Quick answer: Common questions about the challenge cover sweeteners, dairy, early fatigue, cravings, organic food, alcohol, vegetarian diets, slip-ups, coffee, calcium, children, calories, legumes, carbs, cholesterol and intermittent fasting. In short: focus on whole foods, use natural sweeteners sparingly, get calcium from greens and fish, and work with your provider for health conditions.
Key takeaways
Honey and maple syrup are allowed in small amounts, and dairy is left out during the challenge, although some people reintroduce it later.
Feeling tired early on is often your body adjusting to fewer refined carbohydrates, so eating enough and including starchy vegetables can help.
Vegetarian plans and children’s diets are possible with careful planning, but restrictive versions are best guided by a professional.
Food questions
Are honey and maple syrup allowed?
In small amounts; they’re still sugar.
Can I eat dairy?
It’s excluded during the challenge; some people reintroduce ghee or fermented dairy later.
Do I need organic or grass-fed?
It’s ideal but not required. Do what fits your budget.
Can I drink coffee?
Is dark chocolate allowed?
High-cocoa dark chocolate in small amounts.
Can I eat gluten-free grains?
Grains are excluded during the challenge.
How do I get calcium without dairy?
Leafy greens, sardines and salmon with bones, almonds and sesame seeds.
Getting through the challenge
Why am I tired?
Your body may be adjusting to fewer refined carbs; eat enough and include starchy vegetables.
How do I handle cravings?
Use swaps and keep snacks ready. See overcoming challenges.
What if I slip up?
Learn from it and keep going.
Do I need to count calories?
Usually not; focus on whole foods and hunger cues.
Special situations
Vegetarian or vegan?
Possible with careful planning, though harder without legumes.
Is it safe for children?
Whole foods are great for kids, but restrictive diets for children should be guided by their pediatrician.
What about cholesterol?
Effects vary; check your lipids with your provider.
Intermittent fasting?
Compatible for many adults. See intermittent fasting.
Healthy aging lens
Questions are part of learning what works for you. Start with key rules of the challenge.
What the research shows
Common questions about anti-inflammatory eating are best answered by the larger trials of whole-diet patterns.
A Mediterranean-style pattern (Estruch 2018, PREDIMED randomized trial). 7,447 adults aged 55 to 80 at high cardiovascular risk in Spain followed a Mediterranean diet with extra olive oil, a Mediterranean diet with extra nuts, or a lower-fat control diet for a median of 4.8 years. Major cardiovascular events (heart attack, stroke or cardiovascular death) occurred in 3.8% of the olive oil group, 3.4% of the nut group and 4.4% of the control group, about 30% lower risk with either Mediterranean diet. A limitation is that the trial had to be re-analyzed in 2018 because some participants were not properly randomized; the results held after that correction.
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.
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.
Strength of the evidence: The strongest single trial (PREDIMED) supports a Mediterranean-style pattern; evidence for stricter grain-free versions is promising but small and short-term.
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.
Is the anti-inflammatory challenge safe and practical for my situation or my family?
Which common questions about anti-inflammatory eating apply most to me?
How strict do I need to be for this way of eating to help?
Can I still enjoy meals out while following an anti-inflammatory diet?
Frequently asked questions
Is the anti-inflammatory diet low-carb?
Not necessarily; fruit and starchy vegetables are included.
How much meat should I eat?
A palm-sized portion per meal works for many people.
Can I drink alcohol?
It’s excluded during the challenge.
Can I eat legumes?
They’re excluded during the challenge and can be reintroduced later.
Sources
- Poole R, et al. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 2017. PMID: 29167102. https://pmc.ncbi.nlm.nih.gov/articles/PMC5696634/
- 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://pmc.ncbi.nlm.nih.gov/articles/PMC7946062/
- Kliewer KL, Cassin AM, Venter C. Dietary Therapy for Eosinophilic Esophagitis: Elimination and Reintroduction. Clin Rev Allergy Immunol 2018. PMID: 29238902. https://pubmed.ncbi.nlm.nih.gov/29238902/
- MedlinePlus: Nutrition
- MedlinePlus: Calcium
- Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med 2018. PMID: 29897866. https://pubmed.ncbi.nlm.nih.gov/29897866/
- 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/
- 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/
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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