The Doctor’s Kitchen - Eat to Beat Illness: A simple way to cook and live the healthiest, happiest life

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It’s amazing how many times I see ‘inflammation’ as a concept coming up in different medical specialities as one of the potential causes of disease. It has almost become a unifying theory that links conditions of the modern world to our lifestyles. You might think I’m just talking just about the swollen ankle that happens after an injury, or the redness that surrounds a cut on the skin, but high blood pressure, heart disease, dementia, diabetes and mental health problems all have links to an imbalance of inflammation in the body at a cellular level.

WHAT IS IT?

I see many products being labelled as ‘anti-inflammatory’ and I think there is a lot of misunderstanding about what inflammation really is. This chapter will give you more of a tangible idea about the role of inflammation in our health as well as how to tackle the problems related to an imbalance of this essential system.

Inflammation is your body’s normal response to events that cause damage to cells, like an injury or infection. The process involves proteins being released in response to the damage and these proteins send signals to the cells of the immune system to come and help. This is usually a short-lived, adaptive response that involves coordination of many complex signals and organs.

The inflammation process is very important: without it our cells would not be aware of bacteria causing something like a simple skin infection, and leaving the bacteria undetected in our body could lead to an uncontrolled severe infection with significant consequences. Inflammation is critical for infection prevention and to keep the body alert. We have, in essence, evolved to be able to fight infections, and a host of other stressors to the human body, effectively and swiftly using inflammation as an important tool.

However, inflammation is meant to be a temporary, protective response. Whether that’s a reaction to a knee injury or an infection in your digestive tract, inflammation is essentially a big nudge to your body, letting it know something is not quite right and needs to be addressed swiftly. Inflammation is meant to be a short-lived process that resolves over hours, days or, at worst, weeks. However, what we are witnessing in modern society is persistent, low-grade inflammation over longer periods of time, also referred to as ‘meta-inflammation’.

Today we have a number of seemingly small and insignificant stressors that create subtle inflammation over long periods of time and can manifest in a multitude of symptoms. These range from the subtle and vague, such as fatigue, lack of mental clarity and skin irritation, to the more pronounced, including pain, mood disorders and heart disease.

These symptoms will obviously overlap with other causes, but we are becoming more aware of the damaging effects of inflammation imbalance that is at least in part to be related to these and many other conditions.

Examples of stressors potentially causing low-grade inflammation include excess sugar consumption, psychological stress, sedentary behaviour, accumulation of fat tissue and nutrient deficiencies (including vitamin D, Omega-3 and different micronutrients). Depending on our ability to tolerate these factors, the result can be low-grade meta-inflammation. This culmination of seemingly insignificant stressors can potentially tip us into a pro-inflammatory state, putting us at risk of the wide spectrum of conditions that inflammation is related to. This pro-inflammatory imbalance is what I will refer to as ‘inflammation’ for the rest of this chapter and what can be rebalanced with delicious foods and an enjoyable, healthy lifestyle.

While I want you to appreciate the importance of inflammation as a necessary mechanism in our body, when we examine the triggers of inflammation in modern life using this diagram, it becomes obvious why the balance of inflammation has become skewed towards the pro-inflammatory side of things. This meta-inflammation, as I’ve alluded to, has a role in many conditions including mental health disorders such as depression,

high blood pressure

and insulin resistance which is linked to the development of poor sugar control and ultimately Type 2 diabetes.

With this in mind, it’s important to try and find effective ways to prevent this imbalance from occurring and the diagram gives us an idea of what we can do to restore the equilibrium.

STOP THE TRIGGERS

The reassuring fact is that we can manage inflammation effectively and simply with changes to what we eat and how we live. It’s not expensive, it doesn’t require excessive interventions or huge modifications and I’m here to guide you through this process. We have many solutions within our control that we can broadly categorise into two steps. The first is to stop the pro-inflammation triggers in the first place. The second is to introduce diet and lifestyle changes to actively reduce inflammation; we possess the ability and mechanisms to purposely reduce the inflammatory response as well.

The most effective way to STOP inflammation in its tracks is by assessing our diet, which in many cases is the most obvious and clear trigger. Looking at a number of large population studies, the benefits of eating a largely vegetarian diet, from the perspective of reducing inflammation, is undeniable. A number of researchers have demonstrated that eating a western diet made up of refined sugars and carbohydrates, large amounts of animal protein, processed foods and poor-quality fats is related to higher amounts of inflammation signals when measured in the blood.

Conversely, putting more plant foods and fibre in your diet, including good-quality fats that we obtain from nuts and seeds, and eating less animal protein, is linked to significantly lower measures of inflammation.

Essentially, it is a fairly Mediterranean-style of eating and we can reasonably infer from these studies that reduced inflammation is related to less disease and general health protection.

EXCESS BODY FAT

Fat, also known as adipose tissue, is a very useful part of our bodies that we have required during our evolution. Without fat, we wouldn’t have survived long periods where food was scarce. This explains why those who have a genetic predisposition to putting on fat, particularly around their organs and waists, may have actually been at an evolutionary advantage when it came to harsh winters, famine and lack of nutrition for energy.

Essentially, it would have acted as a storage form of energy that was readily accessible when food was not available.

Today, however, the ability to put on and retain fat is a clear disadvantage considering our current food environment full of ‘convenient’, energy dense and nutritionally poor options. With no famine around the corner there isn’t any use to carry fat on our body and we do not end up burning it for energy. To add insult to the situation, if we do accumulate fat predominately around our organs and waistline, it is ‘metabolically active’. That is to say, it promotes inflammatory signals that can contribute to the burden of diseases we’ve mentioned.

This is why the scientific community promote ‘weight loss’ and reducing ones’ body mass index (BMI) as a strategy to counter the effects of excess fatty tissue.

While I agree that fat tissue is pro-inflammatory and people who lose fat can reduce their inflammatory burden,

a narrow focus on weight alone is sometimes a negative goal for a lot of people who struggle to understand the wider context. I believe health can be independent of weight. It is your lifestyle, mindset and diet that are the biggest determinants of a happy, healthy life. I’d rather you focus on building healthy habits with wellbeing as your main goal, rather than a number on a set of scales. When you adopt a diet that reduces refined sugars and carbohydrates and replaces them with fibre, largely plants and colourful vegetables, coupled with the lifestyle changes I discuss throughout this book, you are lowering inflammation.

These are also the habits that can protect against the dangerous type of fat accumulating around our body’s organs (known as visceral fat) that promotes inflammation and leads to health problems. Before we naively use our scales as a measure of success, I implore you to embrace healthy habits and the subjective measurement of how you feel as a better marker of health.

‘A diverse, plant-focused diet with plenty of fibre and a variety of colours is the easiest and most effective way to support your microbes anti-inflammatory ability.’

SUPPORT YOUR GUT

We are in constant communication with our environment via our digestive tract and so it should come as no surprise that inflammation is heavily influenced by the microbes living in our gut.

Our microbiota, the different types of microbes such as bacteria and fungi living mostly in our gut, are important modulators of inflammation. A diverse and healthy population of microbes is associated with lower levels of inflammation and there are a number of mechanisms behind how they achieve this.

Your gut microbes support inflammation balance by increasing antioxidant production and reducing oxidative stress. They maintain the health of the tissues in your digestive tract to lower gut inflammation, which reduces the likelihood of foreign material inappropriately passing into your bloodstream, causing your body to react. Your microbes protect you from infections and improve your ability to control sugar in the blood, plus they actively secrete chemical signals that calm your immune system, preventing an inappropriate inflammatory response. These, and a number of other mechanisms, are why a flourishing, diverse population of microbes is so important from the perspective of balancing inflammation

and as you’ll discover as you read on, the most effective way of nurturing a healthy microbiota is with your food.

There is huge scope for introducing specific bacterial strains to counter the ill effects of inflammation, and some studies have had promising results using probiotics (live bacterial strains in supplemental form).

But, before you reach for specifically designed strains of bacteria that are formulated with ‘anti-inflammation’ claims, let me remind you that your microbiota is best served by a diverse, plant-focused diet with plenty of fibre and a variety of colours. This is the easiest and most effective way to support your microbes’ anti-inflammatory ability.

What follows is a description of lifestyle changes and foods that support your bugs, prevent fat accumulation and balance inflammation through a variety of pathways.

+ Good-quality fats It’s long been thought of as a hindrance to health and wellness to have any fats in your diet because of fears of weight gain and risks to your heart, but once again it comes down to the quality of the fats in your diet rather than purely the amount. Dietary fatty acids from oily fish and nuts can positively impact inflammation by changing the expression of your genes, influencing the inflammation pathways within cells. They’re also the building blocks of molecules that are used to signal your body’s anti-inflammatory response.

Whole sources of fats from plants such as walnuts, macadamia, pumpkin seeds, sunflower seeds and of course extra-virgin olive oil

are great sources of fats that have been shown to be anti-inflammatory. These contain more of the Omega-3 fats that can balance inflammation as we learnt about in the chapter on heart health (here (#u776c38a3-ac52-5167-94e2-1a42719c279e)). I tend to use olive oil liberally in cooking and I use the highest quality, cold-pressed varieties where possible for flavour as well as function.

+ Polyphenols These are a category of health-promoting chemicals that we find in food and there are literally thousands of them. In general, the coloured vegetables lining our supermarket grocery aisles are great sources of these potent compounds that can target processes related to inflammation. These targets have long and confusing names like the protein complex ‘nuclear factor kappa B (NF)-κB’

and the enzyme ‘cyclooxygenase (COX)’

which also happen to be molecular targets for medications that we prescribe for things like arthritis and pain. This isn’t to suggest that we can or should replace drugs with food, but the polyphenols you find in a crisp apple, humble pea or vibrant butternut squash all possess the ability to modulate inflammation by impacting these and many other processes involved in inflammation.

A rainbow diet is the easiest way to guarantee a collection of polyphenols that can lower the inflammatory burden.

+ Green foods Of particular mention are undoubtedly the greens. The impact of brassica vegetables including broccoli, rocket, kale, bok choy and sprouts are absolutely incredible, which is why I try to eat these daily, if not at most mealtimes … and yes, that includes breakfast (try my One-pan Greek Breakfast here (#litres_trial_promo) or Watercress, Walnut and Crayfish here (#litres_trial_promo)). These ingredients contain many chemicals, including some well-studied compounds called sulforaphane and indole-3-carbinole that prevent oxidative stress.

These are some of the most technologically advanced ‘drugs’ and they’re only available in grocery stores. Get them on your plate.

+ Red foods Deep red-coloured foods contain a particular type of flavonoid called anthocyanin that is well known to be a potent anti-inflammatory chemical.

We get these from cheap accessible ingredients such as red cabbage, blue- and red-coloured berries, chard as well as more exotic ingredients such as black rice, red carrots and purple potatoes. The benefits of red foods are complemented by other colours in your diet. I am by no means suggesting only eating red and green foods for inflammation, but discovering how and why these foods reduce oxidative stress and balance inflammation is exciting enough for me to include these in my diet regularly.

+ High-fibre foods Higher glycaemic index (high GI) foods that release sugar into the bloodstream rapidly are associated with greater inflammation measures in the blood.

Regular consumption of these high GI foods, such as refined cereals and grains, breads, pasta, cakes and biscuits (no matter whether they are labelled ‘healthy’, ‘wholegrain’, ‘gluten free’, or anything else that has an apparent health connotation) is associated with a higher inflammatory burden. This is not a call to remove these foods entirely from your diet. I would never want to rob someone the pleasure of enjoying delicious freshly prepared pasta or a warm, fluffy doughnut with sticky jam. But, greater awareness of why these are not the best foods to eat regularly will mould your daily choices and heighten your understanding of what health-promoting food means for you. A simple way to reduce inflammation is simply switching from carbohydrates that quickly release sugar into the blood to foods that are higher in fibre and thus release sugar more slowly.

Examples include split peas, artichokes, onions, whole apples, black beans and yellow lentils. In addition, these foods positively enhance the population of gut microbes by giving them a food source to flourish on.