Inflammation Risk Score
Assess Your Lifestyle Inflammation Factors — 15-Question Assessment
What is Chronic Inflammation?
Inflammation is your body's natural defense mechanism against injury, infection, and foreign invaders. When functioning properly, it is a critical part of healing. However, when inflammation becomes chronic — persisting for weeks, months, or even years — it shifts from being protective to destructive.
Acute vs. Chronic Inflammation:
- Acute inflammation is short-term (hours to days) and localized. It is the body's immediate response to tissue damage or infection — think of the redness, swelling, and warmth around a cut or sprained ankle. This is a healthy, necessary process that resolves once healing occurs.
- Chronic inflammation is low-grade, systemic, and persistent. Unlike acute inflammation, it often produces no obvious symptoms in its early stages. It simmers in the background, slowly damaging tissues and organs over months to years. It is driven by ongoing stressors such as poor diet, obesity, chronic stress, lack of sleep, and environmental toxins.
Key Inflammatory Markers:
- C-Reactive Protein (CRP): Produced by the liver in response to inflammation. High-sensitivity CRP (hs-CRP) is one of the most widely used blood tests for chronic inflammation. Levels above 3.0 mg/L indicate high inflammatory risk, while levels below 1.0 mg/L are considered low risk.
- Interleukin-6 (IL-6): A pro-inflammatory cytokine that plays a central role in the inflammatory cascade. Elevated IL-6 is associated with obesity, cardiovascular disease, and autoimmune conditions.
- Tumor Necrosis Factor-alpha (TNF-alpha): A cytokine involved in systemic inflammation. Chronically elevated TNF-alpha is implicated in rheumatoid arthritis, inflammatory bowel disease, psoriasis, and insulin resistance.
- Erythrocyte Sedimentation Rate (ESR): A nonspecific marker that measures how quickly red blood cells settle in a test tube. Elevated ESR indicates the presence of inflammation but does not specify its source.
Disease Links: Research has established that chronic inflammation is a major driver of the most common and deadly diseases worldwide:
- Cardiovascular disease: Inflammation damages arterial walls, promotes plaque formation, and contributes to atherosclerosis, heart attack, and stroke
- Cancer: Chronic inflammation creates an environment that promotes DNA damage, tumor growth, and metastasis. Up to 20% of cancers are linked to chronic inflammation
- Alzheimer's disease: Neuroinflammation damages brain cells and accelerates cognitive decline. Inflammatory markers are elevated years before symptoms appear
- Type 2 diabetes: Inflammation causes insulin resistance, impairing the body's ability to regulate blood sugar. Visceral fat tissue is a major source of inflammatory cytokines
- Autoimmune diseases: Conditions like rheumatoid arthritis, lupus, and multiple sclerosis are driven by a dysregulated immune response causing chronic tissue inflammation
- Depression: Emerging research shows that elevated inflammatory markers (CRP, IL-6) are associated with depression, suggesting inflammation may play a causal role in mood disorders
Anti-Inflammatory Diet
Diet is one of the most powerful modifiable factors influencing inflammation. What you eat can either fuel inflammation or fight it. The anti-inflammatory dietary pattern most supported by research is the Mediterranean diet.
The Mediterranean Diet:
- Emphasizes fruits, vegetables, whole grains, legumes, nuts, and seeds
- Uses extra virgin olive oil as the primary fat source
- Includes moderate amounts of fish and poultry
- Limits red meat, processed foods, and added sugars
- Allows moderate red wine consumption (optional)
- Multiple large-scale studies (including PREDIMED) have demonstrated significant reductions in inflammatory markers, cardiovascular events, and all-cause mortality
Omega-3 Fatty Acids:
- EPA and DHA (found in fatty fish like salmon, sardines, mackerel, and anchovies) are the most potent dietary anti-inflammatory compounds. They reduce production of pro-inflammatory eicosanoids and cytokines
- ALA (found in flaxseed, chia seeds, and walnuts) is a plant-based omega-3 that has moderate anti-inflammatory effects, though conversion to EPA/DHA is limited
- Aim for at least 2 servings of fatty fish per week, or consider a high-quality fish oil supplement (1–2g EPA+DHA daily)
Antioxidant-Rich Foods:
- Berries (blueberries, strawberries, raspberries) contain anthocyanins that neutralize free radicals and reduce NF-kB activation
- Leafy greens (spinach, kale, Swiss chard) are rich in vitamins C, E, K, and polyphenols
- Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) contain sulforaphane, which activates the body's own antioxidant defenses
- Colorful vegetables — the wider the variety of colors, the broader the range of anti-inflammatory phytochemicals
Turmeric and Curcumin:
- Curcumin, the active compound in turmeric, is one of the most studied natural anti-inflammatory agents
- It inhibits NF-kB, a key molecule that activates genes related to inflammation
- Bioavailability is enhanced when combined with black pepper (piperine) or consumed with dietary fat
- Supplemental doses of 500–2,000 mg of curcumin daily have shown benefits in clinical trials for arthritis, metabolic syndrome, and inflammatory bowel conditions
Pro-Inflammatory Foods to Limit:
- Added sugars and high-fructose corn syrup: Trigger release of inflammatory cytokines and promote insulin resistance
- Trans fats and excessive omega-6 fats: Found in fried foods, margarine, and many processed snacks. They promote inflammatory prostaglandin production
- Refined carbohydrates: White bread, pastries, and sugary cereals cause rapid blood sugar spikes that trigger inflammatory responses
- Processed meats: Hot dogs, sausages, and deli meats contain advanced glycation end products (AGEs) that promote inflammation
- Excessive alcohol: Heavy drinking increases intestinal permeability (leaky gut) and allows bacterial toxins to enter the bloodstream, triggering systemic inflammation
Lifestyle & Inflammation
Beyond diet, several lifestyle factors have a profound impact on your body's inflammatory state. Understanding these connections empowers you to make targeted changes.
Exercise and Inflammation:
- Regular moderate exercise is one of the most effective anti-inflammatory interventions available. Each bout of exercise triggers the release of anti-inflammatory cytokines (particularly IL-6 from muscle contractions, which paradoxically has anti-inflammatory effects during exercise)
- Exercise reduces visceral fat — the metabolically active fat tissue that is a major source of chronic inflammatory signals
- Aim for at least 150 minutes of moderate-intensity aerobic activity per week (walking, cycling, swimming) plus 2 days of strength training
- Even 20 minutes of moderate walking has been shown to trigger an anti-inflammatory response by activating the sympathetic nervous system, which suppresses TNF production
- Caution: Excessive, intense exercise without adequate recovery can temporarily increase inflammation. Balance intensity with rest days
Sleep and Inflammation:
- Sleep deprivation (less than 6 hours per night) significantly increases levels of CRP, IL-6, and TNF-alpha
- Even one night of poor sleep can increase NF-kB activation and inflammatory gene expression
- Chronic sleep disruption alters the hypothalamic-pituitary-adrenal (HPA) axis, leading to elevated cortisol and sustained inflammation
- The optimal range for anti-inflammatory benefit is 7–8 hours per night. Both too little and too much sleep (over 9 hours) are associated with higher inflammatory markers
- Sleep apnea is a particularly potent driver of inflammation due to intermittent oxygen deprivation (hypoxia)
The Stress-Inflammation Axis:
- Psychological stress activates the sympathetic nervous system and HPA axis, leading to release of cortisol and catecholamines. While short-term cortisol suppresses inflammation, chronic stress causes cortisol resistance, where immune cells become less responsive to cortisol's anti-inflammatory signal
- Chronic stress promotes a pro-inflammatory gene expression profile (increased NF-kB activity) and reduces anti-inflammatory gene expression
- Mind-body practices such as meditation, yoga, and deep breathing have been shown in randomized controlled trials to reduce CRP, IL-6, and NF-kB activation
- Social isolation and loneliness independently increase inflammatory markers, highlighting the importance of social connection for immune health
The Gut Microbiome Connection:
- The gut houses approximately 70% of the immune system. An imbalanced microbiome (dysbiosis) can drive systemic inflammation through increased intestinal permeability (leaky gut)
- Beneficial bacteria produce short-chain fatty acids (SCFAs) like butyrate, which have potent anti-inflammatory effects and strengthen the intestinal barrier
- A diet rich in fiber, fermented foods (yogurt, kefir, sauerkraut, kimchi), and diverse plant foods promotes a healthy, anti-inflammatory microbiome
- Antibiotics, chronic stress, and a low-fiber, high-sugar diet can damage the microbiome and increase inflammation
Reducing Your Inflammation Risk
Reducing chronic inflammation requires a multi-faceted approach. Here are actionable steps organized by category:
Dietary Changes:
- Adopt a Mediterranean-style eating pattern with emphasis on whole, minimally processed foods
- Eat at least 5 servings of fruits and vegetables daily, focusing on variety and color
- Include fatty fish (salmon, sardines, mackerel) at least 2–3 times per week
- Use extra virgin olive oil as your primary cooking and dressing oil
- Replace refined grains with whole grains (brown rice, quinoa, whole wheat, oats)
- Minimize added sugar intake to under 25g per day for women and 36g for men (AHA guidelines)
- Add turmeric and ginger to meals for their anti-inflammatory compounds
Physical Activity:
- Aim for 150–300 minutes of moderate aerobic exercise per week
- Include 2–3 sessions of resistance training weekly to build anti-inflammatory muscle mass
- Break up prolonged sitting with movement every 30–60 minutes
- Walking is highly effective — even 7,000–8,000 steps daily significantly reduces inflammatory markers
Sleep and Stress Management:
- Prioritize 7–8 hours of quality sleep per night
- Practice stress-reduction techniques daily: meditation, deep breathing, progressive muscle relaxation, or yoga
- Maintain strong social connections — loneliness is an independent inflammatory risk factor
- Consider cognitive behavioral therapy for chronic stress or anxiety
Supplements with Evidence:
- Fish oil (omega-3): 1–2g EPA+DHA daily has consistent evidence for reducing inflammatory markers
- Vitamin D: Deficiency is linked to increased inflammation. Aim for 1,000–2,000 IU daily if levels are low (check with a blood test)
- Curcumin: 500–1,000 mg daily with black pepper extract for enhanced absorption
- Probiotics: Specific strains (Lactobacillus, Bifidobacterium) can improve gut barrier function and reduce systemic inflammation
- Magnesium: Low magnesium is associated with elevated CRP. Many adults are deficient. Consider 200–400 mg daily
Testing and Monitoring:
- hs-CRP test: The most accessible blood test for chronic inflammation. Ask your doctor to include it in your routine bloodwork. Levels below 1.0 mg/L are ideal; above 3.0 mg/L indicates high inflammation
- Fasting insulin: Elevated fasting insulin indicates metabolic inflammation and insulin resistance
- Omega-3 Index: Measures the percentage of EPA+DHA in red blood cell membranes. An index above 8% is associated with the lowest inflammatory risk
- Reassess your inflammation risk score every 3–6 months to track progress after implementing lifestyle changes
Frequently Asked Questions
Chronic inflammation is a persistent, low-grade inflammatory response that can last for weeks, months, or years. Unlike acute inflammation (the redness and swelling you see around a wound), chronic inflammation is often invisible and systemic, affecting the entire body. It occurs when the immune system stays activated by ongoing stressors such as poor diet, excess body fat, chronic stress, inadequate sleep, smoking, and environmental toxins. Over time, this sustained inflammatory state damages healthy tissues and organs, contributing to the development of heart disease, type 2 diabetes, cancer, Alzheimer's disease, and autoimmune conditions. Chronic inflammation is now recognized as one of the most significant drivers of chronic disease worldwide.
Diet is one of the most powerful modulators of inflammation. Pro-inflammatory foods — such as added sugars, refined carbohydrates, processed meats, trans fats, and excessive omega-6 fatty acids — trigger the release of inflammatory cytokines (IL-6, TNF-alpha) and activate NF-kB, a master regulator of inflammatory gene expression. Conversely, anti-inflammatory foods rich in omega-3 fatty acids (fatty fish, walnuts, flaxseed), antioxidants (berries, leafy greens, colorful vegetables), and polyphenols (olive oil, green tea, turmeric) actively suppress inflammatory pathways. The Mediterranean diet, which emphasizes these anti-inflammatory foods, has been shown in large clinical trials to reduce CRP levels by 20–30% and significantly lower the risk of cardiovascular events, diabetes, and certain cancers.
Yes, regular moderate exercise is one of the most effective anti-inflammatory interventions. During exercise, muscles release IL-6 (a myokine), which, when produced by muscle contractions, has anti-inflammatory effects — it stimulates the production of anti-inflammatory cytokines (IL-10, IL-1ra) and suppresses TNF-alpha. Regular exercise also reduces visceral fat, which is a major source of chronic inflammatory signals. Studies show that even a single 20-minute session of moderate walking can reduce inflammatory markers by activating the cholinergic anti-inflammatory pathway. Long-term exercise programs consistently reduce CRP, IL-6, and TNF-alpha levels. However, excessive intense exercise without adequate recovery can temporarily increase inflammation, so balance and rest days are important.
The C-Reactive Protein (CRP) test, specifically the high-sensitivity CRP (hs-CRP) test, is the most widely used blood test for measuring chronic, low-grade inflammation. CRP is a protein produced by the liver in response to inflammatory signals (primarily IL-6). The hs-CRP test can detect very low levels of CRP in the blood, making it useful for assessing cardiovascular risk and chronic inflammation even when there are no obvious symptoms. Results are interpreted as: below 1.0 mg/L (low inflammatory risk), 1.0–3.0 mg/L (moderate risk), and above 3.0 mg/L (high inflammatory risk). The American Heart Association recommends hs-CRP as part of cardiovascular risk assessment. You can ask your doctor to include it in routine bloodwork. Note that CRP can be temporarily elevated by acute infections, injuries, or illnesses, so testing should ideally be done when you are otherwise healthy.
We recommend reassessing your Inflammation Risk Score every 3 to 6 months. This timeframe allows enough time for lifestyle changes (dietary modifications, exercise routines, stress management practices) to take effect and be reflected in your responses. If you are actively implementing significant changes, you may benefit from reassessing every 3 months to track progress and stay motivated. For clinical monitoring, ask your healthcare provider about periodic hs-CRP blood tests to objectively measure changes in your inflammatory levels alongside this self-assessment. Keep in mind that inflammation levels can fluctuate based on acute factors (illness, injury, temporary stress), so focus on long-term trends rather than any single assessment.
No. This Inflammation Risk Score is an educational self-assessment tool designed to help you evaluate lifestyle and dietary factors that are known to influence chronic inflammation. It is not a medical test, clinical diagnostic tool, or substitute for laboratory testing. The score is based on your self-reported behaviors and habits, not on biomarker measurements. To objectively measure your inflammation levels, you would need blood tests such as hs-CRP, IL-6, or ESR ordered by your healthcare provider. This tool is intended to raise awareness about pro-inflammatory risk factors, help you identify areas for improvement, and motivate positive lifestyle changes. Always consult a qualified healthcare professional for medical advice, diagnosis, or treatment decisions.
Medical Disclaimer
This Inflammation Risk Score is provided for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. This is a lifestyle self-assessment tool based on modifiable risk factors — it is not a clinical diagnostic instrument and does not measure biomarkers. Your results should not be used as a substitute for professional medical evaluation. If you have concerns about chronic inflammation or related health conditions, please consult your healthcare provider. Laboratory tests such as hs-CRP can provide objective measurement of inflammatory status. All calculations are performed in your browser — no personal data is stored on our servers or shared with any third party.
References
- Minihane AM, Vinoy S, Russell WR, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015;114(7):999-1012.
- Calder PC, Bosco N, Bourdet-Sicard R, et al. Health relevance of the modification of low grade inflammation in ageing (inflammageing) and the role of nutrition. Ageing Res Rev. 2017;40:95-119.
- Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832.
- Harvard Health Publishing. Understanding acute and chronic inflammation. Harvard Medical School. 2020. Available at: health.harvard.edu
Inflammation Risk Score: Original multi-factor lifestyle assessment tool developed by MDCodeLookup. Based on evidence-based inflammation risk factors identified in peer-reviewed research (Furman et al. 2019, Minihane et al. 2015, Calder et al. 2017). This tool is not derived from any copyrighted clinical instrument.