Anti-Inflammatory FAQs: We've Answered Your Most Burning Questions

These are the most common questions I get asked by people beginning an anti-inflammatory eating protocol. They're also some of the same ones that I had when I began researching inflammation and diet but couldn't seem to find consistent answers to. This challenged me to delve deeper into the research so I could share straightforward, research-based answers with others. Though researchers still have a lot to discover in some areas, these recommendations are based on what the latest research findings suggest.

Not at all, and I don't expect you to, because I sure don't! In fact, there's nothing that I love more than finding a new packaged food product to shave time and work off dinner prep. However, to do this and follow an anti-inflammatory lifestyle, it is key that you start looking closer at labels to choose more minimally processed products. In my book, you'll find my Store-Bought Product Buying Guide, which walks you through what to look for on packaging. You'll also find guidelines to help you select prepared cereals, breakfast foods, side dishes, salad dressings, snacks, and desserts—as well as a few of my family's favorite brands and products.

Contrary to popular belief, dairy products appear to have an anti-inflammatory effect on most people. In fact, yogurt is recommended to reduce inflammation by supporting gut health. Since saturated fat can contribute to inflammation, moderate intake is best, as well as choosing lower-fat versions. However, those with a dairy allergy or sensitivity should avoid dairy since it will trigger their bodies' inflammatory responses when consumed, negating dairy's anti-inflammatory effects. To accommodate a wide range of needs, most Meals That Heal recipes are either dairy-free or provide a dairy-free ingredient substitute. If you think that you may have a sensitivity to dairy, eliminate dairy from your diet during the Detox & Restore phase. Then slowly reintroduce it, watching for any symptoms.

It's trendy to be gluten-free, but most health professionals advise that only those with a wheat allergy or celiac disease (an autoimmune disease in which gluten causes damage to the small intestine) really need to avoid it. The idea that there may be some individuals who also suffer from gluten sensitivity, a much milder intolerance which there's no real way to screen for or diagnose, has also been dismissed for years.

However, there's growing evidence that gluten sensitivity may be a real thing, and although damage doesn't occur to the intestines as in celiac disease, a sensitivity may trigger subtle inflammatory symptoms. Some may have a true sensitivity while others may be sensitive due to the body being irritated and inflamed already—a situation where food components that normally wouldn't trigger irritation (like gluten) cause further irritation due to the existing inflammation. Based on the latest research, as well as recommendations from a host of medical organizations and universities, my approach to gluten when it comes to meal plans and eating guidelines in Meals That Heal is this:

Avoid or greatly limit gluten during the Detox and Restore phase (or for your first several weeks of anti-inflammatory eating). This is temporary and gives the body time to calm down as irritants are removed and gut microbes are restored.

Once potential irritants have been removed for at least two weeks, then you may want to try adding back a whole grain that contains gluten (such as whole wheat bread or farro). If you do add gluten back to your diet, do it slowly and monitor for any subtle side effects, such as bloating, gas, headaches, and joint pain, and don't add back two potential irritants at the same time (such as dairy and gluten). The exception to this is if you choose a meal plan for a medical condition that may benefit continued avoidance of gluten such as an autoimmune condition.

Gluten-free eating can be healthy or unhealthy depending on your approach. A healthier approach is to focus on swapping processed, gluten-containing foods and refined grains for vegetables, beans, starchy vegetables, fruits, and gluten-free whole grains like quinoa and coarse ground cornmeal. This leads to a more nutrient-dense, less inflammatory diet because of the overall improved diet quality—not necessarily due to gluten avoidance. Simply swapping gluten-containing foods for processed foods labeled "gluten-free" does not improve diet quality or decrease inflammation.

Nightshade vegetables, such as tomatoes, eggplant, peppers, and potatoes, are often blamed for arthritis inflammation due to a compound they contain called solanine. However, there's no conclusive research that nightshades trigger inflammation. These veggies are packed full of anti-inflammatory nutrients, so don't avoid nightshades—unless eating a specific one triggers pain or inflammation symptoms. If it does, the issue likely isn't the nightshade family but rather a sensitivity to one specific food, which can be eliminated.

Since any food or food component can irritate the body further when it's inflamed, it's ideal to eliminate or greatly reduce alcohol intake during the Detox and Restore phase. This gives the body time to calm down. After this phase, you can add an occasional drink, if desired, since alcohol—wine, beer, or liquor—when consumed in moderation can be part of anti-inflammatory eating and living.

Well, I hope so, because I'm definitely not giving up dessert for the rest of my life! But at the same time, I can't ignore that Americans' consumption of excess added sugars is contributing to inflammation and the development of almost all chronic diseases. And what's scary is that most individuals are unaware of just how much added sugar they consume on a daily basis. Because of this, I strongly encourage you to begin by eliminating all added sugars—something that will start to clean up your diet and also illustrate just how prevalent they are in our food supply. Use my Store-Bought Product Buying Guide to walk you through what to look for on the packaging and exactly how added sugars may be disguised on labels. Once individuals are more aware of added sugar prevalence, then I am all about incorporating some added sugars in moderation.

Since it's easy for "moderation" to quickly cross the line into excess, I've found that many (myself included) need specific parameters of what moderate intake should be. A good goal is to aim to keep added sugar intake to less than 3 teaspoons or 12 grams on most days. When this is your norm the majority of days, then it's not a big deal to occasionally indulge.

All must be deemed relatively safe by the Food and Drug Administration to be on the market, but my concern surrounding artificial sweeteners is that the prominent ones that you see on restaurant tables and in food products are sweet-tasting chemical compounds (like aspartame and saccharine) made in a lab. And while deemed safe now, we haven't had time to collect long-term data to really know the effects that consuming these chemicals for 50 or 60 years will have on the body. From an anti-inflammatory standpoint, the body may consider these foreign bodies or irritants—particularly if there's already some low-level inflammation.

Additionally, while they may not be contributing calories or added sugar, research suggests that some artificial sweeteners negatively impact the body's glucose and insulin management, which could also encourage existing inflammation. My approach is to limit artificial sweeteners in general. When I do need to use one, I opt for a low-calorie, plant-based sweetener (such as stevia). A sweetener from a plant, rather than a chemistry lab, seems like a safer and healthier option. Also, research surrounding stevia is positive, even suggesting it may improve glycemic response following a meal.

Intermittent fasting (IF) is a popular eating trend that centers around alternating between short periods of fasting (consuming little to no food for some portion of the day) and periods of regular food intake. A common approach to IF is eating only during an eight-hour window during the day, meaning you fast the remaining 16 hours. Not only does IF appear to decrease inflammation in some individuals, but research also suggests that it may reduce cardiovascular risk, improve insulin sensitivity, and maintain or improve metabolic rate.

However, IF is definitely not for everyone, and much more research is needed. So if the thought of fasting seems dreadful, don't sweat it. Focus on the other dietary aspects with substantial research backing. But if you're not a breakfast eater or tend to go long periods without eating, you're on-trend and don't necessarily need to change anything in terms of your eating frequency.

None of these has magical healing powers—or even the ability to reduce inflammation by themselves. But these are the top foods that I've found repeatedly pop up in research when it comes to offering anti-inflammatory effects to the body.

Such as lettuces (like romaine, red leaf, green leaf, radicchio, arugula), cruciferous greens (like kale, mustard, turnip), spinach, Swiss chard, watercress, and dandelion greens. 

Recommended at least 6 cups per week

The research behind the health benefits of eating leafy greens is some of the strongest with suggested risk reduction of heart disease, type 2 diabetes, some cancers, and brain deterioration. In fact, the risk may decrease with each additional serving consumed. Leafy greens are also packed with folate and phytochemicals with additional antioxidant and anti-inflammatory effects.

Recommended daily as part of fat intake

This pantry staple delivers the inflammation-suppressing compound oleocanthal, plus a small amount of omega-3s. Health benefits that research associates with olive oil include reduced risk of heart attack, stroke, cancer development, joint deterioration, and neurological diseases.

Such as blueberries, strawberries, raspberries, blackberries, boysenberries, and cranberries.

Recommended at least 2 cups per week

All berries are loaded with anthocyanins and antioxidants, which sweep up harmful free radicals that promote inflammation. This directly reduces the risk of heart disease, brain deterioration, and cancer. They're also packed with fiber that reduces cholesterol values and slows the digestive process to keep blood sugar in check.

Such as broccoli, Brussels sprouts, cauliflower, cabbage, collard greens, kale, mustard greens, watercress, kohlrabi, bok choy, rutabaga, turnips, arugula, radish, and watercress.

Recommended at least 5 servings per week.

What separates this crunchy family from other vegetables are sulfur-containing compounds called glucosinolates. Indoles and isothiocyanates are two types of powerful glucosinolates that appear to lower inflammatory markers in the body, lower cancer risk, and possibly initiate the death of cancer cells. On top of that, most cruciferous veggies are packed with antioxidants like vitamin C and beta-carotene, and other anti-inflammatory phytochemicals.

Such as salmon, anchovies, butterfish, sea bass, mackerel, and sardines. 

Recommended 8 to 12 ounces per week 

The omega-3 fats DHA and EPA in salmon and other oily fish play key roles in suppressing inflammation and boosting production of anti-inflammatory compounds. DHA and EPA appear to have a particularly strong link to heart and neurological disease prevention, and fattier fish are one of the few dietary sources.

Such as almonds, Brazil nuts, cashews, chia seeds, flaxseed, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, sunflower seeds, walnuts.

Include 1 ounce, 5 or more days per week

Not only is regular intake associated with healthier body weight, but nuts are packed with omega-3s, antioxidants like vitamin E, protein, and slow-digesting carbohydrates, which support better blood sugar regulation and improve insulin sensitivity. Walnuts and almonds are considered some of the best, but all nuts are good to incorporate as part of daily fat intake.

Such as green, white, oolong, and black teas.

Recommended at least 1 cup per day

Research suggests that regular intake of this antioxidant-rich beverage may suppress both the development and growth of cancer cells, promote the growth of good bacteria, and block or slow the plaque formation associated with Alzheimer's development. This is all thanks to compounds called catechins that appear to be one of the most effective antioxidants in preventing free radical damage. Very few negatives are associated with green tea intake; just watch caffeine intake.

Such as cultured and fermented foods like yogurt, kimchi, kombucha, miso, and sauerkraut, as well as prebiotics.

Recommended daily or at least several times per week

The exact role that "good" microbes play is still unclear, but current research suggests that the relationship between gut health and disease prevention is substantial. Consuming foods with "good" bacteria regularly and consuming a variety of strains are the best ways to encourage a healthy gut—not to mention that these foods are usually nutrient-rich sources of antioxidants, too. Another plus of live cultures in yogurt: The live bacteria produces lactic acid that inhibits the growth of bad bacteria in the gut.

Excerpted from Meals That Heal. Text © 2019 by Carolyn Williams, Ph.D., R.D. First published in 2019 by Tiller Press, an imprint of Simon & Schuster Inc.