Talk:Anti-inflammatory

Section Dietary patterns was deleted last year with comment "no WP:MEDRS sources". I am curious how following sources are not relevant?

Philip C. Calder (2014), "Nutrition and Inflammatory Processes", in Catharine Ross; Benjamin Caballero; Robert J. Cousins; Katherine L. Tucker; Thomas R. Ziegler (eds.), Modern Nutrition in Health and Disease (11 ed.), Lippincott Williams & Wilkins

Aleksandrova, Krasimira; Koelman, Liselot; Rodrigues, Caue Egea (2021-06-01). "Dietary patterns and biomarkers of oxidative stress and inflammation: A systematic review of observational and intervention studies". Redox Biology. 42: 101869. doi:10.1016/j.redox.2021.101869. ISSN 2213-2317. PMC 8113044. PMID 33541846. Zemleroika11 (talk) 02:00, 2 February 2025 (UTC)

The Calder source is out of date by more than 5 years, WP:MEDDATE. The Redox Biology review stated that interventional studies included were only low-to-moderate quality with several limitations, whereas observational studies are not of sufficient evidence quality for claiming a causality relationship; see WP:MEDASSESS (left pyramid).

The uncertain association of various inflammation biomarkers with dietary components produces doubt that a diet-inflammation relationship can be stated for the article. Zefr (talk) 18:34, 2 February 2025 (UTC)

"The Calder source is out of date"

It can be replaced with use of this

Yu X, Pu H, Voss M. Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. British Journal of Nutrition. 2024;132(7):898-918. doi:10.1017/S0007114524001405

https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/overview-of-antiinflammatory-diets-and-their-promising-effects-on-noncommunicable-diseases/AA3166846841DCC1B219C063F52E2A7F

"The uncertain association of various inflammation biomarkers with dietary components produces doubt that a diet-inflammation relationship can be stated for the article."

Anti-inflammatory diet wording is widely used in reliable sources therefore deserves to be reflected in wikipedia. We cannot test or discuss it scientifically within the framework of the article's discussion

"The Redox Biology review stated that interventional studies included were only low-to-moderate quality with several limitations, whereas observational studies are not of sufficient evidence quality"

The Redox Biology review is Systematic Review itself in reliable source, so it is on top of left pyramid. Zemleroika11 (talk) 16:41, 5 February 2025 (UTC)

The evidence on this specific topic of anti-inflammation and dietary patterns is mostly limited to cross-sectional cohort studies. If there was a consistent effect it would be worth citing, however, most of the reviews have noted that the cross-sectional analyses have only reported a limited association between a dietary patterns and lower inflammatory markers. For example this review found that only 22 of 145 cross-sectional analyses found an association, "Evidence of an association between dietary patterns and inflammatory markers longitudinally is limited, with the majority reporting no association". There is only limited evidence on this topic. It would be worth waiting until we have more conclusive evidence. As far as I know there is no large-scale intervention trial data on this topic. I say leave mention of diet from the article until we have better references showing a consistent effect. Veg Historian (talk) 17:15, 5 February 2025 (UTC)

This review did not focus on anti-inflammatory diets, but on dietary patterns in general. Zemleroika11 (talk) 19:07, 5 February 2025 (UTC)

What is your definition of an anti-inflammatory diet? There is no agreed definition but most studies looking at this topic use the Dietary inflammatory index. The review you cited yourself was citing data on the DASH and Mediterranean diet and was strongly supportive of the dietary inflammatory index. The systematic review I cited also looked at Mediterranean dietary patterns but also used the dietary inflammatory index and several others. Veg Historian (talk) 19:57, 5 February 2025 (UTC)

"most studies looking at this topic use the Dietary inflammatory index."

Yes, but study you link to (Hart et el) review many studies which used not Dietary inflammatory index, but Healthy Eating Index or some "healthy, unhealthy, mixed" dietary patterns. Zemleroika11 (talk) 20:57, 5 February 2025 (UTC)

The Hart et al review did use several types of dietary inflammatory index - "Diet scores assessing the inflammatory potential of the diet were assessed in 9 studies that included 34 analyses. These scores included the DII (population-based dietary inflammatory index) by Shivappa et al. in 18 analyses, the Empirical Dietary Inflammatory Index by Tabung in 12 analyses and the Adapted Dietary Inflammatory Index (ADII) by van Woudenbergh in 4 analyses. Higher scores of these three indices indicate a more inflammatory diet".

The Redox review you cited looked at dietary patterns - including paleolithic diet, fast food, Mediterranean and DASH diets. The Redox review also used the Healthy Eating Index (HEI) . Have you actually read these reviews? If you oppose use of the HEI or studies on dietary patterns why cite the Redox review? You cited a review on dietary patterns that cites data from HEI but you criticize another for using it? If you are going to raise a problem with the methodology of a review, at least be consistent with what you are claiming. Veg Historian (talk) 21:56, 5 February 2025 (UTC)

It was not my contribution with link to Redox review, personally I think Yu et al article is better here, as it focuses at anti-inflammatory diets. But I'm not a fan of the minimalist approach to Wikipedia, so i don't mind citing other reviews mentioning the connection between inflammation and dietary patterns in general.

By the way, I see much more weaker sources in NSAID section. Zemleroika11 (talk) 22:34, 5 February 2025 (UTC)

Hi Veg Historian, would this (https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0100084&type=printable) and its update here (https://www.nejm.org/doi/full/10.1056/NEJMoa1800389) count as a large-scale interventional trial? Daphne Morrow (talk) 03:37, 1 November 2025 (UTC)

Both sources are full of conjecture based mainly on low-quality primary studies with a cause-and-effect relationship far from being established.

The Redox Biology source is weak due to the absence of well-designed, interventional RCTs, mostly due to low subject numbers, short study durations (weeks, months), and an inconsistent mix of underlying diseases in the subjects, shown in Table 2, "RCT". No clinical practice guideline (top of left MEDASSESS pyramid) could rely on either of these sources.

As with all dietary studies putatively addressing anti-disease mechanisms, clinical trial and biomarker variables are nearly impossible to control, confounding any rigor in interpreting cause-and-effect mechanisms. Zefr (talk) 17:38, 5 February 2025 (UTC)

I agree with that, BTW while we are at this, you might want to take a look at the Dietary inflammatory index Wikipedia article. Reference 4 there is clearly unreliable because it is a primary study. That article probably needs updating. Veg Historian (talk) 19:59, 5 February 2025 (UTC)

I think that you are over-raising the requirements for sources. Are the sources secondary, in reputable journals or textbooks? Then they are suitable by MEDRS. The requirement for "not older than 5 years" is desirable, but not mandatory. Especially if a more recent review is not available.

The rest is already a scientific discussion, which cannot be conducted by editors here. Or refer to the rule that requires referring not just to reviews, but to reviews of well-designed, interventional RCTs. Zemleroika11 (talk) 18:13, 6 February 2025 (UTC)

Recently a lot of content was added to the "Serotonergic psychedelics" section but most of the content seems to fail WP:MEDRS and are WP:MEDANIMAL studies. These animal studies and in vitro studies are not clinical studies. I think this section should be trimmed. Veg Historian (talk) 10:30, 21 March 2025 (UTC)

I have gone ahead and removed the unreliable content. Studies like this on rat models are not good evidence. This is very weak non-clinical content; even a poster abstract was being cited for a study on rats . Please do not re-add this unreliable content. And why are we citing a podcast on Patreon? . This is very bad editing. If anything is to be added about serotonergic psychedelics and anti-inflammation please find a systematic review or mainstream textbook. Rat models and podcasts will not do. Veg Historian (talk) 17:55, 21 March 2025 (UTC)

Hi Veg Historian. It would've been nice if you'd pinged me when you removed the content. I didn't discover your removal until long after you'd done it. My own fault for not watching the page, but I edit too many pages to watch them all.

The content removal was inappropriate as the sources were largely WP:MEDRS-compliant. They were mainly quality secondary sources. Some primary sources were included, not principally as sources but as supporting references for interested readers to learn more, which WP:MEDRS allows for: "Primary sources may be presented together with secondary sources." WP:MEDRS and WP:MEDANIMAL do not bar preclinical research, but only state that preclinical findings must be made properly clear. Please be mindful of Wikipedia policies when removing content.

I do think that the content I added on psychedelics was disproportionate and undue relative to the rest of the article. This was not purposeful, but was simply me being thorough and was due to the rest of the article being inadequate. In any case, after adding the 5-HT_2A receptor agonists section back, I've opted to slim down it down so that this isn't an issue.

For the rest and continuing discussion, see my other comment in the section below. Thanks. – AlyInWikiWonderland (talk, contribs) 21:32, 24 May 2025 (UTC)

@Zefr:, @AlyInWikiWonderland:

These animal and in vitro studies were re-added in a section "Serotonin 5-HT2A receptor agonists". Some of these sources that have also been added here , like this Frontiers paper are unreliable. Do we really need to include this content? This is very weak material. Veg Historian (talk) 21:00, 24 May 2025 (UTC)

Veg Historian, re: you pinging Zefr, you should be mindful of WP:CANVASSING.

Here is the relevant part of my edit summary for the add-back:

"Add back 5-HT2A agonists. Rewritten and shorter this time (to not be undue/disproportionate relative to rest of article). Note that this page is not only within the purview of WP:MED but also WP:PHARM and preclinical findings in general are fine on Wiki so long as their preclinical nature is clearly stated (see WP:MEDANIMAL). Note lastly that WP:MEDRS requires only quality secondary sources/reviews, not specifically systematic reviews."

The content follows WP:MEDRS requirements and so is fine.

There are a lot of investigational anti-inflammatory drugs that are being evaluated and have received extensive attention. On the order of hundreds of published papers. Not only psychedelics/5-HT_2A receptor agonists but also interventions like N-acetylcysteine, melatonin, omega-3 fatty acids, and tetracycline antibiotics. Regardless of the state of clinical evidence and effectiveness of these agents, they are notable and discussion of them on Wikipedia is warranted. If clinical data supporting them are lacking, that will be of value and interest to readers.

The Frontiers source was for monoclonal antibodies, which are approved drugs. If there are valid issues with a given source, it can be replaced.

Thanks. – AlyInWikiWonderland (talk, contribs) 21:22, 24 May 2025 (UTC)

AlyInWikiWonderland, you have added some unreliable sources on this article that could potentially mislead readers with false information. I am not disputing the systematic reviews you added which are reliable. These were 3 sources you previously added to this article - A rat model study , a poster abstract and a Patreon podcast . That content was removed but you are still citing references which I believe are unreliable.

For example, here is some content you added: "N-Acetylcysteine (NAC) has been found to possess anti-inflammatory effects and has been clinically studied in the treatment of conditions involving inflammation", nothing wrong with that text if it was well sourced but you sourced it to a MDPI predatory journal . The other source you cited for this text is a very weak review piece in Current Opinion in Psychiatry . The review notes "N-acetylcysteine (NAC) may be beneficial for the treatment of bipolar and schizophrenia disorders. However, further translational research is required to confirm these findings". In other words no good evidence. The text you have added "N-Acetylcysteine (NAC) has been found to possess anti-inflammatory effects" is not supporting by the sourcing. If a substance has been found to "possess anti-inflammatory effects" there should be good clinical evidence in the literature. You have failed to show this with the sourcing you provided.

Let's look at another example "Omega-3 fatty acids have been found to have anti-inflammatory effects and have been found to be clinically beneficial in the treatment of certain inflammatory conditions like rheumatoid arthritis" - Your sources included this opinion piece in 2017 , a very weak source. The text you added that Omega 3s are "clinically beneficial in the treatment of certain inflammatory conditions like rheumatoid arthritis" is not supported by any good sourcing. Here is a recent 2024 review of clinical trials "The certainty of the evidence was mostly of "very low/low" quality. Overall, n-3 ONS in RA might have a limited clinical benefit" . In other words no good evidence at this point in time. It is misleading to argue for anti-inflammatory effects from omega 3s on rheumatoid arthritis because the listed sourcing does not support this. Veg Historian (talk) 21:59, 24 May 2025 (UTC)

The section on research and off-label uses was quite verbose, needing some pruning - WP:SUCCINCT and WP:NOTEVERYTHING for preliminary research and possible therapies not confirmed by clinical guidelines or systematic reviews. See Special:Diff/1292197444. Zefr (talk) 18:20, 25 May 2025 (UTC)

Veg Historian: See my comment above again re: the earlier primary sources. And note that those references were not used to source any medical claims (concerning clinical effectiveness or side effects), but instead were cited either for statements related to pharmacology or as supplemental (and non-essential) references for interested readers.

Re: MDPI, WP:RS/P says that MDPI is questionable but acceptable. It is not considered a predatory publisher (since 2015) and many MDPI journals are PubMed-indexed. I often find papers in PubMed and don't even notice who the publisher is. Yes, not everything in PubMed is considered WP:RS, but the paper isn't, say, an OMICS Group publication. In any case, I'm quite fine with sources being replaced with higher-quality ones where applicable.

"Anti-inflammatory" is within the purview of both pharmacology and clinical medicine. When I've used the term "anti-inflammatory effect", I've typically employed it in the pharmacological sense, not in the sense of demonstrated clinical benefits. There is room for both uses on Wikipedia, unless we are to shut out WP:PHARM. Making clinical claims about effectiveness for a given condition is another situation on the other hand.

If you happen to find other quality sources saying that a given intervention is ineffective or based on very low-quality evidence, I'm quite happy for you to add that content and those sources. I just want the subject matter in question to be discussed, whatever the findings may be. My intent with the recent additions was simply to provide an overview of the major different types of approved and investigational/off-label anti-inflammatory agents, which was surprisingly incomplete. To reiterate, the subject matter in question is extensively discussed in the literature and is certainly notable.

Zefr: I'm fine with all those changes you made. Thanks for working on the content. – AlyInWikiWonderland (talk, contribs) 23:04, 25 May 2025 (UTC)

Looking back at the edit history of this article, it started out as being more broadly about substances (drug and non-drug) with anti-inflammatory properties. Then gradually entire sections were summarily removed, until the only things remaining were a few sections on different classes of anti-inflammatory drugs. But then those few sections were all combined into a single section called "Drugs", which is now the only section in the article (other than References).

Since the article now only consists of 1 section entitled "anti-inflammatory drugs", then a more appropriate title for the article would be... "anti-inflammatory drugs". Alternatively, if the article was intended to be more broadly covering anti-inflammatory substances, then some of the sections that were deleted really should be restored and they can be improved if needed.

As far as I can tell, there's currently no article comprehensively covering the different classes of anti-inflammatory drugs, I'm only finding separate articles for a few of the drug classes. But I also don't see an article on the broader category of anti-inflammatory substances including non-drugs. BetsyRogers (talk) 04:53, 30 October 2025 (UTC)

I support having three pages:

- a broad concept article for "anti-inflammatory" that explains multiple things are considered anti-inflammatory (medications, foods, ice etc) and why (e.g. causes reductions in biomarkers, reduction in signs etc)

- "anti-inflammatory drugs" for medicines

- "anti-inflammatory diet" for discussion of foods/diets that have been proposed as anti-inflammatory.

- edit: I withdraw my suggestion of a dedicated food and inflammation article, due to the lack of suitable recent secondary sources. See discussion below Daphne Morrow (talk) 05:21, 30 October 2025 (UTC)

*support The article is just about drugs with anti-inflammatory effects. If there is significant information regarding the diet it should have its own page and definitely not be redirected here.DrTheHistorian✎ 22:54, 30 October 2025 (UTC)

• oppose. This article has likely been trimmed and remained brief because there is overlap with the Inflammation article and with individual articles for approved anti-inflammatory drugs listed under Clinically approved (which could also apply to rituximab, abatacept, and JAK inhibitors). Each approved anti-inflammatory drug is defined by a pain-reduction mechanism, which should be a main focus of a topic entitled anti-inflammatory.

It seems more logical to move and expand the Clinically approved section to the Resolution section of the inflammation article, then to trim further or delete mention of the poorly-studied compounds in the Investigational and off-label section; WP:NOTEVERYTHING.

There is little WP:MEDSCI evidence or consensus on how a diet provides an anti-inflammatory effect – a near-impossible cause-and-effect relation to show in clinical research. It would be futile to have such an article, which is mainly a myth used as a concept umbrella for a whole foods diet like DASH or the Mediterranean diet, which collectively have not been proved, only inferred, to have anti-inflammatory effects. Zefr (talk) 01:38, 31 October 2025 (UTC)

Are you saying it would be difficult to find MEDRS sources like medical textbooks or meta-analyses that would have information about the state of the evidence on anti-inflammatory diets? Daphne Morrow (talk) 02:28, 31 October 2025 (UTC)

By WP:MEDASSESS criteria, yes. There is a difference between personal physicians recommending an "anti-inflammatory diet" (DASH, Mediterranean diet) vs. having a rigorous encyclopedia article on the topic, which unfortunately would be based on low-quality, non-MEDRS reviews like these. Zefr (talk) 03:45, 31 October 2025 (UTC)

What specifically is the problem with those reviews? Daphne Morrow (talk) 05:55, 31 October 2025 (UTC)

Taking the first page of 10 reviews as examples, half are from MDPI, a notorious predatory publishing company (explanation for identifying non-MEDRS factors).

The other half of retrieved sources is far from the MEDASSESS quality of clinical journals (e.g., The Lancet, NEJM) that would give validation of scientific evidence and WP:MEDORG recommendations for an anti-inflammatory diet, which is a mythical, unprovable concept. Zefr (talk) 18:11, 31 October 2025 (UTC)

Do you think all dietary effects are unprovable or just inflammation effects? Daphne Morrow (talk) 20:15, 31 October 2025 (UTC)

I do want to thank you for your help here, I have read over MEDRS several times but understanding the nuances is useful. Daphne Morrow (talk) 21:05, 31 October 2025 (UTC)

See the discussion above under No MEDRS? Specific foods and their nutrients/phytochemicals cannot be controlled as variables in large-scale clinical research nor can they be proved as individual or collective causality factors inhibiting diseases, including inflammation. There is mention of a Dietary inflammatory index, but this is an example of 'association is not evidence of causation'. Zefr (talk) 21:32, 31 October 2025 (UTC)

I'm just not sure that I agree that you can't use suitable controlling mechanisms like mendelian randomisation or even traditional randomisation (eg.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00122-2/abstract , https://www.nejm.org/doi/full/10.1056/NEJMoa1800389 or https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0100084) to prove causality in diet studies. But I can't find enough recent secondary sources for a diet and inflammation article specifically (https://www.nmcd-journal.com/article/S0939-4753(14)00109-4/abstract , https://www.sciencedirect.com/science/article/abs/pii/S1567576922005884 , https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313348 , https://www.sciencedirect.com/science/article/abs/pii/S0271531713001565) , so I'll withdraw my suggestion of a dedicated diet and inflammation article. Daphne Morrow (talk) 22:09, 31 October 2025 (UTC)