Inflammation is a symptom that your patients may have questions about. You’re likely to start by explaining how inflammation could be the result of infection or an injury. Chronic inflammation, however, can lead to more serious health conditions, such as cancer, cardiovascular conditions, and autoimmune illnesses. During conversations with your patients, it could be beneficial to share how diet plays a role. Here are a few ways to get those discussions started.

Explaining Inflammation

Inflammation can be classified in two types: acute (short-term) and chronic (long-term). Here are some ways to explain the differences to your patients.

• Acute inflammation: When describing short-term or acute inflammation, creating a reference can help. Suggest your patients think back to when they scraped a knee and that site became red and swollen, said Ashli Greenwald, MS, advanced practice dietitian at Johns Hopkins Bayview Medical Center in Baltimore. Tell them: “That’s your immune system rushing to heal the damage, resolving in days,” she said.
• Chronic inflammation: A longer-term response is chronic inflammation, which could warrant a bit more medical explanation. Advise your patients that chronic inflammation can last from days to even weeks or months, Greenwald said. This long-term and slow condition could have originated from genetic predispositions, stress, and even a patient’s diet.

Common Inflammatory Symptoms

Chronic inflammation can show itself in a variety of ways, including persistent fatigue, muscle or joint aches, low-grade fevers, gastrointestinal disturbances (such as bloating or altered bowel habits), brain fog, and even mood changes, said Kiran Mullur, MD, assistant professor in the Department of Family and Community Medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

“While these symptoms are important to recognize, they are highly nonspecific and can overlap with numerous other conditions — from autoimmune diseases and chronic infections to metabolic disorders, malignancy, and even prolonged psychological stress,” Mullur said. 

As such, the presence of these symptoms alone should not lead to the assumption that inflammation itself is the diagnosis; rather, they should prompt a thorough evaluation to identify the underlying etiology driving the inflammatory process, he said. 

How the Body Reacts to Inflammation

Inflammation is the body’s complex biological response to harmful stimuli, including pathogens, damaged cells, or irritants. While it can be acute or chronic, the latter has been implicated in numerous conditions, including atherosclerosis, type 2 diabetes, obesity, depression, and neurodegenerative disease, Mullur said.

When treating patients in your primary care practice, understand that inflammation itself is not a diagnosis but a physiologic response to a stimulus, such as infection, trauma, toxins, allergens, or chronic metabolic stress, he said.

“While inflammation plays a critical role in healing and immune defense, persistent, low-grade inflammation can become pathologic, contributing to chronic disease,” Mullur said. From a diagnostic standpoint, labeling “inflammation” as the problem is insufficient unless a practitioner identifies its underlying cause, he said.

Mullur offered these guidelines to delve deeper as you treat your patients. 

• Joint pain plus elevated CRP? He suggests considering autoimmune disease.
• Elevated CRP in an obese patient? He recommends investigating metabolic syndrome, visceral adiposity, or early cardiovascular risk.

Fatigue plus GI complaints? Explore gut dysbiosis, food sensitivities, or IBD — not just a vague inflammatory state, he said.

Exploring Treatment Plans

Your front-line position offers unique opportunities to treat patients. “As PCPs, we can acknowledge the concept of inflammation to build rapport with patients, particularly those influenced by wellness messaging, but should focus redirecting the conversation toward identifying root causes and actionable interventions,” Mullur said.

1. Explain How Dietary Factors Affect Inflammation

Diets high in saturated and trans fats, refined carbohydrates, added sugars, and ultra-processed foods promote pro-inflammatory pathways, leading to higher circulating levels of biomarkers such as C-reactive protein (CRP), interleukin-6 (IL-6), and TNF-alpha, Mullur said. 

Common sources include commercially baked goods, fried fast food, white bread and pasta, sweetened beverages, candy, flavored yogurts, packaged snack foods, instant noodles, frozen pizzas, and processed meats, like hot dogs or chicken nuggets, he outlined. “Regular consumption of these foods can keep the body in a low-grade inflammatory state,” Mullur said. “In contrast, dietary patterns rich in whole grains, fruits, vegetables, nuts, legumes, and omega-3-rich fish are associated with lower levels of these biomarkers and a reduced inflammatory burden.” 

2. Encourage Patients to Make Food Swaps in Their Diet

A “Western diet” high in excess calories, processed foods, sugar, meat, and fat — and low in diverse plant foods — can lead to a potentially unfavorable balance of microbes in the gut and cause inflammation, said Greenwald. To reduce the risk for inflammation, there are modifications you can suggest to patients.

“Swap these unhealthy foods for anti-inflammatory foods, such as fruits, vegetables, whole grains, and lean proteins,” said Greenwood. Also, there are some positive lifestyle changes to adopt to decrease inflammation: Avoid or quit smoking, limit alcohol intake, exercise regularly, get quality sleep, manage stress, and maintain a healthy weight, she said. 

Encourage your patients to eat a colorful, well-balanced diet packed with vegetables and fruit. “Basically, every fruit and vegetable brings its own antioxidants and polyphenols, so aim for at least two servings of fruit and three servings of vegetables each day,” Greenwood said.

3. Suggest an Evidence-Based Meal Plan

The Mediterranean diet is one of the most studied anti-inflammatory plans, according to Greenwood. “It’s all about loading up on vegetables, fruits, whole grains, nuts, legumes, herbs, spices, and using olive oil,” she said. The diet also includes fish, as well red meat and dairy in moderation.