Welcome to Swmdda's Corner, a space used to discuss current topics and happenings with the dietetics community
By Alyssa Pumford
As chronic diseases continue to rise across the United States, patients are beginning to demand more holistic approaches rather than popping pills to heal themselves. As we know, inflammation underlies most chronic diseases and conditions, such as autoimmune disease, inflammatory bowel disease (IBD), type 2 diabetes, arthritis, cardiovascular disease (CVD), cancer and chronic pain. Although there is no standardized anti-inflammatory diet, there are foods that are thought to either reduce or increase inflammation. Educating patients about what these foods are and how to incorporate them into their diet may help reduce their symptoms. But before diving into that, let’s review the science!
Pathophysiology of inflammation: Inflammatory conditions (e.g. infection, acute illness, trauma, toxins, diseases, physical stress) trigger the acute immune response to release eicosanoids and cytokines, which mobilize nutrients required to synthesize positive acute-phase reactants and leukocytes.  Cytokines (specifically IL-1beta, TNF-alpha, IL-6) increase the breakdown of muscle protein to meet the demand for energy during the inflammatory response.  Tissue injury results in declining values of serum albumin, prealbumin and transferrin (also known as negative acute-phase reactants). As the body begins to heal itself, a negative feedback cycle occurs, and inflammation ceases. If these mechanisms of acute inflammation fail to resist infection or heal an injury, chronic inflammation ensues. 
Various nutrients in foods have been shown to reduce inflammatory markers.  Anti-inflammatory foods are high in fiber and have a low glycemic index, and typically include omega-3 fatty acids, antioxidants and polyphenols, and prebiotics and probiotics.
-Omega-3 FA: Foods that have polyunsaturated fatty acids omega-3 DHA and EPA reduce the production of cytokines.  Sources include fatty fish, such as salmon, sardines, mackerel and oysters. Plant foods such as walnuts, chia seeds, flaxseeds and hempseeds contain omega-3 ALA, but DHA and EPA seem to be more effective in lowering inflammation. In general, replacing saturated and trans fat with polyunsaturated and monounsaturated fat reduces markers of inflammation (EAL Grade 1). 
- Antioxidants and polyphenols in plant foods: Antioxidants help fight free radical damage to cells and reduce production of C-reactive protein and histamine.  Polyphenols are phytochemicals in plants that have shown anti-inflammatory effects. Although most plant foods contain these anti-inflammatory properties, fruits and vegetables that seem to contain the most include cruciferous vegetables, onions, garlic, berries, citrus fruits, pomegranates and cherries.  Spices and herbs such as turmeric, ginger, rosemary, cinnamon, red chili powder, and black pepper contain antioxidants and polyphenols that prevent free radical formation. 
-Pre and probiotics for a happy gut: Although more research on the microbiome is needed, there is some evidence that supports consuming pre and probiotics for a healthy gut ecology, which in turn reduces inflammation.  For prebiotics, plant foods containing inulin and oligofructose are preferred because both can be fermented by the gut and promote growth of “good” bacteria. Prebiotic sources are bananas, asparagus, onion, garlic, chicory and artichokes. Probiotics are the actual bacteria themselves and can be found in fermented foods such as miso, sauerkraut, yogurt, kimchi, kefir, tempeh and kombucha.
-High fiber and low glycemic foods: Refined carbohydrates, such as products with white flour, cakes, pastries, white rice, flour tortillas and pasta, have a higher glycemic load, which when consumed lead to higher post-prandial glucose and insulin levels, and can cause inflammation (which is unfortunate, since refined carbs are so delicious!). These refined carbs also tend to have little fiber as well. Carbohydrates high in fiber tend to have a low glycemic load, with the greatest protection from c-reactive protein seen at a total fiber level above 22 grams per day.  Foods high in fiber should be introduced slowly to reduce possible gastrointestinal distress.
Of course, every person is unique and has different tolerances which need to be accounted for. Food journaling with symptoms are needed to discover these intolerances. Common intolerances include dairy, wheat, eggs, veggies from the nightshade group, and artificial flavors and sweeteners. Also, sleep hygiene is incredibly important; 7-8 hours of sleep per night is optimal for anti-inflammatory effects.
The bottom line:
Check out the recipe below for an easy and delicious way to incorporate anti-inflammatory spices into a beverage!
ANTI-INFLAMMATORY GOLDEN MILK *
Serving size: 2
*Adapted from Minimalist Baker