Macronutrients on an Anti-Inflammatory Diet: Protein, Fat, Carbs

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Quick answer: An anti-inflammatory diet balances quality protein, healthy fats and fiber-rich carbohydrates. Choose pasture-raised meat, wild fish and eggs for protein; olive oil, avocado, nuts and fatty fish for fat; and vegetables, fruit and tubers for carbs. Proportions depend on your activity, health and goals.

Key takeaways

Protein builds and repairs tissues, fat supports hormones and vitamin absorption, and carbohydrates supply energy and fiber.

A simple plate is half vegetables, a palm-sized portion of protein and a thumb or two of healthy fat, with fruit or starchy vegetables added to match your needs.

Getting enough protein, quality fats and fiber-rich carbohydrates together can support muscle, metabolism and gut health with age.

Protein

Builds and repairs tissues, enzymes and hormones. Choose pasture-raised meat, wild fish and eggs. See protein.

Fat

Supports hormones, cell membranes and vitamin absorption. Favor olive oil, avocado, nuts, seeds and fatty fish. See healthy fats.

Carbohydrates

Supply energy and fiber. Choose vegetables, fruit, sweet potatoes and squash. See carbohydrates.

Building your plate

Fill half the plate with vegetables, then add a palm-sized portion of protein and a thumb or two of healthy fat, with fruit or starchy vegetables based on your activity. These ranges are general education, not a prescription; personalize them with your provider.

Healthy aging lens

Enough protein, quality fats and fiber-rich carbs together can support muscle, metabolism and gut health with age.

What the research shows

Research on macronutrients suggests the quality of protein, fat and carbohydrate matters at least as much as the exact ratio.

Healthy low-carb vs. healthy low-fat (Gardner 2018, DIETFITS randomized trial). 609 adults without diabetes were coached for 12 months on either a healthy low-fat or a healthy low-carbohydrate diet, with both groups told to focus on whole, minimally processed foods. Weight loss was nearly the same (5.3 kg vs. 6.0 kg), and neither genetic testing nor insulin response predicted who did better on which diet. A limitation is that the low-carb group averaged 30% of calories from carbohydrate, so this was not a strict ketogenic diet.

Fiber and carbohydrate quality (Reynolds 2019, series of meta-analyses). Commissioned in part by the World Health Organization, this work combined 185 cohort studies and 58 clinical trials with 4,635 trial participants. People with the highest fiber intakes had 15% to 30% lower rates of heart disease, stroke, type 2 diabetes and colorectal cancer than those with the lowest, and the greatest benefit was seen at 25 to 29 g of fiber a day. A limitation is that most of this evidence is observational, and it applies to the general population rather than people with existing chronic disease.

How much protein supports muscle (Morton 2018, meta-analysis of 49 trials). This review pooled 49 randomized trials with 1,863 healthy adults doing resistance training for at least 6 weeks. Extra protein added about 0.3 kg of lean mass and 2.5 kg to one-rep max strength, and gains leveled off at a total intake of about 1.6 g of protein per kg of body weight a day. A limitation is that these were healthy adults who lifted weights, not people following keto or fasting specifically.

Strength of the evidence: Overall, well-designed trials show that different macronutrient ratios can work similarly when food quality is high, so the best ratio is the one you can sustain.

When to see a naturopathic doctor

It may be time to see a naturopathic doctor if you have a chronic inflammatory, autoimmune or digestive condition, or if you have diabetes, kidney disease or take medications affected by diet changes. The same is true if you are pregnant, breastfeeding, or have a history of disordered eating, or if you want a plan tailored to your labs, symptoms and goals.

See a medical provider promptly for severe abdominal pain, signs of an allergic reaction such as swelling or trouble breathing, or fainting.

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Questions to bring to your clinician

These questions can help you get the most out of your next visit.

How should I balance protein, fat and carbohydrates on my plate for my goals?

How should I balance protein, fat and carbs on an anti-inflammatory diet?

Would my activity level or blood sugar change the balance that suits me?

How would I know whether my current balance is right for me?

Frequently asked questions

What are macronutrients?

Protein, fat and carbohydrates.

How should I balance them?

Half your plate vegetables, plus protein and healthy fat.

Do I need to count macros?

Not necessarily; plate guides work for many people.

Which sources are best?

Whole, minimally processed foods.

Sources

This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.

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Dr. Ryan Kneessi, ND

Dr. Ryan Kneessi, ND, is a naturopathic doctor in Odenton, Maryland, who practices functional medicine.

Disclosure: I earn a margin on some products purchased through my Fullscript store, and I only recommend products I would use in my own practice.

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