Inflammation Support (and Management) Through Nutrition

Excerpt from https://www.precisionnutrition.com/nutrition-for-injury-part-2 written by the co-founder of Precision Nutrition, John Berardi, PhD

Treating acute injuries requires a tricky balance of managing inflammation while allowing it to do its important job.

Don’t try to avoid the inflammatory process in the acute phases of an injury. It’s critical for Stage 1 recovery.

But don’t make inflammation worse, either. Excessive inflammation could increase total tissue damage, slowing down the repair process.

While managing inflammation in the early stages, we want to reduce pain, as this can cause biomechanical compensations and changes that may lead to secondary injury.

However, again, strategies that eliminate pain often target inflammation. Rushing to eliminate inflammation (and pain) too soon may also reduce healing. Again, it’s a tight balancing act.

Dietary fat for inflammation control

A diet high in trans-fats, omega-6 rich vegetable oils, and saturated fat will be pro-inflammatory (in other words, it’ll worsen inflammation).  A diet high in monounsaturated fats and omega-3 fats will be anti-inflammatory.

The ratio of omega-6 to omega-3 in the diet is important for overall inflammation in the body — especially during normal periods of healthy living when we definitely want to keep inflammation under control.

In these circumstances, the omega-6 to 3 ratio should be anywhere from 3:1 to 1:1, which should lead to a balanced inflammatory profile.

Of course, overall fat balance is important here. With a good balance of saturated, monounsaturated, and polyunsaturated fats (about 1/3 of total fat intake each), the body’s inflammatory profile will look pretty good.

However, purposely decrease omega-6 fats and increase omega-3s (specifically fish oil).  High omega 6:3 ratios reduce collagen production while a low 3:6 ratio supports healing.

Even though relatively higher omega-3s create an anti-inflammatory response in the body, this response doesn’t interfere with repair; rather, it only helps with injury healing and collagen deposition.

Unfortunately, we haven’t yet determined the exact omega 6:3 ratio, nor the amount of fish oil supplementation required to manage inflammation during injury.

Studies with low dose fish oil (~450 mg to 1 g/day) have shown no effect on inflammatory or immune markers while other studies have shown that high dose fish oil (12-15 g/day) may reduce immune cell function in certain populations.

As a result, some authors have recommended anywhere from 3-9 grams of fish oil (salmon oil, sardine oil, menhaden oil, krill oil, etc.) per day.

In addition to the omega 6:3 ratio, research has shown that increased nut and seed consumption, as well as olive oil consumption, can mildly reduce inflammatory biomarkers.

Nuts, seeds, and olive oil likely share a common mechanism.  The monounsaturated fats found in all three contain compounds that can mildly reduce COX enzyme activity (something these foods share with ibuprofen). But again, be careful.  Too high a dose of any anti-inflammatory may reduce acute healing.

Thus: Improve omega 6:3 ratio while adding in healthy monounsaturated fats and balancing saturated, polyunsaturated, and monounsaturated intake. Here are some simple strategies to do this:

To balance your fats:

Increase intake of olive oil, mixed nuts, avocados, flax oil, ground flax and other seeds, etc. Get some of each fat source each day. These foods will balance out the saturated fats naturally present in your protein sources, leading to a healthy profile without needing a calculator. (Bear in mind that you may need to reduce overall portion sizes if you are inactive because of the injury.)

To balance your 6:3 ratio:

Add 3-9 grams of fish oil each day while reducing omega-6 fats like vegetable oils such as corn oil, sunflower oil, safflower oil, cottonseed oil, and soybean oil, etc. This strategy should take care of your omega 6:3 ratio.

Dietary herbs and phytochemicals for inflammation

Beyond healthy fat balance, certain dietary herbs can help manage inflammation.

Turmeric

A flowering plant in the ginger family, turmeric has long been used as an anti-inflammatory agent and in wound healing. Current research shows that the active ingredient, curcumin, is responsible for some of the benefits of turmeric. While adding turmeric to food every day is a good strategy, using 400-600 mg of supplemental turmeric extract 3x per day (or as described on the product label) is probably more manageable for most people.

Garlic

Garlic has been shown to inhibit the activity of the inflammatory enzymes cyclooxygenase and lipoxygenase and affect macrophage function. Again, though, while eating additional garlic is likely a good strategy, garlic extracts may be required for more measurable anti-inflammatory effects. Typically recommended dosing is 2-4 g of whole garlic clove each day (each clove is 1 g) or 600-1200 mg of supplemental aged garlic extract.

Bromelain

Bromelain is another anti-inflammatory plant extract from pineapple. While best known for its digestive properties, bromelain is an excellent anti-inflammatory and analgesic compound although its mechanism of action is poorly understood. Typically bromelain is given in doses of 500-1000 mg/day for the management of inflammation.

Boswellia

A type of tree, Boswellia also has anti-inflammatory uses and has been shown to offer benefit through the inhibition of 5-lipoxygenase and potentially other cytokines. Typically supplemental Boswellia is taken in 300 mg doses 3x per day.

Flavonoids

Found in cocoa, tea, red wine, fruits, vegetables, and legumes, flavonoids can help manage inflammation through their antioxidant actions.  These powerful compounds likely act in other beneficial ways by affecting cell signaling.

It’s probably good to eat more flavonoid-rich foods in general and during acute injuries. Yet it’s often easier to supplement with things like blueberry or grape extracts, green tea extracts, citrus extracts (hesperedin, naringin, etc), and bioflavonoid supplements containing quercetin/dihydroquercetin and rutin, which may lead to more powerful anti-inflammatory effects.

Again, with all of these nutrients, use caution.  During acute phases of injury, we don’t want to completely suppress the inflammatory response.  Don’t stop inflammation from happening; just keep it under control.

And don’t load up on all of these anti-inflammatory supplements at once. Rather, focus on foods rich in natural inflammation-modulating agents such as these:

  • Curry powder/turmeric
  • Garlic
  • Pineapple
  • Cocoa
  • Tea
  • Blueberries

Only supplement if inflammation becomes a major/chronic problem.  This would likely be discussed with your physician first.

Andrea Reynolds, Nutritionist, Ph2
Simplified Nutrition Coaching
simplifiednutritioncoaching@gmail.com
www.simplifiednutritioncoaching.com
Ph: 801-649-4690
6717 S. 900 E., Suite 201
Midvale, UT 84047