Following an anti-inflammatory diet can be confusing. Where do I start? What are the most inflammatory foods? How can I personalize such a diet for the food intolerances I have?

Book: The Inflammation Spectrum

Will Cole, DC, a functional medicine expert in Pittsburgh, Pennsylvania, simplifies this topic in his new book, The Inflammation Spectrum (Avery, 2019). Dr. Cole does not consider lab testing for food allergies specific enough to be helpful. Rather, he uses what I use, an elimination diet plan. His spectrum starts with eliminating four food groups that are inflammatory to most people followed by four more that affect some people. Cole takes the reader through a methodical process of eliminating these foods one at a time and later reintroduces them one at a time per week to help people identify food triggers and create a personalized anti-inflammatory nutrition plan.

Cole distinguishes between a food allergy, food intolerance and food sensitivity. A food allergy involves the immune system and usually presents with an immediate reaction such as a rash, itching and/or hives. In extreme cases, there can be anaphylactic shock. A food intolerance is not immune mediated, but rather results in a digestive reaction such as gas, bloating or other irritable bowel symptoms. This usually comes from lack of enzymes to digest certain food. A food sensitivity is immune mediated, but is a delayed reaction and may be related to how much of the food you consumed. 

With the elimination diet plan, the first four foods to eliminate are grains (with or without gluten), dairy products containing lactose and casein, sugar and added sweeteners of all types, and inflammatory oils such as all processed vegetable oils. These are best avoided anyway in a healthy diet and may be all a person needs to do to reduce inflammation.

The second four food groups to test by elimination include: 

Legumes such as lentils, beans of all types and anything made from soy. Like Steven Gundry, MD notes, Cole points to their high lectin content as reason for avoidance. 

Nuts and seeds including almonds, cashews, hazelnuts and walnuts. I’m surprised by this since I recommend nuts and seeds as superfoods, however, I must admit, some people tell me they are allergic to nuts and seeds.

Eggs, both whole eggs and egg whites. He reports that many people react to egg whites. While I’ve not seen this in my practice, I will look for it more carefully.

Nightshades including tomatoes, peppers, eggplant, white potatoes and goji berries. These all contain alkaloids and are inflammatory to some people. Again, a nod to Dr. Gundry.

On a final note, the author does a lot of preaching or talking down to the reader which some well educated in nutrition may find annoying. He also suggests the reader do a series of mantras which I found somewhat silly like the Stuart Smalley Daily Affirmations on “Saturday Night Live.” If you overlook these quirks, you will find this book a simple and useful framework for following an anti-inflammatory diet. For more sophisticated coverage of this topic, I recommend Terry Wahls, MD’s The Wahls Protocol (Avery, new edition 2020).

Dr. Scherger is an Eisenhower Health Primary Care 365 physician, a core faculty member of the Eisenhower Family Medicine Residency Program, and a team physician for Reliance Hospice. He is also an author and his third edition book Lean and Fit: A Doctor’s Journey to Healthy Nutrition and Greater Wellness is available at

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