What Makes a Diet Inflammatory?
ME/CFS, fibromyalgia, and long-haul COVID are all conditions characterized by chronic, low-grade inflammation. It is also thought that those with the most severe forms of these conditions have the greatest inflammatory burden, both in the body and brain. Any treatment, be it a medication, supplement, or diet, should focus on reducing that inflammatory burden to relieve the hallmark symptoms of these conditions.
When it comes to diet, however, there is no one, single anti-inflammatory diet. Many types of diets can be anti-inflammatory. A vegan diet, a carnivore diet, or a keto diet can all potentially be anti-inflammatory. It’s then important to ask the question: what is it that makes a diet inflammatory? When we know what makes foods inflammatory, then we are better able to reduce or eliminate those foods to relieve symptoms.
There are several inflammatory components in foods to be aware of.
Refined Sugar: Triggers the release of pro-inflammatory cytokines.
A high sugar intake can increase the production of reactive oxygen species (ROS), chemically reactive molecules known to damage cells and DNA. These unstable molecules can also promote the release of inflammatory cytokines by triggering nuclear factor-kappa B (NF-κB), which regulates the expression of proinflammatory genes, leading to the production of cytokines like TNF-α, IL-6, and IL-1β. A cascade of cellular inflammation ensues!
Sugar in moderation, or even only on special occasions, may be completely benign for most. But for those with the most severe forms of ME/CFS and similar postviral conditions, zero added sugar in the diet is required to prevent these inflammatory processes.
2. Excess Calories: Promote inflammation through weight gain and stress an overtaxed mitochondria.
Foods high in calories tend to also be high in refined sugars and carbohydrates. Consumption of these foods tends to lead to weight gain because they are high in calories. This includes sugary drinks, pastries, and white bread. These foods are commonly grabbed by those with low energy because they are quick and easy.
However, these foods can spike blood sugar levels, a metabolic process that also leads to increased inflammatory markers. These foods also put an extra burden on the cell’s powerhouse, the mitochondria. The mitochondria must break these food components down into energy, ATP. However, those with postviral conditions have mitochondrial dysfunction which limits that ability.
Excessive intake of high-calorie foods can lead to increased lipogenesis, the metabolic process by which sugars are converted into fatty acids and stored as fat, particularly around the liver. Accumulation of visceral fat (fat around our internal organs) is closely associated with inflammation. Visceral fat cells (adipocytes) secrete proinflammatory cytokines, including TNF-α and IL-6. Visceral fat tissue also attracts immune cells like macrophages, which further release proinflammatory cytokines. This creates a vicious cycle of inflammation!
3. Trans Fats: Found in partially and fully hydrogenated oils, these manmade fats increase inflammation.
Trans fats have been largely banned or restricted in many countries due to their adverse health effects. However, in some places, like the EU, a limit of 2 grams of industrial trans fats per 100 grams of fat is allowed. The reality is that no amount of trans fats is deemed safe and healthy. For those with inflammatory conditions, trans fats should be 100% avoided. To avoid these, look at food labels. If it says partially hydrogenated or fully hydrogenated, it contains trans fats.
With over 10 years of experience creating nutrition plans for patients, I invite you to create your own personalized nutrition plan with me.
4. Omega-6 Fatty Acids: Promote inflammatory processes when not balanced with omega-3 fatty acids.
The ratio of omega-6 to omega-3 is strongly linked to chronic pain. Those with a higher ratio of 6 to 3 experience greater degrees of pain.
Common examples of omega-6-rich foods are oils like sunflower, corn, soybean, cottonseed, sesame, peanut, and safflower. These oils are especially inflammatory when they are heated. Many processed foods contain these oils in their ingredients list, making processed foods particularly high in omega-6 fats.
The omega-6 fats linoleic acid (LA) and arachidonic acid (AA) are the most problematic and are densely found in these oils and foods. LA and AA are associated with an exaggerated pain response to noxious stimulus (hyperalgesia) and pain from an innocuous stimulus (allodynia)—2 hallmarks of fibromyalgia pain. In fact, common drugs block these pathways by blocking the enzyme that allows LA and AA to be converted into inflammatory molecules. Oral NSAIDs, like ibuprofen or Celebrex, are the most common examples of these enzyme blockers.
5. Artificial Additives & Preservatives: Can trigger inflammatory responses primarily by disrupting the gut microbiome.
Many of these food additives have been associated with worsening intestinal permeability ("leaky gut"). This allows endotoxins (byproducts of bacteria growth and development) like lipopolysaccharides (LPS) to enter the bloodstream. LPS can then trigger an immune response, leading to the release of proinflammatory cytokines such as IL-6, TNF-α, and IL-1β. This can result in local inflammation of the gut lining and worsened digestive symptoms, or it can promote brain fog. LPS and inflammatory cytokines can enter the brain via the vagus nerve amplifying that inflammatory signal.
Did you know that most food additives were developed in the 1970s and 1980s, a time when the gut microbiome wasn’t even on anyone’s mind? That means there were zero safety requirements specific to the gut biome for these additives to be put into foodstuff. We are now seeing research showing the detrimental effects of these additives on the gut microenvironment specifically. Some also suggest that common food additives may be driving the increases in inflammatory bowel disease and younger people developing colon cancer.
Summary
Anti-inflammatory nutrition is essential for those with chronic inflammatory conditions like ME/CFS, fibromyalgia, and long-haul COVID. Many, many diets can be anti-inflammatory. Instead, focus on what makes a diet inflammatory. Refined sugar, high-calorie quick foods, trans fats, omega-6 fats, and foods with chemical additives all promote inflammation through various mechanisms. Those with the most severe forms of postviral conditions should completely remove these foods from the diet. Those with less severe forms should severely limit inflammatory foods in an effort to improve symptoms.
Resources
Sanders AE, Weatherspoon ED, Ehrmann BM, et al. Circulating Polyunsaturated Fatty Acids and Pain Intensity in Five Chronic Pain Conditions. J Pain. 2023;24(3):478-489. doi:10.1016/j.jpain.2022.10.008
Laudisi F, Stolfi C, Monteleone G. Impact of Food Additives on Gut Homeostasis. Nutrients. 2019;11(10):2334. Published 2019 Oct 1. doi:10.3390/nu11102334
