In the future, some experts predict that the CRP test
will be added to other routine medical tests, such as
cholesterol and blood Sugar exams. But if you're
interested now, any doctor can perform it. --C.G.
4. Cut Back on White Foods
Give dairy, sugar, and refined grains a smaller spot on your
plate. Too much dairy and white flour can kick the immune
system into high gear, particularly if you're lactose
intolerant or have celiac disease. In people who suffer from
these conditions, the gut treats dairy and wheat products as
hostile invaders: Often it only takes a bite of bread or a
spoonful of ice cream to get the inflammatory cycle going. One
exception to the dairy rule is eggs, especially those enriched
Sugary foods can also be a problem, especially when eaten
between meals, since they cause a surge in blood sugar. To
reestablish balance, the pancreas lets out a gush of insulin,
which in turn switches on the genes involved in inflammation.
This biochemical roller coaster is thought to contribute to
the onset of Type 2 diabetes.
"When I'm trying to reduce people's inflammation, I make sure
they knock out refined grains, dairy, and sugar," says
LaValle. "You've got to get rid of the inflammatory
5. Take Supplements
If you want to take just one supplement every day, make it
fish oil. But a host of vitamins and herbs can also help. The
most rigorously tested herbal anti-inflammatories are ginger
and turmeric. Both are widely used in India to treat
inflammatory disorders, such as Arthritis and carpal tunnel
syndrome. Physician Andrew Weil suggests taking 400 to 600
milligrams of turmeric extract (either in tablets or capsules)
three times a day.
Ginger is less well studied but still highly regarded. Weil
recommends one to two tablets (500 to 1,000 milligrams) of
powdered dry ginger twice a day with food until pain subsides.
Both ginger and turmeric need to be taken consistently for two
months before showing results.
When it comes to vitamins, E is a good bet. The fat-soluble
vitamin keeps inflammation from even getting started by
disarming integral inflammatory genes. Vitamin E is also a
powerful antioxidant. Galland suggests taking 200 to 400 IU
(134 to 268 mg) of mixed-tocopherol vitamin E daily.