When famous golfer Phil Mickelson won the 2021 PGA Championship, it wasn't just his age that grabbed headlines. At the age of 50, Mickelson is, indeed, the oldest-ever winner of a major golf championship. But even more impressive is the fact that just a few years ago Mickelson felt so bad that he could hardly get out of bed. He has psoriatic arthritis, a painful inflammatory disease of the joints. At that point Mickelson made a key healing decision to change his diet, specifically cutting back on the foods that made his inflammation worse. Chronic diseases, like the one Mickelson has-and also type 2 diabetes, heart disorders, cancers, respiratory diseases and more-tend to be treated as individual conditions. But when you peel back the layers, these conditions all have one thing in common: inflammation.
If you can address the inflammation, chances are good that you can slow the progression of disease and even reverse it, in some cases. A compelling reason to do so? The World Health Organization (WHO) ranks chronic diseases as the greatest threat to human health. And worldwide, three of five people die due to chronic inflammatory diseases.
Though inflammation is often referred to as a silent killer, nutrition experts say that's not really true. Your body does provide some telltale signs that the metaphorical fires are burning. The most positive thing to extract from these experts-and Mickelson's example-is that, in the case of chronic inflammation, what you eat matters. You can tame inflammation through a healthy, anti-inflammatory diet and lifestyle. Here's how and why three registered dietitians advise you to start now.
5 Cardinal Signs of Inflammation
Let's clear up one thing first. Not all inflammation in the body is bad. Short-term (acute) inflammation is your body's way of healing from small trauma, such as a sprained ankle. In this example, the tissue around your ankle swells, getting bruised and hot. You feel pain and your ankle mobility dwindles for a few days. These signs and symptoms of inflammation are a good thing, signaling your body to produce white blood cells and other substances to protect you from infection, bacteria, and viruses.
Chronic inflammation, on the other hand, is a slow-progressing condition that you may not notice at first, but becomes serious and life threatening if it keeps building over time. Though subtle, the signs of chronic inflammation are usually there years before a diagnosis. And many medical experts use the analogy of a fire to describe what's happening.
"Think of chronic inflammation like a small, low-burning fire inside your body," says Carolyn Williams, RD, author of Meals that Heal, 100+ Everyday Anti-Inflammatory Recipes in 30 Minutes or Less ($19, Amazon). "That fire is not going to go out unless you do something about it. If you continue inflammatory habits, that fire is going to spread and start another fire. The culmination of all these little fires burning in the background of your body is a diagnosis of diabetes, a heart attack, joint pain, or something else."
So what are the chronic inflammation symptoms and signs? Williams describes it as waking up in the morning and repeatedly thinking to yourself 'I just don't feel like I'm supposed to feel.' If that inner voice sounds familiar, here are 5 signs of inflammation to look for:
Slightly elevated blood glucose and/or blood pressure: Watch for a pattern of blood glucose and blood pressure that creeps up slowly over time. Comparing your numbers, year over year, at an annual doctor physical is a good way to do so. "Your blood glucose may not be near diabetes level or your blood pressure may not be enough to diagnose you with hypertension yet," explains Williams, "but the steady increase is a sign of inflammation."
Cloudy thinking: "'Brain fog' is a key indicator, given that inflammation impacts our brains as well as our bodies in a process sometimes called 'brainflammation'," says Lulu Cook, RDN, and co-author of The Complete Anti-Inflammatory Diet for Beginners: A No-Stress Meal Plan with Easy Recipes to Heal the Immune System ($24, Amazon).
Joint pain: People don't often miss the warning sign of achy and painful joints, which usually show up first in the small joints of the hands and feet. "Joint pain is common in various types of inflammation-related arthritis," says Ginger Hultin, RDN author of Anti-Inflammatory Diet Meal Prep ($23, Amazon).
Depression and fatigue: "Depression is another early external sign that may be more obvious than the internal impacts of chronic inflammation," says Cook. Another is fatigue, adds Hultin. "Chronic inflammation can definitely affect your energy."
Weight gain: Cook and Williams also say that unintentional weight gain, even 5 to 10 pounds that crept on over a few months, is a sign of underlying chronic inflammation.
Other subtle signs of inflammation in the body? Williams warns that chronic bloating and gassiness is one, as well as delayed wound healing.
Where to Start: Top Inflammation-Causing Foods
One of the first things to consider when trying to eat a diet to reduce inflammation is to address how much added sugar you're consuming. "Added sugars of every kind are the number one culprit in increasing inflammation," says Cook, who often counsels clients on where to start with an anti-inflammation diet. "That means table sugar, honey, raw sugar-all of it. Refined grains like white flour, such as we find in baked goods, are processed similarly to sugar in our bodies and are also inflammatory," says Cook.
In addition to cutting back on foods with added sugars and refined grains, Williams says that a good place to start is to eliminate any foods with trans fats, which often result in inflammation. "Trans fats are unsaturated oils that have been chemically altered," Williams explains in her book, "the result of which is a processed fat that is directly linked to increasing inflammation." Confusingly, packaged foods that contain less than 0.5 grams of trans fat per serving can list 0 grams trans fat on the Nutrition Facts label. So an easier way to know if something you're eating contains them, look at the ingredients. If a product contains "partially hydrogenated oil" that's a good indication it has trans fats. When you eat a lot of processed foods, small amounts of trans fats here and there add up quickly.
Some foods that contain a triple inflammation whammy (added sugars, refined grains, and trans fats) are packaged baked goods, fried foods, and refrigerated doughs and biscuits. Eliminate those and these other 5 foods that are notorious for causing inflammation, and you'll be well on your way to fighting those fires. Hultin adds that alcohol, when used in excess, is highly inflammatory. "While low intakes of wine or beer may be beneficial for some people and some conditions," she says, "it's not a substance that is naturally 'anti-inflammatory' and it can act like a toxin to the body."
What Is an Anti-Inflammatory Diet?
While it's clear that what you eat can either make chronic inflammation better or worse, it's not so clear what the anti-inflammatory diet is. Cook, Williams, and Hultin say the diet can look a little different for everyone, but it's always a matter of prioritizing plant-based foods.
"There is a huge amount of research on the benefits of primarily plant-based foods for reducing inflammation," says Cook. "These high-fiber foods nourish our healthy gut bacteria, which then help reduce inflammation throughout the entire body. They also provide a wealth of antioxidants, vitamins, minerals, and polyphenols that also support the many body systems that are involved in either increasing or reducing inflammation."
But when it comes to plant-based eating, you have some choices. The top two approaches recommended by these nutrition experts are a Mediterranean diet or a vegetarian diet. Either way, your plates should feature a lot of vegetables, beans, fruits, whole grains, and healthy fats such as olive oil, nuts, and avocados, advises Cook. In addition to these, Hultin says to add antioxidant-rich foods, like herbs, spices, tea, and cocoa.
The top 8 anti-inflammatory foods you should eat several times each week? Williams has a clear list of them that research has repeatedly shown to offer anti-inflammatory effects. The great 8 are:
leafy greens: romaine, radicchio, arugula, mustard greens, spinach, Swiss chard
olive oil: extra-virgin or cold-pressed
berries: blueberries, strawberries, raspberries, blackberries, cranberries
cruciferous vegetables: broccoli, kale, cauliflower, Brussels sprouts, bok choy
fatty fish: salmon, anchovies, mackerel, sardines
tea: green, white, oolong, black
nuts and seeds: almonds, Brazil nuts, cashews, chia seeds, pecans, walnuts
gut-health promoters: yogurt, kimchi, kombucha, sauerkraut
What Causes Inflammation Other Than Food?
A diverse plant-based diet is your best defense against chronic inflammation, but it's not the only thing that can keep those low-burning fires at bay. "Another lifestyle factor that can work for or against us is physical activity," says Cook. "Including about 30 minutes a day of movement that you enjoy, whether that's walking or dancing or Tai Chi or running marathons, has direct anti-inflammatory benefits for us. On the flipside, too much time sitting around (aka sedentary time) increases inflammation."
Hultin and Williams add that you can't underestimate prioritizing stress management, getting enough sleep, and eliminating environmental toxins within your control, such as excess pesticide and tobacco smoke exposure. "A holistic approach is likely best to really feel the effects, see the changes in your labs, and get the most benefits to your health," says Hultin.