To conclude this series, David Seaman MS, DC, DACBN has been kind enough to both advise us on
ways to ‘deflame’ the typical diet and comment
on the science of diet and inflammation. For
those of you who don’t know, Dr. Seaman has been well ahead of the curve
on how different foods can up or down regulate
the metabolic reactions that promote or suppress inflammation.
GDA-
It’s been over 10 years since you wrote your landmark book “Clinical Nutrition
for Pain, Inflammation and Tissue healing”.
Regarding systemic up-regulation of pro-inflammatory states induced by food
choices, what has science told us since you wrote the book?
DRS- Fortunately, I was lucky to get interested in an area of research related
to nutrition that has been very consistent over the years. In other words, the
contents and suggestions in the book are consistent with the emerging research.
The difference is that we now know more about the dietary up-regulation of
systemic inflammation. Some of this involves more confusing biochemistry such
as cytokines, growth factors, and cell signaling molecules like nuclear factor
kappa-B. And some is very basic such that we should view basic biochemical
problems from the view of chronic inflammation. For example, we have known for
many years that overeating sugar and fat leads to postprandial hyperglycemia
and hyperlipemia; however we now know that the degree of hyperglycemia and
hyperlipemia is associated with increasing levels of systemic inflammation.
Additionally, we have always known that being over-fat can be associated with
diabetes and heart disease. We now know that excess body fat functions as a
factory that produces inflammatory mediators.
GDA- I promised the readers advice on easy ways to
transition toward a so-called anti-inflammatory way of eating. I guess the 1st
step in the process would be determining areas to address in what they
currently eat. Do you have any thoughts on how the average DC can identify the major
problems a patient has?
DRS- There are some very basic and accurate things we can do. For example,
visual inspection is helpful. Anyone who is overweight is moving toward a state
of chronic inflammation. We add excess pounds by eating pro-inflammatory foods
such as sugar, refined flours, and too many fat calories. So an overweight
should be viewed as one who eats too few vegetables, fruit, and lean meat and
fish. If a patient is regularly taking NSAIDs or Tylenol, this tells us to look
at diet. Linoleic acid from seed/legume oils (corn, safflower, sunflower,
cottonseed, peanut, and soybean) converts into arachidonic acid, which we find
in obese meat from domesticate animals. The arachidonic acid is converted into
prostaglandin E2 by the now famous COX enzymes, which are inhibited by NSAIDs
and Tylenol. A diet history for 3-7 days is also helpful. It becomes readily
apparent that patients do not eat of vegetation, lean meat, and fish. They can
also use the Deflaming Guidelines I have on my website deflame.com, which
contains an inflammation checklist and dietary/supplement recommendations.
GDA- How can we help patients (to coin your phrase)
deflame without selling them a trunk load of pills and powders?
DRS- The key to deflaming is diet, not supplements. So the lion's share of
calories should come from vegetation, lean meat, fish, sweet potatoes, raw
nuts, and seeds such as hemp, chia, and flax. A bare bones supplement approach
to support the deflaming process includes magnesium, fish oil, vitamin D. I
think adding a multivitamin and a probiotic are also good choices if the
patient can afford it.
GDA- Making a nutrition plan too costly, too strict
or too extreme is a recipe for failure in all but the highly motivated or
borderline obsessive.
How can the average person eat a diet that is anti-inflammatory and still live
within the norm? (Meaning they can still have a slice of pizza after their
kid’s
ballgame or hit a drive through on occasion.)
DRS- People can easily deflame by shopping at Super Walmart. Lean meat, chicken
breast and fish are affordable. Five pound bags of frozen vegetables are
inexpensive as are family size bags of frozen fruit. Sweet potatoes are also
very inexpensive as are regular potatoes. And when a modest potato portion is
consumed with protein, the glycemic response is blunted. If people eat this way
for 80-90% of their calories, then the remaining percentage should be used for
pizza, drive throughs, and dessert.
GDA- Any thoughts on the emerging concept that just
being overweight is inflammatory?
DRS- As you know, we are learning that our genes can be protective against
disease or promoters of disease. So I think the overweight issue is dependent
on our unique genetic make up, which we can get an idea about by looking at
some basic blood tests. For example, high sensitivity C-reactive protein
(hsCRP) should be below 1 mg/dL. Fasting glucose should be below 100. When
these rise, we should be thinking that an overweight patient is inflamed. And
we should be more concerned if elevated hsCRP and glucose that are couple with
substantially elevated cholesterol and triglycerides. Even more basic marker is
blood pressure. We know that elevated blood pressure reflects chronic systemic
inflammation. Some individuals are able to handle more weight and keep these
markers within normal limits - it is a mixed bag and should be considered on an
individual basis. However, in general, excess body fat is considered to be a
reservoir of inflammatory mediators. In fact, macrophages are attracted to
excess adipose tissue where they can become activated and overproduce
inflammatory mediators. Adipose tissue itself produces mediators called
adipokines - some are pro-inflammatory and some are anti-inflammatory. With
excess adipose tissue, we produce excessive pro-inflammatory mediators like
resistin and leptin, and less anti-inflammatory adiponectin.
GDA- How about the fact that foods which drive
inflammation also seem to stimulate appetite?
DRS- The gut-brain appetite connection is complex, as is the effect of diet on
the endocrine system. The inflammation connection is more palpable and
understandable for me. I cannot tell if inflammatory foods actually stimulate
appetite or if anti-inflammatory foods function to suppress appetite. Lean
protein and fiber tend to make us feel satiated, so we eat less. Additionally,
I am not sure to what degree the emotional attachment to inflammatory foods plays
a role. I do know that people have variable negative visceral responses when
they are told to eat less sugar and flour, and to eat more anti-inflammatory
foods. I wonder if there is an actual subtle addiction mechanism at work here
that propels people to overeat. In this regard, the movie "Supersize
Me" should make us all pause and think about our eating behaviors.
GDA- Thank you for
advising and updating us on this fascinating
aspect of nutrition.
DRS-My pleasure.