Quick answer: Chronic inflammation can start when the immune system stays switched on from ongoing triggers such as a poor diet, excess body fat, an imbalanced gut, insulin resistance, stress and poor sleep. Diet influences it through omega-6 derived arachidonic acid, the gut microbiome and blood sugar. Eating more omega-3s, fiber, colorful plants, herbs and spices may help tip the balance.
Key takeaways
Chronic inflammation starts when triggers persist and the immune system stays switched on at a low level.
Omega-3 fats compete with the omega-6 fat arachidonic acid, and that balance can shift the body toward calmer inflammatory signals.
An imbalanced gut microbiome and high blood sugar can both feed inflammation, so food choices touch several pathways at once.
How chronic inflammation starts
Short-term inflammation heals. When triggers persist, the immune system stays active at a low level, which over time can damage tissues.
Arachidonic acid
An omega-6 fatty acid that the body converts into pro-inflammatory messengers. Omega-3s compete for the same enzymes and produce calmer signals.
Gut microbiome
An imbalanced microbiome and leaky gut barrier may contribute to inflammation. See diet and gut health.
Insulin resistance
High blood sugar and insulin can promote inflammatory signaling, and inflammation can worsen insulin resistance.
Anti-inflammatory foods
Anti-inflammatory foods include fatty fish, leafy greens and cruciferous vegetables, berries and colorful fruits, olive oil, nuts and seeds, and herbs and spices such as turmeric, ginger and garlic.
Phytonutrients
Flavonoids (berries, tea, cocoa) Carotenoids (carrots, sweet potatoes, leafy greens)
Polyphenols (olive oil, herbs, spices) Glucosinolates (cruciferous vegetables)
Healthy aging lens
Lowering chronic inflammation may support healthy aging. See inflammaging and what is an anti-inflammatory diet.
What the research shows
Inflammation is usually measured in studies with blood markers such as C-reactive protein (CRP). These studies looked at how diet and lifestyle relate to those markers or to heart outcomes.
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.
Two low-calorie days a week (Harvie 2011, randomized trial). 107 premenopausal women with overweight or obesity followed either a 5:2-style plan (about 650 kcal a day on 2 days a week) or a daily 25% calorie cut for 6 months. Weight loss was similar (6.4 kg vs. 5.6 kg), and both groups saw comparable drops in high-sensitivity CRP, LDL cholesterol, triglycerides and blood pressure. Fasting insulin and insulin resistance fell slightly more with the 5:2 approach. A limitation is that only women were studied, for 6 months.
Exercise and CRP (Fedewa 2017, meta-analysis of 83 trials). This review pooled 83 controlled trials with 3,769 people that measured C-reactive protein (CRP), a blood marker of inflammation, before and after at least 2 weeks of exercise training. CRP fell with exercise regardless of age or sex, the drop was larger when weight or body fat also fell, and a smaller drop still occurred without weight loss. A limitation is that the trials varied widely in type and amount of exercise, and some were not randomized.
Strength of the evidence: Diet and exercise can lower inflammation markers modestly, often alongside weight loss, but lower CRP has not been proven to cause better long-term health on its own.
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.
Are there signs of chronic inflammation in my labs or history that we should look at?
Which foods in my current diet might be adding to inflammation?
Would an inflammation lab such as hs-CRP help track my progress?
Which anti-inflammatory foods would be easiest for me to add first?
Frequently asked questions
What causes chronic inflammation?
Ongoing triggers like poor diet, excess weight, gut imbalance, stress and poor sleep.
What is arachidonic acid?
An omega-6 fat that the body turns into pro-inflammatory messengers.
Which foods lower inflammation?
Fatty fish, vegetables, berries, olive oil, nuts, herbs and spices.
How long does it take?
It varies; consistency matters.
Sources
- Furman D, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 2019. PMID: 31806905. https://pmc.ncbi.nlm.nih.gov/articles/PMC7147972/
- Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans 2017. PMID: 28900017. https://pubmed.ncbi.nlm.nih.gov/28900017/
- Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest 2006. PMID: 16823477. https://pmc.ncbi.nlm.nih.gov/articles/PMC1483173/
- Neale EP, Batterham MJ, Tapsell LC. Consumption of a healthy dietary pattern results in significant reductions in C-reactive protein levels in adults: a meta-analysis. Nutr Res 2016. PMID: 27101757. https://pubmed.ncbi.nlm.nih.gov/27101757/
- Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 2018. PMID: 30065258. https://pmc.ncbi.nlm.nih.gov/articles/PMC6146930/
- NIH ODS: Omega-3 Fatty Acids
- MedlinePlus: Antioxidants
- 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/
- Harvie MN, et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int J Obes (Lond) 2011. PMID: 20921964. https://pubmed.ncbi.nlm.nih.gov/20921964/
- Fedewa MV, et al. Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials. Br J Sports Med 2017. PMID: 27445361. https://pubmed.ncbi.nlm.nih.gov/27445361/
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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