Diabetes and an Anti-Inflammatory Diet

Since diabetes is the source of chronic inflammation, and food is so central to controlling blood glucose levels, it makes sense to discuss following an anti-inflammatory diet.

Diabetes and Inflammation

With type 1 or type 2 diabetes, inflammatory cells can strike our bodies, attacking healthy cells, which could also lead to other health complications. 

Some researchers have called type 1 diabetes “a chronic anti-self-inflammatory response,” and there is a theory that inflammation in the pancreas may help cause type 1 diabetes in the first place. 

Type 2 diabetes, which is defined by insulin resistance, can lead to chronic inflammation, which in turn causes more insulin resistance. It’s a vicious cycle. Chronic and systemic inflammation are prominent features of type 2 diabetes.

Responsibly using diabetes drugs, as prescribed by your doctor to help achieve good glucose control, is likely one of the best ways of stopping chronic inflammation from getting out of hand. Another ideal way to address chronic inflammation is through healthy lifestyle decisions.

Food and Inflammation

One way to potentially help reduce the threat of inflammation is by eating a healthy diet, and specifically anti-inflammatory foods.

Many foods can cause internal inflammation. Most dramatic are ultraprocessed foods, like hot dogs, baked goods, microwavable meals, sugar cereals, and snack foods — basically, according to Harvard Medical School, foods high in salt, added sugars, and saturated fat. But it’s not limited to those. Inflammation can also be caused by food products made with refined flour (think white bread, pasta, and cereals), as well as white rice, soda, juices, ice cream, salad dressings, and cured or processed meats.

These ingredients promote chronic inflammation by changing gut bacteria and damaging the gut’s lining. They also switch on the cells’ inflammatory genes. Some studies have linked ultraprocessed foods with these ingredients to, among other deleterious conditions, diabetes. In fact, Harvard’s T.H. Chan School of Public Health identified the buildup of fatty acids in high-fat or high-sugar diets as the potential cause of fat tissue sending signals to immune cells that produce inflammation in various parts of the body, including the pancreas, which can lead to insulin resistance and diabetes. 

Step one in fighting inflammation is to eliminate these foods from our diet.

What Is an Anti-Inflammatory Diet?

Step two is to eat foods that help fight chronic inflammation. Researchers, unsurprisingly, advocate a diet of whole, unprocessed foods, sans added sugar. What they’re finding is that a variety of anti-inflammatory foods eaten daily collectively provide a swath of protective plant chemicals, antioxidants, and fiber that prevent cellular stress and inflammatory signals. Importantly, they also promote healthy gut microbiota, and in the context of diabetes, slow digestion enough to prevent blood glucose surges.

Diets like the Mediterranean diet and the DASH diet incorporate these whole, unprocessed foods. The Mediterranean diet emphasizes plant-based foods, whole grains, healthy fats like olive oil, a moderate amount of cheese and yogurt, and a modest amount of poultry or fish instead of red meat. The DASH diet (which stands for Dietary Approaches to Stop Hypertension), likewise focuses on whole foods and limited proteins. It incorporates plenty of fruits, vegetables, whole grains, lean meats, fish and poultry, nuts and beans, and low-fat or nonfat dairy. 

The Best Anti-Inflammatory Ingredients

An anti-inflammatory diet prioritizes the ingredients that can help tame inflammation. According to a Johns Hopkins Medicine clinical dietician, there are several categories we should be sure to include in our diet — omega-3 fatty acids, vitamin C, polyphenols, and gut-healthy foods. 

Omega-3 fatty acids — especially the long-chain fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) — together seem to have a one-two punch, with DHA having a strong negative impact on pro-inflammatory proteins while EPA improves the balance between pro- and anti-inflammatory proteins, according to a 2020 Tufts University study. Omega-3 fatty acids are found in fatty fish like salmon, mackerel, herring, sardines, tuna, striped bass, and anchovies — or fish oil supplements — as well as nuts, seeds, and vitamin E. 
Vitamin C (ascorbic acid) is helpful for its antioxidant properties. Antioxidants protect cells against damage from free radicals that can cause inflammation. Vitamin C is, of course, found in citrus, but also in produce like bell peppers, berries, tomatoes, cruciferous vegetables, cantaloupe, and many others
Polyphenols are anti-inflammatory compounds that work as antioxidants. Fortunately, many of those same fruits and vegetables that have vitamin C also have polyphenols, but you’ll also find them in dry beans, as well as cherries, apples, and pears. Polyphenols are also in tea, coffee, and chocolate.
Finally, there are prebiotics and probiotics. These are gut-healthy foods — foods that promote a beneficial bacterium, or flora, in the intestines to create a healthy immune system and reduce inflammation. 

The most common probiotics are fermented foods, including pickled foods like kimchi, sauerkraut, yogurt, and miso. But there’s a caveat. They must have live organisms as part of their ingredients, and not all fermented foods do. Reading labels is necessary here. Look for wording like “live, active cultures” on the labels when seeking foods packed with probiotics since some fermentation processes (think making beer or wine, baking, or canning) remove the probiotics. And watch out for high sodium levels in pickled foods and fat in cheese. 

Prebiotics also contain live microorganisms, but they’re typically found in high-fiber foods, like whole grains, bananas, greens, onions, garlic, and soybeans. Or, like probiotics, they can be added to foods. Both probiotics and prebiotics can also be taken as supplements but check first with your doctor to make sure they’re right for you. 

Separately, there have also been studies that have investigated the anti-inflammatory benefits of spices. Johns Hopkins noted that cinnamon, for example, can lower blood sugar in people with type 2 diabetes, turmeric can reduce inflammation, garlic can keep blood vessels flexible and reduce cholesterol and triglycerides, and cayenne’s capsaicin provides pain relief. Additionally, a 2018 study looked at numerous spices to understand how components in them can inhibit inflammatory pathways that lead to chronic inflammation. In the context of diabetes, the researchers identified 6-gingerol in ginger as having a therapeutic effect on diabetes. 

Are these claims definitive? There are other studies that discount the health benefits of spices. So, while spices elevate the flavors of our food, the jury is still out on whether they actually have documentable health benefits around chronic inflammation.

Eating an Anti-Inflammatory Diet With Diabetes

We already know there’s no perfect food regimen for people with diabetes, but we do have robust guides to the types of food that can help us better manage the condition, whether it’s type 1 or type 2.

Experts from the American Diabetes Association agree that most people with diabetes should :

Eat more nonstarchy vegetables.
Eat less sugar and refined grains.
Choose whole foods over highly processed foods.

Experts also identify the Mediterranean and DASH diets as examples of diabetes-friendly eating frameworks that focus on fresh fruits and vegetables, seafood, legumes, whole grains, lean proteins, olive oil, and low salt. In other words, high fiber, low- to moderate-heart healthy fats, low sodium, and unprocessed foods.

Thankfully, it should be easy to incorporate the best anti-inflammatory ingredients into a diabetes-friendly diet, which should put you in a position to manage your blood sugar control and reduce inflammation at the same time.

17 Foods That Are High in Vitamin C. Cleveland Clinic. April 2023.

Anti-inflammatory Diet. Johns Hopkins Medicine.

Antioxidants. Mayo Clinic.

Clark M, Kroger CJ and Tisch RM. Type 1 Diabetes: A Chronic Anti-Self-Inflammatory Response. Front. Immunol. December 2017.

Diet Review: Anti-inflammatory Diet. Harvard T. H. Chan School of Public Health. October 2021.

Everything You Need to Know About Omega-3s. Everyday Health. February 2023.

How to Get More Probiotics. Harvard Health Publishing. July 2023.

Kunnumakkara AB, Sailo BL, Banik K, Harsha C, Prasad S, Gupta SC, Bharti AC, Aggarwal BB. Chronic diseases, inflammation, and spices: how are they linked? J Transl Med. January 2018.

Mediterranean Diet. Cleveland Clinic.

New study finds fish oil omega-3s EPA and DHA work differently on chronic inflammation. Tufts Now. December 2020.

Pandey, Kanti Bhooshan, and Syed Ibrahim Rizvi. “Plant polyphenols as dietary antioxidants in human health and disease.” Oxidative Medicine and Cellular Longevity. December 2009.

Randeria, Shehan N et al. “Inflammatory cytokines in type 2 diabetes mellitus as facilitators of hypercoagulation and abnormal clot formation.” Cardiovascular diabetology vol. 18,1 72. 4 Jun. 2019

Quick-start Guide to an Anti-inflammation Diet. Harvard Health Publishing. April 2023.

The Role of Inflammation in Diabetes. Southern Medical Association. May, 2021.

5 Spices with Healthy Benefits. Johns Hopkins Medicine.

What are probiotics and prebiotics? Mayo Clinic.

 

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