Quick answer: During the anti-inflammatory challenge, avoid grains, legumes, dairy, refined sugar, processed foods, refined vegetable oils, artificial sweeteners, alcohol, processed meats and soy. These foods are removed because they are common triggers or easy sources of refined carbs and additives. Some, like legumes and dairy, can be reintroduced later to see how you tolerate them.
Key takeaways
During the challenge, grains, legumes, dairy, refined sugar and processed foods are set aside.
Refined grains can spike blood sugar, and gluten is a particular trigger for people with celiac disease or sensitivity.
After the challenge, you reintroduce foods one at a time so you can learn which ones bother you.
Foods to avoid during the challenge
Grains
Wheat, rice, oats, corn and others. Refined grains spike blood sugar, and gluten is a trigger for people with celiac disease or sensitivity.
Legumes
Beans, lentils and peanuts contain lectins and phytates that some people find hard to digest. See anti-nutrients.
Dairy
A common source of digestive symptoms for people with lactose intolerance or dairy sensitivity.
Refined sugar
Added sugars raise blood sugar and are linked with inflammation.
Processed foods
Often high in refined carbs, additives and industrial oils.
Refined vegetable oils
Common in fried and packaged foods.
Artificial sweeteners
May affect the gut microbiome and cravings in some people.
Alcohol
Can irritate the gut and liver, especially in larger amounts, and disrupt sleep.
Processed meats
Linked with higher risk of some cancers when eaten often.
Soy products
A common allergen; highly processed soy is avoided during the challenge.
After the challenge
Reintroduce foods one at a time to learn your triggers. See transitioning after the challenge.
Healthy aging lens
Cutting back on ultra-processed foods and added sugar is an important dietary step for long-term health. See foods to eat.
What the research shows
The foods this guide suggests limiting, mainly ultra-processed foods, refined grains and added sugar, have been studied in trials and large reviews.
Ultra-processed vs. unprocessed food (Hall 2019, inpatient randomized crossover trial). 20 adults lived at the NIH Clinical Center and ate an ultra-processed diet for 2 weeks and an unprocessed diet for 2 weeks, with meals matched for calories, sugar, fat, fiber and sodium and eaten as freely as they liked. On the ultra-processed diet they ate about 508 kcal more per day and gained 0.9 kg; on the unprocessed diet they lost 0.9 kg. A limitation is that it was a small, short study in a controlled setting, not real life.
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.
Paleo-style eating across trials (Manheimer 2015, meta-analysis). This review pooled 4 randomized trials with 159 people who had at least one feature of metabolic syndrome. Compared with guideline-based diets, the Paleo-style diets produced short-term improvements in waist size (about 2.4 cm) and triglycerides (about 0.4 mmol/L), with smaller, uncertain changes in blood pressure, HDL and fasting glucose. A limitation is that only 4 small trials lasting up to 6 months were available.
Strength of the evidence: The evidence most clearly supports limiting ultra-processed foods; evidence for removing whole grains and dairy for everyone is weaker, so that part is best personalized.
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.
Want an anti-inflammatory eating plan built for you?
A free 15-minute consultation with Dr. Kneessi. No cost, no obligation. In-office in Odenton, MD or by telehealth.
Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Which foods are most worth removing for me, and how should we reintroduce them?
Which foods on the avoid list would be most worth cutting back on for me?
Should I remove these foods all at once or step by step?
How would I know whether avoiding these foods is helping me?
Frequently asked questions
What foods should I avoid?
Grains, legumes, dairy, sugar, processed foods, refined oils, alcohol, processed meats and soy.
Do I have to avoid these forever?
No, many can be reintroduced to test tolerance.
Why avoid legumes?
Some people find their lectins and phytates hard to digest.
Is dairy inflammatory?
Not for everyone; it’s a common trigger for some.
Sources
- Rubio-Tapia A, et al. American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease. Am J Gastroenterol 2023. PMID: 36602836. https://pubmed.ncbi.nlm.nih.gov/36602836/
- Misselwitz B, et al. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut 2019. PMID: 31427404. https://pmc.ncbi.nlm.nih.gov/articles/PMC6839734/
- Suez J, et al. Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance. Cell 2022. PMID: 35987213. https://pubmed.ncbi.nlm.nih.gov/35987213/
- Bishehsari F, et al. Alcohol and Gut-Derived Inflammation. Alcohol Res 2017. PMID: 28988571. https://pmc.ncbi.nlm.nih.gov/articles/PMC5513683/
- Chan DS, et al. Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PLoS One 2011. PMID: 21674008. https://pmc.ncbi.nlm.nih.gov/articles/PMC3108955/
- MedlinePlus: Food Allergy
- MedlinePlus: Gluten Sensitivity
- Hall KD, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab 2019. PMID: 31105044. https://pubmed.ncbi.nlm.nih.gov/31105044/
- Reynolds A, et al. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet 2019. PMID: 30638909. https://pubmed.ncbi.nlm.nih.gov/30638909/
- Manheimer EW, et al. Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. Am J Clin Nutr 2015. PMID: 26269362. https://pubmed.ncbi.nlm.nih.gov/26269362/
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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