Diet, Supplements and Inflammation
This is a blog post I wrote for The Carter and George Practice.
As a dietitian, I am asked many questions relating to symptoms we experience and the food we eat. If you google “diet and inflammation” one of the first things that will pop up is information about an “anti-inflammatory diet”. There are also lots of supplements which can be bought claiming to help reduce pain and inflammation.
But how much truth is there to these claims, and how much is backed up by evidence?
The first thing to remember is that inflammation is a normal immune process which helps to fight infections and promote healing from injuries. However, inflammation in specific medical conditions can lead to pain and discomfort, affecting quality of life, as seen in osteoarthritis, rheumatoid arthritis and inflammatory bowel disease.
So, what does work?
Generally staying a healthy weight has been shown to help reduce inflammation throughout the body. If you are overweight or obese, a weight loss of 5-10% has been shown to help reduce symptoms of osteoarthritis. Alongside this, omega-3 polyunsaturated fatty acids, such as those found in oily fish have anti-inflammatory properties and may help to manage inflammation. Ideally, it is recommended to consume at least one (preferably two) portions of oily fish per week, such as salmon, tuna (although not tinned tuna), mackerel or sardines.
Antioxidants help to protect the body from “oxidative stress” which may also be involved in inflammation. These are found in a range of animal and plant sources. The main antioxidants to think about are Vitamins A, C and E. Although evidence for these vitamins reducing inflammation is limited, it would be beneficial to ensure you are having adequate amounts as part of a healthy balanced diet. Getting these vitamins from food is preferable to supplements, as they come with other nutrients, which can help absorption in the gut. Some examples of food with these vitamins include eggs, red and green peppers, broccoli, nuts and seeds. A Mediterranean Diet incorporates all the above aspects. It includes poultry, fish, and less lean red meat than a typical UK diet, plenty of vegetables (fresh, frozen or canned), fresh fruit, olive oil, wholegrain cereals, peas, beans, nuts and seeds. This means saturated fats are reduced and replaced by unsaturated fats, including omega 3. This diet may also reduce your risk of type 2 diabetes, high blood pressure, and high cholesterol, which are risk factors for heart disease.
Many supplements such as curcumin (derived from turmeric), avocado seeds, willow bark extract, and pine bark extract claim to help reduce inflammation. Most of the evidence is looking at these supplements with osteoarthritis. Curcumin has been found to provide a clinically significant effect compared to a placebo in short term studies, and no adverse effects were found. This was with a daily dose of 180mg curcumin or 1500mg curcuminoid. However, it is important to note these were generally low-quality studies. Recently it was noted that a high dose of turmeric (x6 538mg turmeric extract capsules per day) was found to directly contribute to iron deficiency anaemia. Therefore, I would caution anyone who is thinking of taking supplements to discuss this with their doctor or dietitian first.
Overall, it is important to remember that changing your diet or taking supplements will not be a magic cure, but it may lessen flare ups, or reduce your pain by a few notches. The Mediterranean Diet provides benefits not only by increasing omega 3, which has anti-inflammatory properties, but also by helping to manage risk factors for other metabolic diseases. If you decide to try supplements, I would recommend trying it for a short time (e.g. 3 months) after speaking to your doctor or dietitian, to see if there is a noticeable difference in your symptoms.