Everything About Inflammation — Part 4

We previously discussed how DAMPs or damaged associated and PAMPs or pathogen associated molecular patterns can chronically activate inflammation.  The damage associated referring to tissue components released from degenerative tissue such as joints.  The pathogen associated referring to chronic infections such as in the gut.

In this 3rd blog on what triggers chronic inflammation we deal with diet related inflammatory activation.  Literally, what we eat either drives or prevents inflammation and subsequently the most common diseases associated with aging.  The link between diet and inflammation relates to several factors including:

  • Intake of inflammatory foods
  • Intake of anti-inflammatory foods
  • The level of insulin signaling

Research into the inflammatory versus anti-inflammatory components in food compares the levels of serum inflammatory markers such as C-reactive protein in chronic dietary exposure to these different components. (1) Comparing the effect of different chronic diets led to the development of the dietary inflammatory index (DII).  Negative score for a food component reflects an anti-inflammatory effect, while a positive score indicates pro-inflammatory. For example, saturated fat has a score of +0.429 or inflammatory. In contrast omega-3 fatty acids have a score of -0.436 and tea, which contains healthy phenols, has a score of -0.536.

While it is challenging to look at all of these scores for an individual’s diet and decide anti-inflammatory of pro-inflammatory, looking at different dietary patterns is helpful.  The standard American diet, which is high in processed foods and fast food, has a score of +4.07, or pro-inflammatory.  In contrast the Mediterranean diet, which is high in whole grains, vegetables, fish, nuts and olive oil, has a score of -3.96 which is anti-inflammatory.

The highly processed food diet and its takeout twin, fast food is highly pro-inflammatory.  It is this trait that connects it with the substantially higher rates of chronic diseases in those who habitually consume it.

A new study looking at the association between the DII score and chronic disease investigated the relationship between DII score and osteosarcopenia risk. (2) Osteosarcopenia is the combined loss of bone density and of muscle mass.  Osteosarcopenia is driven by inflammation.  The study divided DII score in 1418 men and women >50 years of age into three levels.  Compared to the third with the lowest DII scores, the risk of osteosarcopenia was 123% higher in the middle third and 147% higher in the highest DII score group.

One additional factor is insulin signaling.  Immune cells involved in triggering inflammation have insulin receptors which coordinate their energy production when they need to respond to something such as an infection.  High insulin signaling creates excessive immune cell inflammatory activation.  The high sugar and carbohydrate content of the standard American diet causes insulin resistance where cells begin to not respond well to insulin. To try to “force” an insulin response the body will produce high levels of insulin and thus inflammation.

Clearly, diet can either cause or prevent inflammation, and inflammation is highly linked to triggering a broad group of chronic diseases.  Inflammation is the major diet/disease link.  We can eat to live, or we can live to eat which comes down to healthy or unhealthy.

Marx et al.  THE DIETARY INFLAMMATORY INDEX AND HUMAN HEALTH: AN UMBRELLA REVIEW OF META-ANALYSES OF OBSERVATIONAL STUDIES. Adv Nutr, 2021;12(5):1681–1690.

Ostovar et al.  THE ASSOCIATION OF DIETARY INFLAMMATORY INDEX AND OSTEOSARCOPENIA IN IRANIAN ADULTS: RESULTS OF Iranian multicenter osteoporosis study.J Diab & Metabol Disord, 2025;24:53.