Here I am on another personal mission. If you’re following me, you’ll know that I just had a big surprise at my annual checkup: high cholesterol- even despite a mostly healthy lifestyle. (Read more about that here.) A less surprising development has led me into this latest dig though: psoriatic arthritis. I’m 37 and I’ve had plaque psoriasis since I was in elementary school. Thankfully it’s nothing major, but it is quite annoying. In recent years I’ve started to have unprovoked joint pain so my PCP has been on alert for psoriatic arthritis. As of late though, I’m having all of the injuries- ankle, both hamstrings, shoulder, neck (only where it attaches to my skull), and today my elbow started giving me trouble. Now some of these were provoked: I rolled my ankle repeatedly, hurt my shoulder lifting my 8 year old into his bunk bed, pulled both hamstrings showing off that I unexpectedly became able to do the splits (laugh it up!)… Not all of the recent and persistent pains are related to an event, though. All of this has me of the belief that chronic inflammation (possibly from psoriatic arthritis) is causing me to be a bit fragile.

My doctor had me reconnect with a dermatologist and they’re ready to get me started on a pretty serious medication. Of course it has lots of data behind it and loads of positive patient stories, but I just cannot get comfortable with it. Now, I am not suggesting that everyone should suddenly quit all of their medications, I’m a pharmacist for crying out loud. But something about suppressing my immune system with pharmaceuticals is really bothering me. And after agreeing to start the medication, I’m having second thoughts. I’ve decided that I’m going to hold off for now and try something else. You guessed it- more diet changes. An anti-inflammatory diet is a thing and it would also align with my needs for lowering my cholesterol (which is also connected to inflammation). I figure it’s worth a try before I commit to this new medication. I mean, I haven’t even tried yet. So here we go on my latest mission. Here are the details:

What Are Some Medical Conditions That Could Benefit From An Anti-Inflammatory Diet? 

An anti-inflammatory diet can be beneficial for various medical conditions, as chronic inflammation is often a key factor in many diseases. Some of the conditions that may benefit from such a diet include:

1. Rheumatoid Arthritis – This autoimmune condition causes inflammation in the joints, and an anti-inflammatory diet can help reduce pain, swelling, and stiffness.
2. Osteoarthritis – Although it’s primarily due to wear and tear of the joints, inflammation still plays a role, and an anti-inflammatory diet may help reduce symptoms.
3. Heart Disease – Chronic inflammation is a contributor to heart disease, and a diet rich in anti-inflammatory foods may help reduce the risk of heart attacks and strokes.
4. Type 2 Diabetes – Inflammation is involved in insulin resistance, and anti-inflammatory foods may help manage blood sugar levels and reduce inflammation associated with diabetes.
5. Inflammatory Bowel Diseases (IBD) – Conditions like Crohn’s disease and ulcerative colitis involve inflammation in the digestive tract, and an anti-inflammatory diet may help reduce flare-ups and symptoms.
6. Asthma – Chronic inflammation in the airways makes asthma worse, and an anti-inflammatory diet can help manage symptoms and reduce the frequency of attacks.
7. Autoimmune Diseases – Conditions like lupus, multiple sclerosis, and psoriasis are characterized by inflammation due to an overactive immune system, and dietary changes can help control flare-ups.
8. Chronic Pain Conditions – Conditions like fibromyalgia and chronic back pain may be worsened by inflammation, and an anti-inflammatory diet could help reduce overall pain.
9. Alzheimer’s Disease – Inflammation in the brain is thought to play a role in neurodegenerative diseases like Alzheimer’s, and certain foods may help manage inflammation and protect brain health.
10. Cancer – Some types of cancer are associated with chronic inflammation, and an anti-inflammatory diet might support overall health during treatment and reduce inflammation-related complications.

An anti-inflammatory diet typically includes foods like fruits, vegetables, whole grains, fatty fish, nuts, and seeds, while limiting processed foods, added sugars, and unhealthy fats. Always consult with a healthcare provider before making significant dietary changes, especially when managing a medical condition.

Tell Me About The Biochemistry Of An Anti-Inflammatory Diet.

The biochemistry of an anti-inflammatory diet centers around how specific foods and nutrients influence pathways involved in inflammation at the cellular and molecular levels. Chronic inflammation is often linked to the activation of various pro-inflammatory molecules, such as cytokines, prostaglandins, and other mediators, which contribute to diseases like arthritis, cardiovascular disease, and metabolic disorders. An anti-inflammatory diet seeks to reduce or balance this inflammation by influencing these pathways.

Here are some key biochemical mechanisms through which an anti-inflammatory diet can exert its effects:

1. Omega-3 Fatty Acids

• Sources: Fatty fish (like salmon, mackerel), flaxseeds, walnuts, chia seeds.
• Biochemical Role: Omega-3 fatty acids (particularly EPA and DHA) are converted into anti-inflammatory molecules called resolvins and protectins, which actively work to resolve inflammation. They also inhibit the production of pro-inflammatory molecules like prostaglandins and leukotrienes derived from omega-6 fatty acids. These effects help reduce the overall inflammatory response in the body.

2. Polyphenols and Antioxidants

• Sources: Berries, green tea, dark chocolate, olive oil, turmeric (curcumin), vegetables (especially leafy greens), and fruits.
• Biochemical Role: Polyphenols (such as flavonoids, resveratrol, and curcumin) act as antioxidants, scavenging free radicals that contribute to oxidative stress and inflammation. These compounds also modulate key inflammatory signaling pathways, such as the NF-kB pathway and MAPK pathway, which regulate the production of cytokines and other inflammatory markers.
  • Curcumin, for example, blocks NF-kB activation, preventing the expression of pro-inflammatory cytokines like TNF-alpha and interleukins.
  • Flavonoids can also inhibit enzymes like COX-2 (cyclooxygenase-2), which plays a major role in the production of inflammatory prostaglandins.

3. Fiber

• Sources: Whole grains, fruits, vegetables, legumes, and seeds.
• Biochemical Role: Dietary fiber, especially soluble fiber, is fermented by gut microbiota to produce short-chain fatty acids (SCFAs), such as butyrate. Butyrate has anti-inflammatory effects in the colon by inhibiting the activation of inflammatory pathways (e.g., NF-kB and inflammasome activation). SCFAs also support the integrity of the intestinal barrier, reducing gut permeability, which can trigger systemic inflammation.
• High-fiber diets are also linked to reduced levels of systemic inflammatory markers like C-reactive protein (CRP).

4. Monounsaturated Fats

• Sources: Olive oil, avocados, nuts, and seeds.
• Biochemical Role: The monounsaturated fats, particularly oleic acid found in olive oil, have been shown to have anti-inflammatory effects by influencing prostaglandin synthesis. Oleic acid may also enhance the activity of anti-inflammatory transcription factors, such as peroxisome proliferator-activated receptors (PPARs), which can decrease the expression of inflammatory genes.

5. Vitamins and Minerals

• Vitamin D: Modulates the immune response by enhancing the production of anti-inflammatory cytokines and inhibiting the production of pro-inflammatory cytokines like TNF-alpha. It also has a role in regulating the T-cell response, which is critical in immune function.
• Vitamin C: Known for its antioxidant properties, it can neutralize free radicals, thereby reducing oxidative stress, which is a driver of inflammation. It also helps to maintain the integrity of the endothelial cells in blood vessels, preventing chronic inflammation in vascular tissues.
• Magnesium: Acts as a cofactor for various enzymes involved in energy production and has been shown to reduce systemic inflammation by regulating the activity of inflammatory cytokines.

6. Polyunsaturated Fatty Acids (Omega-6 Fatty Acids)

• Sources: Vegetable oils (corn, sunflower, safflower oils), nuts, seeds.
• Biochemical Role: While omega-6 fatty acids are essential, they can be pro-inflammatory when consumed in excess relative to omega-3 fatty acids. They are converted into arachidonic acid, which is a precursor for the synthesis of pro-inflammatory molecules like prostaglandins and leukotrienes. An anti-inflammatory diet generally emphasizes a proper balance between omega-3 and omega-6 fatty acids, as an imbalance may promote chronic inflammation.

7. Nitrates and Nitric Oxide

• Sources: Beets, spinach, arugula, and other leafy greens.
• Biochemical Role: Nitrates found in vegetables are converted into nitric oxide in the body. Nitric oxide has vasodilatory effects, improving blood flow and reducing vascular inflammation. Additionally, nitric oxide modulates immune cell activity, supporting anti-inflammatory pathways.

8. Probiotics and Gut Health

• Sources: Yogurt, kefir, sauerkraut, kimchi, and other fermented foods.
• Biochemical Role: A healthy gut microbiome can influence systemic inflammation. Probiotics are beneficial bacteria that help maintain a balanced immune response. They can also produce anti-inflammatory compounds like SCFAs and help regulate the balance of pro-inflammatory and anti-inflammatory cytokines.

9. Phytochemicals

• Sources: Garlic, ginger, onions, and turmeric.
• Biochemical Role: Compounds like allicin (from garlic), gingerol (from ginger), and curcumin (from turmeric) inhibit the activity of pro-inflammatory enzymes like COX-2 and LOX (lipoxygenase), reducing the synthesis of inflammatory mediators. They can also suppress the activation of the NF-kB pathway, which is involved in the expression of inflammatory genes.

10. Low Glycemic Index Carbohydrates

• Sources: Whole grains, legumes, fruits, and vegetables.
• Biochemical Role: High-glycemic foods (e.g., refined sugars and processed carbohydrates) can cause spikes in blood glucose levels, leading to the activation of inflammatory pathways like the advanced glycation end products (AGEs) pathway. These compounds contribute to oxidative stress and inflammation. A diet low in high-glycemic foods can help reduce the release of inflammatory markers.

Summary of Anti-Inflammatory Diet Biochemistry

An anti-inflammatory diet works by modulating various biochemical pathways that regulate inflammation. It emphasizes the intake of foods rich in antioxidants, omega-3 fatty acids, fiber, vitamins, minerals, and polyphenols, which:

• Reduce the production of pro-inflammatory mediators (cytokines, prostaglandins, leukotrienes).
• Support the body’s antioxidant defenses, reducing oxidative stress.
• Promote gut health and microbiota balance, which is linked to systemic inflammation.
• Encourage the resolution of inflammation through the production of anti-inflammatory molecules.

By targeting these biochemical pathways, an anti-inflammatory diet can help reduce chronic low-grade inflammation and, in turn, may reduce the risk of or improve symptoms in conditions like cardiovascular disease, arthritis, diabetes, and more.

How Can I Implement An Anti-Inflammatory Diet?

Implementing an anti-inflammatory diet involves incorporating nutrient-rich foods that reduce chronic inflammation and avoiding those that promote it. Here’s a clear guide with examples to help you create an anti-inflammatory meal plan:

1. Focus on Anti-Inflammatory Foods

These foods are rich in antioxidants, healthy fats, and other compounds that help reduce inflammation:

A. Healthy Fats

• Omega-3 Fatty Acids: These fats are potent anti-inflammatory agents.
  • Examples: Fatty fish (salmon, mackerel, sardines), chia seeds, flaxseeds, walnuts, hemp seeds, and algae-based supplements.
• Monounsaturated Fats: These fats also have anti-inflammatory properties.
  • Examples: Olive oil, avocados, almonds, and cashews.

B. Vegetables and Fruits

Colorful fruits and vegetables are high in antioxidants like vitamins C and E, polyphenols, and fiber, all of which help reduce inflammation.

• Examples:
  • Leafy greens: Spinach, kale, arugula, and swiss chard.
  • Berries: Blueberries, strawberries, raspberries, and blackberries.
  • Cruciferous vegetables: Broccoli, Brussels sprouts, cauliflower, and cabbage.
  • Other veggies: Carrots, bell peppers, tomatoes, sweet potatoes, and beets.

C. Whole Grains

Whole grains are rich in fiber, which promotes gut health and reduces systemic inflammation.

• Examples: Quinoa, brown rice, oats, barley, farro, and whole wheat.

D. Nuts and Seeds

These are rich in healthy fats, fiber, and antioxidants that help reduce inflammation.

• Examples: Almonds, walnuts, chia seeds, flaxseeds, pumpkin seeds, and sunflower seeds.

E. Herbs and Spices

Certain herbs and spices contain bioactive compounds that have anti-inflammatory effects.

• Examples:
  • Turmeric (curcumin) – Add it to soups, stews, smoothies, or tea.
  • Ginger – Use fresh or dried ginger in smoothies, teas, or as a spice in stir-fries and salads.
  • Garlic – Add crushed or chopped garlic to sauces, soups, and dressings.
  • Cinnamon – Sprinkle on oatmeal, smoothies, or baked goods.

F. Probiotic-Rich Foods

A healthy gut microbiome is crucial for reducing inflammation. Probiotics help balance gut bacteria and promote immune health.

• Examples: Yogurt (unsweetened), kefir, sauerkraut, kimchi, miso, tempeh, and kombucha.

2. Limit or Avoid Inflammatory Foods

Some foods can promote inflammation and should be limited or avoided:

A. Refined Carbohydrates and Sugars

These foods cause blood sugar spikes and the release of inflammatory molecules.

• Examples to avoid: White bread, pastries, sugary snacks, soda, and processed cereals.
• What to choose instead: Whole grains (brown rice, quinoa, oats), fruits, and vegetables.

B. Trans Fats and Saturated Fats

These fats increase the production of pro-inflammatory molecules like prostaglandins.

• Examples to avoid: Processed and fried foods, baked goods made with partially hydrogenated oils, fatty cuts of red meat, and high-fat dairy (e.g., full-fat cheese, butter).
• What to choose instead: Lean meats (chicken, turkey), fatty fish (salmon), plant-based oils (olive oil, avocado oil).

C. Processed Meats

Processed meats contain preservatives and unhealthy fats that promote inflammation.

• Examples to avoid: Bacon, sausage, hot dogs, deli meats, and other cured meats.
• What to choose instead: Fresh, lean meats, plant-based proteins (tofu, tempeh, legumes).

D. Artificial Additives

Certain additives and preservatives can contribute to inflammation.

• Examples to avoid: Artificial sweeteners, monosodium glutamate (MSG), and highly processed food preservatives.
• What to choose instead: Whole, unprocessed foods with minimal additives.

3. Hydration

Staying hydrated helps reduce inflammation, as water is essential for proper cellular function and waste removal.

• Examples: Drink plenty of water, herbal teas (e.g., ginger or green tea), and avoid sugary or artificially sweetened beverages.

4. Meal Planning and Examples

Here’s how you could structure a daily anti-inflammatory meal plan:

Breakfast

• Option 1: Oatmeal with chia seeds, blueberries, walnuts, and a drizzle of honey or cinnamon.
• Option 2: Smoothie with spinach, flaxseeds, frozen berries, ginger, and almond milk.
• Option 3: Whole-grain toast with avocado, a sprinkle of turmeric, and a side of fruit.

Lunch

• Option 1: Quinoa salad with kale, chickpeas, avocado, olive oil, lemon, and a sprinkle of turmeric and black pepper.
• Option 2: Grilled salmon with a side of steamed broccoli and sweet potatoes.
• Option 3: Lentil soup with spinach, carrots, onions, garlic, and a dash of olive oil.

Dinner

• Option 1: Stir-fried vegetables (bell peppers, onions, and carrots) with tofu or chicken, ginger, and garlic, served with brown rice.
• Option 2: Baked cod with roasted Brussels sprouts, roasted beets, and quinoa.
• Option 3: Zucchini noodles with tomato sauce (homemade with garlic, onions, and basil) and a side of mixed greens with olive oil dressing.

Snacks

• Option 1: A handful of almonds and a small apple.
• Option 2: Greek yogurt with a sprinkle of flaxseeds and chia seeds.
• Option 3: Carrot sticks with hummus.

5. Cooking Tips

• Use healthy oils: Opt for olive oil or avocado oil for cooking and dressings.
• Experiment with spices: Use anti-inflammatory spices like turmeric, ginger, cinnamon, and garlic to flavor your meals.
• Cook at home: Preparing meals at home allows you to control the ingredients and avoid processed foods.
• Limit processed food: Try to avoid pre-packaged and fast foods, as they often contain unhealthy fats, sugars, and additives.

6. Other Considerations

• Meal Timing: Try to eat smaller, balanced meals throughout the day to avoid blood sugar spikes and to support healthy metabolism.
• Exercise: Regular physical activity can help reduce inflammation. Aim for a combination of aerobic exercises and strength training.
• Stress Management: Chronic stress can contribute to inflammation. Consider incorporating relaxation techniques like meditation, deep breathing, or yoga into your routine.

One thing to note is that I’m not going to beat myself up over any of this. Any kind of dietary change (or any lifestyle change) generally needs to be done in stages if it’s going to stick and have a meaningful impact. But this is where I’m at and I’m absolutely giving this a try before taking the road of suppressing my immune system. Hopefully I’ll have good news to report in time. If you feel compelled to make similar changes, I hope you remember a few things. First and foremost, please talk to your doctor about this as it relates to any medical conditions. Secondly, be consistent in you efforts. You don’t have to be perfect, but you do have to consistently keep your goals in mind and apply them. Lastly, be kind to yourself. Making the effort at all is the kindest thing you can do for yourself, but don’t negate the benefits of the effort by beating yourself up along the way. Just press on, friends!