Are anti-inflammatory diets woo?

[bolo]

My podiatrist has suggested an anti-inflammatory diet as a way to help alleviate tendonitis in my feet. Is this woo?

There are clearly some wootastic promoters of such diets out there. On the other hand, the general thrust seems to be pretty sensible, e.g. more fruit and veg, less fried stuff and refined carbs.

[Tessa K]

There's this on anti-inflammatory diets for other conditions although they don't link to any of the research they mention. The sites that have diets for tendonitis are mainly 'alternative' healthcare ones. They may be right but my instinct is to discount them espcially as they talk about alkaline diets and inevitably have supplements to sell.

This one looks a bit less woo.

Basically, if you want to tell crap from Christmas, talk to a clinical dietitian.

[shpalman]

There's this on anti-inflammatory diets for other conditions although they don't link to any of the research they mention. The sites that have diets for tendonitis are mainly 'alternative' healthcare ones. They may be right but my instinct is to discount them espcially as they talk about alkaline diets and inevitably have supplements to sell.

Chronic inflammation seems to have become a thing; I don't really understand it.

This one looks a bit less woo...

That one says to (1) eat enough food

Consuming inadequate calories, vitamins, minerals and the right balance of macronutrients – especially protein – will impair wound healing and exacerbate the loss of tendon, as well as muscle, mass and function.

and (2) here's how to increase inflammation

Increasing the amount of dietary nitrates in your diet (beetroot, spinach, rocket and celery are all good sources) can positively influence the amount of nitric oxide in your blood, which is shown to help increase blood flow through the capillaries, by relaxing and widening the capillaries.

which is what you actually need in the case that the tendon is injured and needs to heal.

So I suppose it depends on why the tendon is inflamed. And if you follow a diet of

more fruit and veg, less fried stuff and refined carbs

then you may lose weight, which means less stress on your feet.

[GeenDienst]

It is beyond question that obesity is an inflammatory state. The visceral fat (we talked about briefly earlier) that comes with it secretes all sorts of pro-inflammatory substances that then f.ck over your pancreas. Inflammation is an important facet of the mechanisms behind atherosclerosis,that givez u teh heart attackz. I could dig out a review or two subject to either side can BA.

But - here's the thing - antioxidants have been well trialled in states of high cardiovascular risk. The HOPE trial (CV disease and/or diabetes, >9000 patients randomised to vit E or placebo) showed precisely f.ck all effects of vit E supplementation on adverse cardiovascular outcomes, including in those with diabetes (higher CV risk) and there was a suggestion of harm after long term follow up (heart failure).

Patients in the vitamin E group had a higher risk of heart failure (RR, 1.13; 95% CI, 1.01-1.26; P = .03) and hospitalization for heart failure (RR, 1.21; 95% CI, 1.00-1.47; P = .045).

The ORIGIN Study (12,000 or with new diabetes or prediabetes so randomised to omega-3 supplement or placebo for 5 years) also showed the square root of f.ck all effect on CV risk.

The good news is that the nasty, livery fat tends to go first when people lose weight. So, the best anti-inflammatory diet is any diet that works. Loss of 5-10% of original weight makes a real difference to metabolic status.

[dyqik]

My podiatrist has suggested an anti-inflammatory diet as a way to help alleviate tendonitis in my feet. Is this woo?

Off the main topic:

Having had plantar fasciitis and tendonitis in my achilles for the past three years, which is now mostly under control: the ways to alleviate that, and which are almost certainly applicable to other tendonitis in the general area are a) better shoes, with selected orthotics, and never going bare foot and b) physio. And c) ultrasonic ablation of scar tissue on the relevant tendons if that doesn't work. And time.

d) losing weight to lower the load on the feet is something that is applicable to me as well.

The simplest anti-inflammatory diet is to add three Sodium Naproxen tablets a day to your diet.

[murmur]

We are in the "not a great deal of evidence" area really, although some of the dietary suggestions in the OP are fairly standard "healthy" diet things. So, not out and out woo (unless you look in very woo-y places, in which case every sodding thing is woo-ridden).

And what dyqik said about fascist plantars: that's what worked for The Bread Goddess.

[shpalman]

It is beyond question that obesity is an inflammatory state. The visceral fat (we talked about briefly earlier) that comes with it secretes all sorts of pro-inflammatory substances that then f.ck over your pancreas. Inflammation is an important facet of the mechanisms behind atherosclerosis,that givez u teh heart attackz. I could dig out a review or two subject to either side can BA.

But - here's the thing - antioxidants have been well trialled in states of high cardiovascular risk. The HOPE trial (CV disease and/or diabetes, >9000 patients randomised to vit E or placebo) showed precisely f.ck all effects of vit E supplementation on adverse cardiovascular outcomes, including in those with diabetes (higher CV risk) and there was a suggestion of harm after long term follow up (heart failure).

Patients in the vitamin E group had a higher risk of heart failure (RR, 1.13; 95% CI, 1.01-1.26; P = .03) and hospitalization for heart failure (RR, 1.21; 95% CI, 1.00-1.47; P = .045).

The ORIGIN Study (12,000 or with new diabetes or prediabetes so randomised to omega-3 supplement or placebo for 5 years) also showed the square root of f.ck all effect on CV risk.

The good news is that the nasty, livery fat tends to go first when people lose weight. So, the best anti-inflammatory diet is any diet that works. Loss of 5-10% of original weight makes a real difference to metabolic status.

Thanks for this!

(This generally points out that you need vitamins and that but it only counts if you get them from food and not supplements.)

[GeenDienst]

I should add, briefly that HOPE was a very positive trial. It was a 2x2 factorial design that evaluated an ACE inhibitor (ramipril) at the same time as vit E. Randomisation to ramipril was associated with substantial and significant relative risk reductions (by 22%) in nasty CV outcomes, more than expected from the modest drop in blood pressure.

So, it wasn't that these people were refractory to treatment or anything - the positive outcome of the ACEI arm shows that improvement of outcomes was possible in this high-risk population, and I would argue that this adds weight to the neutral outcome of the vit E arm.

[calmooney]

As shpalman said supplements and diet are not the same thing. Diets such as Mediterranean and Paleo have been shown to reduce inflammatory markers (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877627/). Also, despite their vasodilatory effect, dietary nitrates have been shown to reduce inflammation not promote it (e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707742/).

More specfically, this paper "Obesity, Metabolic Syndrome, and Musculoskeletal Disease: Common Inflammatory Pathways Suggest a Central Role for Loss of Muscle Integrity" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829464/) suggests a possible link between systemic inflammation and muscle/tendon issues e.g. "many common inflammatory pathways have been implicated in the pathogenesis of the interrelated tissues of the musculoskeletal system (e.g., tendinopathy, osteoporosis, and osteoarthritis)."

Losing weight helped my chronic achilles tendonosis FWIW.