Anti-inflammatory Diet: What It Consists Of And What’s True

Inflammation – acute and chronic – is a process mediated by various tissues and immune factors, which can have different “dimensions” and “characteristics”, depending on the case. The severe one triggers unequivocal reactions and often has obvious causes.

Then there is a mild or partial form of inflammation, sometimes silent until the onset of its consequences – but not for this reason to be underestimated – which is in fact the basis of problems such as atherosclerosis, some joint degeneration , etc.

Various theories have been proposed that strongly correlate autoimmune complications with chronic systemic inflammation. To date, the link is recognized, but not fully explained; in the sense that it is not clear to us which is the cause and which is the effect – probably, the relationship goes both ways.

The essential principle of the anti-inflammatory diet is to increase the molecules that defend us against oxidative stress and are able to positively affect systemic inflammation.

But are we really able to independently understand “if” and “to what extent” we are inflamed?

Self-Diagnosis: Is It Possible?

How to understand if the body is inflamed?

We begin by specifying that oxidative stress is impossible to evaluate “acutely” without specific hematological analyses.

Furthermore, inflammation is a process that determines very specific symptoms and clinical signs :

• locally, for example in a joint : redness, warmth, pain ;
• systemically: fever , chills, tiredness /loss of energy, headache , loss of appetite , asthenia , etc.

In the absence of a similar picture, the subject cannot be defined as “really” inflamed.

But then, why did we say that oxidative stress and inflammation are at the root of many diseases?

Because some conditions, such as obesity , can stimulate some inflammatory pathways without triggering a frank, severe and acute picture of inflammation. However, a systemic alteration of parameters typical of inflammation such as C-reactive protein (CRP) and erythrocyte sedimentation rate ( VES ) is observed

Therefore, in the absence of an evaluable clinical picture, and without appropriate hematological analyses, it is absolutely not possible to understand if our body is in inflammation.

Anti-inflammatory foods

What are the most powerful natural anti-inflammatories?

The most powerful natural antioxidants are undoubtedly some foods of plant origin .

Their effective anti-inflammatory capacity is however questionable, because it is not scientifically demonstrable on the body .

However, a strong relationship was found between adequate consumption of fruit and vegetables and reduction of morbidity and mortality due to chronic degenerative diseases .

In any case, the problems associated with insufficient consumption should not be confused with an alleged therapeutic effect .

It is no coincidence that in the obese, the parameters of inflammation tend to decrease even with simple weight loss, although it is undeniable that by increasing the natural antioxidants various advantages can be obtained in this sense.

But how can we figure out which food is more anti-inflammatory than the others?

Every food that contains antioxidants is therefore able to contribute to the ” cleansing ” of the organism from free radicals .

This potential can be assessed thanks to a measurement system called total antioxidant capacity ( TAC ) , which analyzes the health effects of antioxidants present in the overall diet, reporting an inverse link with systemic inflammatory markers ( C-reactive protein or CRP and leukocytes ).

However, it must be emphasized that it is not the concentration of a single antioxidant that reflects the TAC of a product, but rather its power as a phytocomplex , based on the synergy and redox interactions between the various active ingredients it contains.

To tell the truth, these interactions are also created between the various foods in the diet, increasing the oxidizing potential of the same – provided it is well structured.

Based on this principle, food composition tables are not a completely reliable tool, as they only take into account the amount of the single antioxidant molecule.

This is why several studies on the evaluation of the total antioxidant capacity have been carried out, which have laid the foundations for the coining of the well-known anti-inflammatory diet.

Moreover, in vivo , antioxidant compounds act by exploiting different mechanisms ; this means that no single method can be used to evaluate the TAC of a food.

This is why an Italian study (cited below in the bibliography) evaluated three tools for measuring the in vivo antioxidant action of some phytocomplexes; respectively: Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP) and ferric reducing-antioxidant power (FRAP).

Also noteworthy is the study entitled ” The total antioxidant content of more than 3100 fodds, beverages, spices, herbs and supplements used worldwide “, which appeared in the Nutrition Journal in 2010.

Thus a database was created on which to draw for the drafting of the anti-inflammatory diet.

Flaming the Body

How to lighten the whole body with diet

The alteration of the inflammatory parameters we mentioned above can be prevented or compensated for by the following nutritional measures:

• In the event of obesity, reaching a normal weight : after reducing calories ( low-calorie diet ) and motor training (motor protocol for the treatment of overweight );
• If necessary, rebalancing of the lipid fraction : reduction of saturated fats in favor of unsaturated fats , limiting the intake of arachidonic acid , and increasing the intake of omega 3 polyunsaturated fatty acids – especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA);
• If deficient, increase in the intake of essential nutrients with an antioxidant action : vitamin E or alpha- tocopherol , vitamin C , carotenoids , zinc and selenium ;
• Increase in foods with antioxidant action : these are all foods with a composition that ensures an antioxidant effect independent of essential nutrients. We are talking above all of polyphenols , instead abundant in vegetables etc.

Attention! It doesn’t mean that animal-based foods don’t contain non- vitamin or mineral antioxidants . Meat and fish , for example, abound in lipoic acid and Coenzyme Q10 . However, due to their overall nutritional composition, they are not suitable for use in the anti-inflammatory diet.

So, by choosing the right anti-inflammatory foods and in the right amounts, we may be able to reduce oxidative stress and the risk of systemic inflammation-related diseases.

By constantly choosing the wrong ones instead, we may not introduce the right amounts of antioxidants and anti-inflammatory nutrients, indirectly favoring dysmetabolic , pro-oxidative, pro-inflammatory and pathological processes .

We have said that the total antioxidant capacity depends on the synergy and oxido-reductive interactions between the different molecules present in the food, and that in vivo the phytocomplexes act differently than in vitro.

In drafting the anti-inflammatory diet, therefore, it is above all necessary to take into account the overall composition; not of the properties of the single food.

Let’s go into detail.

Are there any foods that cause inflammation? If yes, what are they?

According to the anti-inflammatory diet theory, certain foods “might” increase systemic inflammation.

However, the most important academic studies deny this hypothesis.

However, it is indisputable that:

• the lack of vitamins and minerals implicated in the fight against oxidative stress, and a poor supply of other natural antioxidants (such as many polyphenols), contribute massively to the increase of oxidative stress .
• An excess of arachidonic acid, if not adequately compensated by the right levels of omega 3, increases inflammation and cardiovascular risk ;
• obesity contributes to increased parameters of chronic inflammation , but the correlation on junk food is  indirect ;

In any case, for the sake of disclosure, let’s make a short list of foods that, according to the anti-inflammatory diet, could increase oxidative stress and inflammation:

• refined carbohydrates, such as white bread and sweets;
• French fries and other fried foods ;
• soda and other sugary drinks;
• red ( hamburgers , steaks) and processed meats ( hot dogs , sausage );
• margarine , lard and lard .

Are there any foods that reduce inflammation? If yes, what are they?

Even with regard to foods that reduce oxidative stress and inflammation, scientific insights offer only incomplete or interpretable results . That is to say:

• The phytocomplexes objectively have an antioxidant role;
• However, in healthy people , increasing them in the diet does not result in any changes in inflammation-related parameters.

Therefore, the anti-inflammatory diet could be a useful intervention only for subjects who do not eat fruits and vegetables . A person who already consumes the portions recommended for a healthy and balanced diet would not get any benefit.

Again for informative correctness, let’s make a short list of foods that, according to the anti-inflammatory diet, could decrease oxidative stress and inflammation:

• tomatoes ;
• olive oil ;
• green leafy vegetables , such as spinach , cabbage of various kinds (daughter and flower);
• walnuts , hazelnuts and almonds ;
• blue fish , salmon and other fish from cold seas.
• Some fruits, such as strawberries , blueberries , cherries and oranges ;

Example of anti-inflammatory food fix

Here is an example of an anti-inflammatory food fix:

• 5 portions of vegetables and fruit with high antioxidant power (e.g. berries , red plums , spinach, broccoli , etc.);
• 2 portions of hot drinks such as coffee , tea and chocolate ;
• 1 portion of 200 ml of a drink such as freshly squeezed orange juice , juice mix (orange, carrot, lemon ) etc;
• 1-2 glasses of red wine ;
• Extra virgin olive oil .

In a subject showing high levels of C-Reactive Protein, such a diet “could” contribute to reducing its values.

For Sports

Anti-inflammatory diet in sport

During muscle exercise, high levels of reactive oxygen species or ROS (from reactive oxygen species ), real free radicals , are produced , also associated with an increase in muscle damage.

For this reason, in recent years, endurance athletes have become very interested in increasing the nutritional intake of antioxidants. Antioxidant supplementation appears to effectively attenuate exercise-induced oxidative stress.

Conversely, there is a growing body of evidence indicating detrimental effects of antioxidant supplementation compared to the health and performance benefits of exercise.

A review on the subject (available in the bibliography) concluded that:

More research is needed to produce evidence-based guidelines regarding the use of antioxidant supplements during exercise. Adequate vitamin and mineral intake through a varied and balanced diet is recommended , as this remains the best method to maintain the optimal state of antioxidants in subjects who practice sport . ”

Free radicals are in fact partially responsible for training adaptations . Their increase is, in simple terms, one of the keys to obtaining improvements in performance.

This is because they act as real signalers and, if on the one hand the cells “know” that they have to counteract them, on the other hand the tissues would not be able to improve themselves unless stimulated in this way.

Insight: Inflammation and Oxidative Stress

What is inflammation and how is it activated?

Inflammatory damage can be caused by physical agents ( trauma , heat, etc.), by chemical agents (toxic compounds, acids, etc.) and by biological agents ( bacteria , viruses , etc.).

The response to the damage, precisely inflammation, is given by the cells that have survived the action of it and therefore it is mainly a local reaction that medical terminology indicates by adding the suffix -ite to the name of the organ concerned (for example the terms tendinitis , hepatitis indicate an inflammation, respectively, of a tendon and of the liver ).

It has been said to be a predominantly local and not exclusively local reaction as various molecules that are synthesized and released by the cells involved in the inflammation phenomenon pass into the blood and act on distant organs, in particular on the liver, stimulating the liver cells to release other substances that are responsible for the acute phase response to inflammation.

The appearance of fever and leukocytosis (increase in the number of leukocytes circulating in the blood) represent other systemic manifestations of inflammation.

In itself, inflammation is a useful process for the body, as it allows to neutralize (if present) the agent that caused the damage, and reintegrate the normal condition pre-existing to the harmful event.

In the case of a muscle injury, for example, the ensuing inflammatory process will be necessary above all to activate a redistributive process of the damage itself (in this case the agent that caused the damage will be a physical agent, e.g. a trauma, and there will therefore be no need to eliminate the agent that caused the damage, as is the case in other cases).

The best known symptoms of inflammation are local temperature increase, swelling, redness, soreness and functional impairment.

The phenomena that cause these symptoms are mainly due to events involving the blood microcirculation .

A very rapid initial vasoconstriction will be followed by the relaxation of the smooth muscle fibrocells present on the walls of the terminal arterioles , with consequent vasodilatation and greater blood flow in the trauma area (hence the appearance of the increase in local temperature and redness).

Subsequently, the greater flow of blood “stagnates” in the trauma area, thus increasing the viscosity of the blood (due to the aggregation of red blood cells and the exit towards the intracellular junctions of the “liquid” part of the blood); the leakage of leukocytes from the blood to the extravascular compartment will also begin, where they are recalled by particular cytokines.

Thus the exudate is formed , the cause of the swelling in the trauma area, consisting of a liquid part and a part of cells suspended in it. Finally, the repartition process of the cellular damage will begin.

The set of processes just described is mediated by numerous molecules which trigger, maintain and even limit the modifications of the microcirculation.

These molecules are called chemical mediators of inflammation, and can have different origins and different fates.

They are histamine , serotonin , the metabolites of arachidonic acid ( prostaglandins , leukotrienes and thromboxanes), lysosomal enzymes , cytokines (type 1 and type 2), nitric oxide , the kinin system and the complement system.

Instead, the cells involved in the inflammatory processes are made up of mast cells , basophilic , neutrophilic and eosinophilic granulocytes , monocytes/macrophages , natural killer cells, platelets , lymphocytes , plasma cells, endotheliocytes and fibroblasts .

Inflammation is therefore a temporary process of regeneration and reintegration of the normal condition following damage; however, if the agents causing the damage persist or there is a preferential production of type 1 cytokines, it can become chronic.

In this case there is initially a progressive reduction of the processes described above affecting the microcirculation -as occurs in healing-, while at the same time the cellular infiltrate is progressively made up of macrophages and lymphocytes which frequently arrange themselves around the vascular wall like a sleeve which causes its compression.

As a consequence of this, a state of tissue suffering occurs determined both by the presence of the infiltrate and by the reduction of the blood supply caused by the vascular compromise.

Subsequently the fibroblasts can be stimulated to proliferate with the consequence that many chronic inflammations culminate with an excessive formation of connective tissue which constitutes the so-called fibrosis or sclerosis .

For example, this is the case of cellulite , an aesthetic blemish that affects many women, caused by the increase in volume of fat cells in some areas of the body (thighs, buttocks , etc.) with lack of drainage of liquids and local inflammation processes that they can lead, in the more advanced stages, to fibrosis and sclerosis with the formation of micronodules which give the skin the classic “orange peel” appearance.

What is oxidative stress and how is it activated?

Free radicals are molecules or fragments of molecules characterized by the presence of one or more unpaired and independently existing electrons; they have a strong oxidizing or reducing power and are very unstable, as such, they give rise to a series of oxidative-reductive effects with a clear prevalence of oxidative ones.

The formation of free radicals is a process that occurs in many cellular biochemical reactions – for example they can form during the respiratory chain – but also due to the physical action exerted by radiant energy on our body; among the best known free radicals, the superoxide anion and hydrogen peroxide deserve mention .

Oxidative stress is linked to an imbalance between the production of reactive species (free radicals) and antioxidant defenses.

Oxidative stress is in fact involved in the etiology of many chronic-degenerative disorders, such as cardiovascular diseases, diabetes , cancer and neurodegenerative processes (eg Alzheimer’s ).

In intense physical activity, oxidative stress is a factor that can affect athletic performance.

Intense physical exercise notoriously causes an increase in biochemical reactions linked to the need to produce the energy necessary to carry out muscular work and this also causes an increase in the production of oxygen free radicals, which can contribute to direct damage to the muscle and the appearance of symptoms of post-workout muscle soreness .

Bibliography

• Pellegrini, N., Re, R., Yang, M. & Rice-Evans, CA (1999) ” Screening of dietary carotenoids and carotenoid-rich fruit extracts for antioxidant activities applying the 2, 2_-azobis(3-ethylenebenzothiazoline-6 -sulfonic) acid radical cation decolorization assay. ” Methods Enzymol. 299:379-389.
• Pellegrini N., Serafini M, Colombi B., et al. ” Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays “. J Nutr. 2003, 133:2812-2819.
• La Vecchia, C., Altieri, A. & Tavani, A. (2001) ” Vegetables, fruit, antioxidants and cancer: a review of Italian studies “. Eur. J. Nutr. 40:261-267.
• Brighenti F, Valtuena S, Pellegrini N, et al. ” Total antioxidant capacity of the diet is inversely and independently related to plasma concentration of high-sensitivity C-reactive protein in adult Italian subjects. ” Br J Nutr 2005;93:619 -25.
• FrlichI, Riederer P (1995) ” Free radical mechanisms in dementia of Alzheimer type and the potential for antioxidative treatment .” Drug Res 45:443-449.
• Ghiselli, A., Serafini, M., Maiani, G., Azzini, E. & Ferro-Luzzi, A. (1995) ” A fluorescence-based method for measuring total plasma antioxidant capability “. Free Radic. Biol. Med. 18:29-36.
• Benzie, IFF & Strain, JJ (1999) ” Ferric reducing antioxidant power assay: direct measure of total antioxidant activity of biological fluids and modified version for simultaneous measurement of total antioxidant power and ascorbic acid concentration. ” Methods Enzymol. 299:15-27.
• Carlsen et al. ” The total antioxidant content for more than 3100 fodds, beverages, spices, herbs and supplements used worldwide “. J Nutr 2010, 9:3.
• Valtuena S, Pellegrini N, Franzini L, et al. ” Food selection based on total antioxidant capacity can modify antioxidant intake, systemic inflammation, and liver function without altering markers of oxidative stress “. Am J Clin Nutr 2008;87:1290-7.
• Peterlenj TT, Coombes JS ” Antioxidant supplementation during exercise training: beneficial or detrimental? ” Sports Med. 2011;41(12):1043-69.