MSK: Anti-inflammatory Diet Guide

Anti-inflammatory Diet Guide

This guide contains information to help you follow an anti-inflammatory diet.

Pain And Inflammation

People with long-term (chronic) pain are likely to be in a pro-inflammatory state, meaning there is more inflammation in the body. This often means an increase in pain, because inflammation sensitizes pain receptors in the skin and central nervous system. Diet can also contribute to increased inflammation in the body.

Pain And Diet

Pro-inflammatory Diets

The Western diet is pro-inflammatory - it is common in the U.S. and other developed countries. It lacks fruits and vegetables and contains large amounts of red meat, high-fat dairy products, refined grains, high-sugar foods, and highly processed foods. These foods cause an increase in pro-inflammatory substances and a decrease in anti-inflammatory substances.

A pro-inflammatory diet also contributes to excess body weight, which makes it more difficult to manage long-term (chronic) musculoskeletal pain. This type of diet is also linked to other chronic conditions like heart disease, diabetes, and depression.

Anti-inflammatory Diets

Anti-inflammatory diets have a lot of fruits and vegetables (with phytonutrients - healthy plant chemicals); a moderate amount of chicken, fish, eggs, and milk products; and minimal red meat and processed foods. They also include healthy fats (e.g. omega-3 fatty acids), vitamins and minerals (micronutrients), and fiber.

One well-known type of anti-inflammatory diet is the Mediterranean diet, which is based on traditional eating patterns of countries surrounding the Mediterranean sea (like Greece, Spain, and Italy).

The nutrients found in anti-inflammatory diets like the Mediterranean diet can help lessen painful conditions like chronic low back pain. These diets are also linked to healthy body weight and decreased risk of chronic conditions.

Anti-inflammatory Foods


  • Seafood: tuna, salmon, mackerel, trout, sardines, anchovies, shellfish

  • Healthy oil: flax, olive, avocado

  • Grains, breads, and cereals: Whole grain bread, pasta, cereal, bulgar, farro, quinoa, oats, buckwheat, and brown or wild rice

  • Fruit: especially blueberries, strawberries, raspberries, oranges, apples, cherries, bananas, grapes, and kiwi (preferably organic)

  • Vegetables: leafy greens, tomatoes, peppers, cauliflower, broccoli, onions, brussels sprouts, mushrooms, avocados, sweet potatoes (preferably organic)

  • Legumes: beans, chickpeas, lentils, and peas

  • Nuts and seeds: almonds, walnuts, flaxseed, cashews, and pumpkin and sunflower seeds

  • Herbs and spices: ginger, turmeric, garlic, chili pepper, oregano, cinnamon, rosemary, cloves, cumin, paprika

  • Tea: green and herbal

Pro-inflammatory Foods


  • Red meat: beef, pork, lamb

  • Processed meats: bacon, deli meats, sausage, hot dogs, ham, and jerky

  • Unhealthy oils: corn, soy, sunflower, safflower, canola, peanut

  • Simple carbohydrates: sugary breakfast cereals, white bread, rice, flour

  • High-sugar: desserts, sugary drinks, pastry

  • High-fat dairy: milk, butter, margarine, cream, cheese, ice cream, cream soups

  • Fried food: French fries, fried chicken and fish, Fast foods

  • Alcohol

  • Salt

Nightshade Vegetables and Inflammation

Nightshade vegetables include tomatoes, eggplant, bell peppers, potatoes, and the spices paprika and cayenne pepper.

Some people think nightshade vegetables trigger flare-ups of inflammatory conditions. The truth? There isn’t any evidence of a link between these foods and inflammation, however, some people may be sensitive to them.

If you think the nightshades worsen your symptoms, avoid them for two weeks, and see if your symptoms improve.

Anti-inflammatory Meal Ideas & Recipes


  • Eggs

    • 2 hard-boiled eggs* with ½ avocado on 1 slice of whole-grain bread - rye, barley, or Ezekiel bread (sprouted grain bread)

      • *Add 1 teaspoon (5 g) of flaxseed meal or hemp seeds for extra omega-3 fatty acids

    • 2 scrambled eggs with turmeric

    • 2 poached eggs with smoked salmon and avocado

  • Oatmeal** cooked in water or any milk of your choice, with:

    • ½ cup (120 g) of berries and 2 tablespoons (20 g) of sunflower seeds

    • ½ cup (120 g) of unsweetened applesauce, 2 tablespoons (20 g) chopped almonds, and a dash of cinnamon, nutmeg, or pumpkin pie spice for extra flavor

    • ½ teaspoon (2.5 g) unsweetened cocoa powder and 1 teaspoon (5 g) of nut butter

      • **Rolled and steel-cut oats are higher in fiber and less processed than quick oats

  • Cocoa chia pudding with raspberries*: 1 cup (240 mL) Greek yogurt, 2 tablespoons (20 g) of chopped walnuts, ¼ cup (60 g) blueberries

  • Energizing protein smoothie with 1 tablespoon (15 g) unsweetened cocoa powder, ½ cup (120 mL) almond milk, 2 tablespoons (20 g) peanut butter or almond butter, ¼ cup (60 g) oats, 1 to 2 tablespoons (15-20 g) flaxseed, and ½ to 1 cup (120-240 mL) water or almond milk to blend

  • Morning parfait: combine 1 cup (240 mL) Greek yogurt, 1 cup (190 g) berries, 1 Tbsp (15 g) peanut butter, 1 Tbsp (15 g) flax seeds or ground flax seeds (known as flaxseed meal), 1 tsp (5 g) pumpkin seeds

Lunch or Dinner

You can prepare these meals or some of the ingredients ahead of time. You can store it for up to three days in the refrigerator or freeze it for later use.

  • Turkey/Chicken Bean Chili

    • Combine lean ground turkey or chicken, kidney beans, onions, celery, red peppers, garlic, seasonings like chili powder, paprika, cumin, or cayenne, diced or crushed tomatoes, and tomato paste

  • Tuna Wrap:

    • 1 whole grain tortilla, 1 can tuna in olive oil (drained), 1 cup (30 g) spinach, 1/2 cup (115 g) cherry tomatoes, 1/2 avocado

  • Mexican Grain Bowl:

    • 1 cup (160 g) brown rice, 1/2 cup (85 g) black beans, 3 oz (85 g) grilled chicken, 1 cup (160 g) roasted vegetables, 1/2 cup (85 g) pico de gallo

  • Healthy soups

    • Mushroom and barley

    • Pumpkin

    • Lentil soup

  • Healthy protein, vegetable, and starch meal

    • Grilled or sautéed fish or chicken breast with roasted, grilled, sautéed, or stir-fried vegetables

    • Quinoa, sweet potato, or squash

  • Vegetable curry or stew with a side of quinoa

    • Combine cauliflower, mushrooms, sweet potatoes, carrots, bell peppers, celery, onion, garlic, and spices. Serve with 1 cup (160 g) quinoa

  • Vegetable ratatouille with a side of bulgur or barley

  • Build a salad

    • Start with a base: arugula, spinach, and/or kale

    • Pick a protein: tuna, hard-boiled eggs, chickpeas, black beans, edamame, cottage cheese, and/or grated cheese

    • Add some color: sweet potatoes, mixed bell peppers, mushrooms, beets, and/ or celery

    • Add some crunch: chopped walnuts, sliced almonds, and/or roasted chickpeas

    • Top with a dressing or healthy fat: avocado, olives, flaxseed, hemp seed, olive oil with dried herbs, and/or pesto


  • 1 serving of Greek yogurt

  • 1 serving of fruit

  • ¼ cup (60 g) of raw unsalted nuts

  • Carrots with 2 tablespoons (20 g) of hummus or guacamole

  • ½ ounce (14 g) dark chocolate (aim for at least 70% cacao)

  • 1 cup (240 g) cooked edamame

  • ½ cup (120 g) of cottage cheese with 1 serving of fruit

  • 1 baked pear or apple with cinnamon, nutmeg, and walnuts

  • 2 dates with ¼ cup (60 g) of raw unsalted nuts


To add sweetness use small amounts of dark chocolate, honey, maple syrup, or stevia.

Eating Out

Even though restaurant food may be challenging, you can still maintain your anti-inflammatory diet. It is easier when you plan ahead. You can call the restaurant to ask questions or review their menu online.

Here are some ideas to consider, depending on the type of cuisine.


  • Cioppino, a fish or mixed seafood stew combined with fresh tomatoes in a wine sauce. Ask if the base contains heavy cream, if so ask for it without the high-fat dairy product.

  • Baked or grilled chicken or fish with a side of vegetables. Ask for it without butter, cream, or other high-fat, high-sugar sauces.

  • Whole wheat pasta dish. Ask for olive oil or vegetable (marinara) sauce. Ask for additional vegetables.


  • Order sushi with vegetables and salmon or tuna

  • Request brown, instead of white rice

  • Try miso soup or seaweed salad

  • Ask for low-salt soy sauce

  • Avoid tempura and sweet and mayonnaise-based sauces


  • Many spices used in Indian cooking are anti-inflammatory (e.g. clove, cinnamon, ginger, turmeric)

  • Try curry or dal (lentil- or garbanzo-based dish)

  • Avoid dishes with added cream

  • Order chicken or fish tandoori - tandoori is an Indian cooking method using a traditional clay oven

  • A great side dish is palak paneer (Indian cottage cheese cooked with spinach and spices)

Fast Food And Quick-Service

  • Burgers, chicken, and sides

    • Choose grilled instead of fried chicken

    • Skip the cheese, sauce, and bacon

    • Instead of French fries, choose a side salad with low-fat dressing

    • Have the burger without a bun

    • Avoid soda and milkshakes

  • A taco salad with leafy greens, beans, guacamole, salsa, and lean protein

  • Chicken or seafood fajitas are a healthy choice since they have grilled, lean protein and a variety of vegetables

Take-along Snacks

When you’re away from home, take an anti-inflammatory snack with you. Make sure you check the portion size and ingredient list. Some excellent choices are:

  • Dark chocolate bars (2-3 squares of dark chocolate) *More cacao is better - aim for 70%

  • Protein, energy bars (Choose those with only a few ingredients)

  • Snack-size nut butters

  • Snack-size nuts or trail mix

  • Seeds

  • Popcorn (air-popped and without butter)

Think about how you can make your own mixes. You can create combinations of dark chocolate pieces, almonds, sunflower seeds, popcorn, cashews, walnuts, pumpkin seeds, and so on.

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