“Anti-inflammatory diet”: Is it real or just hype?

This is indeed not a gimmick. Anti-inflammatory diet is a concept that has only recently become popular. Last year, the Tumor Nutrition Committee of the Chinese Anti-Cancer Association, the Community Nutrition and Health Management Branch of the Chinese Nutrition Society, and the Clinical Nutrition Branch of the Chinese Nutrition Society jointly issued the "Expert Consensus on Anti-Inflammatory Diet for Cancer Prevention" [1]. The anti-inflammatory diet mentioned in it can not only provide prevention and auxiliary treatment strategies for cancer patients, but also provide scientific dietary guidance and suggestions for healthy people.

But wait a minute, how can inflammation, a minor problem that happens every now and then, be associated with such a serious disease? This has to start with the two faces of inflammation.

0 1

The two faces of inflammation: “protection” and “harm”

Inflammation is very common in daily life. Once a bump or infection occurs, redness, swelling, heat, pain and other symptoms will appear on the local skin. It comes and goes quickly, and it often takes only a few minutes or a few days for the wound to heal and the infection to recover. This is acute inflammation , which is a line of defense for our immune system. Its essence is to resist damage from the outside world, remove harmful factors, repair injured tissues, and protect our health.

There is another type of inflammation which is very hidden and difficult to detect with the naked eye, but the inflammatory markers commonly used in clinical practice are at a higher level within the normal range. This state is called systemic chronic low-grade inflammation , which often lasts for a long time and can cause damage throughout the body, increasing the risk of various chronic diseases such as cardiovascular and cerebrovascular diseases and cancer.

Diseases caused by chronic inflammation have been recognized as one of the most important causes of death in the world today, with more than 50% of deaths attributable to diseases related to chronic inflammation, such as ischemic heart disease, stroke, malignant tumors, diabetes, chronic kidney disease, non-alcoholic fatty liver disease, etc. It is not only the trigger of chronic diseases, but also one of the causes of aging [2].

Therefore, reducing chronic inflammation is an important strategy in the health management of chronic diseases . Some human-controllable factors are very beneficial for reducing this chronic inflammatory state, such as physical exercise, smoking cessation, alcohol restriction, and scientific diet.

Diet is an important regulator of inflammation. A reasonable diet can improve the body's chronic inflammatory state and is the hub for promoting the prognosis of chronic diseases. However, an unreasonable pro-inflammatory diet is an important risk factor for chronic diseases.

In a 2020 study, scientists discovered the relationship between the inflammatory potential of dietary patterns and the risk of cardiovascular disease. The results showed that dietary patterns with higher pro-inflammatory potential were associated with a higher risk of cardiovascular disease, while reducing pro-inflammatory levels in the diet could effectively prevent the risk of cardiovascular disease [3].

The pro-inflammatory potential of diet is associated with the risk of cardiovascular disease[3]

0 2

What is an anti-inflammatory diet?

So which foods are pro-inflammatory and which are anti-inflammatory?

A widely adopted tool is the Dietary Inflammatory Index (DII), which is specifically used to assess the inflammatory potential of a diet. It includes 45 dietary components, as shown in the figure below. A positive score indicates pro-inflammatory potential, a negative score indicates anti-inflammatory potential, and a score of 0 indicates neither pro-inflammatory nor anti-inflammatory. The larger the absolute value of the score, the stronger the corresponding effect [4].

An inflammatory index of 45 dietary components, developed by public health researchers at the University of South Carolina [4]

According to this scoring table, dietary components with pro-inflammatory potential are: saturated fat, total fat, trans fat, energy, cholesterol, vitamin B12, carbohydrates, iron, and protein.

Dietary ingredients with anti-inflammatory potential include turmeric, dietary fiber, plant compounds such as flavonoids, unsaturated fatty acids, vitamins, minerals, etc.

0 3

Anti-inflammatory diet recommendations

Staple Food

Whole grains are foods with anti-inflammatory potential. They are not only rich in dietary fiber, but also have a low GI value, which can reduce the risk of pancreatic cancer, breast cancer, and colorectal cancer. Whole grains such as brown rice, black rice, buckwheat, oats, and corn are all common whole grain foods. In addition, wheat bran and wheat germ are rich in dietary fiber and various phenolic substances, and are also a healthy staple food choice.

The glycemic index of refined rice and noodles is high, and large intake can easily cause large fluctuations in blood sugar and insulin, and increase inflammation levels. You can consider eating them with whole grains, beans, and potatoes.

Fat

In addition to controlling total fat intake to no more than 30% of total energy, you should also pay attention to reducing foods high in saturated fat and trans fat .

Saturated fats are mainly found in: animal fats, such as fat from pigs, cattle and sheep, butter, lard, tallow, etc.;

Trans fats are mainly found in: biscuits and pastries, fried foods, etc.

Choose more foods rich in polyunsaturated fats, especially polyunsaturated fatty acids of the n-3 family, which are consumed less and lacking in Chinese people. Common foods rich in n-3 include: flaxseed oil, deep-sea fish, deep-sea algae , etc.

protein

Protein has a mild pro-inflammatory potential, so try to choose high-quality protein, such as fish, poultry, eggs, lean pork, beef and mutton, dairy products, soy foods, nuts, etc., and eat less processed meat .

Vegetables and Fruits

Fruits and vegetables are rich in vitamins, minerals and plant compounds, and have good anti-inflammatory activity. An ideal anti-inflammatory diet should include a large amount of fruits and vegetables.

Plant compounds are generally active substances contained in plant foods. These substances themselves have strong antioxidant, anti-inflammatory, anti-tumor, hypoglycemic, hypolipidemic, cardiovascular and nerve protection and other effects. For example, plant polyphenols and lycopene that we often hear about are widely present in plant foods such as fruits, vegetables, and whole grains.

Polyphenol compounds: Plant polyphenols can be said to be the most common type of substances in nature, including flavonoids (flavonoids, isoflavones, anthocyanins, etc.) and phenolic acids (benzoic acid, cinnamic acid, etc.) all belong to this category.

Terpenoids: Common terpenoids include lycopene, β-carotene, and lutein. There are also triterpenoids, which are more popular recently and are rich in some tea oils.

Beverages

Although alcohol has anti-inflammatory potential, it can cause tumors and is not recommended.

Phytochemicals such as polyphenols in green tea and black tea have a clear preventive effect on many types of tumors. You can drink them in moderation according to your personal health condition.

Seasoning

Condiments that are commonly consumed in the Chinese diet, such as onions, ginger, garlic, and pepper, also have anti-inflammatory activity and can be used flexibly in the diet to enhance the anti-inflammatory potential of the overall diet.

In the DII rating, the anti-inflammatory king is turmeric , which is a medicinal and edible raw material with good medical value. The active ingredient is curcumin, which is widely used. It can be used as a pigment, flavor enhancer, and preservative in hot pot seasonings, meat products, candies, pickles, and beverages. In addition, it is also the main ingredient of curry. The yellow color of curry comes from curcumin, so curry is also a condiment with anti-inflammatory potential.

turmeric

Although some types of food can be divided into anti-inflammatory and pro-inflammatory, the anti-inflammatory diet does not mean that you can only eat anti-inflammatory foods, but emphasizes **combining different foods into an overall anti-inflammatory dietary pattern. **After all, it is unrealistic for you to completely give up fried chicken and barbecue, but you should eat some other beneficial foods to balance it, so that the overall diet level meets both nutritional and anti-inflammatory standards.

In fact, if you look closely, you will find that the so-called anti-inflammatory diet is basically the same as the healthy diet that we usually recommend to everyone. They have a high degree of overlap, including the more famous Mediterranean diet we usually hear about and Japan's Okinawa diet, which are actually considered to be dietary patterns with anti-inflammatory properties.

No matter what the concept is, they all lead to the same goal, which is to guide everyone to choose food that is good for health.

Statistics just released by the National Health Commission (August 29) show that the average life expectancy in my country has reached 78.6 years[5]. This is a long lifespan. The current priority is to consider how to improve the quality of life. If we do not want to spend the next 30 years of our lives in a hospital bed relying on medication and injections, we must start now, start by eating well, and build a good physical foundation.

References:

[1] “Expert consensus on anti-inflammatory diet for cancer prevention”.

[2] Xie Hailun, Shi Hanping. Current status and progress of inflammation research[J]. Electronic Journal of Tumor Metabolism and Nutrition, 2024, 11(01): 9-19.

[3]Li J, et al. Dietary Inflammatory Potential and Risk of Cardiovascular Disease Among Men and Women in the US J Am Coll Cardiol. 2020 Nov 10;76(19):2181-2193.

[4]Hébert JR et al. Perspective: The Dietary Inflammatory Index (DII)-Lessons Learned, Improvements Made, and Future Directions. Adv Nutr. 2019 Mar 1;10(2):185-195.

[5] Statistical Communiqué on the Development of my country's Health Care Industry in 2023.