Doctor’s Tip: Chronic inflammation and the role of diet
My friend and colleague, Chris Miller, M.D., is very knowledgeable about inflammatory and autoimmune diseases because of personal experience and through helping many patients with these diseases. She was an ER doctor in Aspen for several years, and now offers lifestyle counseling. Unfortunately for us, she has accepted a position in Vermont and will be leaving soon.
— Greg Feinsinger
Chronic inflammation has been shown to be the common link among the leading causes of death and disability, including heart disease, diabetes, cancer, autoimmunity, Alzheimer’s disease, depression, asthma, allergies and premature aging.
Diet and lifestyle choices actually make a significant impact on the amount of chronic inflammation we experience, yet it is often overlooked. We know these illnesses are inflammatory in nature, and treatment is often with anti-inflammatory medications, such as NSAIDS (Ibuprofen, Aspirin, Naproxen), COX-2 inhibitors (Celebrex), steroids such as Prednisone, and biologics that block specific inflammatory cells, such as TNF-alpha, IL-1 or IL-6.
Often, when we look upstream we can greatly reduce the amount of inflammation that is triggered, leading to significant improvement in health and reduction of medications.
Enter the role of diet. Many studies have recently shown that the foods we eat can be a great modulator of inflammation and our immune system, revving it up or turning it down. For example, diets rich in fiber have been shown to be necessary to feed the healthy gut bacteria, which, as it turns out, play a significant role in maintaining the integrity of the gut barrier and communicate with the immune system, helping to develop tolerance and appropriate immune response.
Without the fiber, the gut barrier, which is one cell layer thick, can break down, leading to large undigested foods being absorbed into the blood stream. About 70 percent of the immune system is in the gut, as this is a major source of exposure to foreign particles and invaders.
This is the phenomenon of endothelial hyper-permeability, or leaky gut. The immune system does not recognize these larger, undigested food particles and goes into attack mode. Therefore, a high-fiber diet is essential for a healthy microbiome and immune system balance.
Additionally, foods themselves can be pro- or anti-inflammatory, turning on or off the inflammatory process.
For example, arachidonic acid is a polyunsaturated fatty acid found in animal fats, such as meat, dairy, chicken, pork and fish, as well as highly processed foods, and leads to the release of pro-inflammatory cells.
When we remove these foods, we are able to rapidly lower the chronic inflammation response, especially if we eat foods rich in anti-inflammatory polyunsaturated omega-3 fatty acids, such as flax seeds, chia seeds, green leafy vegetables, walnuts and hemp seeds.
And, in fact, people with chronic inflammatory disorders show remarkable reduction in inflammatory markers such as CRP and ESR, as well as great improvement in symptoms, such as reduced joint pains, improved asthma and better energy and mood.
To really create an anti-inflammatory diet, emphasis is on whole, unprocessed plant foods, such as vegetables, fruits, legumes, whole grains, and nuts and seeds. The more of these types of foods we eat, filled with vitamins, minerals, antioxidants and disease-fighting phytonutrients, the quicker and more effectively we can reduce chronic inflammation.
The aim is to eat a diverse and colorful array of these foods to allow variety and ensure there are no nutrient deficiencies. Also, by eating lower calorie, fiber-rich plant-based whole foods, people are able to attain their healthy weights. As excess fat itself is pro-inflammatory, a nutrient-rich, lower calorie diet is important for reversing systemic inflammation.
To really enhance the anti-inflammatory response, adding herbs and spices have been shown to play a significant role as well. Some examples include turmeric, ginger, cloves, cinnamon, rosemary, saffron, cayenne pepper, basil, thyme, green tea and many others.
Try adding cloves and cinnamon to oatmeal; saffron, turmeric, ginger and pepper to vegetable stir fries; and basil, oregano, rosemary and thyme to pasta sauces and veggie dishes. They not only spice up your meal, they also turn on genes that turn off inflammation.
It’s time to look upstream, at the sources of chronic inflammation, and take control of it right where it starts. Fortunately, we now know just how effective diet can be at preventing, halting and even reversing chronic illnesses. And it all begins with what’s on our forks.
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