Anti-Inflammatory Food Swaps: Grains, Dairy, Sugar and More

Written by Dr. Ryan Kneessi, ND

Grains and pasta

In place of grains and pasta, try cauliflower rice, zucchini or sweet potato noodles, or spaghetti squash.

Dairy

Instead of dairy, try coconut, almond or cashew milk, coconut yogurt, and nutritional yeast for a cheesy flavor, or use ghee instead of butter if sensitive.

Legumes and peanut butter

Swap peanut butter for almond, cashew or sunflower seed butter, and use mushrooms or extra vegetables in place of beans.

Sweeteners

For sweetness, use small amounts of raw honey, maple syrup or dates, or mashed banana or applesauce in baking.

Potatoes and bread

Instead of potatoes and bread, try sweet potatoes, parsnips or cauliflower mash, lettuce wraps, collard wraps or cassava tortillas, and almond or coconut flour bread.

Thickeners and condiments

For thickening, use arrowroot or tapioca starch, choose coconut aminos instead of soy sauce, and make homemade dressings and mayonnaise with avocado or olive oil.

Sweets and pizza

For sweets, try frozen banana “nice cream” or dark chocolate in moderation, and for pizza, a cauliflower or almond flour pizza crust.

Healthy aging lens

Swaps help with cravings, but whole foods should remain the base of your plate. See foods to eat and keto-friendly substitutes.

What the research shows

Food swaps work by trading refined, processed foods for whole-food versions. These studies show why that trade may matter.

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.

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.

Strength of the evidence: The evidence supports swapping toward whole foods, fiber and olive oil; it does not show that any single swap changes health by itself.

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.

Frequently asked questions

Sources

• MedlinePlus: Nutrition
• MedlinePlus: Food Labeling
• 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/
• 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/

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.