Dr. Will Cole
Reviewed by: Joseph E. Scherger, MD, MPH
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?
Dr. Will Cole, a functional medicine doctor in Pittsburgh, simplifies this topic in his new book, The Inflammation Spectrum (Avery, 2019). Dr. Cole points out that lab testing for food allergies and intolerances is usually not specific enough to be helpful. Rather he uses what I use, an elimination diet plan. Most useful is how his “spectrum” starts with the four food groups that are inflammatory to all or most people. He follows this with four more food groups that show inflammation in some people only. For the second group, these foods may be healthy in some and not tolerated by others. You end up with a personalized anti-inflammatory nutrition plan.
Dr. Cole distinguishes between a food allergy, intolerance and sensitivity.
A food allergy involves the immune system and there is usually an immediate reaction such as a rash, itching, and hives. In an extreme case there can be anaphylactic shock.
A food intolerance is not immune mediated but rather your digestive system has a reaction reflecting poor digestion, such as gas, bloating or other irritable bowel symptoms. This usually comes from lacking the enzymes to digest the food.
A food sensitivity is immune mediated but is a delayed reaction and may be related to how much of the food you consumed. The symptoms are also part of the irritable bowel syndrome.
The first four foods to eliminate are:
1. Grains (with or without gluten),
2. Dairy products containing lactose and casein,
3. Sugar and added sweeteners of all types, and
4. Inflammatory oils such as all the processed vegetable oils.
On a healthy diet these are best to be eliminated or avoided. That may be all a person has to do to be on an anti-inflammatory diet.
The second four food groups that are inflammatory to some people are:
5. Legumes such as lentils, beans of all types, and anything made from soy. Like Dr. Stephen Gundry, he points to their high lectin content.
6. Nuts and Seeds, including almonds, cashews, hazelnuts, and walnuts. I’m surprised by this since I list nuts and seeds as “Superfoods” on my website: www.leanandfitlife.com. I must admit that some people tell me they are “allergic” to nuts and seeds.
7. Eggs, both whole eggs and egg whites. He comments that many people react to egg whites. I’ve not seen this since egg whites are mostly the protein albumin and I will start looking for this.
8. Nightshades, including tomatoes, peppers, eggplant, white potatoes and goji berries. These contain alkaloids and are inflammatory to some people. Again a nod to Dr. Gundry.
Dr. Cole takes the reader through a methodical process of eliminating the foods one at a time by the week and then later reintroducing them one at a time, also by a slow process of a week for each change. This way a person should be secure in the knowledge of what to eat for their most t anti-inflammatory diet.
Dr Cole does a lot of preaching or talking down to the reader and someone well educated in nutrition may find this annoying. He also suggests the reader do a series of “mantras” I find somewhat silly like the Stuart Smalley Daily Affirmations on Saturday Night Live. If you overlook these quirks of the book, this is a simple and useful framework for following an anti-inflammatory diet. For a more sophisticated coverage of this topic, see Dr. Terry Wahls, The Wahls Protocol. (Avery, new edition 2020).