ASK DR. BETH | By Dr. Beth Prinz

Operation: Low Inflammation

“Silent Inflammation,” what is it and why should we avoid it? How do we know if we have it? How can we prevent or reverse it? 

Silent inflammation is chronic subclinical inflammation that can smolder along undetected for years. A person may be completely unaware they have silent inflammation until their doctor tells them they have fatty liver, diabetes, prediabetes, or heart disease. 

Implicated in cancer, depression, Alzheimer’s, and autoimmune disorders silent inflammation is systemic, affecting any organ system in the body including the fat tissues, the liver, the central nervous system, the blood vessels, and the gut.

Scientists are still working out all the factors involved, but the “Western Diet” and obesity are believed to play a major role. Adipose (fat) tissues become inflamed (infiltrated with immune cells). These inflamed fat cells no longer function properly and become toxic. Inflammatory cytokines are released and insulin signaling is impaired. Toxic fat cells spread to other organs (muscle, liver, and pancreas) and metabolic syndrome develops. Unchecked, progresses to type 2 diabetes within 8 to 10 years. There are many other pathways and hormone signals potentially involved. 

Our modern diet has tipped the balance in favor of inflammation. For this reason, it is imperative we “stoke” the anti-inflammatory pathways with our daily food choices to bring us back to, and maintain, our health.

In The Journal of Nutrition 2009, researchers published a dietary Inflammatory Index.  Scientists anaylzyed relevant journal articles from 1950 to 2007. Foods and components received a score ranging from -1 pro-inflammatory, to +1 anti-inflammatory. Foods deemed neutral with regard to inflammation received a 0 score.

Researchers validated the index by showing that it predicts changes in high-sensitivity C-reactive protein (hs-CRP).  A simple blood test your doctor can order this test at your next check-up, hs-CRP is a red flag, indicating diet and lifestyle needs attention. You may need a cardiovascular risk assessment too because hs-CRP is highly correlated with risk for heart disease. (The leading cause of death in the U.S.)

But no need to wait for a blood test.  A glance (honest look) at our diets tells us what we need to know.

The most potent dietary triggers of inflammation are sugar, fats, and cholesterol.  All oils and fats promote inflammation, including monounsaturated fats found in olive oil. However, the most inflammatory fats are transfats, saturated (animal) fat, and omega-6 polyunsaturated fat. The two main omega 6-fatty acids in the American diet are linoleic, (constituting 50 percent to 75 percent of vegetable and seed oils such as corn, soy, sunflower and safflower), and arachidonic, (found primarily in eggs, chicken, and other meats).  Both linoleic and arachidonic acid feed directly into the pro-inflammatory eicosanoid pathway in the body (the same pathway we try to block with NSAIDs such as ibuprofen when we have acute injury and pain.)

According to the National Health and Nutrition Examination Survey (NHANES), published by the National Institutes of Health, the top ten sources of saturated fat in the American diet are: cheese, pizza, desserts, dairy desserts, chicken, sausage, hot dogs, bacon, ribs, burgers, Mexican dishes, beef, and milk. The top sources of omega 6-fatty acids are: chicken, desserts, salad dressing, potato and corn chips, nuts seeds and pizza.  Americans are getting added sugars mostly from: sodas/energy/sport drinks, desserts, fruit drinks, (ice cream), candy, breakfast cereal, table sugar, sweetened tea and syrups.

Eliminating these foods would be the first and most important step toward reducing chronic inflammation.

All the top anti-inflammatory ingredients are plants or plant-derived, with the exception of omega-3 fatty acids, which are mostly found in fish.  Magnesium is the most anti-inflammatory substance listed, (0.905 out of 1.0). This is not surprising, given that magnesium sits in the center of the chlorophyll molecule in plants, therefore green leafy vegetables are a major source of magnesium.

Turmeric, beta-carotene, fiber, vitamin A, tea, and red wine also topped the list. 

All plant antioxidants, flavonoids, and polyphenols reduce inflammation. Pre- and probiotics (fiber) reduce inflammation by promoting gut barrier function, preventing inflammatory antigens from entering the circulation.

In summary, a low-inflammation diet is abundant in whole fruits, vegetables, whole grains, oily fish, tea, legumes, and spices such as garlic, ginger, turmeric, and herbs. It is low in sugar, cholesterol, chicken, eggs, meat, and fat (particularly animal fat.)

Time and again, I have observed patients make the change to a low inflammation diet with impressive results.  Joint pains and body aches disappear, inflammatory markers normalize, and the patient feels better than they have in years.

In Ojai, our options for low inflammation eating are all around us. Try Rainbow Bridge, Farmer’s Market, Nest, Food Harmonics, Farmer and the Cook, Westridge Market, Noso Vita, and Azu for great plant-based options.