Anti-Inflammatory Diet

Acute vs chronic inflammation. Understanding the difference

The word "inflammation" is used loosely in popular health writing, often as a generic stand-in for "anything bad in the body". The reality is more specific, and the distinction between acute and chronic forms matters.

Chronic inflammation is measured through blood biomarkers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α). These can be elevated in the absence of any obvious illness, simply from the cumulative effect of poor diet, sedentary behaviour, excess body fat (particularly visceral fat around the organs), poor sleep, and chronic stress.

A Nature Medicine paper (Furman et al., 2019) described chronic systemic inflammation as "a unifying theory of ageing and age-related disease", noting that it underlies conditions as diverse as cardiovascular disease, type 2 diabetes, cancer, depression, Alzheimer's disease, rheumatoid arthritis, inflammatory bowel disease, and sarcopenia. This does not mean inflammation causes all of these conditions in a simple linear way, but it is a significant shared contributory mechanism.

What causes chronic inflammation?

Chronic low-grade inflammation has multiple drivers, many of which are modifiable. Diet is one of the most important and one of the most actionable.

Dietary drivers in detail

• Ultra-processed food. High in refined sugars, saturated and trans fats, emulsifiers, and preservatives. The 2024 BMJ umbrella review found high UPF consumption associated with higher rates of cardiovascular disease, depression, and multiple other inflammation-driven conditions. See UPF guide.
• Refined carbohydrates and added sugar. Cause rapid blood glucose spikes followed by surges of insulin and reactive oxygen species (ROS) that trigger inflammatory signalling. Advanced glycation end products (AGEs) generated from sugar binding to proteins or fats activate inflammatory pathways. See sugar guide.
• Excess saturated fat from processed meat. The combination of haem iron, nitrosamines, AGEs, and saturated fat is pro-inflammatory.
• Low omega-3 / high omega-6 ratio. Imbalanced fatty acid intake shifts eicosanoid production towards pro-inflammatory molecules. See omega-3 and omega-6 guide.
• Low fibre intake. Fibre feeds gut bacteria that produce anti-inflammatory short-chain fatty acids. Low fibre means weakened gut barrier and more systemic inflammation. See fibre guide.

Diet works best as part of a broader lifestyle approach that also addresses sleep, stress, movement, and weight. The lifestyle drivers (visceral obesity, sedentary behaviour, poor sleep, chronic stress, smoking, alcohol, dysbiosis) all independently contribute to chronic inflammation and cannot be fully offset by diet alone.

How diet influences inflammation. The mechanisms

Polyphenols and antioxidants

Plant foods contain thousands of naturally occurring compounds (polyphenols, flavonoids, carotenoids, glucosinolates) that have direct anti-inflammatory effects by:

• Scavenging reactive oxygen species (ROS) that trigger inflammatory signalling
• Inhibiting the NF-κB pathway, the master regulator of inflammatory gene expression
• Modulating the production of pro-inflammatory cytokines (CRP, IL-6, TNF-α)
• Supporting beneficial gut bacteria that in turn produce anti-inflammatory metabolites

Polyphenols are largely absent from ultra-processed foods.

Omega-3 fatty acids and the eicosanoid balance

EPA and DHA from oily fish are converted into resolvins, protectins, and maresins. Specialised pro-resolving mediators (SPMs) that actively resolve inflammation. This is mechanistically distinct from blocking inflammation (which is how NSAIDs work). SPMs help the immune system switch off the inflammatory response after it has done its job. A diet consistently high in omega-3 shifts this balance favourably.

Dietary fibre and short-chain fatty acids

When gut bacteria ferment dietary fibre, they produce short-chain fatty acids, particularly butyrate. Butyrate maintains the gut barrier (reduced permeability means less endotoxin entering the bloodstream), has direct anti-inflammatory effects on immune cells in the gut and systemically, and reduces NF-κB activity in gut epithelial cells. A diverse, high-fibre diet supports the gut bacteria that produce butyrate. A low-fibre, UPF-dominated diet starves them. See gut health guide.

Advanced glycation end products (AGEs)

AGEs are compounds formed when proteins or fats bind with sugars at high temperatures. They are generated both in the body (from high blood glucose) and in ultra-processed foods (particularly from dry-heat cooking of processed meat, biscuits, crackers). AGEs activate inflammatory receptor pathways (particularly RAGE, the receptor for advanced glycation end products) and contribute to atherosclerosis, diabetes complications, and accelerated ageing. A diet low in AGEs (whole foods, moist cooking methods) reduces this inflammatory load.

The overall diet pattern effect

No single nutrient or food drives inflammation in isolation. The net effect of the overall diet, captured by tools like the Dietary Inflammatory Index (DII), is what matters. A meta-analysis found that each 1-unit increase in DII is associated with a 10% higher odds of elevated CRP. Demonstrating that the cumulative inflammatory character of the diet is measurable and clinically relevant.

The Dietary Inflammatory Index and the Mediterranean diet

The Dietary Inflammatory Index (DII)

The DII was developed in 2013 by researchers at the University of South Carolina, based on a systematic review of the published literature on diet and inflammation. It rates 45 dietary components on their association with six inflammatory markers (CRP, IL-1β, IL-4, IL-6, IL-10, and TNF-α), assigning a pro- or anti-inflammatory score to each. A complete diet can then be given an overall DII score, ranging from -8.87 (maximally anti-inflammatory) to +7.98 (maximally pro-inflammatory).

Higher DII scores (more pro-inflammatory diet) are consistently associated in large prospective studies with elevated CRP and IL-6, higher rates of cardiovascular disease, higher cancer incidence, greater depression risk, and higher all-cause mortality. The DII validates what dietary pattern research suggests: a diet rich in fruits, vegetables, whole grains, fish, and olive oil scores negatively (anti-inflammatory); a diet rich in red and processed meat, refined carbohydrates, saturated fat, and UPF scores positively.

The Mediterranean diet. The best-evidenced anti-inflammatory pattern

The Mediterranean dietary pattern (high consumption of vegetables, fruit, whole grains, legumes, nuts, olive oil, and fish; moderate consumption of dairy; and low consumption of processed and red meat) consistently shows the most anti-inflammatory profile in large studies. A 2024 British Journal of Nutrition review confirmed that Mediterranean-style diets show "substantial effects on biomarkers of inflammation" in randomised controlled trials.

The Mediterranean diet is the same dietary pattern with the strongest evidence across all the health outcomes covered in this series. Cardiovascular disease, longevity, mental health, and gut health. Its anti-inflammatory profile is one of the key mechanisms through which it produces those benefits. A 2024 UK Biobank study of over 23,000 individuals found that higher Mediterranean adherence was associated with significantly lower systemic inflammation scores and substantially reduced risk of premature death. Those most closely following the Mediterranean pattern showed a materially reduced impact of inflammation on mortality compared to those with low adherence. See whole foods for the broader picture.

Foods with the strongest anti-inflammatory evidence

Anti-inflammatory eating is about patterns, not individual foods. But certain foods and food groups have particularly strong evidence for reducing inflammatory markers.

Other foods with supportive evidence

Green tea (epigallocatechin gallate, EGCG) is associated with lower CRP in large Asian population studies; 2 to 4 cups daily is a practical UK habit. Fermented foods (plain yogurt with live cultures, kefir, sauerkraut, kimchi, miso) support gut microbiome diversity, which in turn reduces gut permeability and systemic inflammation. The 2021 Stanford Cell study found that a diet high in fermented foods for 10 weeks significantly reduced 19 inflammatory markers. See gut health. Browse the relevant encyclopedia categories: fish & seafood, vegetables, fruit, grains, pulses, nuts and seeds, herbs and spices, oils and fats.

Pro-inflammatory vs anti-inflammatory foods

The same way of eating that supports lower inflammation supports the rest of long-term health. The same dietary pattern that drives inflammation drives most of the chronic diseases on this site.

Anti-inflammatory eating in practice. Not a protocol, a pattern

The most important framing for this page: there is no single "anti-inflammatory diet" that you follow in a prescribed way. The term describes a way of eating characterised by more whole, minimally processed plant foods (in as much variety as possible), regular oily fish, olive oil as the primary fat, and less ultra-processed food, refined carbohydrate, added sugar, and processed meat.

This is not a list of foods to fear or eliminate. It is not a detox protocol. It is not an extreme elimination diet. It is the same whole food, plant-forward pattern that the evidence supports across all the other health outcomes covered in this series.

Practical anti-inflammatory shifts anyone can make

1. Eat oily fish twice a week. Mackerel, sardines, salmon, herring. The single most impactful food-level change for omega-3 and inflammation.
2. Fill half your plate with vegetables at main meals. Aim for colour variety. Different colours deliver different polyphenol types. Include leafy greens (spinach, kale, rocket) at least three or four times per week.
3. Eat berries several times a week. Frozen blueberries, raspberries, and blackberries are inexpensive and nutritionally equivalent to fresh. Add to porridge, yogurt, or eat as a snack.
4. Switch to extra virgin olive oil for dressings, raw use, and low-medium heat cooking. Use rapeseed oil for higher-heat cooking.
5. Make legumes a weekly staple. A tin of lentils or chickpeas added to soups, curries, or salads three or four times a week adds fibre, polyphenols, and anti-inflammatory nutrients in one practical step.
6. Hit 30g of fibre per day. The fibre to gut bacteria to SCFA to gut barrier pathway is one of the most important anti-inflammatory mechanisms in the diet. Whole grains, pulses, vegetables, and fruit are the practical routes.
7. Reduce ultra-processed food. Not because any single ingredient is the problem, but because the overall nutritional profile of a UPF-dominated diet is consistently pro-inflammatory.
8. Use herbs and spices liberally. Turmeric with black pepper, ginger, garlic, rosemary, and oregano all add polyphenols. The amounts in cooking are modest compared to clinical doses but contribute to overall polyphenol diversity.
9. Drink green or herbal tea. An easy way to add polyphenols without significant dietary change.
10. Address sleep and chronic stress. Diet is the most modifiable piece of the inflammation picture, but chronically poor sleep and unmanaged stress independently drive inflammation in ways that diet alone cannot fully counteract.

Anti-inflammatory eating and specific conditions

A note on diagnosed inflammatory conditions

For people with diagnosed inflammatory conditions (rheumatoid arthritis, inflammatory bowel disease, psoriasis, lupus, multiple sclerosis, or similar), an anti-inflammatory dietary pattern may be a useful complement to medical treatment. However:

• Dietary intervention is adjunctive, not a replacement for prescribed treatment.
• Some people with inflammatory bowel disease react adversely to high-fibre foods during flares. This is not a failure of the anti-inflammatory diet concept but a reason to work with a gastroenterologist and registered dietitian who can advise on timing.
• Specific elimination diets (nightshade-free, gluten-free, etc.) are sometimes promoted for inflammatory conditions without the evidence base to support broad recommendation. The general anti-inflammatory pattern described here is better supported.

Cardiovascular disease and inflammation

Atherosclerosis (the underlying mechanism of most heart attacks and strokes) is an inflammatory process. The plaque that builds up in artery walls involves chronic immune activation and inflammatory signalling. Reducing systemic inflammation through diet has direct cardiovascular relevance. The PREDIMED trial, which showed significant cardiovascular event reduction from a Mediterranean diet, specifically found reductions in inflammatory biomarkers as part of the mechanism.

Type 2 diabetes and inflammation

Chronic inflammation drives insulin resistance, a central feature of type 2 diabetes. Adipose tissue inflammation (from excess visceral fat), gut barrier dysfunction, and elevated CRP are all associated with worsening insulin sensitivity. An anti-inflammatory dietary pattern, combined with weight management and physical activity, addresses multiple pathways simultaneously.

Mental health and neuroinflammation

Neuroinflammation (inflammation within the brain) is increasingly recognised as a significant mechanism in depression, anxiety, and neurodegenerative conditions. The gut-brain axis, through which gut microbiome changes and gut permeability drive systemic and neurological inflammation, is an active area of research. See food and mental health guide.

Key stats and mechanisms at a glance