How to optimise your diet to manage inflammation


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Unhealthy eating habits coupled with sedentary and stressful lifestyles are known to contribute to poor health. What might be surprising to learn is that inflammation is not only a core contributor to poor health, but one that can also be either exacerbated or elevated by our diet and lifestyle choices. Most importantly, inflammation is considered to be a silent epidemic that contributes to the majority of chronic diseases, slowly progressing over a period of years.  The significance of adopting good dietary and lifestyle habits in our earliest years often only really comes into play for most of us when we reach the age when the symptoms of inflammation begin to become apparent.

If it seems that I am condemning inflammation wholesale, I should first point out that it is both a natural and necessary part of the body’s immune system, functioning to protect us from infection and allowing us heal and repair.  The products generated during a natural inflammatory response, however natural, are highly destructive, and the body must ensure that the resolution phase of the inflammatory response is tightly orchestrated so that inflammation doesn’t get out of hand.  Without this dampening effect, inflammation can continue unregulated; if this continues long term, a myriad of health issues may ensue. Factors such as stress and diet can directly contribute to and affect how we manage this ‘silent’ inflammation.

The classic example of how diet and lifestyle can lower our risk of poor health is what is known as the Mediterranean diet. Obviously, this is not a ‘diet’ per se, but rather the traditional eating habits of people living in and around the Mediterranean and includes countries such as Spain, Italy, France and Greece. The benefits of the Mediterranean diet have been recognised from as far back as the 1940s, when the dietary practices involved the consumption of large amounts of olive oil, unrefined cereals, legumes, vegetables and fruit. In addition, consumption of fish was high but consumption of meat products was low.  This was coupled with moderate consumption of both dairy products and wine.  Foods were locally sourced and therefore fresh and often organic.  Lifestyles were generally relaxed in nature, people were more active and stress levels were generally low.   So good was this method of diet and lifestyle, that a meta-analysis of studies published in 2008 suggested that following a Mediterranean way of life is likely associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson’s disease and Alzheimer’s disease (13%). [1]

Sadly, the impact of ‘progress’ or ‘westernisation in terms of food processing and refining methods means that the ‘original’ Mediterranean diet in its true sense has changed significantly over the years, but by understanding and adopting key principles of the Mediterranean diet (whilst incorporating a more active and less stressful lifestyle) it is relatively easy to benefit from this anti-inflammatory diet, both to reduce the risk of developing inflammatory issues later in life, and to manage already existing inflammatory issues.

Understanding fats

olive-oilOlive oil is particularly beneficial for heart health. Rich in mono-unsaturated fatty acids (MUFA) like oleic acid and palmitoleic acid that help in lowering LDL or ’bad’ cholesterol and to increase HDL – ‘good’ cholesterol.  Extra-virgin, cold-pressed olive oil, is rich in compounds called polyphenols and is also an excellent source of vitamin E.  Together these powerful antioxidants contribute to the anti-inflammatory health benefits of olive oil.    As olive oil is not particularly heat stable (though more so than many typically used oils), it is best to use it as a dressing on salads rather than for cooking;  when cooking it’s best to use coconut oil.  Whilst the fats in coconut oil are technically the saturated type (actually falling into the category of medium-chain fats), it can be heated quite safely, with the additional benefit that its high levels of beneficial fats (such as lauric acid) can help kill harmful pathogens like bacteria and viruses.

The high intake of oily fish associated with the Mediterranean diet ensures that the balance of omega-6 (which can exacerbate inflammation) to omega-3 fatty acids (which are anti-inflammatory) are kept in check.  Oily fish such as anchovies, sardines and mackerel are particularly rich in EPA and DHA, which can help regulate inflammation and are associated with improved cognitive function and can improve heart health.  People who eat more fish tend to have lower intake of red meat.  This is not to say that having the occasional steak is detrimental to health as long as it is from organic grass-fed animals.  This is in contrast to meat from grain-fed animals which can be higher in both saturated fat and omega-6 fat and be generally poorer in the overall nutrient profile.  If you are not a fan of oily fish, it’s worth topping up your omega-3 levels with a good quality fish oil.  Pharmepa MAINTAIN not only provides highly bioavailable EPA and DHA, but also includes the omega-6 fatty acid GLA.  Not all omega-6s are pro-inflammatory and it’s important to get a good balance of anti-inflammatory omega-6 as well as omega-3!  The organic cold-pressed evening primrose oil (which we use as our source of GLA) is also rich in polyphenols (specifically triterpenes), which are powerful anti-inflammatory and antioxidant compounds.

The role of protein

Protein obtained from the diet is broken down into numerous building blocks called amino acids.  These sit patiently in an amino acid ‘pool’ until they are required to make new proteins, such as enzymes, hormones and other molecules required by the immune system (as well as for general growth and repair).  Some amino acids are considered to be essential and must be obtained in the diet.  If they are not added to our amino acid ‘pool’ then the body is unable to create important proteins required to support daily functions. Both fish and grass-fed meat, unlike processed refined meats (like basic ‘value’ range sausages, fish fingers and so on) will offer quality protein (that is, protein that provides all the essential amino acids).  Avoiding (or minimising) processed meat and including quality meat and fish is therefore essential, not just for regulating inflammation but also for numerous other biological processes.

Carbohydrate sources

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One of the key features of the Mediterranean diet is the lack of refined and processed carbohydrate; this is a diet that is rich in whole grains (these provide complex carbohydrates) as well as fruit and vegetables and it’s important to have a minimum of 5 portions of fruit and vegetables day (although the ideal ratio of vegetables to fruit should be around 4 vegetable portions to 1 fruit portion).  Fruit contains natural fruit sugars, which are metabolised directly by the liver; if eaten in high quantities, this can put unnecessary strain on the health of the liver, which needs to stay in tip top shape to ensure that it is able to perform its job of detoxifying the body. Choosing fruits like berries that are naturally low in sugar content can be healthier than sugary fruits such as tropical fruits like mango and pineapple.  Choosing complex carbohydrates that are broken down slowly is excellent for helping to manage healthy blood sugar levels, unlike refined white sugar which is added to a lot of processed refined food products;  the high sugar intake associated with western diets is now widely known to directly contribute to numerous inflammatory conditions.  Vegetables provide an essential nutrient profile, including cofactors (required for many biological processes), antioxidants and essential vitamins and minerals. In addition to providing an excellent source of protein and similar to other vegetables, legumes (foods such as beans, lentils and peas) are also rich in fibre and complex carbohydrates (healthier carbohydrates that not only help regulate blood sugar levels but also have the added benefits of keeping the gut functioning well); they are also rich in healthy fats, and essential minerals and vitamins.  As the nutrient profile differs between types of legumes, with each kind offering a unique nutritional profile, eating a variety of types can also make a tasty alternative to meat and fish.

Quality dairy

Another key feature of the Mediterranean diet was the moderate consumption of dairy products, mainly in the form of cheese and yogurt.  These would have been locally sourced and from cows, sheep and goats that were fed on natural diets.  Whilst dairy can be quite high in saturated fat, the nutrient profile from local animals would be similar to that of organic grass-fed meat, i.e. rich in good fats such as omega-3 and rich in other essential nutrients. In addition, organic eggs from free range birds will offer additional nutrients including quality protein (providing the full spectrum of essential amino acids) and omega-3 fats.

The benefits of whole foods

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When we step through the doors of our local supermarket we are confronted with aisle upon aisle of tins, packets, tubs, bottles and boxes of ‘food’ products.  Some need no preparation, some need heating, some need mixing.  Our demand for convenience has overshadowed our understanding of the importance of consuming food in its whole, natural and unadulterated form.  Depending on where you shop (let’s face it, some supermarkets are significantly guiltier than others) you may come across aisles of fruit and vegetables where, sadly, most of the offerings will have been transported miles (if not continents) to appear on those shelves.  The nutrients offered can often be insignificant and of poor quality and we merely feed and fill our bellies rather than supply our bodies with the many hundreds (and more) individual nutrients required to fuel the similar amount of metabolic processes that keep us functioning on a daily basis.

Shopping locally and visiting your local butcher, organic farm or market will take you closer to obtaining the quality of nutrients  supplied by a typical Mediterranean diet than any of your local supermarkets.  If you are fortunate enough to have use of a small amount of land, or access to an allotment you can grown your own vegetables and fruit (and possibly also keep free-range chickens), offering you even more control over the type of food you choose to eat.  Consider the benefits of an anti-inflammatory diet, one that excludes processed foods and focuses on oily fish (preferably non-farmed), whole foods and organic products from free-range animals: it provides the best combination of nutrients to control, reduce or dampen inflammatory processes for optimal long-term health.

 

[1]  Adherence to Mediterranean diet and health status: meta-analysis. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. BMJ. 2008 Sep 11;337:a1344.

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Dr Nina Bailey

About Dr Nina Bailey BSc, MSc, PhD, RNutr

Nina is a leading expert in marine fatty acids and their role in health and disease. Nina holds a master’s degree in Clinical Nutrition and received her doctorate from Cambridge University. Nina’s main area of interest is the role of essential fatty acids in inflammatory disorders. She is a published scientist and regularly features in national health publications and has featured as a nutrition expert on several leading and regional radio stations including SKY.FM, various BBC stations and London’s Biggest Conversation. Nina regularly holds training workshops and webinars both with the public and health practitioners.

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