As promised in part 1, this month contains lists of foods that tend to up-regulate and down-regulate the degree of inflammatory response during the metabolic processes that follow ingestion. They are not inclusive. It is important to note that small amounts foods that up-regulate the inflammatory reactions will not nullify the effect of a mainly anti-inflammatory meal. An example would be a packet of sugar and pat of butter on a large bowl of oatmeal. On the other hand, foods that down-regulate inflammation may lose some or all of their benefit if they are prepared incorrectly such as battered deep fried vegetables.
In part one, the 5 major dietary causes that promote an imbalance favoring an excessive inflammatory response were identified. Four of them -- too much saturated fat (& the related partially hydrogenated family)1 too many refined carbohydrates (including sugars)1 and the dietary ratio imbalances of elevated omega-6/omega-3 oils2 and sodium/potassium3 are well known. However, energy imbalances that cause body fat accrual are often overlooked as a cause of systemic inflammation. Yet, it appears simply eating too much too often may be the most powerful factor in the promotion of an exaggerated inflammatory response.4 For example, 444 teenagers (249 boys + 195 girls) were studied for the purpose of evaluating how fitness can prevent cardiovascular disease5. They were divided into 4 groups: normal bodyweight & physically fit; normal weight/unfit; overweight & fit; overweight/unfit. Testing revealed serum levels of C-reactive protein were not associated by fitness. Rather, CRP corresponded to the subjects who were overweight:
23% of the normal weight, fit teens had CRP elevations
24% of the normal weight, unfit teens and CRP elevations
50% of the overweight, fit teens had CRP elevations
56% of the overweight, unfit teens had CRP elevations
Bodyweight had a much greater effect on systemic inflammation than the degree of fitness did. The dietary imbalances we discussed in part one (too much - saturated fat, refined grains/sugars, sodium/potassium, omega-6/omega 3) yield a food pattern (fatty, starchy, sweet and salty) that promotes overeating by triggering neurochemical responses that hyper-stimulate our appetites. We prefer to eat these foods together and therefore they drive inflammation by both their individual biochemical properties and the overlooked effect of hunger amplification during consumption. For example, consider how a plate of celery & carrot sticks effects your appetite compared to the same plate full of fresh baked chocolate chip cookies. When you start eating the celery and carrot sticks, after a few you’ve had enough. But with cookies (each of which has 10-20 times more calories than the celery/carrot sticks) the more you eat, the more you want until you’re really full. And what do we get when we eat chocolate chip cookies? Refined starch, sugars and saturated fat. Although there is not a significant amount of sodium in CC cookies, my analysis of 5 brands/recipes yielded ratios from 7:1 to 3:1, with an average of 5:1. The recommended daily allowance for sodium and potassium (2400mg & 3500mg respectively) works out to a 1:1.5 ratio. Finally, CC cookies are not a significant source of polyunsaturated fats. However, the small amounts they do have yield a 10:1 omega-6/omega-3 ratio. That is not as bad as the 15:1 ratio the average American consumes, but is still high enough to promote an inflammatory marker increases and symptoms in some conditions such as rheumatoid arthritis and asthma.6
Next month we will discuss how to reverse a diet from pro-inflammatory to anti-inflammatory.
Foods Generally Considered Pro-Inflammatory:
American cheese, bacon, bologna, bratwurst, brownies, (white) breads - including buns, rolls and bagels, butter, cake, candy, cereals*, cheese (American, cheddar, creamed, gouda, jack, mozzarella, provolone, Swiss) cookies, corn chips, corn syrup, crackers*, cream, croissants, corn chips, Danish, doughnuts, egg rolls, French fries, French toast, (deep) fried foods, fruit juices, granola*, hamburgers, hash browns, honey, hot dogs, ice cream, jam/jelly, margarine, molasses, muffins, noodles*, onion rings, pancakes, pastrami, pepperoni, pie, pickles, pita bread*, pizza, pasta*, popcorn, potato chips, pretzels, puddings, relish, ribs (beef or pork), rice (white), salami, sausage, sherbet, shortening, sodas/soft drinks, syrup, tortillas (flour), tortilla chips, waffles, whipped cream, whole dairy.
*Unless 100% whole grain and high fiber.
Foods Generally Considered Anti-Inflammatory:
Acai, Amaranth, Anchovies, apples, apricots, arugula, artichokes, asparagus, avocado, bananas, beans (green beans, black beans, kidney beans, garbanzo beans, pinto beans, lima beans, soy beans), bean sprouts, beets, Berries (blackberries, blueberries, boysenberries, goji berries gooseberries, raspberries, strawberries) bok choy, broccoli, Brussels sprouts, cabbage, canola oil, cantaloupe, carrots, cauliflower, celery, cherries, cranberries, cucumbers, dairy (nonfat), eggplant, endive, gooseberries, grapes, grapefruit, herring, honeydew, kale, lemons, lentils, mackerel, mango, mangosteen, millet, mushrooms, mustard greens, nectarines, noni, nuts - raw (almonds, Brazil nuts, cashews, chestnuts, filberts, hazelnuts, macadamia, pecans, peanuts, walnuts) oats, okra, olive oil, onions, oranges, papaya, parsnips, pears, peas, peaches, peppers-bell and hot, persimmons, pineapple, pomegranate, plums, poultry (no skin) prunes, pumpkin, quinoa, rhubarb, rutabaga, salmon, sardines, scallions, seeds (flax, poppy, pumpkin, sesame, sunflower) spices (cinnamon, cayenne, garlic, ginger, green tea, parsley, pepper, nutmeg, oregano, rosemary, turmeric) spinach, squash (butternut, crook neck, summer, winter, zucchini), sweet potatoes, tomatoes, trout, tuna (water packed), turnips, water chestnuts, watermelon, wild game, yams.
1. Esmaillzaded, A. Azadbakht, L. Home use of Vegetable Oils, Markers of Systemic Inflammation, and Endotheilial Dysfunction. AJCN 2008;88(4) 913-21
2. Zhao, G., Etherton, T.D., Martin, K.R. et al. Dietary alpha-Linolenic Acid Reduces Inflammatory and Lipid Cardiovascular Risk factors in Hypercholesterolemic Men and Women. J. Nutr. 2004;134:2991-97
3. Cook, N.R., Obarzanek, E., Cutler, J.A. et al. Joint Effects of Sodium and Potassium Intake on Subsequent Cardiovascular Disease. Arch Intern Med. 2009;169(1):32-40
4. Basu, A. Devaraj, S., Jialal, I. Dietary factors that Promote or Retard Inflammation. Arterioscler Thromb Vasc Biol. 2006;26:995-1001
5. Warnberg, J Ruizn JR, Sjostrom, M. et al. Association of Fitness and Fatness to Low-Grade Systemic Inflammation in Adolescents. The AVENA study. Med.Sci. Sport Exerc. 2006;38(5) S8, A-613
6. Simopoulos, A.P. The Importance of the Omega-6/Omega-3 Fatty
Acid Ratio in Cardiovascular Disease and Other Chronic Diseases.
Exp Biol Med. 2008;233:674-88