Inflammation is one of those words that gets weaponized constantly in the nutrition space — anti-inflammatory diets, inflammatory foods, inflammatory lifestyles. It sells supplements, it drives clickbait, and most of the time it’s used without any real explanation of what inflammation actually is or when it matters.
On Episode 18 of Skol Sessions, I sat down with Dr. Charles Cavo of Pounds Weight Loss to cut through the noise. Dr. Cavo brings a clinical perspective to a topic that’s often dominated by influencers and naturopaths with something to sell. What follows is an edited version of our conversation.
Let’s start at the beginning. What is inflammation?
Inflammation is a broad term. At its most basic, it’s characterized by three things: pain (the Latin dolor), pallor, and heat (dubor). Those characteristics happen through different pathways in the body and can actually be tested through bloodwork, depending on what kind of inflammation you’re looking for.
When we’re talking about food and lifestyle, we’re mostly looking at how your immune system responds to certain inputs — and at blood markers that tell us whether ongoing inflammation is present.
What’s the difference between the inflammation you get from a sprained ankle versus the kind that comes from your diet?
They’re actually different pathways. When you twist your ankle, you see localized swelling, heat, and redness — that’s your body’s tissue repair response kicking in. It’s not primarily your immune system. When people talk about food-related inflammation, they’re talking about an immune response. Your gut has a very thin barrier between the outside world and your body, and 70 to 80% of your immune system lives right there in your intestine. Certain foods can trigger an immune reaction at that barrier.
The key thing to understand is that neither type of inflammation is inherently bad. A small dose is necessary. That localized swelling after a hard workout? That’s the inflammation, repair, and remodeling cycle that makes you stronger. The problem is dose and duration.
So acute inflammation from training — the soreness, the swelling — that’s actually a feature, not a bug?
Exactly. The same applies to things like sauna and cold plunge. Those stressors cause a short burst of oxidative stress and inflammation. Your body reacts, then it stops, and you recover better than you were before. We call those pulsatile episodes of inflammation — brief, intentional, beneficial.
Chronic inflammation is the opposite. That’s when the stressor doesn’t go away — chronically eating foods that trigger your immune system, chronically having elevated blood sugar, chronically exposing yourself to things your body can’t clear. That’s when you get into trouble.
When you’re working with a patient you suspect has chronic inflammation, what are you looking for in bloodwork?
C-reactive protein (CRP) is the most common marker people talk about, and it’s a useful one. CRP is a protein made in the liver that rises when your immune system is active — it’s essentially a fire alarm. A CRP above 10 tells us there’s inflammation somewhere.
The problem is it’s not specific. You can have elevated CRP from a cold, a hard workout, or a rough night of sleep. I actually had a CRP of 8 after a few Halloween parties and a head cold — which, technically, meant I was “inflamed,” but the context matters enormously.
Beyond CRP, we look at a CBC (complete blood count, which examines white blood cells), metabolic panels, uric acid, and triglycerides. Uric acid in particular is a marker I pay close attention to when food sensitivities are suspected.
What about food allergy and sensitivity panels? I see those advertised constantly.
I haven’t found much utility in just blasting a full food allergy panel on someone who’s feeling off. Food allergies are more severe and you want to catch those. But sensitivities — which are what most people are actually dealing with — really start with listening to the patient. What are they eating? What symptoms are they experiencing? A shotgun test often creates unnecessary restrictions without identifying what’s actually wrong.
My approach is to start by eliminating the most obvious culprits, monitor symptoms and CRP, and reintroduce foods methodically. It’s more work, but you end up with a much clearer picture and far fewer restrictions than you actually need.
What are the foods most likely to drive inflammation?
The Harvard Chan School of Public Health puts hyper-processed foods and added sugars at the top of the list — and I’d agree. Those are the ones we’re most confident cause inflammation across most people, partly because of the foods themselves and partly because of the chemicals added during processing that our bodies simply haven’t evolved to handle.
Beyond that, it gets individual. Wheat tends to cause problems for a lot of people. Dairy does for some. Red meat gets lumped in, but I’d caveat that — we’re really talking about processed deli meats, not a grilled steak. The problem is that these lists get turned into blanket rules, and you end up with people avoiding perfectly nutritious foods because of a headline.
Let’s talk about fructose specifically, because I see fruit getting demonized now. What’s actually happening when your body processes fructose?
Here’s the thing with fructose: your cells have to invest their own energy to break it down, expecting to come out ahead. With fructose, they don’t — they get back less than they put in. That surprises the cell, and one of the byproducts of that failed breakdown is uric acid. Uric acid signals cellular starvation, which triggers increased insulin, increased appetite, inflammation, and fatigue. You got something sweet on your tongue, but metabolically, your body got shortchanged.
Now, fruit in its natural whole state? That’s a different equation. You’ve got fiber, water, vitamins, and minerals alongside the fructose, and they change how your body handles it. The problems come when people remove the fiber and water — dried fruit is basically mainlining fructose to your liver. Same with juice. Those aren’t health foods. But a whole piece of fruit in a reasonable amount? Generally fine.
You mentioned allulose earlier — what is that, and why does it behave differently from regular sugar?
Allulose is a naturally derived sugar that your body can’t actually break down. It tastes like sugar, looks like sugar, but it doesn’t get metabolized the same way. Because your cells can’t process it, you don’t get the uric acid spike or the insulin response you get from fructose. In fact, allulose actually reduces insulin and helps stabilize blood sugar — we’ve seen blood sugar drop 20 to 30 points in diabetic patients, and we’ve seen it resolve insulin resistance.
It works on some of the same receptors as GLP-1 medications like Ozempic, which means some of the same benefits — appetite regulation, blood sugar control — but in a form you put in your coffee instead of injecting. It’s significantly cheaper and more accessible. I think it’s going to be a major player as people learn more about it.
What about omega-3s — are they anti-inflammatory on their own, or is it really about the omega-6 to omega-3 ratio?
Both, honestly. The balance matters — most people’s diets are heavily skewed toward omega-6s, especially if they’re eating conventional rather than grass-fed or free-range animal products. Getting that ratio right is foundational.
But omega-3s do also upregulate anti-inflammatory pathways independently. That said, more isn’t always better. You want the ability to mount an inflammatory response when you need it — if you have a viral infection, a fever is your body doing its job. Suppressing inflammation too aggressively has its own costs.
One practical note: if you’re taking a fish oil supplement and you’re getting fish burps, throw it out. That taste means the oil has been oxidized — it’s rancid. Oxidized fish oil does more harm than good. Don’t buy cheap fish oil.
Let’s talk about the gut microbiome. It’s everywhere right now. What should people actually know about it?
You have more bacteria in your gut than you have cells in your body. That microbiome plays a massive role in how you process food, how your immune system functions, and how much inflammation you’re carrying around. A disrupted or imbalanced microbiome can cause systemic inflammation by itself.
We can actually test for specific bacterial imbalances using a breath test — you drink a sugar called lactulose that only bacteria can break down, and we measure how much methane and hydrogen you’re breathing out. That can tell us whether you have an overgrowth of certain bacteria (what’s known as SIBO), and we can treat it.
The biggest disruptors of the microbiome? Chronic antibiotic use tops the list. Stress, alcohol, processed foods, and smoking are all in there too. Even common over-the-counter medications like ibuprofen can be surprisingly disruptive. If you do need an antibiotic, ask about taking a probiotic alongside it — it can significantly reduce the collateral damage.
If someone suspects food is causing their inflammation, what’s a reasonable protocol to follow?
Start by eliminating the obvious culprits: sugar, processed foods, additives, dairy, and wheat. Not forever — just to get a clean baseline. Most people start to feel a difference around seven days. Then you start reintroducing foods one at a time, tracking symptoms and, ideally, CRP levels.
The degree of sensitivity matters for how long that process takes. Someone who’s been eating a major trigger food daily for years is going to need more time to clear it than someone who only has it occasionally.
What I’d push back on is the one-week “cleanse” framing. A week isn’t enough to draw meaningful conclusions, and most cleanses aren’t structured for proper reintroduction anyway. If you’re going to do an elimination protocol, do it right — commit to the elimination phase, then reintroduce systematically.
Any general recommendations for people who just want to reduce inflammation baseline?
Protein first. There are essential amino acids your body cannot make — you have to eat them. Protein should anchor every meal.
Don’t neglect fat. There are also essential fats your body can’t synthesize, and they directly participate in inflammatory and anti-inflammatory pathways. Fish two or three times a week is great; a quality omega-3 supplement if not.
Minimize processed foods and added sugar. Not because carbohydrates are evil, but because hyper-processed, high-sugar foods are the clearest drivers of chronic inflammation we have.
Take vitamin D and magnesium. Most people are deficient in both. Both matter for inflammation regulation.
Sleep. Underrated, non-negotiable.
Use purposeful stress. Sauna, cold plunge, hard training — these create short bursts of controlled inflammation that make your system more resilient. The key is recovery.
And if you’re dealing with symptoms — fatigue, irritability, skin issues, digestive changes, chronic pain — don’t wait. Start with food, check your CRP, and work with someone who will actually listen to you rather than hand you a generic list of things to avoid.
Dr. Charles Cavo practices at Pounds Weight Loss. You can catch the full conversation on Skol Sessions Episode 18 on YouTube.
Erik Castiglione is the owner and head coach of Viking Athletics in West Hartford, CT.