Anti-Inflammatory Diet

Diet Reference Archive: a label for a family of eating patterns

Anti-Inflammatory Diet

A name for ways of eating built on vegetables, fruit, whole grains, beans, nuts, olive oil and fish, with less refined carbohydrate, fried food, sugary drinks and red and processed meat. It is not one defined diet, and it is promoted as a way to lower the long-lasting, low-level inflammation linked to chronic disease.

Family: Guideline-endorsed and evidence-based dietary patterns Promoted by: no single owner; researchers, clinicians and commercial authors all use the name First appeared: no single origin; the research scoring tools date from 2009 GRADE certainty of evidence: no single rating, because the name does not define one diet to rate; ratings by outcome and comparison are in the review record

ON THIS PAGE

1. In brief
2. Overview
3. In practice
4. For the coach
5. The evidence (opens on request)
6. Mechanisms (opens on request)
7. Risks, contraindications and myths (opens on request)
8. Key terms
9. Review questions
10. References
11. Evidence rating and review record

The summary and sections 1 to 3 are the short version and are open when the page loads. Sections 4 to 6 hold the research detail, the biology, and the cautions. Each of those opens when you select its heading, and you can read the page without opening them. Back to the Diet Reference Archive index.

In brief

What is it? A name, not a single diet. Most versions ask for plenty of vegetables, fruit, whole grains, beans, nuts, olive oil and fatty fish, and less refined carbohydrate, fried food, sugar-sweetened drinks and red and processed meat. In that form it looks a great deal like the Mediterranean and DASH patterns. Other versions add long lists of foods to cut, and those lists disagree with one another.

Does it work? No one defined plan carries the name, and the purpose-built plans reviewed here do not establish effects on heart attacks, cancer or length of life. The research that uses the name is of 3 kinds. Observational studies score how inflammatory a person's usual eating is and follow what happens: people whose eating scores most inflammatory have more heart disease and higher death rates than people whose eating scores least, but these studies cannot show that the eating caused it. One large review judged the evidence limited for most of the 38 outcomes it examined, and another rated the evidence for an association moderate in certainty for 3 outcomes: new cardiovascular disease, death from any cause and colorectal cancer.

Small, short trials of eating plans given the name, mostly in people with conditions such as rheumatoid arthritis who stayed on their medication, report modest improvements in pain compared with ordinary eating, at very low certainty. And trials of named patterns that measure blood markers of inflammation find that the Mediterranean pattern lowers some markers slightly compared with control diets, with results that vary widely from trial to trial. A change in a blood marker is not the same as less disease.

Is it safe? The food at its center is ordinary food, and in its usual form it removes no food group. Two cautions come up most often. The name travels with supplements, and a federal health agency states that some concentrated curcumin products, the main compound in turmeric, may harm the liver. And some versions hand out long lists of foods to cut, which can leave gaps in nutrition and turn eating into a set of rules.

Who should not do it without talking to a doctor or dietitian first? Anyone hoping to use it for a diagnosed inflammatory condition, such as rheumatoid arthritis or inflammatory bowel disease, where the trials tested it alongside medical treatment, not in place of it. Anyone thinking of changing or stopping a medication because of it. Anyone taking warfarin, who needs a steady intake of the vitamin K in leafy greens. Anyone planning to add supplements while taking prescription medicine. Anyone with chronic kidney disease, whose needs depend on stage, lab results and treatment. Anyone who is pregnant and considering supplements or a list that cuts food groups.

Related pages: Mediterranean Diet, DASH Diet and MIND Diet. Full list on the archive index.

1. Overview

What you eat

There is no official food list, so what a person eats depends on which version they follow. The versions share a core. A widely read consumer description from Harvard Health Publishing names tomatoes, olive oil, green leafy vegetables such as spinach, kale and collards, nuts such as almonds and walnuts, fatty fish such as salmon, mackerel, tuna and sardines, and fruits such as strawberries, blueberries, cherries and oranges (Harvard Health Publishing, 2026). A review written for clinicians describes the plan as a pattern that centers on whole, plant-based foods rich in healthy fats and plant compounds, and that keeps blood sugar steady after meals (Ricker & Haas, 2017).

Branded versions add their own structure. The food pyramid published by the physician Andrew Weil puts vegetables, herbs and spices, cooked Asian mushrooms and water at the base with no limit; whole grains, tea, fruit and healthy fats at 3 to 5 servings a day; fish and shellfish, whole soy foods, and beans and lentils at 1 to 2 servings a day; and sweets such as dark chocolate, pasta, and other protein sources such as cheese, yogurt and eggs as occasional foods (Weil, n.d.). Its 2026 redesign kept those tiers (Weil Nutrition Corner, 2026).

Versions built for research trials go in their own directions. The Swedish trial in rheumatoid arthritis described in section 4 delivered salmon and other fish 3 to 4 times a week, bean and lentil dishes, whole grains, potatoes, vegetables, fruit, berries, nuts, low-fat dairy foods and a daily drink containing live bacteria, known as a probiotic (Vadell et al., 2020). A feeding study in the United States, by contrast, removed wheat and other grains high in gluten, corn, soy, all dairy foods, tomatoes, potatoes, peppers and eggplant, citrus fruit, beef, pork, shellfish, eggs, added sugar, caffeine and peanuts (Zwickey et al., 2019).

What you avoid or limit

The consumer description lists refined carbohydrates such as white bread and pastries, French fries and other fried foods, soda and other sugar-sweetened drinks, red meat and processed meat, and margarine, shortening and lard (Harvard Health Publishing, 2026). Most versions agree on that list.

Beyond it, the versions disagree, sometimes directly. Tomatoes and oranges are on the consumer list of foods to eat, and the feeding study above removed both (Harvard Health Publishing, 2026; Zwickey et al., 2019). The Swedish trial included potatoes and dairy foods, and the feeding study removed them (Vadell et al., 2020; Zwickey et al., 2019). One diet designed for inflammatory bowel disease, known as the IBD-AID, restricts certain carbohydrates (Olendzki et al., 2014), while another designed for the same disease, the Groningen anti-inflammatory diet, keeps plain dairy foods and wheat and includes lean meat and eggs (Campmans-Kuijpers & Dijkstra, 2021). Whether a limit is a firm rule or a general direction depends on the version, and a client may be following a list more strictly than its author intended.

Where it came from

The name has 3 separate roots, and a client may have met any of them.

The research root is a set of scoring tools. In 2009 researchers published an index that rates the inflammatory potential of a person's overall diet, and tested it against a blood marker of inflammation, C-reactive protein, in about 600 adults followed for a year (Cavicchia et al., 2009). A team at the University of South Carolina then rebuilt it as the Dietary Inflammatory Index. To build it they screened about 6,500 articles, scored 1,943 of them for whether each of 45 food components raised, lowered or did not change 6 markers of inflammation, and set each person's intake against intakes recorded in 11 populations around the world (Shivappa et al., 2014).

A second tool, the empirical dietary inflammatory index, came out of the Nurses' Health Study. It uses the 18 food groups that best predicted 3 inflammation markers in 5,230 of that study's participants, 9 counted as raising inflammation and 9 as lowering it (Tabung et al., 2016). These tools measure eating. Neither one is an eating plan.

The popular root is commercial and personal. Andrew Weil's anti-inflammatory food pyramid is the best-known branded version, and its 2026 redesign was announced as its first major update in 20 years, consolidating 16 food categories into 5 tiers (Weil Nutrition Corner, 2026).

The clinical root is a group of diets designed by researchers for particular conditions, including rheumatoid arthritis and inflammatory bowel disease. Each was built for its own study and differs from the others in its details (Campmans-Kuijpers & Dijkstra, 2021; Keshteli et al., 2022; Olendzki et al., 2014; Vadell et al., 2020).

What it claims to do

The central claim is that long-lasting, low-level inflammation drives many chronic diseases, and that eating differently can lower it. The announcement of Andrew Weil's redesigned pyramid states that the diet was developed to help reduce chronic inflammation and lower the risk of related conditions, including heart disease, certain cancers and Alzheimer's disease, and that its foods support immune health, metabolic balance and longevity (Weil Nutrition Corner, 2026). Consumer articles frame particular foods as foods that fight inflammation (Harvard Health Publishing, 2026), and supplements are sold on the same claim.

Clients bring narrower claims too: that the diet will ease joint pain, calm a digestive condition, clear the skin, lift mood, or bring down a blood test result. Section 4 takes the evidence on each kind of claim in turn. Those claims are not equally supported, and several rest on changes in blood markers rather than on changes in health.

What it gets right

The foods at the center of nearly every version are the foods that heart-health guidance already asks for: vegetables, fruit, whole grains, beans, nuts, unsaturated oils and fish, with less refined carbohydrate, sugary drinks and processed meat. That is why the consumer description points to the Mediterranean diet as a plan that closely follows it (Harvard Health Publishing, 2026). Many clients who use the name mean foods already described in general dietary guidance; others bring restrictive lists. Section 3 describes how a coach works with either.

The research behind the name also did something useful. By scoring whole diets rather than single nutrients, it shifted attention to the overall pattern of eating, which is where the evidence in nutrition is strongest.

How clients describe it, and what it gets confused with

Clients say "I'm eating anti-inflammatory," "I've cut out inflammatory foods," "I'm off nightshades," "my naturopath put me on an anti-inflammatory protocol," "I take turmeric for inflammation," or "my CRP was high, so I changed my diet." Each of these can mean something different, from eating more vegetables and fish to following a long list of exclusions to taking a handful of supplements. Ask before assuming.

The name is most often confused with the Mediterranean Diet, which much of the research treats as the model anti-inflammatory pattern; with the DASH Diet and the MIND Diet; and with elimination diets for particular conditions, such as the autoimmune protocol, the Low-FODMAP Diet and the Gluten-Free Diet, which are more restrictive and are used under clinical supervision for specific diagnoses. Those diets are listed on the archive index.

2. In practice

A typical day of eating

Breakfast is oatmeal with berries and walnuts, with tea or coffee. Lunch is a lentil or bean soup with a large salad dressed in olive oil, and a piece of fruit. An afternoon snack is a handful of almonds or an orange. Dinner is baked salmon or sardines, brown rice or another whole grain, and roasted vegetables with garlic and herbs. Water is the usual drink. Nothing here is unusual food, and it closely resembles a Mediterranean day. What varies from version to version is mostly what is left out.

Cost, products, and who profits

The eating itself needs no program, membership or product, and the core foods include inexpensive staples such as beans, lentils, oats, frozen vegetables and canned fish, alongside costlier ones such as fresh fish, nuts, berries and olive oil. In one cross-sectional study of 6,838 Spanish older adults at high cardiovascular risk, eating that scored as more anti-inflammatory cost more per 1,000 calories, as did closer adherence to the Mediterranean pattern; the cost was estimated from national food price data, not from what people paid (Bouzas et al., 2023). A client with limited money can follow the pattern through the cheaper foods.

Money attaches to the name in 3 places. The first is supplements. Andrew Weil's pyramid includes a daily supplement tier: a multivitamin and mineral with antioxidants, coenzyme Q10, 2 to 3 grams of fish oil, and 2,000 IU of vitamin D3, and the page that presents it links to a marketplace, a shop page for products sold with the Origins brand, and a 14-day free trial of a subscription site (Weil, n.d.). Turmeric and curcumin capsules are marketed on anti-inflammatory claims, and the National Center for Complementary and Integrative Health states that not enough is known to conclude definitively whether turmeric or curcumin benefits any health purpose (National Center for Complementary and Integrative Health, 2025).

The second is publishing: a magazine, a newsletter and courses built on the name (Weil Nutrition Corner, 2026). The third is the research tool itself. Papers using the Dietary Inflammatory Index disclose that its inventor owns a controlling interest in a company set up to license the index for apps used in patient counseling, and that researchers on those papers are employees of that company (Marx et al., 2021; Shivappa et al., 2018). That disclosure does not make the research wrong. It is worth knowing that some of the most-cited studies of the index come from people with a stake in it.

Environmental footprint

The footprint depends mostly on which foods a person chooses within the pattern. Across modeling studies of more sustainable diets, the reductions in greenhouse gas emissions, land use and water use generally tracked how much animal food was cut (Aleksandrowicz et al., 2016). In 15,318 Chinese adults, diets that scored as more pro-inflammatory went with higher greenhouse gas emissions, which the researchers estimated from the foods people reported eating (Yao et al., 2025). Both are estimates built from what people eat, not measurements, and neither tested a diet under this name.

Cultural fit

At the level of the pattern the fit is broad. Vegetables, beans, whole grains, fish and a plant oil as the main fat are part of many food traditions, and a client can move toward the pattern through the foods of their own kitchen. The fit narrows at the level of the list. Popular lists name particular foods, such as matcha, Asian mushrooms, berries or a specific oil, that reflect one author's choices rather than anything the research requires, and some lists cut staple foods such as tomatoes, potatoes, peppers, corn, wheat or dairy that sit at the center of many cuisines. A client who feels that eating this way means giving up the food they grew up with is usually following a list, not the pattern.

What makes people stop

There is little direct evidence. In the Swedish rheumatoid arthritis trial, 47 of 50 participants completed at least one diet period, and the reasons for dropping out were difficulty eating, the onset of another serious illness, and moving out of the area the study delivered food to (Vadell et al., 2020). In a 6-month trial in Croatia, 44 of the 125 people randomized were excluded from the final analysis, mainly because they did not follow the dietary recommendations; both the anti-inflammatory group and the comparison group were on reduced-calorie diets (Kenđel Jovanović et al., 2020).

Beyond those figures, what follows is observation rather than measured data: long lists of foods to avoid are hard to keep up in social settings and in family meals, supplements cost money every month, and a person who expected to feel different within weeks may stop when they do not.

What happens when you stop

The searches for this page found no study that followed people after they stopped a diet under this name. The trials described in section 4 ran from 4 weeks to about 13 months, too short to say which changes last. The Swedish trial used a crossover design, in which each person ate both diets with a break of about 4 months between them, and that design assumes that effects fade during the break (Vadell et al., 2020). It says nothing about what happens to a person who stops after years of eating this way.

Common variations

The branded version most clients will have met is Andrew Weil's anti-inflammatory food pyramid, redesigned in 2026 (Weil, n.d.; Weil Nutrition Corner, 2026). Research teams have built their own versions for particular conditions: a portfolio of foods for rheumatoid arthritis tested in Sweden (Vadell et al., 2020); the IBD-AID for inflammatory bowel disease, first reported in a series of patients rather than a trial (Olendzki et al., 2014); the Groningen anti-inflammatory diet for the same condition (Campmans-Kuijpers & Dijkstra, 2021); a menu plan for ulcerative colitis tested in Canada (Keshteli et al., 2022); a strict exclusion version tested in people with diabetes or prediabetes (Zwickey et al., 2019); and nutritional support based on the Dietary Inflammatory Index for people receiving chemotherapy for lung cancer (Zhang et al., 2023).

Researchers also apply the name to established patterns. One review of rheumatoid arthritis counted Mediterranean, vegetarian, vegan and ketogenic diets as anti-inflammatory (Schönenberger et al., 2021). Another counted Mediterranean, DASH, Nordic, ketogenic and vegetarian diets (Jiang et al., 2025). A third included low-carbohydrate and ketogenic diets among its examples (Law et al., 2025). Some of those patterns contradict each other on bread, grains and fat. When a study reports that anti-inflammatory diets did something, the first question is which diets it means.

3. For the coach

SCOPE OF PRACTICE

A health and wellness coach does not prescribe, adjust, endorse or discourage this or any way of eating, and does not diagnose or treat. The coach helps the client understand what they have chosen, notice how it is going, and decide what to do next. Three points in particular belong to someone else. A client who wants to use eating to manage a diagnosed inflammatory condition, such as rheumatoid arthritis or inflammatory bowel disease, needs the clinician who treats that condition and a registered dietitian, because the trials of eating plans in those conditions tested them alongside medical treatment, not in place of it.

A client who is thinking of changing or stopping a medication because of how they are eating is making a decision that belongs with the prescriber. And a coach does not read or interpret blood tests: whether a C-reactive protein result is high, what it means and whether it has changed are the clinician's questions. A client who wants an individual eating plan built for them, including a plan for cutting foods and adding them back, is describing the work of a registered dietitian.

Who does what

The physician

Diagnoses and treats any inflammatory condition the client has, orders and interprets the blood tests that bear on it, such as C-reactive protein, the erythrocyte sedimentation rate or, in bowel disease, fecal calprotectin, and decides whether any medication should change. The specialist who treats the condition, often a rheumatologist or gastroenterologist, is the right person for questions about eating as part of that treatment. The prescriber or pharmacist is the right person for questions about supplements alongside prescription medicine, including blood thinners such as warfarin.

The registered dietitian

Builds and monitors an individual eating plan. For this pattern that usually means adapting it to a diagnosed condition, such as a diet designed for inflammatory bowel disease; running any plan that removes foods and adds them back to test a suspected reaction; checking that a version which cuts food groups still meets the client's needs; and helping a client on warfarin keep vitamin K intake steady rather than avoiding greens.

The health and wellness coach

Finds out what the client is hoping the eating will do, and where that hope came from. Tests the plan against the client's actual life: the budget, who cooks, who else eats at the table, how much the list is costing in time and worry. Helps the client choose a first change small enough to hold. With the client's permission, can share general information from recognized authorities, such as what a federal fact sheet says about a supplement, and explore how the client wants to use it. Notices whether the eating is widening or narrowing, and holds the referral line when a question belongs to a clinician.

What a client bringing this diet needs

Clients arrive with this name for a handful of reasons: a diagnosis of an inflammatory condition and a wish to do something beyond medication; a blood test result that a clinician mentioned; persistent pain, fatigue or digestive trouble without a clear answer; or something read or heard that promised to fix several things at once. The reason shapes the conversation. A client with rheumatoid arthritis who is hoping for less morning stiffness needs something different from a client who read that inflammation causes weight gain and wants a list.

What the coaching conversation offers that a search engine cannot is room to separate what the client wants from the list they were handed. Many clients use this name for foods already described in general dietary guidance; others bring restrictive lists. The coach explores what this client means and wants, and supports the client's own decisions within the referral boundaries below. That includes helping the client see their own reasons, notice whether a list is serving them, and keep the people treating them informed.

What to ask

• When you say anti-inflammatory, what does that look like on your plate?
• What are you hoping will be different if this works?
• Who else knows you are eating this way, and what do they think about it?

Referral red flags

A client with a diagnosed inflammatory condition who says they want to use food instead of their medication, or who has already cut back on a medication, goes to the prescriber now, before anything else. The case series behind one bowel disease diet reported that patients were able to stop medications, but those were 11 people reviewed after the fact with no comparison group, and medication decisions stay with the treating clinician (Olendzki et al., 2014). A client on warfarin who is eating much more leafy green food, or much less, should tell the prescriber, because people taking warfarin need a consistent intake of vitamin K, and sudden changes can strengthen or weaken the drug's effect (National Institutes of Health Office of Dietary Supplements, 2021).

A client adding supplements, particularly concentrated curcumin products or high-dose fish oil, while taking prescription medicine should check with the prescriber or pharmacist first (National Center for Complementary and Integrative Health, 2025; National Institutes of Health Office of Dietary Supplements, 2025). A client who reports new or worsening symptoms, such as joint swelling, bleeding, persistent digestive changes, yellowing of the skin or eyes, or weight loss they did not intend, is describing something a clinician needs to see, and the coach does not guess at the cause.

A client whose list keeps getting longer is worth asking about it: what each cut is for, whether it causes distress, whether it is narrowing what they eat, and whether it is getting in the way of meals with other people. There are ordinary reasons for cutting foods, from an allergy or celiac disease to a dietitian's elimination plan. Where the answers raise a real concern about disordered eating, the coach follows their own referral process.

Special populations

Pregnancy and breastfeeding

Whether a version is safe and suitable in pregnancy depends on which version it is and on the person's own needs. The search for this page found one randomized trial of a diet under this name in pregnancy: in 98 pregnant women with inflammatory bowel disease who were already taking the drug infliximab, a version of the IBD-AID in the last 3 months of pregnancy lowered disease activity scores and blood and stool markers of inflammation compared with usual eating, and fewer of their infants had functional digestive problems; birth weight did not differ clearly (Ye et al., 2024). Observational studies link more pro-inflammatory diet scores in pregnancy with more complications, particularly preeclampsia and preterm birth (de Freitas et al., 2022). Supplements are a different matter: the National Center for Complementary and Integrative Health states that turmeric supplements during pregnancy may be unsafe, and that little is known about their safety while breastfeeding at amounts above those in food (National Center for Complementary and Integrative Health, 2025). Any question about a supplement or a restrictive list during pregnancy belongs to the obstetric clinician or a dietitian.

Children and adolescents

A review of 25 trials of nutrition programs for children with obesity found that common anti-inflammatory diets were missing or underrepresented among them (Lewis & Brown, 2017), and the search for this page found no trial of a diet under this name in healthy children. Observational studies link more pro-inflammatory scores in adolescents with higher odds of a high body mass index, with no consistent link to blood pressure (Leite et al., 2025). A coach works with the adult in front of them, and a child's eating belongs to the family and the pediatrician. A long list of forbidden foods is a poor fit for a growing child.

Older adults

Whether a version suits an older adult depends on which version it is and on the person's own needs. Observational studies link more pro-inflammatory scores with sarcopenia, the loss of muscle mass and strength with age (Diao et al., 2023). In one trial in 66 frail adults with colorectal cancer, 12 weeks of dietary education based on the Dietary Inflammatory Index improved nutritional status and quality of life compared with routine health education; frailty improved within the education group, and the abstract does not report a clear difference from the comparison group on frailty itself (Wang et al., 2025). Lists that cut dairy or other staple foods can make it harder to meet protein and calcium needs, and a smaller appetite leaves less room for error. Those are questions for a dietitian.

Athletes and people with high activity

The search for this page found only cross-sectional studies of athletes' diet scores, and no trial of a diet under this name in athletes. A person training hard may need more total food than a list-based version allows, which is a question of quantity rather than of the pattern.

People taking medication for diabetes, blood pressure, or blood thinning

The food changes themselves are similar to those of the Mediterranean and DASH patterns. A client on insulin, a sulfonylurea or blood pressure medication who plans a substantial change in eating keeps the prescriber informed before making it. Blood thinners need particular care: people taking warfarin need a consistent intake of vitamin K, and supplements that travel with this name, including fish oil and curcumin, are a question for the prescriber or pharmacist before they start.

People with a history of disordered eating

The search for this page found no study of whether following a diet under this name raises the risk of disordered eating. This is still the population where the list-based versions matter most. A pattern described as foods to eat and foods that cause inflammation invites a split between safe and unsafe food, and a client with a history of disordered eating may experience it as a new set of rules. Distress, narrowing and interference with daily life are what raise a concern. A concern goes to the client's clinician under the existing care plan.

Client misconceptions

Three come up most. The first is that a food, a spice or a supplement can fight inflammation on its own. The whole-diet studies summarized here cannot establish the effect of a single food or supplement. Turmeric and curcumin have their own human research, but the National Center for Complementary and Integrative Health says the evidence does not establish a definitive health benefit, and some highly bioavailable curcumin products have been linked to liver injury (National Center for Complementary and Integrative Health, 2025).

The second is that a drop in a blood marker such as C-reactive protein shows the diet is working against disease, when a marker can fall with weight loss or for other reasons, and the searches for this page found no trial showing that lowering a marker with a diet under this name means less disease. The third is that the diet can replace treatment for an inflammatory condition, when in the rheumatoid arthritis and ulcerative colitis trials described in section 4 most participants stayed on their usual medication, and the diet was tested alongside it. Each is addressed in section 6.

🤝 COACHING CONNECTION

Linda has rheumatoid arthritis and comes in with a printed list of inflammatory foods from a friend. She has stopped eating tomatoes and bread, bought 2 bottles of turmeric capsules, and says she wants to be strict about it this time. The coach asks what she is hoping will change. Linda says the mornings, when her hands are stiff. The coach asks what her rheumatologist knows about the list and the capsules. She says she has not mentioned either, because she did not want to be told it was silly. The coach asks what she would want her rheumatologist to know. Linda decides to take the capsule bottles to her next appointment and ask about them. Then she talks about the salmon her husband used to cook on Sundays, and wonders whether that might be a place to start. Nothing was recommended, and the list was never evaluated.

4. The evidence

(select the heading to open or close this section)

Because the name covers many diets, the evidence has to be read one question at a time, and 3 kinds of evidence have to be kept apart. Observational studies of diet scores consistently find that people whose usual eating scores as more inflammatory have more cardiovascular disease, more of several cancers and higher death rates, but they show association, not cause. Trials of eating plans purpose-built and given the name are small and short, mostly in people with a specific condition, and their clearest findings are modest changes in symptoms or in blood markers, at low or very low certainty. Trials of named patterns, most often the Mediterranean pattern, show small changes in blood markers; they are evidence about those patterns, not about the name.

The purpose-built anti-inflammatory eating plans reviewed here do not establish effects on heart attacks, strokes, cancer incidence or recurrence, or survival. Established patterns such as DASH and the Mediterranean diet have separate evidence, covered on their own pages.

Evidence from randomized controlled trials

A trial assigns people to a diet by chance and compares them with people assigned to something else, which is the strongest way to test whether the diet itself causes a result. The trials under this name fall into 2 groups. Some test an eating plan their authors designed and called anti-inflammatory, usually in a few dozen people with a particular condition, for weeks to months. Others test an established pattern and measure markers of inflammation. The second group is evidence about the pattern tested, not about the name as a whole. The Mediterranean Diet page carries that pattern's own trials.

Cardiometabolic outcomes

The purpose-built anti-inflammatory eating plans reviewed here do not establish effects on heart attacks, strokes or deaths from cardiovascular disease; their trials measured risk factors. Established patterns such as DASH and the Mediterranean diet have separate evidence, covered on their own pages. In a feeding study in which all meals were prepared by the research team, 30 adults with diabetes or prediabetes were randomly assigned, 2 to 1, to a strict anti-inflammatory diet or to a comparison diet based on American Diabetes Association recommendations, matched as closely as possible for protein, carbohydrate, fat and fiber, for 6 weeks. Both groups lost a little weight, blood sugar and blood fats moved in the same direction in both, and the anti-inflammatory diet did not lower markers of inflammation more than the comparison diet (Zwickey et al., 2019).

A 2025 review reported lower blood pressure across several dietary patterns, but its methods allowed a group's own starting values to serve as the comparison, and its pooled blood pressure estimate includes such a comparison for a trial that had randomized people between 2 versions of the DASH diet. This page therefore does not use that pooled estimate (Jiang et al., 2025). Evidence for specific established patterns is described on their own archive pages.

Blood markers of inflammation

This is where most of the trial evidence lies, and it needs care, because a marker is not a disease. C-reactive protein, interleukin-6 and similar substances rise in the blood during inflammation. A diet that lowers them has changed a measurement. Whether that change protects anyone from illness is a separate question, and the searches for this page found no trial under this name that answered it.

A review of 22 trials of dietary patterns published from 2015 to 2020 found the clearest reductions with the Mediterranean pattern, tested in 16 of its trials: interleukin-6 was lower by 1.07 pg/mL, from 0.20 to 1.94 lower, and C-reactive protein lower by 1.00 mg/L, from 2.02 lower to 0.01 higher, an interval that includes no difference. Results for both varied widely from trial to trial. The C-reactive protein result also depended on which trials were counted: leaving out one trial made it clearer, and the review's correction for possibly missing small trials shrank it to 0.15 lower, from 1.13 lower to 0.83 higher (Koelman et al., 2022).

The same review did not find clear reductions in C-reactive protein for the DASH diet or for a group of vegetarian, vegan and Nordic diets, each tested in 4 trials, and it did not rate the certainty of its evidence (Koelman et al., 2022). An umbrella review of 30 meta-analyses of 7 patterns reached a similar order for C-reactive protein, Mediterranean first, then vegetarian and vegan and then reduced-calorie diets, and classed the evidence as weak on its own scale; intermittent fasting, ketogenic, Nordic and paleolithic diets showed no reduction (Tran et al., 2024).

Weight change runs through all of this. In a 6-month Croatian trial, 125 adults with obesity were assigned either to a reduced-calorie anti-inflammatory diet or to a standard reduced-calorie diet, and the 81 who completed it improved in both groups on body composition, cardiometabolic and inflammatory measures. The standard diet group lowered C-reactive protein and interleukin-6 somewhat more, and the anti-inflammatory group lowered tumor necrosis factor alpha more. The authors concluded that the fall in inflammatory markers may have come more from losing body fat than from the particular foods (Kenđel Jovanović et al., 2020). A study that lets weight change cannot separate the effect of the food from the effect of the weight.

Rheumatoid arthritis and other inflammatory conditions

Rheumatoid arthritis has the most trials. A systematic review pooled 7 randomized trials with 326 participants that compared Mediterranean, vegetarian or vegan diets, grouped as anti-inflammatory, with ordinary diets. Pain was 9.22 mm lower on a 100 mm scale, from 4.29 to 14.15 mm lower. The authors cite 7 to 11 mm as the smallest change patients notice when pain starts at a moderate level, so the average falls in that range while the smallest reduction the interval allows does not. They rated the certainty very low using GRADE, because no trial could hide from participants what they were eating while pain is self-reported, and because the interval is wide. C-reactive protein was 2.51 mg/L lower, from 6.10 lower to 1.08 higher, so no clear difference was detected, also rated very low (Schönenberger et al., 2021).

In the largest trial in the review, which compared a Mediterranean diet, an exercise program, both, and neither, the diet added no benefit beyond exercise, and the authors suggest part of the effect may belong to any lifestyle program compared with none. Two of the vegetarian trials also began with a fast of 7 to 10 days, so they did not test eating alone (Schönenberger et al., 2021).

The Swedish ADIRA trial tested a purpose-built anti-inflammatory portfolio of foods in 50 adults with rheumatoid arthritis, 89 percent of those analyzed taking disease-modifying medication. Each person ate the anti-inflammatory diet and a diet resembling typical Swedish eating for about 10 weeks each, in random order, with food covering about half of daily energy needs delivered for 5 days of each week. In the main analysis the difference in disease activity score between the 2 diets was 0.29 points in favor of the anti-inflammatory diet, from 0.65 lower to 0.08 higher, which did not reach statistical significance. Secondary, unadjusted tests in the 44 people who completed both periods favored the anti-inflammatory diet (Vadell et al., 2020).

A later report from the same trial found no effect on C-reactive protein or the erythrocyte sedimentation rate in the group as a whole, and a lower sedimentation rate only among the 29 participants who followed the diet closely (Hulander et al., 2021). A 2023 correction to the main paper fixes only the spelling of its title and changes no result (Vadell et al., 2023).

Other conditions have single small trials. In 53 adults with ulcerative colitis in remission, 48 of them on medication for it, 6 months of an anti-inflammatory menu plan did not demonstrate a reduction in relapse compared with Canada's national food guide, with the same dietitian counseling schedule in both groups: 5 of 26 people relapsed against 8 of 27, crude proportions that did not differ significantly. The trial was designed for 70 people to detect a large difference, relapse in 10 percent against 40 percent, and recruited 53. A stool marker of gut inflammation was below the trial's threshold at the end in 69.2 percent on the anti-inflammatory diet against 37.0 percent on the comparison diet (Keshteli et al., 2022).

In 30 people with gum inflammation, 4 weeks on a diet low in processed carbohydrates and animal protein and high in omega-3 fats, fiber and antioxidants was compared with no change in diet. Gum bleeding fell significantly in the diet group, and blood markers of inflammation did not differ between the groups (Woelber et al., 2019). In 106 people receiving chemotherapy for lung cancer, 3 months of nutritional support based on the Dietary Inflammatory Index improved reported fatigue and C-reactive protein compared with usual eating (Zhang et al., 2023). Each of these is one trial, and the searches for this page found no repeat of any of them.

Cancer

The purpose-built anti-inflammatory eating plans reviewed here do not establish effects on developing cancer, on cancer returning, or on survival after cancer. Established patterns such as DASH and the Mediterranean diet have separate evidence, covered on their own pages. The lung cancer trial above measured fatigue and blood markers during chemotherapy, which matter to patients but are not cancer outcomes (Zhang et al., 2023).

Body weight, as measured

This archive reports body weight as something a study measured, in that study's own numbers, and not as a goal or as a measure of whether an eating pattern worked; see the standing rule in the review record at the foot of this page. The one exception is weight a person loses without meaning to, which can signal a health problem and is a reason to involve a clinician, never a sign that a diet worked.

In the Croatian trial, where both groups were asked to eat fewer calories, the anti-inflammatory group lost 7.06 percent of body weight over 6 months and the standard diet group 6.21 percent, among those who completed the trial; total and visceral fat fell slightly more in the standard diet group (Kenđel Jovanović et al., 2020). In the review of rheumatoid arthritis trials, weight was 3.73 kg lower on the diets than on ordinary diets, from 2.01 to 5.45 kg lower, rated very low in certainty (Schönenberger et al., 2021). In the 6-week feeding study both groups lost a small amount of weight, with no clear difference between them (Zwickey et al., 2019), and in the gum trial the diet group lost weight (Woelber et al., 2019). The ADIRA trial asked participants to keep their weight steady (Vadell et al., 2020).

Mortality

The purpose-built anti-inflammatory eating plans reviewed here do not establish effects on survival. Their trials were mostly short and small, and a trial that records deaths is not necessarily large enough to estimate an effect on them. Established patterns such as DASH and the Mediterranean diet have separate evidence, covered on their own pages.

Eating behavior and wellbeing

A review of 23 trials in 3,294 adults with at least one chronic disease, covering a range of diets its authors classed as anti-inflammatory, found a small improvement in the physical part of quality-of-life scores compared with usual care or other diets, a standardized difference of 0.17, from 0.06 to 0.27, across 18 trials, which the authors say may not be clinically relevant. No clear effect was detected on the mental part, 0.09, from 0.02 lower to 0.20 higher. They rated certainty low for both, using GRADE. No included trial had a low risk of bias, and the authors judged only 4 of the 23 trial diets to be of adequate anti-inflammatory quality (Law et al., 2025).

The review's main text and detailed GRADE table disagree about the reasons for lowering certainty, and its results and discussion give different counts of adequate diets, 4 and 5; this page reports the table's domain judgments and the results count (Law et al., 2025).

Evidence from long-term prospective cohort studies

A cohort study follows people who already eat a certain way and records what happens to them. It can show that a pattern goes with an outcome; it cannot by itself show that the pattern caused it. In this literature, eating is scored with one of the indexes described in section 1, most often the Dietary Inflammatory Index, and people with the most pro-inflammatory scores are compared with people with the least. Because the scores come from questionnaires about usual eating, and because people who eat differently also differ in income, smoking, activity and much else, these associations carry the usual limits of observational research. Many of the syntheses below also mix prospective cohorts with case-control studies, which ask people how they used to eat after they are already ill, and those are weaker still.

The cohort estimates below compare outcomes over follow-up, and none is a crude count of events. Later paragraphs identify case-control and cross-sectional results separately; their odds ratios or differences are not follow-up risks.

Cardiometabolic outcomes

The largest single analysis used the food-based index in 3 United States cohorts of nurses and health professionals, mostly White: 74,578 women followed from 1984, 91,656 women from 1991 and 43,911 men from 1986, through 2015 or 2016, with 15,837 new cases of cardiovascular disease. Comparing the highest fifth of scores with the lowest, the hazard ratio for cardiovascular disease was 1.38, from 1.31 to 1.46; for coronary heart disease 1.46, from 1.36 to 1.56; and for stroke 1.28, from 1.17 to 1.39. Risk rose step by step with the score. The associations held after adjustment for body mass index, smoking, activity and medication use, and after further adjustment for other measures of diet quality (Li et al., 2020).

An updated 2025 synthesis of 30 cohort studies from 9 countries, covering 669,205 people, compared the highest with the lowest Dietary Inflammatory Index category. For death from cardiovascular disease, across 16 studies, the hazard ratio was 1.29, from 1.24 to 1.35, with little variation between studies.

The same synthesis's combined figure for developing cardiovascular disease, 1.23 from 1.14 to 1.33, counts 6 studies of high blood pressure as cardiovascular disease, and its study table reports more cases than participants for one study; among the 7 studies of cardiovascular disease itself the figure was 1.33, from 1.15 to 1.53, and the review's correction for possibly missing studies lowered the combined figure to 1.11, from 1.02 to 1.20 (Ni et al., 2025). An earlier synthesis by the index's developers, mixing cohort, case-control and cross-sectional studies and combining new disease with death, found a relative risk of 1.36, from 1.19 to 1.57, across 14 studies (Shivappa et al., 2018).

An umbrella review that graded 38 outcomes on its own credibility scale found the evidence convincing only for heart attack, based on 6 case-control and prospective studies with 2,497 cases, and classed the association with cardiovascular disease as a whole as weak (Marx et al., 2021). A published letter on that review discussed what umbrella reviews can and cannot show and reported no error in its figures, and the authors replied (Gianfredi et al., 2022; Marx et al., 2022).

A second umbrella review, which used GRADE, rated the association between the highest and lowest Dietary Inflammatory Index categories and new cardiovascular disease moderate in certainty: relative risk 1.43, from 1.11 to 1.84, from 6 cohort studies. The same review rated death from cardiovascular disease, with the same comparison in 11 cohort studies, very low in certainty: relative risk 1.32, from 1.19 to 1.46 (Farazi et al., 2023). These ratings cover that review's own analyses of the Dietary Inflammatory Index, not the food-based index in the 3-cohort analysis or the 2025 synthesis above. They are published judgments about how certain an association is, not certainty that prescribing a diet prevents disease.

Cancer

The same 2 umbrella reviews found more pro-inflammatory scores associated with higher cancer risk. The first rated the evidence highly suggestive for cancer overall and for colorectal, pancreatic, respiratory and oral cancers, and noted that case-control studies, which are open to recall bias, outnumbered prospective ones (Marx et al., 2021).

The second umbrella review, using GRADE, rated the association with colorectal cancer moderate in certainty for each 1-point increase in the Dietary Inflammatory Index: a pooled estimate of 1.06, from 1.04 to 1.08, across 4 cohort and 4 case-control studies, and also moderate in the 4 cohort studies alone, relative risk 1.04, from 1.03 to 1.04. That per-point comparison differs from the first review's comparison of the highest with the lowest categories. For most other cancer sites the second review rated the evidence low or very low, and most of that evidence came from case-control studies (Farazi et al., 2023).

Body weight, as measured

A 2026 synthesis of 22 studies, 19 of them cross-sectional and 3 prospective cohorts, found a small association between more pro-inflammatory scores and higher body mass index, a standardized difference of 0.17, from 0.09 to 0.25, in the cross-sectional studies (Gu et al., 2026). A cross-sectional study measures diet and weight at the same time and cannot say which came first.

Mortality

Death from any cause was higher with more pro-inflammatory scores. Across 12 prospective cohort studies with 44,809 deaths, the relative risk comparing the highest with the lowest scores was 1.24, from 1.16 to 1.32; the size of the association varied between studies, and there were signs that smaller studies reported larger effects, although the largest single study still found a higher risk, 1.16, from 1.10 to 1.22. The umbrella review classed that evidence as highly suggestive on its own scale (Marx et al., 2021). The second umbrella review rated a different comparison moderate in certainty using GRADE: each 1-point increase in the index was associated with a relative risk of death of 1.05, from 1.02 to 1.07, across 6 cohort studies (Farazi et al., 2023).

Depression

A synthesis of 11 studies with 101,950 participants found that a more pro-inflammatory diet was associated with 40 percent higher odds of depression or depressive symptoms, an odds ratio of 1.40, from 1.21 to 1.62. The studies were a mix of cross-sectional and longitudinal designs, and the authors found that study design and the type of effect measure were the main sources of disagreement between them (Tolkien et al., 2019). The authors suggest an anti-inflammatory diet may be a useful intervention; that is their proposal, and the observational data do not test it.

Highlighted studies

These 4 studies carry the most weight for this page: a large cohort analysis and an umbrella review of observational studies, a review of trials, and a purpose-built trial. Each is described so that a reader can judge it without opening the paper.

On a narrow screen, scroll the table sideways to see every column.

Highlighted studies for the Anti-Inflammatory Diet

Study	Design	Sample size	Duration	Finding	The limitation that matters
Li et al., 2020, 3 United States cohorts	Prospective cohort studies, analyzed together	210,145 nurses and health professionals, 15,837 new cases of cardiovascular disease	Up to about 32 years of follow-up	Comparing the highest fifth of food-based diet scores with the lowest, the hazard ratio for cardiovascular disease was 1.38, from 1.31 to 1.46, after adjustment for body mass index, other risk factors and other measures of diet quality	Observational: it shows an association, not that changing diet changes risk. Diet was self-reported, and participants were mostly White health professionals
Marx et al., 2021, an umbrella review of the Dietary Inflammatory Index	Umbrella review of 15 meta-analyses of observational studies	4,360,111 people across the meta-analyses, covering 38 health outcomes	Varied by study	A more pro-inflammatory diet score was associated with higher risk for 27 of the 38 outcomes. On the review's own credibility scale, the evidence was convincing only for heart attack; highly suggestive for death from any cause, cancer overall, and colorectal, pancreatic, respiratory and oral cancers; and suggestive, weak or absent for the other 31 outcomes	Every study in it is observational, many are case-control or cross-sectional, and the score measures eating, not a diet anyone was assigned to. Its scale weighs statistics, not study design. 2 of its authors developed the index or work for the company that licenses it
Schönenberger et al., 2021, a systematic review of diets called anti-inflammatory in rheumatoid arthritis	Systematic review and meta-analysis of randomized trials	7 trials, 326 people with rheumatoid arthritis, mostly women	The pooled trials ran from about 2 months to 13 months	Pain on a 100 mm scale was 9.22 mm lower on the diets than on ordinary diets, from 4.29 to 14.15 mm lower. The smallest change patients notice is thought to be 7 to 11 mm. Certainty very low	The diets pooled were Mediterranean, vegetarian and vegan, not one diet, and no trial could hide from participants which diet they were on, while pain is something they report themselves. No clear difference in C-reactive protein was detected
Vadell et al., 2020, the ADIRA trial	Randomized crossover trial, assessors blinded, efforts to mask participants	50 adults with rheumatoid arthritis, 47 analyzed	2 periods of about 10 weeks, with a break of about 4 months between them	The difference in disease activity score between the anti-inflammatory diet and a diet like typical Swedish eating was 0.29 points in favor of the anti-inflammatory diet, from 0.65 lower to 0.08 higher, which did not reach statistical significance. A secondary, unadjusted comparison in the 44 people who completed both periods favored the anti-inflammatory diet	The main analysis did not show a difference, and the favorable result comes from secondary tests with no correction for multiple comparisons. The study supplied food covering about half of daily energy needs, 5 days a week

Head to head

The trials of purpose-built diets under this name each compared one diet with one comparison diet, and the comparison differed every time: a diet based on American Diabetes Association recommendations (Zwickey et al., 2019), a standard reduced-calorie diet (Kenđel Jovanović et al., 2020), Canada's national food guide (Keshteli et al., 2022) and a diet resembling typical Swedish eating (Vadell et al., 2020). Against an active, healthy comparison diet, the purpose-built diets did not clearly outperform it on blood markers: no marker differed in the feeding study, and in the Croatian trial each group lowered different markers more. The ulcerative colitis trial is the exception on a stool marker, not on relapse. Comparisons between named patterns, such as Mediterranean against DASH, are carried on those patterns' own pages.

Where the evidence is absent

The purpose-built anti-inflammatory eating plans reviewed here do not establish effects on heart attacks, strokes, cancer incidence or recurrence, or survival. Established patterns such as DASH and the Mediterranean diet have separate evidence, covered on their own pages. The purpose-built trials summarized above were mostly short; longer studies of established patterns cannot supply one effect estimate for this undefined label. There is no agreed definition, so 2 studies using the name may be testing meaningfully different diets, and the reviews that pool them combine patterns that disagree on grains, dairy and fat.

The trial evidence comes largely from people with specific conditions, such as rheumatoid arthritis and inflammatory bowel disease, most of them also on medication, so it says little about healthy people using the diet for prevention. The strongest observational findings rest on scores built by researchers, some of whom have a commercial stake in the score. The searches for this page found no trial showing that lowering a blood marker of inflammation with a diet under this name lowers the risk of disease. Children, athletes and older adults with several conditions appear mainly in observational studies, and the one pregnancy trial found was in women with bowel disease. And the supplements that often travel with the name have their own, separate evidence, which this page does not rate.

5. Mechanisms

(optional reading; select the heading to open or close this section)

This section explains how the diet is thought to work in the body. You can skip it. Nothing in the coaching sections depends on it.

Established mechanisms

Inflammation is the body's response to injury and infection. In its short-term form it is protective: it brings immune cells to a wound or an infection and then settles. A long-lasting, low-level form, sometimes called chronic low-grade inflammation, is associated with cardiovascular disease, cancer and other chronic conditions (Cavicchia et al., 2009; Marx et al., 2021). It is measured in research through substances in the blood, such as C-reactive protein and interleukin-6, which rise when inflammation is active. These are markers. They show that inflammation is present; they are not the disease.

What has been shown in people is that diet and markers move together. Scores of dietary inflammatory potential predict C-reactive protein and other markers in the populations used to test them (Cavicchia et al., 2009; Li et al., 2020; Tabung et al., 2016), and some eating patterns lower some markers modestly in trials, as section 4 reports. Body fat is part of the same picture. In trials where people lost weight, markers fell in both the anti-inflammatory group and the comparison group, and the authors of one such trial concluded that loss of body fat may explain more of the fall than the particular foods (Kenđel Jovanović et al., 2020; Zwickey et al., 2019).

Proposed mechanisms

Several further explanations are plausible and widely repeated, and none of them supports a claim in section 4. The first concerns fats. Omega-3 fats from fish replace some of a different fat in cell membranes that the body turns into signaling molecules involved in inflammation, and compete with the enzymes that make them; that is the reasoning behind the fish in almost every version (Schönenberger et al., 2021). The second concerns fiber. Fiber from plant foods feeds bacteria in the large intestine, which produce short-chain fatty acids that may calm immune activity (Marx et al., 2021; Schönenberger et al., 2021). The third concerns plant compounds called polyphenols, found in vegetables, fruit, tea, olive oil and spices; the proposal is that they dampen the body's inflammatory signaling (Marx et al., 2021).

A mechanism shown in cells, in animals or in a change of markers is a reason to study a diet, not evidence that the diet prevents or treats a disease. Each of these ideas is under investigation. None is a reason to tell a client that eating this way will do something for them.

6. Risks, contraindications and myths

(select the heading to open or close this section)

Warnings from professional or regulatory bodies

The searches for this page found no warning from a health body about the eating pattern itself. There is a federal warning about a product that often travels with it. The National Center for Complementary and Integrative Health, part of the National Institutes of Health, states that highly bioavailable formulations of curcumin, the main compound in turmeric, "may harm your liver," and that liver damage has been reported in some people who took them. It also states that turmeric supplements during pregnancy may be unsafe (National Center for Complementary and Integrative Health, 2025).

Nutrient gaps

The pattern at the center of the name removes no food group and should not, on its own, create a gap. Gaps come from the lists. A version that cuts dairy, grains or a whole family of vegetables removes what those foods supply, such as the calcium in dairy foods and the fiber in whole grains. The strict version tested in the United States feeding study, which removed dairy among many other foods, supplied 55 percent of the recommended calcium intake and 92 percent of the recommended vitamin B12 in its designed menus (Zwickey et al., 2019). Whether a particular version meets a particular person's needs is a question for a registered dietitian.

Who should not follow it without medical supervision

Anyone using the diet as part of managing a diagnosed inflammatory condition, such as rheumatoid arthritis, inflammatory bowel disease or another autoimmune condition, because the trials tested it alongside treatment and the treating clinician needs to know about any change. Anyone taking warfarin, because the pattern raises intake of leafy greens, and people taking warfarin need a consistent intake of vitamin K, since sudden changes can strengthen or weaken the drug's effect (National Institutes of Health Office of Dietary Supplements, 2021). Anyone who plans to take the supplements that come with some versions while also taking prescription medicine.

Anyone with chronic kidney disease, because how much potassium and phosphorus is right depends on the stage of the disease, lab results and whether the person is on dialysis; the kidney care team decides, and the pattern's plant foods are not a hazard for everyone with kidney disease. Anyone following a version that cuts several food groups, especially during pregnancy, in childhood or in older age. And anyone with a history of disordered eating, where a list of foods that cause inflammation can become a set of rules.

Medication interactions

A coach never adjusts medication. The point of knowing these is to know when to send a client back to the prescriber. The foods themselves interact with medication in the same ways as other healthy patterns. For warfarin, the issue is the steadiness of vitamin K intake from leafy greens (National Institutes of Health Office of Dietary Supplements, 2021). For insulin, sulfonylureas and blood pressure medication, a client planning a substantial change in eating keeps the prescriber informed before making it.

The supplements are a separate matter. Fish oil can have antiplatelet effects at high doses and might prolong clotting time in people taking warfarin, although most research indicates that doses of 3 to 6 grams a day do not significantly affect clotting in people on warfarin (National Institutes of Health Office of Dietary Supplements, 2025). The National Center for Complementary and Integrative Health advises anyone taking medicine to talk with their health care provider before using any herbal product, including turmeric (National Center for Complementary and Integrative Health, 2025). A client adding either should ask the prescriber or pharmacist first.

Signs it is going wrong

Physical signs a coach or a family member might notice are new or worsening joint pain or swelling, persistent digestive changes, unusual bruising or bleeding in someone on a blood thinner, yellowing of the skin or eyes, dark urine or unusual tiredness in someone taking turmeric or curcumin supplements (National Center for Complementary and Integrative Health, 2025), and weight loss the person did not intend. Each is a reason to involve a clinician, not a diagnosis; the coach notices and encourages the client to tell their clinician, and working out the cause is the clinician's job.

Behavior matters as much, and has to be read with care. Cutting a food can come from an allergy, celiac disease, a religious practice, a cultural preference or a dietitian's elimination plan, so on its own it tells a coach little. A list that keeps growing, talk of foods as poison or as causing damage, anxiety after eating something on the list, or turning down meals with other people carries more meaning and is worth asking about directly. The questions are the same in every case: what the behavior is for, whether it causes distress, whether it is narrowing what the person eats, and whether it is getting in the way of daily life. None of this is a diagnosis. Where the answers raise a real concern about disordered eating, the coach follows their own referral process.

Myths and where they came from

Myth: turmeric, or another single food or supplement, fights inflammation

Where it came from: laboratory studies of individual plant compounds, repeated in marketing and in lists of anti-inflammatory foods. What is true: the whole-diet studies summarized here cannot establish the effect of a single food or supplement. Turmeric and curcumin have their own human research, but the National Center for Complementary and Integrative Health states that not enough is known to conclude definitively that they benefit any health purpose, and it warns that some highly bioavailable formulations of curcumin may harm the liver (National Center for Complementary and Integrative Health, 2025).

Myth: tomatoes, potatoes, eggplant and peppers cause inflammation

Where it came from: these vegetables belong to the nightshade family, decades-old studies in mice suggested a compound in them could damage the gut lining, and some people report feeling better without them. What is true: the Arthritis Foundation says there is little scientific evidence on either side, that newer studies in mice found the opposite for some nightshade foods, and that mouse studies rarely translate well to people (Arthritis Foundation, 2025). A person who suspects a reaction to a particular food is describing something a dietitian can test properly.

Myth: if my C-reactive protein goes down, the diet is working

Where it came from: the research tools behind the name were built and tested against blood markers, and markers are what most short trials measure. What is true: a marker can fall with weight loss, with medication or for other reasons. In 2 of the trials on this page, healthy comparison diets lowered markers about as much as the anti-inflammatory diet did (Kenđel Jovanović et al., 2020; Zwickey et al., 2019). The searches for this page found no trial showing that lowering a marker with a diet under this name prevents disease.

Myth: an anti-inflammatory diet can replace medication for an inflammatory disease

Where it came from: reports of patients who did better on a diet, including a case series in which patients with inflammatory bowel disease stopped at least one medication (Olendzki et al., 2014). What is true: that series described 11 patients reviewed after the fact with no comparison group, and in the randomized trials in rheumatoid arthritis and ulcerative colitis, most participants stayed on their medication and the diet was tested alongside it (Keshteli et al., 2022; Vadell et al., 2020). Neither of those trials demonstrated a difference on its main outcome.

7. Key terms

Inflammation

The body's response to injury or infection. Short-term inflammation protects and heals; long-lasting, low-level inflammation is associated with chronic disease.

Biomarker, or marker

A substance measured in the blood or elsewhere that reflects a process in the body. C-reactive protein and interleukin-6 are markers of inflammation. A change in a marker is not the same as a change in disease.

C-reactive protein

A protein made by the liver that rises during inflammation. The high-sensitivity test detects the small rises seen in low-level inflammation. Interpreting a result belongs to a clinician.

Dietary Inflammatory Index

A score that rates the inflammatory potential of a person's overall diet, built from published research on how 45 food components affect 6 markers of inflammation. It measures eating; it is not an eating plan.

Empirical dietary inflammatory index

A second score, built from the 18 food groups that best predicted inflammation markers in a large United States cohort of nurses.

Umbrella review

A review of reviews: it gathers the published meta-analyses on a question and assesses them together.

Hazard ratio

A measure from studies that follow people over time: how much more often an event happens per unit of time in one group than in another. A hazard ratio of 1.38 means events happened about 38 percent more often.

Credibility class

A way of grading observational associations, from convincing to weak, by the size of the evidence, how consistent it is and signs of bias. It is a different scale from GRADE, and its labels are not interchangeable with GRADE's.

GRADE

The 4-level scale used in clinical guidelines to say how certain the evidence for a conclusion is: high, moderate, low or very low. It rates the evidence for one outcome at a time, not the diet.

Crossover trial

A trial in which each participant tries both diets in turn, in random order, usually with a break between them, so that each person is compared with themselves.

Primary outcome

An outcome specified in advance as a main test of the intervention; a trial can have more than one. Secondary results also need interpretation in light of the analysis plan and the number of comparisons. An exploratory positive result does not overturn an inconclusive primary analysis.

8. Review questions

1. Explain in 3 sentences why this page describes the anti-inflammatory diet as a label rather than a diet. Then name the 2 established patterns it most resembles, and give one example of 2 versions that disagree about a food.
2. A client says a study showed that anti-inflammatory diets lower pain in arthritis. Using the review described in section 4, explain which diets that review pooled, how large the effect was compared with the smallest change patients notice, and why its certainty was rated very low.
3. The ulcerative colitis trial on this page reported a positive result, and it also did not demonstrate a difference on its main outcome. Explain how both can be true, and why the difference matters when a client repeats the headline.
4. A client with rheumatoid arthritis tells you she has cut out bread and tomatoes, bought turmeric capsules, and is thinking about skipping her methotrexate because food is more natural. Write what you would say and what you would ask, and say exactly where the referral line is.
5. Where did the belief that nightshade vegetables cause inflammation come from, and what does the Arthritis Foundation say about the evidence? Write the 2 sentences you would use with a client who raises it.

9. References

Aleksandrowicz, L., Green, R., Joy, E. J., Smith, P., & Haines, A. (2016). The impacts of dietary change on greenhouse gas emissions, land use, water use, and health: A systematic review. PLOS ONE, 11(11), Article e0165797. https://doi.org/10.1371/journal.pone.0165797

Arthritis Foundation. (2025, December 18). What you should know about nightshades and arthritis. arthritis.org/health-wellness/healthy-living/nutrition/anti-inflammatory/how-nightshades-affect-arthritis

Bouzas, C., Pastor, R., García, S., Monserrat-Mesquida, M., Martínez-González, M. Á., Salas-Salvadó, J., Corella, D., Schröder, H., Martínez, J. A., Alonso-Gómez, Á. M., Wärnberg, J., Vioque, J., Romaguera, D., Lopez-Miranda, J., Estruch, R., Tinahones, F. J., Lapetra, J., Serra-Majem, L., Riquelme-Gallego, B., . . . Tur, J. A. (2023). Association of monetary diet cost of foods and diet quality in Spanish older adults. Frontiers in Public Health, 11, Article 1166787. https://doi.org/10.3389/fpubh.2023.1166787

Campmans-Kuijpers, M. J. E., & Dijkstra, G. (2021). Food and food groups in inflammatory bowel disease (IBD): The design of the Groningen anti-inflammatory diet (GrAID). Nutrients, 13(4), Article 1067. https://doi.org/10.3390/nu13041067

Cavicchia, P. P., Steck, S. E., Hurley, T. G., Hussey, J. R., Ma, Y., Ockene, I. S., & Hébert, J. R. (2009). A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. The Journal of Nutrition, 139(12), 2365-2372. https://doi.org/10.3945/jn.109.114025

de Freitas, N. P. A., Carvalho, T. R., Gonçalves, C. C. R. A., da Silva, P. H. A., de Melo Romão, L. G., Kwak-Kim, J., & Cavalcante, M. B. (2022). The Dietary Inflammatory Index as a predictor of pregnancy outcomes: Systematic review and meta-analysis. Journal of Reproductive Immunology, 152, Article 103651. https://doi.org/10.1016/j.jri.2022.103651

Diao, H., Yan, F., He, Q., Li, M., Zheng, Q., Zhu, Q., Fang, F., & Cui, W. (2023). Association between Dietary Inflammatory Index and sarcopenia: A meta-analysis. Nutrients, 15(1), Article 219. https://doi.org/10.3390/nu15010219

Farazi, M., Jayedi, A., & Shab-Bidar, S. (2023). Dietary inflammatory index and the risk of non-communicable chronic disease and mortality: An umbrella review of meta-analyses of observational studies. Critical Reviews in Food Science and Nutrition, 63(1), 57-66. https://doi.org/10.1080/10408398.2021.1943646

Gianfredi, V., Nucci, D., Amerio, A., Signorelli, C., Odone, A., & Dinu, M. (2022). What can we expect from an umbrella review? [Letter to the editor]. Advances in Nutrition, 13(2), 684-685. https://doi.org/10.1093/advances/nmab150

Gu, R., Qi, M., Lu, H., Miao, X., Wang, Y., Lin, X., Wang, R., Huang, Z., & Xia, S. (2026). High dietary inflammatory index is associated with an increased risk of overweight and obesity in adults: A meta-analysis of observational studies. Frontiers in Nutrition, 13, Article 1881176. https://doi.org/10.3389/fnut.2026.1881176

Harvard Health Publishing. (2026, February 24). Foods that fight inflammation. health.harvard.edu/healthy-aging-and-longevity/foods-that-fight-inflammation

Hulander, E., Bärebring, L., Turesson Wadell, A., Gjertsson, I., Calder, P. C., Winkvist, A., & Lindqvist, H. M. (2021). Proposed anti-inflammatory diet reduces inflammation in compliant, weight-stable patients with rheumatoid arthritis in a randomized controlled crossover trial. The Journal of Nutrition, 151(12), 3856-3864. https://doi.org/10.1093/jn/nxab313

Jiang, R., Wang, T., Han, K., Peng, P., Zhang, G., Wang, H., Zhao, L., Liang, H., Lv, X., & Du, Y. (2025). Impact of anti-inflammatory diets on cardiovascular disease risk factors: A systematic review and meta-analysis. Frontiers in Nutrition, 12, Article 1549831. https://doi.org/10.3389/fnut.2025.1549831

Kenđel Jovanović, G., Mrakovcic-Sutic, I., Pavičić Žeželj, S., Šuša, B., Rahelić, D., & Klobučar Majanović, S. (2020). The efficacy of an energy-restricted anti-inflammatory diet for the management of obesity in younger adults. Nutrients, 12(11), Article 3583. https://doi.org/10.3390/nu12113583

Keshteli, A. H., Valcheva, R., Nickurak, C., Park, H., Mandal, R., van Diepen, K., Kroeker, K. I., van Zanten, S. V., Halloran, B., Wishart, D. S., Madsen, K. L., & Dieleman, L. A. (2022). Anti-inflammatory diet prevents subclinical colonic inflammation and alters metabolomic profile of ulcerative colitis patients in clinical remission. Nutrients, 14(16), Article 3294. https://doi.org/10.3390/nu14163294

Koelman, L., Egea Rodrigues, C., & Aleksandrova, K. (2022). Effects of dietary patterns on biomarkers of inflammation and immune responses: A systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition, 13(1), 101-115. https://doi.org/10.1093/advances/nmab086

Law, L., Heerey, J. J., Devlin, B. L., Brukner, P., De Livera, A. M., Kemp, J., Attanayake, A., Skou, S. T., Bricca, A., & Culvenor, A. G. (2025). Effect of anti-inflammatory diets on health-related quality of life in adults with chronic disease: A systematic review and meta-analysis. BMJ Nutrition, Prevention & Health, 8(1), Article e001257. https://doi.org/10.1136/bmjnph-2025-001257

Leite, L. O., Lira, C. R. N., Pitangueira, J. C. D., & Costa, P. R. F. (2025). Dietary inflammatory index, body adiposity indicators and blood pressure in children and adolescents: A systematic review and meta-analysis. Nutrition Research Reviews, 38(2), 944-960. https://doi.org/10.1017/S0954422425100164

Lewis, K. A., & Brown, S. A. (2017). Searching for evidence of an anti-inflammatory diet in children: A systematic review of randomized controlled trials for pediatric obesity interventions with a focus on leptin, ghrelin, and adiponectin. Biological Research for Nursing, 19(5), 511-530. https://doi.org/10.1177/1099800417715734

Li, J., Lee, D. H., Hu, J., Tabung, F. K., Li, Y., Bhupathiraju, S. N., Rimm, E. B., Rexrode, K. M., Manson, J. E., Willett, W. C., Giovannucci, E. L., & Hu, F. B. (2020). Dietary inflammatory potential and risk of cardiovascular disease among men and women in the U.S. Journal of the American College of Cardiology, 76(19), 2181-2193. https://doi.org/10.1016/j.jacc.2020.09.535

Marx, W., Veronese, N., Kelly, J. T., Smith, L., Hockey, M., Collins, S., Trakman, G. L., Hoare, E., Teasdale, S. B., Wade, A., Lane, M., Aslam, H., Davis, J. A., O'Neil, A., Shivappa, N., Hebert, J. R., Blekkenhorst, L. C., Berk, M., Segasby, T., & Jacka, F. (2021). The Dietary Inflammatory Index and human health: An umbrella review of meta-analyses of observational studies. Advances in Nutrition, 12(5), 1681-1690. https://doi.org/10.1093/advances/nmab037

Marx, W., Veronese, N., Kelly, J., Collins, S., Trakman, G. L., Wade, A., Lane, M., Aslam, H., O'Neil, A., Hebert, J. R., Blekkenhorst, L., Berk, M., & Jacka, F. (2022). Reply to V Gianfredi et al. [Letter to the editor]. Advances in Nutrition, 13(2), 685-686. https://doi.org/10.1093/advances/nmab151

National Center for Complementary and Integrative Health. (2025, April). Turmeric: Usefulness and safety. National Institutes of Health. nccih.nih.gov/health/turmeric

National Institutes of Health Office of Dietary Supplements. (2021, March 29). Vitamin K: Fact sheet for health professionals. ods.od.nih.gov/factsheets/VitaminK-HealthProfessional

National Institutes of Health Office of Dietary Supplements. (2025, August 22). Omega-3 fatty acids: Fact sheet for health professionals. ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional

Ni, Y., Yao, Q., Xu, T., & Li, X. (2025). Dietary inflammatory index and cardiovascular risk and mortality: An updated systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 12, Article 1626523. https://doi.org/10.3389/fcvm.2025.1626523

Olendzki, B. C., Silverstein, T. D., Persuitte, G. M., Ma, Y., Baldwin, K. R., & Cave, D. (2014). An anti-inflammatory diet as treatment for inflammatory bowel disease: A case series report. Nutrition Journal, 13, Article 5. https://doi.org/10.1186/1475-2891-13-5

Ricker, M. A., & Haas, W. C. (2017). Anti-inflammatory diet in clinical practice: A review. Nutrition in Clinical Practice, 32(3), 318-325. https://doi.org/10.1177/0884533617700353

Schönenberger, K. A., Schüpfer, A. C., Gloy, V. L., Hasler, P., Stanga, Z., Kaegi-Braun, N., & Reber, E. (2021). Effect of anti-inflammatory diets on pain in rheumatoid arthritis: A systematic review and meta-analysis. Nutrients, 13(12), Article 4221. https://doi.org/10.3390/nu13124221

Shivappa, N., Godos, J., Hébert, J. R., Wirth, M. D., Piuri, G., Speciani, A. F., & Grosso, G. (2018). Dietary Inflammatory Index and cardiovascular risk and mortality: A meta-analysis. Nutrients, 10(2), Article 200. https://doi.org/10.3390/nu10020200

Shivappa, N., Steck, S. E., Hurley, T. G., Hussey, J. R., & Hébert, J. R. (2014). Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutrition, 17(8), 1689-1696. https://doi.org/10.1017/s1368980013002115

Tabung, F. K., Smith-Warner, S. A., Chavarro, J. E., Wu, K., Fuchs, C. S., Hu, F. B., Chan, A. T., Willett, W. C., & Giovannucci, E. L. (2016). Development and validation of an empirical dietary inflammatory index. The Journal of Nutrition, 146(8), 1560-1570. https://doi.org/10.3945/jn.115.228718

Tolkien, K., Bradburn, S., & Murgatroyd, C. (2019). An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis. Clinical Nutrition, 38(5), 2045-2052. https://doi.org/10.1016/j.clnu.2018.11.007

Tran, D. Q., Nguyen Di, K., Quynh Chi, V. T., & Nguyen, H. T. H. (2024). Evaluating the effects of dietary patterns on circulating C-reactive protein levels in the general adult population: An umbrella review of meta-analyses of interventional and observational studies. British Journal of Nutrition, 132(6), 783-793. https://doi.org/10.1017/s0007114524001648

Vadell, A. K. E., Bärebring, L., Hulander, E., Gjertsson, I., Lindqvist, H. M., & Winkvist, A. (2020). Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA): A randomized, controlled crossover trial indicating effects on disease activity. The American Journal of Clinical Nutrition, 111(6), 1203-1213. https://doi.org/10.1093/ajcn/nqaa019

Vadell, A. K. E., Bärebring, L., Hulander, E., Gjertsson, I., Lindqvist, H. M., & Winkvist, A. (2023). Erratum to "Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA): A randomized, controlled crossover trial indicating effects on disease activity" [Erratum]. The American Journal of Clinical Nutrition, 118(6), 1244. https://doi.org/10.1016/j.ajcnut.2023.10.023

Wang, Y., Liu, Y., Cheng, L., He, J., Cheng, X., Lin, X., Miao, X., Huang, Z., & Xia, S. (2025). Effects of 12-week dietary inflammatory index-based dietary education on frailty status in frail patients with colorectal cancer: A randomized controlled trial. Nutrients, 17(13), Article 2203. https://doi.org/10.3390/nu17132203

Weil Nutrition Corner. (2026, January 8). Dr. Andrew Weil and daughter Diana Weil update anti-inflammatory food pyramid for 2026 after 20 years [Press release]. PR Newswire. prnewswire.com/news-releases/dr-andrew-weil-and-daughter-diana-weil-update-anti-inflammatory-food-pyramid-for-2026-after-20-years-302656043.html

Weil, A. (n.d.). Dr. Weil's anti-inflammatory food pyramid. DrWeil.com. drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid

Woelber, J. P., Gärtner, M., Breuninger, L., Anderson, A., König, D., Hellwig, E., Al-Ahmad, A., Vach, K., Dötsch, A., Ratka-Krüger, P., & Tennert, C. (2019). The influence of an anti-inflammatory diet on gingivitis: A randomized controlled trial. Journal of Clinical Periodontology, 46(4), 481-490. https://doi.org/10.1111/jcpe.13094

Yao, Z., Lv, Y., Yang, W., Wu, M., Li, S., & Meng, H. (2025). Associations between inflammatory potential of diet with the risk of all-cause mortality and greenhouse gas emissions in Chinese adults. Nutrients, 17(7), Article 1218. https://doi.org/10.3390/nu17071218

Ye, Y. M., Wei, M. H., Lv, K. N., Xue, X. H., Shen, R., & Liu, J. H. (2024). Effects of an anti-inflammatory diet (AID) on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease treated with infliximab (IFX). Scandinavian Journal of Gastroenterology, 59(12), 1297-1305. https://doi.org/10.1080/00365521.2024.2423828

Zhang, Y., Cui, G., Xiu, Y., & Zhao, M. (2023). The effect of nutritional support based on the dietary anti-inflammatory index on cancer-related fatigue in lung cancer patients undergoing chemotherapy. Cancer Nursing, 46(5), 394-404. https://doi.org/10.1097/ncc.0000000000001124

Zwickey, H., Horgan, A., Hanes, D., Schiffke, H., Moore, A., Wahbeh, H., Jordan, J., Ojeda, L., McMurry, M., Elmer, P., & Purnell, J. Q. (2019). Effect of the anti-inflammatory diet in people with diabetes and pre-diabetes: A randomized controlled feeding study. Journal of Restorative Medicine, 8(1), Article e20190107. https://doi.org/10.14200/jrm.2019.0107

Evidence rating and review record

Every page in this archive rates its evidence with GRADE, the same 4-level scale used in the clinical guidelines you will meet in practice. High means further research is very unlikely to change the conclusion. Moderate means further research may change it. Low means further research is likely to change it. Very low means the conclusion is uncertain. GRADE rates each outcome separately, so a diet can be high for one outcome and very low for another. Each row below says whether the rating comes from a named published review or is this page's own judgment, and exactly which comparison it rates. A high rating means the research is solid; it does not mean the diet is right for everyone, and it does not mean a coach should recommend it.

Four things about this table matter before reading it. The first row is not a rating: the label as a whole cannot be rated, which is why the banner at the top of the page carries no single rating. The observational rows rate how certain it is that an association exists, and an association between a diet score and a disease is not evidence that changing the diet changes the disease. Two outcomes appear twice, because a published review rated a different comparison, each 1-point increase in the index rather than the highest against the lowest scores; the 2 ratings are not interchangeable. And 1 row uses a credibility scale that is not GRADE, and 1 row records that no rating could be assigned from the synthesis available; the table names the tool in every row.

Ratings marked as this page's own judgment were assigned from the evidence given in each row's reasons; ratings from a published review are reported exactly as that review published them.

On a narrow screen, scroll the table sideways to see every column.

GRADE certainty of evidence by outcome, with who rated it and why

Outcome	Certainty	Who rated it, and for which comparison	Why it is rated this way
The anti-inflammatory diet as a whole	Not rated	This page's own judgment. No comparison is possible	A GRADE rating needs a defined intervention, a defined comparison and a defined outcome. The name covers many different diets, some of which contradict each other, so there is no single intervention to rate. Each row below rates one exact comparison instead.
Developing cardiovascular disease, in people whose eating scores as more pro-inflammatory	Moderate, for an association	Farazi et al., 2023, using GRADE. Highest against lowest Dietary Inflammatory Index category, 6 cohort studies	Relative risk 1.43, from 1.11 to 1.84, as published in the review's Table 1. The review gives its domain-by-domain reasons in a supplementary table that this page did not open, so they are not reported here. The rating covers this review's own analysis of the Dietary Inflammatory Index; it does not extend to the food-based index in the 3-cohort analysis (Li et al., 2020) or to the 2025 synthesis (Ni et al., 2025). It is a published judgment about an observational association, not certainty that prescribing a diet prevents disease.
Death from cardiovascular disease, highest against lowest category	Low, for an association	This page's own judgment, using GRADE. Highest against lowest Dietary Inflammatory Index category, 16 cohort studies (Ni et al., 2025)	Cohort studies start low. Results were consistent and precise, hazard ratio 1.29, from 1.24 to 1.35. The correction for possibly missing studies changed the estimate little, which does not show that publication bias is absent. Not raised, because confounding by other habits cannot be ruled out. The rating is for the direction of the association. Farazi et al. (2023), using GRADE on an earlier set of 11 cohort studies with the same comparison, rated this outcome very low; Marx et al. (2021) classed it weak on their own scale.
Heart attack, highest against lowest category	Convincing, on a credibility scale that is not GRADE	Marx et al., 2021, using credibility classes. Highest against lowest Dietary Inflammatory Index category, 6 case-control and prospective studies, 2,497 cases	The only outcome of 38 to meet every criterion of the top class: relative risk 1.72, from 1.42 to 2.08, with little variation between studies. The authors classified it as showing neither small-study effects nor excess significance, while separately flagging possible publication bias. The scale weighs statistics, not study design, and its labels are not interchangeable with GRADE labels.
Death from any cause, highest against lowest category	Low, for an association	This page's own judgment, using GRADE. Highest against lowest Dietary Inflammatory Index category, 12 prospective cohort studies, 44,809 deaths, as reanalyzed by Marx et al., 2021	Cohort studies start low. The size of the association varied between studies, but the range expected for a new study, 1.01 to 1.51, lies entirely above no effect. Smaller studies reported larger effects, but the largest study still found a higher risk, relative risk 1.16, from 1.10 to 1.22, so this concern is not judged enough to lower confidence in the direction of the association; it is a reason not to rely on the precise size, and the rating is not raised. Marx et al. classed this evidence highly suggestive on their own scale.
Death from any cause, for each 1-point increase in the Dietary Inflammatory Index	Moderate, for an association	Farazi et al., 2023, using GRADE. Each 1-point increase in the index score, 6 cohort studies	Relative risk 1.05, from 1.02 to 1.07, as published in the review's Table 1; the domain-by-domain reasons are in a supplementary table this page did not open. This is a different comparison from the row above, so the 2 ratings are not interchangeable. It is a published judgment about an observational association, not certainty that changing diet prevents death.
Colorectal cancer, highest against lowest category	Very low, for an association	This page's own judgment, using GRADE. Highest against lowest Dietary Inflammatory Index category, 11 case-control and prospective studies, 20,076 cases, as reanalyzed by Marx et al., 2021	Observational studies start low. Lowered 1 level for risk of bias, because many of the studies asked people who already had cancer to recall how they used to eat. Smaller studies also reported larger effects, a further concern that cannot lower the rating below very low. The rating covers this mix of designs, not prospective studies alone.
Colorectal cancer, for each 1-point increase in the Dietary Inflammatory Index	Moderate, for an association	Farazi et al., 2023, using GRADE. Each 1-point increase in the index score, 4 cohort and 4 case-control studies	Pooled estimate 1.06, from 1.04 to 1.08, as published in the review's Table 2. The combined evidence is not all prospective. The review also rated the 4 cohort studies alone moderate, relative risk 1.04, from 1.03 to 1.04, and the 4 case-control studies alone moderate. The domain-by-domain reasons are in a supplementary table this page did not open. This is a different comparison from the row above.
Blood pressure, diets counted as anti-inflammatory against comparison diets	Not rated from this synthesis	This page's own judgment. Jiang et al., 2025, which did not rate certainty; 13 trials pooled for blood pressure	The pooled comparisons include a comparison with participants' own starting values for a trial that had randomized people between 2 versions of the DASH diet, so the pooled estimate cannot be read as one diet compared with another until its comparisons are reconciled. This means no trustworthy rating can be assigned from this analysis; it is not a finding of no effect. Evidence for established patterns is on their own pages.
C-reactive protein, Mediterranean pattern against control diets, adults	Very low	This page's own judgment, using GRADE. Koelman et al., 2022, which did not rate certainty; 11 randomized trials, 1,805 participants	Trials start high. Lowered 1 level for risk of bias, because outcome-assessment and selective-reporting methods were often unclear, and 2 levels for very serious inconsistency: the trial estimates range from little change to reductions of about 3 mg/L, with a heterogeneity statistic (I²) of 97 percent. No separate deduction is made merely because the pooled interval includes no difference. The review's abstract and results table give different heterogeneity figures; this page uses the results table. A correction for possibly missing trials shrank the estimate toward no difference. This is a blood marker, not a disease-prevention result.
Pain in rheumatoid arthritis, diets grouped as anti-inflammatory against ordinary diets	Very low	Schönenberger et al., 2021, using GRADE. Mediterranean, vegetarian or vegan diets against ordinary diets, 7 trials, 326 people	Randomized trials start high. Lowered 2 levels for risk of bias, because participants knew their diet and pain is self-reported, and 1 level for imprecision, because the interval, 4.29 to 14.15 mm lower, includes changes smaller than patients notice.
C-reactive protein in rheumatoid arthritis, same comparison	Very low	Schönenberger et al., 2021, using GRADE. 5 trials, 267 people	2.51 mg/L lower, from 6.10 lower to 1.08 higher. Lowered 1 level for risk of bias and 2 levels for imprecision, because the interval is wide and the sample small. A blood marker, not a disease outcome.
Body weight in rheumatoid arthritis trials, as measured, same comparison	Very low	Schönenberger et al., 2021, using GRADE. 6 trials, 286 people	3.73 kg lower, from 2.01 to 5.45 kg lower. Lowered 1 level for risk of bias and 2 levels for inconsistency. Reported as a measurement, not as a goal.
Quality of life, physical component, in adults with a chronic disease	Low	Law et al., 2025, using GRADE. Diets the authors classed as anti-inflammatory against usual care or other diets, 18 trials	Standardized difference 0.17, from 0.06 to 0.27, which the authors say may not be clinically relevant. The authors' detailed GRADE table lowers certainty 1 level for risk of bias and 1 for inconsistency.
Quality of life, mental component, same comparison	Low	Law et al., 2025, using GRADE. 18 trials	Standardized difference 0.09, from 0.02 lower to 0.20 higher, so no clear effect was detected. The authors' detailed GRADE table lowers certainty 1 level for risk of bias and 1 for inconsistency.

How this archive talks about weight. This page reports what studies measured, including body weight, and does not treat weight change as a goal or as a measure of a diet's success. Weight a person loses without meaning to can be a sign of a health problem, and where it is, the page names it as a reason to see a clinician. People are described the way the study described them.

Last reviewed: Reviewed and approved by James Peth, MS, MPH, PhD, on October 3, 2026. Written as a draft September 27, 2026, and brought to candidate September 28, 2026, for its first and only outside review, the combined final review of 5 archive pages, completed September 30, 2026. What changed: at candidate, the page was checked against the full texts of the umbrella review of the Dietary Inflammatory Index, the published letter and reply on it, the 3-cohort analysis, the trial meta-analysis of blood markers, and the correction to the ADIRA trial; figures from 3 reviews were corrected or narrowed after their study tables were checked; searches were run for each special population, cost and environmental footprint, and 9 studies were added; the rating table was completed, with this page's own ratings assigned from the evidence in each row; the September 28 template changes were applied.

Revision after the combined final review, October 1, 2026. The full text of the second umbrella review of the Dietary Inflammatory Index (Farazi et al., 2023) was read and its published GRADE ratings were added for the exact comparisons it rated: they replace this page's own rating for developing cardiovascular disease and add separate rows for death from any cause and colorectal cancer per 1-point increase in the index. The pooled blood pressure estimate from a 2025 review was removed and its rating withdrawn, because its comparisons include a comparison with starting values. The reasons for the quality-of-life ratings were corrected to that review's detailed GRADE table, and the reasons for this page's C-reactive protein rating were revised.

Statements about single foods and supplements, about outcomes the purpose-built plans do not establish, about the definition of a primary outcome, about the heart attack classification and about study designs in the observational section were corrected; broad statements of approval of the pattern were narrowed; and article numbers in the references were labeled. Status: reviewed and approved October 3, 2026, after a targeted outside recheck verified the rating changes.

Next scheduled review: August 2027. Pages built on annual guidance are rechecked each year. The supplement guidance cited on this page comes from federal fact sheets that are updated from time to time and should be rechecked first.

---

Diet Reference Archive | One James

Prepared by James Peth, MS, MPH, PhD

© 2026–2027 One James. All rights reserved.

This page is for education and coaching practice. It is not medical or dietary advice.