Eat to Beat Inflammation
Foods have pharmaceutical effects. By tweaking your diet, you can lower your risk of diseases that start with inflamed tissue

Julie Beun-Chown

At first, it was just little things — a bit of stiffness around her hips that soon wore off.

Then, suddenly, the driveway at Moira Blahut’s Toronto home seemed a lot steeper. At just 43, Moira was creeping along like a woman twice her age. Still, she shrugged it off and exercised to keep her joints limber.

But by the autumn of 2006, she could no longer ignore the devastating truth: her osteoarthritis caused by hip dysplasia had become so bad, she couldn’t even bend over to tie her shoes.

That was then. These days, Moira is acting her age. Her shoelaces no longer torment her, the driveway has mercifully flattened out, and she’s lost so much weight, she’s thinking of taking up yoga.

“I have greater well-being,” she says. “I’m healthier, and I feel mentally more balanced.”

Miracle cure? More like a little applied science. After consulting with Dr. Joey Shulman — a Toronto-based chiropractic doctor, registered nutritional consulting practitioner and author of The Natural Makeover Diet (Wiley) — Moira went on an anti-inflammatory regimen. Gone were pro-inflammatory foods such as sugar, refined carbohydrates, saturated and hydrogenated fats and fatty red meat.

And gone, too, was her excess weight, lethargy and the inflammation in her hips.

If she was surprised by the results, researchers are not. “There are thousands of scientists doing this research on inflammation and diet as it affects weight and obesity,” says Dr. John Di Battista, editor of the international journal Inflammation Research and a professor of medicine at Montreal’s McGill University. “There is no question that diet will moderate your symptoms. You do not need to be a physician to realize that.”

Nor do you need to be a scientist to grasp that poor diet and lifestyle are part of the impetus for the steady increase in inflammation-related conditions such as arthritis, asthma, diabetes, psoriasis, soft-tissue cancers, colitis. depression and brain disease.

“We’re in the midst of an epidemic of excessive production of these inflammatory factors, and these are causing chronic disorders,” says Dr. Bruce Holub, a professor emeritus of nutritional sciences at Ontario’s University of Guelph. Consider the stats. By 2031, Alzheimer’s disease and related dementias are expected to almost double. By 2031, deaths from heart disease will grow seven times as fast as the population. Canada’s incidence of inflammatory bowel disease — already among the world’s highest — is increasing. An estimated one in two North Americans will have inflammatory disease at some point in their lives.

Photo : Bernard Clark

The Offenders

Not surprisingly, the very things that make foods so tasty — sugar and saturated and trans fats — are the main culprits. High intakes of simple and refined carbohydrates and foods sweetened with high-fructose corn syrup flood the body with insulin, create more stored fat and trigger the formation of eicosanoids and cytokines, pro-inflammatory substances that  damage cells. “Certain F-words are bad,” says Holub, “and fructose is one that is really bad.”

A dietary imbalance between different kinds of healthy fats can promote a pro-inflammatory reaction. Human beings benefit from a ratio of around four to one of omega-6 fatty acids (from oils such as sunflower and corn ) to omega-3 fatty acids (from fish, walnuts and flaxseed). But our modern diets tend to be richer in omega-6s, which in excess favour inflammation, than in omega-3s, which counteract pro-inflammatory substances.

Our Western diet’s focus on fast food has put the four-to-one ratio seriously out of whack. “We went from an original ratio of 1.5 to one to more than 30 to one,” says Dr. Floyd Chilton, a leading inflammation researcher at Wake Forest University in Salem, N.C. “These fatty acids control the levels of messengers for inflammation. It’s not a surprise to anyone that the change in ratio has a traumatic effect on the amount of inflammatory disease.”

Between diet, alcohol, smoking and lack of exercise, adds Shulman, “we’ve turned the switch on for inflammation. It doesn’t mean you’re in an acute inflammatory position all the time, but a lot of us are walking around in a chronic mild inflammatory state.”

Anti-Inflammatory Foods

Now for the good news. It is possible to ward off inflammatory problems and manage existing symptoms with diet and exercise.

A Mediterranean-type diet rich in fish, poultry, whole grains, olive oil, fruits, legumes, nuts, flaxseed and vegetables is the “Rolls- Royce” of anti-inflammatory diets, says Holub. Italian investigators at Second University of Naples found that after two years on the Mediterranean diet, patients had significant decreases in circulating pro-inflammatory factors, body weight, blood pressure and levels of blood glucose, insulin, total cholesterol and triglycerides.

Just how an anti-inflammatory diet works, and to what extent, is still under investigation, cautions Myriam Géhami, a registered dietitian and coordinator of the Nutrition Clinic at the University of Montreal. “In nutrition, there needs to be a lot of studies and analysis demonstrating the link. Right now, the best advice we can give people regarding cardiovascular disease, cancer and other conditions is to reduce intake of saturated fat and trans fatty acids and increase consumption of omega-3 fatty acids.” In addition, eat more fruits, vegetables and whole grains such as brown rice and barley and consume fish at least twice a week.

Following that advice — with reference to Canada’s Food Guide to Healthy Eating — and incorporating the tips below is prudent, says Holub. “You may not know which component in which food is active, but doing the whole diet means you’re generally replacing bad foods with good ones.”

Fish, Flax, Walnuts and Soybeans

These foods are good sources of omega-3 fatty acids. Scientists have long known that the omega-3s docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) suppress pro-inflammatory factors. What they didn’t know, until recently, is that DHA and EPA do double duty and are themselves converted into potent anti-inflammatory compounds called resolvins. According to Holub, that’s an important addition to what we know about the anti-inflammatory power of omega-3s. “There was a review in 2005 of several rheumatoid arthritis studies, and they all showed moderate benefits in symptom reduction from taking an average dose of 2.6 grams of omega-3 fatty acids a day, or more, for 12 weeks,” says Holub.

Although very high intakes of omega-3s can raise the risk of bleeding, moderate intakes are safe. The U.S. Food and Drug Administration considers anything up to three grams a day to be safe for most people. And no one is going to get too much from the twice-weekly servings of fish recommended by Canada’s Food Guide to Healthy Eating. (For more on omega-3 fatty acids, go to www.dhaomega3.org and www.uoguelph.ca/~bholub. Also, turn to p. 16 and see “The Facts on Fat.”)

Recommendation 

While the best source of omega-3 fatty acids is at least two to four weekly servings of deep-coloured, cold-water fatty fish such as anchovies, herring, sardines, salmon and mackerel, these essential nutrients are also found in English walnuts, ground flaxseed and cooked soybeans. The long-chain omega-3s from fish are generally considered more effective than alpha-linolenic acid, the form derived from plant sources.

Bright-Coloured Plant Foods

Red, green, blue or purple — the more colourful the fruits and vegetables, the more they contain plant compounds such as anthocyanins, bioflavonoids and carotenoids, which damp down inflammation and protect cells from damage by rogue oxygen molecules called free radicals. At the University of Michigan, researchers found that the juice of tart cherries contains enough anthocyanins to block inflammation as effectively as acetylsalicylic acid. They do this by inhibiting the pro-inflammatory enzymes cyclooxygenase one and two.

Photo : Bernard Clark

Recommendation

Follow Canada’s Food Guide to Healthy Eating and have eight to 10 servings of fruits and vegetables daily.

Pungent Foods

Turmeric, garlic, ginger, onions and cayenne pepper — the basis of a great curry? Absolutely. Effective anti-inflammatory compounds? Very likely. While research is ongoing, early studies indicate these foods contain powerful antioxidants and phytochemicals that may turn off inflammation. According to the World Health Organization, the incidence of Alzheimer’s disease in India — where curry is a staple — is 4.4 times less than that in North America. The explanation may come from curcumin in turmeric, a bioactive phytochemical (plant compound) that. according to a 2004 study from the University of California, Los Angeles and the U.S. Department of Veterans Affairs, “shows promise for the prevention of Alzheimer’s disease.”

Photo : Bernard Clark

Recommendation 

Use generously. “We’ve been eating these foods and spices for millennia,” says Di Battista, “and there’s no doubt they have positive health effects.”

Fibre

Soluble and insoluble fibre aid digestion, speed waste elimination, lower cholesterol and reduce the risk of inflammation and heart disease. “If you’re not eliminating,” says Shulman, “you’re autointoxicating. Fibre helps flush toxins out. It’s an internal Dustbuster.”

Recommendation

Eat 28 grams (about one ounce) of fibre daily in six to eight servings of skin-on fruits and vegetables, legumes, high-fibre cereals and whole grains such as bulgur, cornmeal, brown rice, barley and oatmeal.

Healthy Weight

Improving your health by shedding pounds may seem self-evident, but investigators at the University of Buffalo can now add more details as to why. In obese people at risk of diabetes and heart disease, they found inflammation in some of the immune system’s large white blood cells — in lymphocytes and monocytes, to be exact. The inflamed cells promote the build-up of fatty deposits in the arteries (atherosclerosis) and activate fat cells to produce more pro-inflammatory factors. They also interfere with the way the body responds to the glucose-storing signals of the hormone insulin, laying the groundwork for insulin resistance and type 2 diabetes.
           
Recommendation

Ask your doctor about starting a weight-reduction and exercise program.

Wine

Does a glass of red wine a day keep inflammation at bay? Quite possibly, say U.K. researchers at Imperial College in London. They found that resveratrol, an antioxidant in red wine and dark grape juice, acts as an anti-inflammatory in cases of airway inflammation. But more isn’t better. Heavy long-term alcohol consumption causes a sustained inflammatory response in the liver, which can lead to a fatty liver and liver fibrosis and cirrhosis.

Photo : Bernard Clark

Recommendation

Drink in moderation. An occasional glass of Cabernet Sauvignon, Syrah or Pinot Noir may deliver more resveratrol than wines from other grape types, but bear in mind that non-fermented red and purple grape juice also deliver some of this antioxidant.

Naps Nip Inflammation

People who regularly take midday naps may be 40% less likely to die from heart disease, according to a study of 24,000 volunteers at the Harvard School of Public Health in Boston. Why? Possibly because high stress has been linked to increased inflammation in blood vessels, and naps reduce stress.

Depression and Inflammation

Depressed men have exaggerated inflammatory responses to stress — possibly due to early-life anxiety, says a study from Atlanta’s Emory University. Inflammation-linked depression in new moms may yield to anti-inflammatory omega-3 fatty acids, according to researchers at the University of New Hampshire in Durham.

Good Inflammation, Bad Inflammation

A splinter slides under a fingernail — ouch! While you reach for the tweezers, your body is reacting to this invasion in a far more complex way. Initially, mast cells trigger the creation of tiny leaks in the blood vessel walls to let immune cells reach the injury site. Meanwhile, big white blood cells called macrophages launch an attack on the invader, and more immune cells arrive to destroy it and sweep away damaged tissue. You see a painful red swelling — the unpleasant, if temporary, price of your immune system’s protection.

The trouble arises when the immune system won’t quit and causes chronic underlying inflammation. Depending on your genetic predisposition and the site where the runaway inflammation takes hold, it can result in problems ranging from colitis and cancer to asthma, heart disease and dementia.

Parkinson's and Inflammation

Parkinson’s disease may be linked to inflammation caused by allergies. Researchers at the Mayo Clinic in Rochester, Minn., found that patients with allergic rhinitis were nearly three times more likely to develop this degenerative brain disease than those with no allergies.