The Anti-Inflammatory Diet is not a diet in the popular sense – it is not intended as a weight-loss program (although people can and do lose weight on it), nor is it an eating plan to stay on for a limited period of time. Rather, it is way of selecting and preparing foods based on scientific knowledge of how they can help your body maintain optimum health.
Inflammation is part of the body’s immune response; without it, we can’t heal. But when it’s out of control—as in rheumatoid arthritis—it can damage the body. Plus, it’s thought to play a role in obesity, heart disease, and cancer.
Foods high in sugar and saturated fat can spur inflammation. “They cause overactivity in the immune system, which can lead to joint pain, fatigue, and damage to the blood vessels,” says Scott Zashin, MD, clinical professor at the University of Texas Southwestern Medical Center in Dallas.
Along with influencing inflammation, The Anti-Inflammatory Diet will provide steady energy and ample vitamins, minerals, essential fatty acids, dietary fiber, and protective phytonutrients.
How to Follow a Healthy Anti-Inflammatory Diet
In order to follow a healthy anti-inflammatory diet, you should aim for variety, and include as much fresh food as possible. While minimizing your consumption of processed foods and fast food, you should eat an abundance of fruits and vegetables.
1. Caloric Intake
Most adults need to consume between 2,000 and 3,000 calories a day. Women, and smaller and less active people need fewer calories. Men and bigger and more active people need more calories.
If you are eating the appropriate number of calories for your level of activity, your weight should not fluctuate greatly. The distribution of calories you take in should be as follows: 40 to 50 percent from carbohydrates, 30 percent from fat, and 20 to 30 percent from protein.
Try to include carbohydrates, fat, and protein at each meal.
On a 2,000-calorie-a-day diet, adult women should consume between 160 to 200 grams of carbohydrates a day. Adult men should consume between 240 to 300 grams of carbohydrates a day. The majority of this should be in the form of less-refined, less-processed foods with a low glycemic load.
Reduce your consumption of foods made with wheat flour and sugar, especially bread and most packaged snack foods (including chips and pretzels).
- Eat more whole grains such as brown rice and bulgur wheat, in which the grain is intact or in a few large pieces. These are preferable to whole wheat flour products, which have roughly the same glycemic index as white flour products.
- Eat more beans, winter squashes, and sweet potatoes.
- Cook pasta al dente and eat it in moderation.
- Avoid products made with high fructose corn syrup.
On a 2,000-calorie-a-day diet, 600 calories can come from fat – that is, about 67 grams. This should be in a ratio of 1:2:1 of saturated to monounsaturated to polyunsaturated fat.
Reduce your intake of saturated fat by eating less butter, cream, high-fat cheese, unskinned chicken and fatty meats, and products made with palm kernel oil.
- Use extra-virgin olive oil as a main cooking oil. If you want a neutral tasting oil, use expeller-pressed, organic canola oil. Organic, high-oleic, expeller pressed versions of sunflower and safflower oil are also acceptable.
- Avoid regular safflower and sunflower oils, corn oil, cottonseed oil, and mixed vegetable oils.
- Strictly avoid margarine, vegetable shortening, and all products listing them as ingredients. Strictly avoid all products made with partially hydrogenated oils of any kind. Include in your diet avocados and nuts, especially walnuts, cashews, almonds, and nut butters made from these nuts.
- For omega-3 fatty acids, eat salmon (preferably fresh or frozen wild or canned sockeye), sardines packed in water or olive oil, herring, and black cod (sablefish, butterfish); omega-3 fortified eggs; hemp seeds and flaxseeds (preferably freshly ground); or take a fish oil supplement (look for products that provide both EPA and DHA, in a convenient daily dosage of two to three grams).
On a 2,000-calorie-a-day diet, your daily intake of protein should be between 80 and 120 grams. Eat less protein if you have liver or kidney problems, allergies, or autoimmune disease.
- Decrease your consumption of animal protein except for fish and high quality natural cheese and yogurt.
- Eat more vegetable protein, especially from beans in general and soybeans in particular. Become familiar with the range of whole-soy foods available and find ones you like.
2. Fiber Intake
- Try to eat 40 grams of fiber a day. You can achieve this by increasing your consumption of fruit (especially berries), vegetables (especially beans), and whole grains.
- Ready-made cereals can be good fiber sources, but read labels to make sure they give you at least 4 and preferably 5 grams of bran per one-ounce serving.
3. Vitamins and Minerals
The best way to obtain all of your daily vitamins, minerals, and micronutrients is by eating a diet high in fresh foods with an abundance of fruits and vegetables. In addition, supplement your diet with the following antioxidant cocktail:
- Vitamin C, 200 milligrams a day.
- Vitamin E, 400 IU of natural mixed tocopherols (d-alpha-tocopherol with other tocopherols, or, better, a minimum of 80 milligrams of natural mixed tocopherols and tocotrienols).
- Selenium, 200 micrograms of an organic (yeast-bound) form.
- Mixed carotenoids, 10,000-15,000 IU daily.
- The antioxidants can be most conveniently taken as part of a daily multivitamin/multimineral supplement that also provides at least 400 micrograms of folic acid and 2,000 IU of vitamin D. It should contain no iron (unless you are a female and having regular menstrual periods) and no preformed vitamin A (retinol). Take these supplements with your largest meal.
- Women should take supplemental calcium, preferably as calcium citrate, 500-700 milligrams a day, depending on their dietary intake of this mineral. Men should avoid supplemental calcium.
To get maximum natural protection against age-related diseases (including cardiovascular disease, cancer, and neurodegenerative disease) as well as against environmental toxicity, eat a variety of fruits, vegetables and mushrooms.
- Choose fruits and vegetables from all parts of the color spectrum, especially berries, tomatoes, orange and yellow fruits, and dark leafy greens.
- Choose organic produce whenever possible. Learn which conventionally grown crops are most likely to carry pesticide residues and avoid them.
- Eat cruciferous (cabbage-family) vegetables regularly.
- Include soy foods in your diet.
- Drink tea instead of coffee, especially good quality white, green or oolong tea.
- If you drink alcohol, use red wine preferentially.
- Enjoy plain dark chocolate in moderation (with a minimum cocoa content of 70 percent).
Drink pure water, or drinks that are mostly water (tea, very diluted fruit juice, sparkling water with lemon) throughout the day.
Use bottled water or get a home water purifier if your tap water tastes of chlorine or other contaminants, or if you live in an area where the water is known or suspected to be contaminated.
6. Other Dietary Supplements
If you are not eating oily fish at least twice a week, take supplemental fish oil, in capsule or liquid form (two to three grams a day of a product containing both EPA and DHA). Look for molecularly distilled products certified to be free of heavy metals and other contaminants.
- Talk to your doctor about going on low-dose aspirin therapy, one or two baby aspirins a day (81 or 162 milligrams).
- If you are not regularly eating ginger and turmeric, consider taking these in supplemental form.
- Add coenzyme Q10 (CoQ10) to your daily regimen: 60-100 milligrams of a softgel form taken with your largest meal.
- If you are prone to metabolic syndrome, take alpha-lipoic acid, 100 to 400 milligrams a day.
1. Fatty Fish
Oily fish, like salmon, mackerel, tuna and sardines, are high in omega-3 fatty acids, which have been shown to help reduce inflammation. To get the benefits, however, you need to eat fish several times a week, and it should be cooked in healthy ways: In a 2009 study from the University of Hawaii, men who ate baked or boiled fish (as opposed to fried, dried, or salted) cut their risk of heart disease by 23% compared to those who ate the least.
2. Whole Grains
Consuming most of your grains as whole grains, as opposed to refined, white bread, cereal, rice, and pasta can help keep harmful inflammation at bay. That’s because whole grains have more fiber, which has been shown to reduce levels of C-reactive protein, a marker of inflammation in the blood, and they usually have less added sugar.
But a 2013 Harvard study found that not all products labeled “whole grain” are much healthier than their refined counterparts. To be sure you’re getting the benefits, look for foods with a whole grain as the first ingredient, and no added sugars.
3. Dark Leafy Greens
Studies have suggested that vitamin E may play a key role in protecting the body from pro-inflammatory molecules called cytokines—and one of the best sources of this vitamin is dark green veggies, such as spinach, kale, broccoli, and collard greens. Dark greens and cruciferous vegetables also tend to have higher concentrations of vitamins and minerals—like calcium, iron, and disease-fighting phytochemicals—than those with lighter-colored leaves.
Another source of inflammation-fighting healthy fats is nuts—particularly almonds, which are rich in fiber, calcium, and vitamin E, and walnuts, which have high amounts of alpha-linolenic acid, a type of omega-3 fat. All nuts, though, are packed with antioxidants, which can help your body fight off and repair the damage caused by inflammation. Nuts (along with fish, leafy greens, and whole grains) are a big part of the Mediterranean diet, which has been shown to reduce inflammation in as little as six weeks.
Several studies have suggested that isoflavones, estrogen-like compounds found in soy products, may help lower CRP and inflammation levels in women—and a 2007 animal study published in the Journal of Inflammation found that isoflavones also helped reduce the negative effects of inflammation on bone and heart health in mice.
Avoid heavily-processed soy whenever possible, which may not include the same benefits and is usually paired with additives and preservatives. Instead, aim to get more soy milk, tofu, and edamame (boiled soybeans) into your regular diet.
6. Low-Fat Dairy
Milk products are sometimes considered a trigger food for inflammatory diseases like rheumatoid arthritis, because some people have allergies or intolerances to casein, the protein found in dairy. But for people who can tolerate it, low-fat and nonfat milk are an important source of nutrients. Yogurt can also contain probiotics, which can reduce gut inflammation.
“Foods with calcium and vitamin D, such as yogurt and skim milk, are good for everyone,” says Karen H. Costenbader, MD, associate professor of medicine and rheumatoid arthritis doctor at Harvard Medical School. In addition to their anti-inflammatory properties, she says, “it is important to get enough calcium and vitamin D for bone strength, and possibly reduction of cancer and other health risks.”
“Colorful vegetables are part of a healthier diet in general,” says Dr. Costenbader. “As opposed to white potatoes or corn, colorful peppers, tomatoes, squash, and leafy vegetables have high quantities of antioxidant vitamins and lower levels of starch.” Bell peppers are available in a variety of colors, while hot peppers (like chili and cayenne) are rich in capsaicin, a chemical that’s used in topical creams that reduce pain and inflammation.
Peppers, however, are nightshade vegetables—which some doctors and patients believe can exacerbate inflammation in people with rheumatoid arthritis. “What helps one person may be harmful to another,” says Dr. Zashin. “You just need to pay attention to your diet and your symptoms, and stick with what works for you.”
Tomatoes, another nightshade veggie, may also help reduce inflammation in some people. (Of course, Dr. Zashin’s advice about what works for you, individually, applies here, as well.)
Juicy red tomatoes, specifically, are rich in lycopene, which has been shown to reduce inflammation in the lungs and throughout the body. Cooked tomatoes contain even more lycopene than raw ones, so tomato sauce works, too—and a 2012 Iranian study found that tomato juice consumption was also beneficial.
This vegetable’s brilliant red color is a tip-off to its equally brilliant antioxidant properties: Beets (and beetroot juice) have been shown to reduce inflammation, as well as protect against cancer and heart disease, thanks to their hearty helping of fiber, vitamin C and plant pigments called betalains.
10. Ginger and Turmeric
These spices, common in Asian and Indian cooking, have been shown in various studies to have anti-inflammatory properties. “While the evidence in terms of RA inflammation is not very strong, they are vegetables—and part of a healthy, vegetable-rich diet,” says Dr. Costenbader.
Turmeric, the ingredient that gives curry its yellow color, works in the body by helping to turn off a NF-kappa B, a protein that regulates the immune system and triggers the process of inflammation, researchers say. Its relative ginger, meanwhile, has been shown to reduce inflammation in the intestines when taken in supplement form.
11. Garlic and Onions
There’s a good reason why these pungent vegetables are known for their immunity-boosting properties. In test-tube and animal studies, garlic has been shown to work similarly to NSAID pain medications (like ibuprofen), shutting off the pathways that lead to inflammation. Onions contain similar anti-inflammatory chemicals, including the phytonutrient quercetin and the compound allicin, which breaks down to produce free radical-fighting sulfenic acid.
12. Olive Oil
“Anything that fits into a heart-healthy diet is probably also good for inflammation—and that includes healthy, plant-based fats like olive oil,” says Dr. Zashin, author of Natural Arthritis Treatment. In fact, a 2010 Spanish study found that the Mediterranean diet’s myriad health benefits may be largely due to its liberal use of olive oil, especially the extra-virgin kind. The compound oleocanthal, which gives olive oil its taste, has been shown to have a similar effect as NSAID painkillers in the body.
All fruits can help fight inflammation, because they’re low in fat and calories and high in antioxidants. But berries, especially, have been shown to have anti-inflammatory properties—possibly because of anthocyanins, the powerful chemicals that gives them their rich color.
Studies have shown, for example, that red raspberry extract helped prevent animals from developing arthritis; that blueberries can help protect against intestinal inflammation and ulcerative colitis; and that women who eat more strawberries have lower levels of CRP in their blood.
14. Tart Cherries
In a 2012 presentation, Oregon Health & Science University researchers suggested that tart cherries have the “highest anti-inflammatory content of any food.” Studies have found that tart cherry juice can reduce the inflammation in lab rats’ blood vessels by up to 50%; in humans, meanwhile, it’s been shown to help athletes improve their performance and reduce their use of anti-inflammatory pain meds.
Experts recommend eating 1.5 cups of tart cherries, or drinking 1 cup of tart cherry juice, a day to see similar benefits.
Anti-Inflammatory Diet Plan for One Day
As one example of a day’s worth of anti-inflammatory eating, a breakfast of toasted steel-cut oatmeal with berries, yogurt, or other topping and coffee or green tea. Lunch could be tuna salad on 7-grain bread and a smoothie with seasonal fruits. For a snack, try an ounce of dark chocolate and about four walnuts. Dinner could be spaghetti with turkey meat sauce, spinach salad with oranges and walnuts, and apple cranberry pie made without butter.
Salmon, flaxseeds, and walnuts (all rich in omega-3s) are star players, along with antioxidant-rich fruits and vegetables such as berries, broccoli, carrots, and spinach. Olive oil is the primary source of fat. Choosing lean meats and low-fat dairy products keeps saturated fat levels down. Vegetable oils, which are high in omega-6 fats (getting too much omega-6 fat is believed to increase inflammation), and simple carbohydrates are minimized.
Certain spices, such as garlic, turmeric, ginger, and chili peppers, also have potent inflammation-reducing abilities, so menus are inflected with Indian, Asian, and Latin flavors.