Inflammation Is Complex — Your Diet Doesn’t Have to Be
What midlife women really need to know about food, inflammation, and feeling better without fear or food rules.
Somewhere along the way, "anti-inflammatory" became a branding tool. Suddenly, everything from smoothies to supplements began being marketed as anti-inflammatory. Dash of turmeric in your latte? Anti-inflammatory. Sugar-free? Anti-inflammatory. But, in true diet and wellness culture style, contradictions weren’t hard to find with both the plant and carnivore camps declaring their diets anti-inflammatory. What they all have in common is the familiar pattern of fear and food rules disguised as wellness, overshadowing any truth to the relationship between food and inflammation. So, let’s call it like it is: most “anti-inflammatory” diet advice is usually just re-branded “clean eating”.
If you're in midlife or menopause, you've probably heard that inflammation is something to be aware of (which is true), but what’s often left out of the conversation is that managing inflammation isn’t as simple as what food is on your plate. Food isn’t the only potential source of inflammation, as stress, lack of sleep, and even trauma have all been linked to inflammation. Let’s not forget the determinants of health either, especially the ones that influence access to health care, clean water and air quality. And of course, there’s the hormone connection.
So, let’s unpack this complicated conversation.
Inflammation and Menopause: What’s Happening?
Up to 70% of women will report joint and muscle pain in perimenopause and menopause. It wouldn’t surprise me if the actual number was higher than that, given how often this topic comes up with friends and patients alike.
It doesn’t come as a big shock either as estrogen has known anti-inflammatory effects. During perimenopause and the menopause transition, estrogen levels drop and inflammatory markers may rise. This may play a role in:
Joint and muscle pain
Mood and brain health
Cardiometabolic shifts (like rising cholesterol or blood sugar)
In postmenopause, the conversation around inflammation continues as the risks to heart health and bone health (and other chronic illnesses) continue. And there is some research on how patterns of eating influence inflammatory markers in post-menopausal women, so it’s not misguided to wonder whether food can support a healthy inflammatory response to support your long-term health. But that doesn’t mean cutting out entire food groups, demonizing birthday cake, or side-eying your morning toast like it’s responsible for all your symptoms.
What is Inflammation and Where Did the “Anti-Inflammatory Diet” Come From?
Inflammation isn’t always a bad thing. Acute inflammation is your body’s natural immune response to injury or threat, and without it you wouldn’t heal when you cut yourself, for example. Chronic inflammation occurs when this immune response lingers longer than necessary, often without an obvious cause, and has been associated with conditions like cardiovascular disease, diabetes, arthritis, and even depression. All of these are going concerns for anyone over the age of forty, regardless of their menstrual status.
In the 1990s researchers took a closer look at how certain dietary patterns might influence inflammation as a driver of chronic disease, and in 2010, the Dietary Inflammatory Index (DII), a system for scoring foods according to their effect on inflammation and stress in the body, was published. A bit unsurprisingly, they found that certain patterns of eating, especially those high in fiber, antioxidants, and omega-3s tended to have lower inflammatory markers.
But then came the wellness industry and did what it does best. It took nuanced science and turned it into a marketing opportunity. Instead of focusing on patterns of eating and broader lifestyle support, a more marketable idea took hold: eliminate “inflammatory” foods to achieve better health. Cue the endless stream of “anti-inflammatory” books, plans and shopping lists demonizing gluten, sugar, dairy, nightshades, and even fruit.
While I find the DII interesting, I don’t find it a very helpful clinical tool. It’s overly reductionistic, very all-or-nothing, privileged, and overcomplicates the obvious in my opinion.
What Is Anti-Inflammatory Eating? (And What Isn’t)
When it comes to addressing inflammation through diet, several studies have found that patterns of eating that include more fish, vegetables, fruits, whole grains, nuts, and unsaturated fats such as olive oil, can help lower markers of inflammation. A lot of trendy “anti-inflammatory” diets focus on specific foods or supplements, but the science shows it’s the overall eating pattern that matters most, especially ones rich in plants and fiber.
So, while the idea of a magic anti-inflammatory diet is tempting, you’re better off remembering that the patterns of eating matter more than individual foods.
This is where gentle nutrition and nutrition by addition come in.
You don’t need a set of rules, or lists of ‘eat this, not that’. You need habits that fit your life, and ones that support your health without setting off your inner food police.
So What Does an Anti-Inflammatory-ish Pattern Look Like?
There’s no one way to eat “right” for inflammation, but there are some patterns that keep showing up in the research that may be worth exploring.
Remember, it’s not about having salmon every night or becoming someone who loves kale chips (you’re allowed to hate them). It’s about the overall vibe of your plate more often than not.
That might look like:
A cozy soup with beans or lentils and whatever greens you have kicking around in the fridge.
Toast with olive oil and tomatoes, or with peanut butter and berries, depending on the mood.
A weeknight meal where roasted veggies meet up with a handful of seeds or a drizzle of tahini.
A snack that includes something satisfying and something colorful (think crackers and hummus with berries on the side).
Taking a tuna sandwich for lunch more often, but no pressure if you’d rather sprinkle flax or hemp on your oatmeal instead.
The magic isn’t in the single ingredient; it’s in the rhythm of your meals. A little more fiber, a few more plants, a little more variety, and a little more enjoyment can all support your health without inviting “shoulds” to the table.
In other words, supporting inflammation in midlife isn’t about micromanaging every bite. It’s about choosing foods that feel good to you and for you, building satisfying meals, and letting go of the idea that there’s one perfect way to eat.
What About Dairy, Gluten, and Sugar?
Good news, cheese lover! Several studies, like this one, have not found a link between dairy foods and markers of inflammation. In some cases, those who consumed more dairy foods had less measurable inflammation than those who ate less. The same has generally been found with gluten, so long as there’s no celiac disease. Let’s not forget that many gluten-containing whole grains, such as whole wheat, are excellent sources of fiber and consistently associated with less inflammation.
This sugar myth might be the most persistent myth of all: “Sugar is toxic and causes inflammation.”
No one is saying that eating a lot of sugar is good for you, or that we shouldn’t care about it. But it’s the patterns of eating that include a lot of foods high in sugar that are associated with inflammation, not the sugar itself. And that’s very different from saying sugar causes inflammation on its own.
A study of healthy postmenopausal women found that increasing dietary sugar (measured as glycemic load) did not raise markers of inflammation or insulin resistance over 18 months. This suggests sugar alone isn’t directly inflammatory; rather, it’s the overall diet and lifestyle context that matters most.
So no, that piece of cake isn’t going to ruin your health. And the stress from panicking about cake? That might be more inflammatory.
Instead of narrowing in on black-and-white rules such as “no sugar”, try asking: What foods do I genuinely enjoy that also add color, fiber, or healthy fats? When we shift from fear to curiosity, we build habits that support our health and nourish our relationship with food.
I’ll stop there for today, but I’m open to a part two, so let me know if you have any other questions about inflammation, diet, and menopause nutrition.