Updated: May 23
At our first nutrition Q&A session in April, the topic of an anti-inflammatory diet came up as a recurring theme. Let’s explore this to find out what inflammation is and why it’s wise to eat an anti-inflammatory diet.
What is inflammation?
Inflammation can be life-saving when it is acute. Think of what happens when you cut your finger. The area around the cut is likely to become red, swollen and even hot to the touch. If the wound is bad, you might see pus. These are all signs of acute inflammation.
The body responds to the threat of infection by sending white blood cells to the scene to kill any pathogens. The influx of white blood cells, and the compounds they release, explains the redness, swelling and heat. If all is working well, our immune system tackles the problem and the inflammation resolves – great!
Inflammation can occur in our bodies in response to a variety of causes. The problem comes when it does not resolve in a timely way. This is chronic inflammation, and it is known to be involved in many chronic diseases, such as cardiovascular disease, diabetes, autoimmune conditions and cancer. Chronic inflammation is known to be involved in multiple stage of tumour initiation and growth. In fact, tumour-promoting inflammation is one of the hallmarks of cancer. Going back to our cut finger analogy, cancer is sometimes called “the wound that never heals”.
The role of diet
Don’t be downhearted at this point. There are multiple nutrition and lifestyle strategies that we can use to reduce chronic inflammation. Managing stress, getting good quality sleep and avoiding a sedentary lifestyle are all important. The overall pattern of our diet can influence inflammation too.
In fact, nutrition researchers have developed a means of quantifying the inflammatory potential of food, using a “dietary inflammatory index” (DII). Common foods and nutrients have been scored according to whether studies have shown that they increase or decrease the amounts of inflammatory markers in the bloodstream after being eaten. For example, saturated fat is inflammatory, whilst many herbs and spices are anti-inflammatory. The higher the DII, the higher the inflammatory potential of the diet(1).
There have now been several studies looking at the association between DII and cancer outcomes. A 2017 meta-analysis found that across a range of cancer types, those eating the lowest DII had a 67% reduced risk of cancer-specific mortality compared to those eating the most inflammatory diet(2). There have been studies on breast(3), ovarian(4) and prostate cancer which have all shown improved cancer outcomes with an anti-inflammatory diet.
Could an anti-inflammatory diet help with treatment-induced joint pain?
Although I could not find any studies looking at DII and joint pain, the research does show that when aromatase inhibitors such as letrozole reduce oestrogen, the body produces more inflammatory molecules which are associated with joint pain(5). These are the same inflammatory molecules which are reduced by diets with the lowest DII, so it’s not unreasonable to assume that an anti-inflammatory diet will help ease joint pain.
What does an anti-inflammatory diet look like?
The anti-inflammatory diet is very similar to the traditional Mediterranean Diet. Note that this is the type of Mediterranean diet eaten in traditional communities in places such as rural Greece, rather than pizza and pasta! Anti-inflammatory foods include:
A wide variety of vegetables of all colours – note too that deep colours tend to be more anti-inflammatory
Herbs and spices, such as turmeric, garlic, ginger and rosemary
Fruit, especially berries
Oily fish: salmon, mackerel, anchovies, sardines and herring
Green and black tea (as well as herbal teas)
Healthy fats such as extra virgin olive oil, avocados, nuts and seeds
Whole grains and pulses
Appropriate amounts of lean animal protein
April’s recipes are all anti-inflammatory, so why not have a look and pick some to try that take your fancy?
References
1. Shivappa, N., Steck, S.E., Hurley, T.G. et al. (2014). ‘Designing and developing a literature-derived, population-based dietary inflammatory index’, Public Health Nutrition, 17(8), pp1689-1696. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925198/ (Accessed 28 April 2023).
2. Fowler, M.E. and Akinyemiju, T.F. (2017). ‘Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes’, International Journal of Cancer, 141(11), pp2215-2227. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056732/ (Accessed 28 April 2023).
3. Wang, K., Sun, J.-Z., Wu, Q.-X. et al. (2020). ‘Long-term anti-inflammatory diet in relation to improved breast cancer prognosis: a prospective cohort study’, NPJ Breast Cancer, 6: 36. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426822/ (Accessed 28 April 2023).
4. Sasamoto, N., Wang, T., Townsend, M.K. et al. (2022). ‘Pre-diagnosis and post-diagnosis dietary patterns and survival in women with ovarian cancer’, British Journal of Cancer, 127(6), pp1097-1105. Available at https://pubmed.ncbi.nlm.nih.gov/35760897/ (Accessed 28 April 2023).
Hyder, T., Marino, C.C., Ahmad, S. et al. (2021). ‘Aromatase Inhibitor-Associated Musculoskeletal Syndrome: Understanding Mechanisms and Management’, Frontiers in Endocrinology, 12:713700. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353230/ (Accessed 2 May 2023).