Diet and Inflammation

By Dr. Eric Hochman, MD
Gulfshore Concierge Medicine

Diet and InflammationAs Hippocrates once noted in the 5th century BC: “Let food be thy medicine, and let thy medicine be food”. He spoke of the value in eating well and recognized that certain foods influence good health.  Obviously much time has passed since those early days, but food and nutrient consumption still play a key role in our society today.  It is hard to read a magazine, listen to the radio, watch television, or search the internet without seeing numerous references to how our diet affects our health.  “Anti-inflammatory diets” are particularly popular today.  Google ‘anti inflammatory diet’ and you will retrieve over 27 million hits in about a quarter of a second.   Many of these articles tout the inflammation fighting qualities of certain foods and supplements.  However, when it comes to true evidenced based medicine, the supporting studies in humans are sparse.  For example, although claims have been made that avoiding certain food in favor of other foods is beneficial for rheumatic diseases, according to UpToDate, (the medical go-to source for clinicians which summarizes the most current, vetted research), fish oil is the only supplement/food with proven evidence of benefit on their list.

So then why do we hear so much about “anti-inflammatory” diets? Chronic inflammation is a pervasive condition in society.  It impacts millions of people and can potentially lead  to debilitating symptoms such as pain and gastrointestinal complaints, as well as life threatening diseases including strokes, heart attacks and even cancer.  It is paramount to find strategies that can reduce the body’s inflammatory burden.  Although a definitive causal relationship has not been found in most circumstances, some foods are linked to higher levels of inflammation, and some to lower levels.  According to Christopher Cannon, MD, associate professor at Harvard Medical School, the anti-inflammatory diet is “probably very close to the Mediterranean diet”.  Therefore consuming a diet rich in plant based foods (like fruits, vegetables, whole grains, legumes and nuts) with little processed foods, and an emphasis on fish may help limit inflammation.

Numerous studies promote the health benefits of fruits and vegetables.  They are good sources of phytonutrients, vitamins, minerals, and antioxidants.  Some studies have demonstrated that those who consume a larger amount of fruits and vegetables have a lower total inflammatory burden.  Although it is not yet clear as to whether or not there is a cause and effect relationship, the association is clear.  There is at least some data to suggest that antioxidant rich foods like blueberries (which are full of flavonoids), red grapes (which contain quercetin, a potent bioflavonoid which inhibits the flow of histamines) and dark green vegetables (such as kale, spinach, and broccoli) are associated with decreased inflammation.  Furthermore, dark green vegetables and avocados are also high in Vitamin E, which may play a key role in protecting the body from pro-inflammatory molecules called cytokines.  In addition, orange juice has been found to help neutralize the inflammatory stress from a high fat or high carbohydrate meal (due to it’s vitamin C and flavonoids).

Like fruits and vegetables, foods high in Omega 3 fatty acids are thought to be a key factor in reducing inflammation as well. In a Journal of Nutrition study on postmenopausal women, patients with the highest levels of omega 3 in their diet had lower levels of two inflammatory proteins, C-reactive protein (CRP) and lnterleukin 6 (IL6). Fish, especially salmon, mackerel, and tuna, are an excellent source of Omega 3. In a study published in American Family Physician journal, 3 grams or more per day of Omega 3 has been found effective in reducing morning stiffness and number of tender and swollen joints in those with Rheumatoid Arthritis.

Foods that contain whole grains have more fiber, which has been shown to reduce levels of CRP, the inflammatory marker. When checking ingredients, whole grains should be listed as the first ingredient, and products labeled “100%” whole grain are best. Brown rice and bulgar wheat are good choices, while refined carbohydrates such as pasta and white rice should be avoided. In addition to fruits, vegetables, fish, and whole grains, there is evidence to suggest that nuts, like almonds and walnuts, produce an anti-inflammatory response. Studies have associated nuts with reduced markers of inflammation and even a lower risk of cardiovascular disease and diabetes.

In contrast to the anti-inflammatory foods, there are a group of foods thought to be inflammation promoting. According to Harvard Health Publications and Harvard Medical school, the following foods are associated with inflammation and should be limited as much as possible: refined carbohydrates, fried foods, soda, red meat/processed meat and margarine/shortening. Generally speaking, foods high in sugar and saturated fat can spur inflammation.

According to the University of Texas Medical Center, “they cause overactivity in the immune system, which can lead to joint pain, fatigue, and damage to the blood vessels”. While the bulk of this article has highlighted food and its potential impact on inflammation, it should be noted that level of activity may also influence the level of inflammation in the body. There is a strong correlation between exercising and reduced inflammation.

More active people have lower levels of CRP. It has been found that moderate physical activity induces the production of antioxidants,
which can help lower markers of inflammation. Therefore, experts recommend incorporating exercise into daily routine for this and other synergistic health advantages.

Although definitive evidence is still needed to prove that “anti-inflammatory” diets can directly lower inflammation and prevent
disease, preliminary data is certainly suggestive that preferentially choosing foods known to be associated with a lower total body inflammatory burden can be beneficial to your health. When this strategy is combined with exercise and a reduction in inflammation promoting foods, it will have the most benefit.

The properties of natural nutrition are simple…
Let’s remember the acronym NAG

Natural,  as in unprocessed, unrefined foods such as whole grains and legumes.

Alive, meaning food that still contains live enzymes, such as fresh fruit, vegetables, and sprouts.

Good Quality,  meaning grown in soil rich in essential nutrients such as organically grown foods (pesticide free and grown without synthetic fertilizers).

These simple words can serve as a guide to everyone wishing to improve their health.  Awareness and understanding of the simplicity of our nutritional needs will inevitably lead to individual and collective good health.  We need to learn to look at good nutrition, not as a means to stop  our diseases, but as a tool to create our own immunity and overall good health.

Where do we find quality food?
The neighborhood supermarket  is not always our best source of natural food.  Fruit and vegetables are often imported from foreign countries, and by the time they reach our table they have lost all  major nutrients.  In our country  fruit and vegetables are often grown carelessly in poor soil full of pesticides, all in the name of profit and certainly with no regards for the health of the consumer.

Fortunately we see an emerging trend towards fresh markets consciously striving to offer quality organic  produce, and local farmers’ markets where you can actually speak to the person who grows your food, and find products you won’t find anywhere else.  These markets are a wonderful way to bring people together because they are fun.  The farmers connect with the consumers who love what they sell and appreciate their hard work.  The satisfaction of buying  natural foods, socializing  with like minded people while enjoying  the fresh air is good for body and soul.

What can we expect in  the future?
We are not doomed to perpetuate obesity and malnutrition!  All it takes is a conscious rethinking of our everyday food choices.  That’s where courage comes in handy.  It is so much easier to maintain status quo, believe what we are told and hope for the best.   What we really need to do, however, is to take a good look at the quality of food that’s foisted on us too many times, and, yes, complain!

As more and more consumers demand the quality of food that we are entitled to, we will find that food manufacturers and suppliers will begin to provide it.  We will then see a significant move towards the prevention of obesity and disease starting with a most important requisite:  natural nutrition.

Danielle Perrault, Certified Holistic Nutritionist, has been teaching and promoting natural, holistic nutrition for over twenty years.  She first founded the Canadian School of Natural Nutrition in 1994, then expanded internationally with the World Institute of Natural Nutrition with Head Office in Fort Myers, Florida.

Gulfshore Concierge Medicine

Eric Hochman, M.D. is an award winning physician who is triple board certified in Internal Medicine, Pediatrics and Rheumatology and founder of Gulfshore Concierge Medicine (GCM). He has been practicing in Naples since 2004 and is currently the President of the Collier County Medical Society.  Dr. Hochman is a guest columnist for the Naples Daily News writing about the benefits of the Blue Zones Project. He is on staff at NCH Hospitals and Physicians Regional Medical Center and has expertise in treating common diseases such as high cholesterol and diabetes. He also has competed additional training and is considered an expert at managing problems related to the musculoskeletal system.

GCM is a state-of-the-art doctor’s office that provides exceptional care to patients and offers a personalized four-step approach to optimize health and maximize longevity called the WELLStrides(tm) Plan. GCM follows the concierge medical model where patients pay an annual fee for comprehensive care that includes access to personalized medical care 24/7, same day appointments with ‘no rush’, individualized and thorough health plans, in-office lab testing, immunizations, medical travel assistance, VIP service, and much more.

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