The Anti-Inflammatory Mediterranean (AIM) diet is an eating pattern that combines healthy components of traditional Mediterranean and Asian dietary patterns to maximize the healing potential of the foods included. Both cultures traditionally offer foods associated with good health and longevity. The basis for the anti-inflammatory diet is the increase of beneficial anti-inflammatory foods and reduction of pro-inflammatory foods. This leverages the growing evidence base that some of the dietary components found in foods, such as fruits, berries, vegetables, nuts, whole grain, and foods of marine origin – among others, has been associated with improvements in quality of life and longevity, as well as a reduced risk of several chronic diseases, including:
• Cardiovascular disease
•Type 2 diabetes
• Metabolic syndrome
• Neurodegenerative diseases (e.g., Alzheimer’s, Parkinson’s, dementia)
• Inflammatory bowel disease
• Certain cancers (breast, prostate, bowel, lung and others)
• Chronic fatigue syndrome and fibromyalgia
• Arthritis
INFLAMMATION
Understanding the role of inflammation in health emphasizes the power of nutrition to modulate the inflammatory pathways. Acute inflammation is an immunologically mediated process, necessary for the body to repair and heal itself. However, a chronic state of inflammation can lead to tissue damage, increased morbidity and increased mortality. There is compelling research that has demonstrated that a healthy anti-inflammatory diet is protective against pro-inflammatory illnesses such as cancer, heart disease, arthritis, obesity, and dementia.
“Eat food, not too much, mostly plants”
— MICHAEL POLLAN
The Anti-Inflammatory Mediterranean (AIM) Diet Pyramid
From the bottom of the AIM pyramid up...
WATER
How much: Throughout the day - 50 to 68 fl. oz. (1.5 to 2 liters)
Healthy choices: Drink pure water, or drinks that are mostly water (tea, very diluted fruit juice, sparkling water with lemon) throughout the day. Alkaline water is currently just a fad and offers no real benefit, so no need to waste your money on it
Why: Water is essential for maintaining hydration, as well as supporting digestion and regular elimination
VEGETABLES
How much: 6 servings per day minimum (one serving is equal to 2 cups salad greens or ½ cup vegetables cooked, raw, or juiced)
Healthy choices: Lightly cooked dark leafy greens (spinach, collard greens, kale, Swiss chard), cruciferous vegetables (broccoli, cabbage, Brussels sprouts, kale, bok choy and cauliflower), carrots, beets, onions, peas, squashes, sea vegetables and washed raw salad greens
Why: Vegetables are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity. Go for a wide range of colors, eat them both raw and cooked, and choose organic when possible.
FRUITS
How much: 3 to 6 servings per day (one serving is equal to 1 medium-size piece of fruit, ½ cup berries or chopped fruit, ½ cup of dried fruit)
Healthy choices: Raspberries, blueberries, strawberries, peaches, nectarines, oranges, pink grapefruit, red grapes, plums, pomegranates, blackberries, cherries, apples, and pears – all lower in glycemic load than most tropical fruits
Why: Fruits are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity. Go for a wide range of colors, choose fruit that is fresh in season or frozen, and buy organic when possible.
WHOLE AND CRACKED GRAINS
How much: 3 to 6 servings a day (one serving is equal to about ½ cup of cooked grains)
Healthy choices: Brown rice, basmati rice, wild rice, buckwheat groats, barley, quinoa, steel-cut oats
Why: Whole grains digest slowly, reducing frequency of spikes in blood sugar that promote inflammation. Whole grains means grains that are intact or in a few large pieces, not whole-wheat bread or other products made from flour.
PASTA (AL DENTE)
How much: 2 to 3 servings per week (one serving is equal to about ½ cup cooked pasta)
Healthy choices: Organic pasta, rice noodles, bean-thread noodles, and part whole-wheat and buckwheat noodles like Japanese udon and soba
Why: Pasta cooked al dente (when it has “tooth” to it) has a lower glycemic index than fully cooked pasta. Low-glycemic-load carbohydrates should be the bulk of your carbohydrate intake to help minimize spikes in blood glucose levels.
HEALTHY FATS - Olives, Nuts, Seeds and Olive Oil
How much: 3-6 servings per day of oil (one serving is equal to 1 teaspoon of oil), 1-2 servings of olives or nuts (one serving is 1/8 cup of nuts - amount that fits in the palm of your hand, 5-10 olives, 1 tablespoon of flaxseed, 1/2 of an avocado)
Healthy choices: For cooking, use extra-virgin olive oil and expeller-pressed grapeseed oil. Other sources of healthy fats include nuts (especially walnuts), avocados, and seeds, including hemp seeds and freshly ground flaxseed. Omega-3 fats are also found in cold-water fish, omega-3 enriched eggs, and whole-soy foods. Organic, expeller-pressed, high-oleic sunflower or safflower oils may also be used, as well as walnut and hazelnut oils in salads and dark roasted sesame oil as a flavoring for soups and stir-fries.
Why: Healthy fats are those rich in either monounsaturated or omega-3 fats. Extra-virgin olive oil is rich in polyphenols with antioxidant activity.
HEALTHY HERBS AND SPICES
How much: Unlimited amounts
Healthy choices: Turmeric, curry powder (which contains turmeric), ginger and garlic (dried and fresh), chili peppers, basil, cinnamon, rosemary, thyme
Why: Use these herbs and spices generously to season foods. Turmeric and ginger are powerful natural anti-inflammatory agents.
BEANS AND LEGUMES
How much: At least 2 servings per week (one serving is equal to ½ cup of cooked beans or legumes)
Healthy choices: Beans like Anasazi, adzuki and black, as well as chickpeas, black-eyed peas, and lentils
Why: Beans are rich in folic acid, magnesium, potassium and soluble fiber. They are a low-glycemic-load food. Eat them well cooked either whole or pureed into spreads like hummus.
FISH AND SHELLFISH
How much: At least 2 servings per week (one serving is equal to 4 ounces of fish or seafood)
Healthy choices: Wild Alaskan salmon (especially sockeye), herring, sardines, markerel, and black cod (sablefish)
Why: These fish are rich in omega-3 fats, which are strongly anti-inflammatory. If you choose not to eat fish, take a molecularly distilled fish-oil supplement that provides both EPA and DHA in a dose of 2 to 3 grams per day.
WHOLE-SOY FOODS
How much: 1 to 2 servings per day (one serving is equal to ½ cup tofu or tempeh, 1 cup soy milk, ½ cup cooked edamame, or 1 ounce of soynuts)
Healthy choices: Tofu, tempeh, edamame, soynuts, soymilk
Why: Soy foods contain isoflavones that have antioxidant activity and are protective against cancer. Choose whole-soy foods over fractionated foods like isolated soy-protein powders and imitation meats made with soy isolate.
COOKED ASIAN MUSHROOMS
How much: Unlimited amounts
Healthy choices: Shiitake, enokitake, maitake, oyster mushrooms (and wild mushrooms if available)
Why: These mushrooms contain compounds that enhance immune function. Avoid eating mushrooms raw.
White Meat, Eggs, Red Meat
How much: No more than 2-3 servings a week (one portion is equal to 1 ounce of cheese, one 8-ounce serving of dairy, 1 egg, or 3-4 ounces cooked poultry or skinless meat - about the size of a deck of playing card)
Healthy choices: High-quality low fat natural cheese and yogurt (especially Greek), organic, omega-3 enriched eggs, skinless poultry, grass-finished lean meats
Why: In general, try to reduce consumption of animal foods. If you eat chicken, choose organic, cage-free chicken and remove the skin and associated fat. Use organic dairy products moderately, primarily yogurt and natural cheeses such as Emmental (Swiss), Jarlsberg, and true Parmesan. If you eat eggs, choose omega-3-enriched eggs (from hens that are fed a flax-meal-enriched diet) or organic eggs from free-range chickens. If you eat beef, limit this is 1 serving a week and choose organic grass fed beef.
Potatoes
How much: No more than 3 servings a week
Healthy choices: Sweet potatoes, yams, purple or other colored flesh potatoes
Why: There's no reason to shun potatoes because they look like a "bad" starch. Select sweet potatoes or deeply colored potatoes instead of white potatoes as they are a more complex carbohydrate and have a lower glycemic index. Read more about the good versus the bad carbs. As long as they're not deep fried, potatoes can be good for your heart and in fact are a staple in the diet of the longest lived peoples around the world. They're rich in potassium, which can help lower blood pressure. And they're high in fiber, which can lower the risk for heart disease.
TEA
How much: 2 to 4 cups per day
Healthy choices: White, green, oolong teas
Why: Tea is rich in catechins, antioxidant compounds that reduce inflammation. Purchase high-quality tea and learn how to brew it correctly for maximum taste and health benefits.
SUPPLEMENTS
How much: Daily
Healthy choices: High quality multivitamin/multimineral that includes key antioxidants (vitamin C, vitamin E, mixed carotenoids, and selenium); coenzyme Q10; 2 to 3 grams of a molecularly distilled fish oil; 2,000 IU of vitamin D3
Why: Supplements help fill gaps in your diet when you are unable to get your daily requirement of micronutrients. Learn more about supplements
RED WINE
How much: Optional, no more than 1 to 2 glasses per day
Healthy choices: Red wine
Why: While water should be the primary beverage consumed on the AIM diet, red wine can be enjoyed in moderation as it is a traditional component of the diet and provides some health benefits. Red wine is a source of resveratrol, a type of polyphenol that may extend longevity as a result of its anticarcinogenic, anti-inflammatory, and antioxidant properties. Limit intake to no more than 1 to 2 servings per day. If you do not drink alcohol, best not to start.
HEALTHY SWEETS
How much: Sparingly
Healthy choices: Unsweetened dried fruit, dark chocolate, fruit sorbet
Why: Dark chocolate provides polyphenols with antioxidant activity. Choose dark chocolate with at least 70 percent pure cacao and have an ounce a few times a week. Fruit sorbet is a better option than other frozen desserts.