Inflammation is the body's first line of defense for a scratch or a scrape. But when that defense mistakes the body for the enemy, it can launch devastating attacks against tissue, causing damage that can be a factor in conditions like arthritis and diabetes, as well as potentially deadly diseases like cancer and heart disease.

While medical research seeks better ways to teach the immune system to recognize the difference between friend and foe, Suzanne Judd, PhD, a professor in the Department of Biostatistics at the University of Alabama at Birmingham School of Public Health, has been investigating the triggers that launch the body's self-attack.

A nutritional epidemiologist, Judd, along with researchers at Emory University, has been searching through detailed data from a subset of 639 participants from the nationwide Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

"We looked at 19 foods and four lifestyle characteristics to get a better picture of how they relate to inflammation," Judd said. "Detailed records of the foods each individual reported eating regularly were compared with the same participant's inflammatory status as measured by blood levels of C-reactive protein and interleukins 6, 8 and 10. We calculated the strengths of association between the inflammatory markers and food choices and lifestyle element, and were able to weight each factor. Some were associated with less inflammation and others were linked to more.

"We have a dietary inflammation score (DIS) and a lifestyle inflammation score (LIS). There were previous scores for particular nutrients, but people needed to know what foods seem to reduce or increase inflammation. We compared both individual foods and the nutrients in those foods and found that the scoring held true.

"The scores were validated in more than 14,200 additional REGARDS participants. Higher scores were strongly associated with inflammation biomarkers. People who reported eating a lot of fruits and vegetables tended to have less inflammation.

"We have been asked why we have such a strong association with fruits, but don't show anything on leafy greens. It's because people were reporting what they ate, and it seems a lot more people like apples and berries than broccoli and kale. We will need more leafy green fans to score them. But red tomatoes were a winner."

Problem foods that strongly associated with inflammation were grouped among the usual suspects, but were highly individual to each participant. Processed foods with added sweeteners and saturated fats often were a problem. Some people had problems with dairy or eggs, while for others the triggers were legumes or highly processed grains. There were also some food sensitivities that were very individual in nature.

"There are some general things we can say, like avoid saturated fats, added sugars and highly processed foods, and eat more fruits and vegetables," Judd said. "Go for a range of colors, because that's where the nutrients are. But overall, people can be their own best doctor by paying attention to what they eat and how they feel. If inflammation affects your mobility, look back to see what you ate and did the day before. If a pattern is developing, try avoiding that food for a while and see if you feel better.

"Lifestyle showed a strong or possibly even stronger link to inflammation. The number one factor is smoking. Unfortunately, 10 to 20 percent of the population still smokes. We also looked at body mass index, activity and alcohol. While a little red wine may have beneficial effects for the heart, more alcohol is linked to higher inflammation. Research in cancer indicates that there is no safe level of alcohol."

The team's findings were reported in the December 2019 issue of the Journal of Nutrition. The new DIS and LIS scoring system will be used as a tool in future epidemiological studies of the combined contributions of diet and lifestyle in systemic inflammation.

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Key Words

Inflammation, inflammatory foods, lifestyle, smoking and inflammation, Suzanne Judd PHD, UAB , University of Alabama at Birmingham School of Public Health, Emory University, Journal of Nutrition, REGARDS

Inflammation is the body's first line of defense for a scratch or a scrape. But when that defense mistakes the body for the enemy, it can launch devastating attacks against tissue, causing damage that can be a factor in conditions like arthritis and diabetes, as well as potentially deadly diseases like cancer and heart disease.

While medical research seeks better ways to teach the immune system to recognize the difference between friend and foe, Suzanne Judd, PhD, a professor in the Department of Biostatistics at the University of Alabama at Birmingham School of Public Health, has been investigating the triggers that launch the body's self-attack.

A nutritional epidemiologist, Judd, along with researchers at Emory University, has been searching through detailed data from a subset of 639 participants from the nationwide Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

"We looked at 19 foods and four lifestyle characteristics to get a better picture of how they relate to inflammation," Judd said. "Detailed records of the foods each individual reported eating regularly were compared with the same participant's inflammatory status as measured by blood levels of C-reactive protein and interleukins 6, 8 and 10. We calculated the strengths of association between the inflammatory markers and food choices and lifestyle element, and were able to weight each factor. Some were associated with less inflammation and others were linked to more.

"We have a dietary inflammation score (DIS) and a lifestyle inflammation score (LIS). There were previous scores for particular nutrients, but people needed to know what foods seem to reduce or increase inflammation. We compared both individual foods and the nutrients in those foods and found that the scoring held true.

"The scores were validated in more than 14,200 additional REGARDS participants. Higher scores were strongly associated with inflammation biomarkers. People who reported eating a lot of fruits and vegetables tended to have less inflammation.

"We have been asked why we have such a strong association with fruits, but don't show anything on leafy greens. It's because people were reporting what they ate, and it seems a lot more people like apples and berries than broccoli and kale. We will need more leafy green fans to score them. But red tomatoes were a winner."

Problem foods that strongly associated with inflammation were grouped among the usual suspects, but were highly individual to each participant. Processed foods with added sweeteners and saturated fats often were a problem. Some people had problems with dairy or eggs, while for others the triggers were legumes or highly processed grains. There were also some food sensitivities that were very individual in nature.

"There are some general things we can say, like avoid saturated fats, added sugars and highly processed foods, and eat more fruits and vegetables," Judd said. "Go for a range of colors, because that's where the nutrients are. But overall, people can be their own best doctor by paying attention to what they eat and how they feel. If inflammation affects your mobility, look back to see what you ate and did the day before. If a pattern is developing, try avoiding that food for a while and see if you feel better.

"Lifestyle showed a strong or possibly even stronger link to inflammation. The number one factor is smoking. Unfortunately, 10 to 20 percent of the population still smokes. We also looked at body mass index, activity and alcohol. While a little red wine may have beneficial effects for the heart, more alcohol is linked to higher inflammation. Research in cancer indicates that there is no safe level of alcohol."

The team's findings were reported in the December 2019 issue of the Journal of Nutrition. The new DIS and LIS scoring system will be used as a tool in future epidemiological studies of the combined contributions of diet and lifestyle in systemic inflammation.