on October 27, 2026
Diet and inflammation: what is the relationship?
Chronic pain represents a major health problem and can affect people of all ages. Diet should not be considered a substitute therapy for medical treatment, but it can become an important component of a nutritional program aimed at improving the metabolic profile and reducing some of the factors that contribute to inflammation.
The idea that food can modify the biological environment in which inflammatory processes develop and persist is now supported by a growing number of studies. However, research does not point to a single “anti-inflammatory” food or a universal diet suitable for everyone.
The overall dietary pattern appears to be the most important factor.
The most recent evidence, in particular, indicates a beneficial role for the Mediterranean diet. A meta-analysis published in 2026, including 33 randomized studies and 3,476 participants, found a significant reduction in some markers, including high-sensitivity C-reactive protein, IL-6, and IL-17, while other parameters, such as TNF-α and CRP, did not show a statistically significant improvement.
This result is important because it shows that the effect of diet on inflammation is real but not uniform: it depends on the type of diet, the population studied, the duration of the intervention, and the biomarker considered.
The gut microbiota as an interface between diet and the immune system
One of the central elements in the relationship between diet and inflammation is the gut-microbiota-immune system axis.
The gut microbiota continuously interacts with the mucosa, the host's metabolism, and the immune system. The availability of fiber, polyphenols, and other dietary substrates influences the production of microbial metabolites, while an overall unbalanced diet can contribute to changes in the composition and function of the microbial community.
This relationship is particularly interesting in diseases characterized by immune dysregulation. The source material highlights the possible link between microbiota alterations and inflammatory intestinal and systemic diseases.
However, contemporary research suggests caution: dysbiosis cannot be considered the sole cause of autoimmune diseases. Genetics, environment, metabolism, medications, infections, and lifestyle all play a role in a much more complex biological network.
Targeted interventions on the microbiota also show promising but inconclusive results. A recent meta-analysis of 28 randomized studies involving a total of over 2,000 patients with autoimmune diseases showed possible reductions in CRP and TNF-α with microbiota modulation interventions, but with high heterogeneity among the studies. The authors therefore consider the results still exploratory.
The practical consequence is important: nourishing the microbiota does not simply mean adding a probiotic, but rather creating an overall diet that supports the intestinal ecosystem and is tailored to the individual.
The Biomolecular Model as the basis of an anti-inflammatory diet
The biomolecular model is now one of the most solid frameworks for creating a diet aimed at metabolic health and inflammation modulation.
Characteristic foods include:
· vegetables and other produce;
· fruit, particularly berries;
· legumes;
· whole grains;
· nuts;
· vegetable oils (burdock, evening primrose, flaxseed, cumin, olive;
Vegetable oils provide monounsaturated fatty acids and numerous phenolic compounds, as well as EPA and DHA, while vegetables, fruit, legumes, and nuts contribute fiber, vitamins, minerals, and polyphenols.
A systematic review and meta-analysis of clinical studies found that a Mediterranean diet enriched with olive oil can reduce IL-6 and CRP/hs-CRP, although heterogeneity among the studies is high.
Another meta-analysis of controlled studies reported improvements in several inflammatory markers and some endothelial parameters with a Mediterranean diet enriched with extra virgin olive oil compared to a low-fat diet.
These data help explain why the term “anti-inflammatory diet” should be interpreted primarily as a dietary pattern, rather than as a list of individual miracle foods.
Glycemic load and carbohydrate quality
The source material pays particular attention to foods with a high glycemic index.
The general principle is sound, but it must be interpreted correctly.
A diet high in free sugars and refined carbohydrates can promote excessive energy intake, blood sugar and insulin abnormalities, and, over the long term, worsen the metabolic profile.
However, it is not necessary to eliminate all carbohydrates.
Choices should favor foods with greater nutrient density and fiber content, such as legumes, vegetables, whole grains, and pseudocereals, adjusting quantities and distribution based on individual energy needs and metabolic status.
The central concept is therefore the metabolic quality of the entire meal, not simply the glycemic index assigned to a single food.
Omega-3: a link between diet and inflammatory mediators
EPA and DHA are involved in the composition of cell membranes and the production of lipid mediators involved in regulating the inflammatory response.
The quality of fats consumed can therefore contribute to the metabolic environment in which inflammatory processes develop.
Their presence should therefore be considered as part of an overall balanced diet, along with replacing excessive saturated fats with unsaturated fat sources.
Polyphenols, berries, and plant-based foods
Berries, vegetables, legumes, nuts, and extra virgin olive oil provide a wide variety of bioactive compounds.
These include anthocyanins, flavonoids, phenolic acids, and other polyphenols.
They are of interest because of their ability to interact with various cellular pathways involved in redox homeostasis, the inflammatory response, and cell communication.
Quercetin and resveratrol, mentioned in the source material, belong to this broad family of molecules.
However, it is important not to automatically apply the results obtained from a single molecule, often studied at pharmacological or experimental doses, to the food that contains it.
The most plausible biological benefit comes from the combination of many substances present in the diet and their regular consumption over time.
Histamine: when an elimination diet may be appropriate
Another component addressed in the original material is histamine. Histamine is a physiological mediator involved in immune and allergic responses and is produced and stored by mast cells and basophils, among other cells.
The problem arises when this physiological fact is turned into the idea that excessive dietary histamine is generally responsible for chronic inflammation.
So-called histamine intolerance remains a complex clinical area in which there is no universally validated diagnostic biomarker. A 2025 review highlights this difficulty and indicates a low-histamine diet as a possible strategy for selected individuals, followed by the gradual reintroduction of foods.
A systematic review found the strongest evidence for low-histamine diets in chronic urticaria, while further studies are needed for many other conditions.
Controlled provocation studies also call for caution: in a placebo-controlled study, most participants did not show true histamine intolerance according to the criteria used.
For this reason, a low-histamine diet should not become a permanent do-it-yourself restriction. When indicated, it should be temporary, structured, and followed by the gradual reintroduction of tolerated foods.
What to actually put on the table
A diet aimed at modulating inflammation can therefore start with a few simple principles:
More plant-based foods. Vegetables, other produce, fruit, and legumes should make up an important part of the daily diet.
More quality fats. Vegetable oils, nuts, and fish are interesting sources of unsaturated fats.
Adequate protein. Fish, eggs, legumes, in appropriate quantities, and other protein sources can help preserve muscle mass.
More fiber. Legumes, vegetables, fruit, and whole grains provide important substrates for intestinal metabolism.
Fewer ultra-processed foods. Reducing the regular consumption of energy-dense, low-nutrient products helps improve the overall quality of the diet.
Fewer excesses of sugar and salt. The problem is not a single food, but its regular and disproportionate consumption within the overall dietary pattern.
The source material also suggests foods such as quinoa, buckwheat, rice, amaranth, sorghum, and teff as alternatives to gluten-containing grains.
It is important to clarify that the absence of gluten does not automatically make a food anti-inflammatory. The exclusion of gluten is necessary in some conditions, such as celiac disease, while for other people, there is no general reason to eliminate it.
Diet and the brain: from neuroinflammation to cognitive function
The relationship between diet, metabolism, and the brain is one of the most interesting areas of preventive nutrition.
The brain is particularly sensitive to oxidative stress, alterations in energy metabolism, and systemic inflammatory processes. A diet rich in plant-based foods, unsaturated fats, and polyphenols can help create a favorable metabolic environment.
However, in this case too, it is necessary to distinguish between biologically plausible mechanisms and clinical evidence of the prevention of neurodegenerative diseases.
Some randomized studies have observed favorable effects of the Mediterranean diet on specific cognitive domains. In a randomized trial of 447 older adults at high cardiovascular risk, the groups assigned to a Mediterranean diet with extra virgin olive oil or nuts showed improvements compared to the control group in several composite cognitive measures.
Another longer-term randomized study found better cognitive scores in participants assigned to a Mediterranean diet enriched with extra virgin olive oil or nuts.
However, the overall evidence is not uniform. A review of randomized studies highlighted predominantly modest and not always significant results, without definitive evidence of dementia prevention.
The correct message is therefore that a good diet can support brain health, not that it can prevent or treat Alzheimer's, Parkinson's, or other neurodegenerative diseases on its own.
Muscle, nervous system, and physical activity
Nutrition must be considered together with movement.
Sedentary behavior promotes loss of muscle mass, worsening insulin sensitivity, and reduction in functional capacity. In contrast, regular physical activity and strength training are essential tools for maintaining muscle and function during aging.
The combination of an adequate diet and exercise appears particularly interesting even in frail older adults.
A randomized trial published in 2026 studied a protein-enriched Mediterranean diet, with or without exercise, in older adults at risk of malnutrition and cognitive decline. After six months, both nutritional interventions significantly improved nutritional status, and improvements in cognitive scores were also observed compared to the control.
Nutrition, therefore, should not be separated from physical function: eating well and keeping muscle active are two components of the same health project.
An anti-inflammatory diet must be personalized
Clinical research does not support the idea of an identical anti-inflammatory diet for everyone.
A person with visceral obesity and insulin resistance has different needs compared to a normoweight subject with sarcopenia. Similarly, someone suffering from inflammatory bowel disease cannot be nutritionally treated like a person with rheumatoid arthritis, food allergy, or simple musculoskeletal pain.
The systematic exclusion of numerous foods can also become counterproductive, especially when it leads to nutritional deficiencies, excessive reduction in dietary variety, or involuntary weight loss.
A meta-analysis dedicated to anti-inflammatory diets in rheumatoid arthritis highlighted a possible reduction in pain, but with very low overall evidence and a high risk of bias.
This finding is particularly important: nutrition can be a valuable support, but it must not be presented as a substitute for pharmacological therapy when the latter is indicated.
The concept of anti-inflammatory nutrition
The goal should not be to build a diet made of prohibitions, but to gradually modify the metabolic and nutritional terrain through sustainable choices.
More plant-based foods, fiber, legumes, extra virgin olive oil, nuts, and minimally processed foods; adequate protein intake; control of excess calories and sugars; regular physical activity; attention to sleep quality and body composition.
It is this combination, rather than a single food or a single molecule, that represents the paradigm most consistent with the available evidence today.
Anti-inflammatory nutrition can therefore be considered not as a universal “food cure,” but as a lifestyle medicine tool, to be built around the person and integrated, when necessary, with diagnosis, medical therapy, physical activity, and clinical monitoring.
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Bibliographic references
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3. Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients. 2022.
4. The effects of the mediterranean diet on inflammation, quality of life, and mortality in autoimmune diseases: A systematic review. 2026.
5. The effects of the mediterranean diet supplemented with olive oils on pro-inflammatory biomarkers and soluble adhesion molecules: a systematic review and meta-analysis of randomized controlled trials. 2025.
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7. Lim S, et al. Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr. 2022;104:104758.
8. Murphy CH, et al. Does supplementation with leucine-enriched protein alone and in combination with fish-oil-derived n-3 PUFA affect muscle mass, strength, physical performance, and muscle protein synthesis in well-nourished older adults? Am J Clin Nutr. 2021;113(6):1411-1427.
9. Valls-Pedret C, et al. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA Intern Med. 2015.
10. Martínez-Lapiscina EH, et al. Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. J Neurol Neurosurg Psychiatry. 2013;84(12):1318-1325.
11. Jackson K, et al. Evidence for Dietary Management of Histamine Intolerance. Int J Mol Sci. 2025;26(18):9198.
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