Health Revolution

3. INSIGHT (#ulink_11a5ee1d-3d05-565f-b624-4c5bdf8aab9b)

It’s a spring night in Lund, Sweden, 2013.

It’s just the kind of fresh spring evening that creates such expectations of life, love and all the other wonderful things that belong to the light time of year. Students are riding their bikes towards the city centre. Trees are budding in the Lundagård park next to the cathedral’s sandstone walls. The magnolia by the cream-coloured university building will soon begin to bloom, just in time for May Day, when student singers will once again sing a welcome to spring and the beautiful month of May.

Together with the other members of the advisory committee that meets regularly in order to support the university’s big 350-year jubilee, I’m sitting in the old Biskopsgården, just below the library. At the last minute, I’ve decided to attend this meeting, even though my calendar is full. It will turn out to be a significant event.

Every time the group gets together, we have the privilege of meeting one of the most innovative researchers at the biggest university in the Nordic region. Today we’re going to meet a specialist in nutrition research. Professor Inger Björck is introduced and steps forward to talk about her brand-new research. Only a few minutes into her presentation, I realise that her findings are very important, even somewhat sensational.

She gives us a brief background.

Professor Björck leads the Center for Preventive Nutrition Research at Lund University. Scientists there are conducting interdisciplinary research about how a variety of diseases can be counteracted with a proper diet, as well as research into what is known as the metabolic syndrome.

The metabolic syndrome, a medical term that has become more and more common, includes three conditions: diabetes, obesity and high blood pressure. Each of these conditions carries risks. But together, they form a type of super risk for serious heart disease, stroke and other cardiovascular diseases. It is also suspected that this metabolic condition is connected to certain forms of cancer and even to an increased risk of dementia.

Researchers haven’t quite been able to explain the metabolic syndrome. One theory is that it has to do with insulin, the hormone released by the pancreatic gland when you eat sugar-containing foods and whose function it is to move the broken-down sugar into the cells. People with diabetes 1, which often begins to manifest in the teenage years or even earlier, lack the ability to produce enough insulin.

But there is also an acquired form that sneaks up on people later in life, diabetes 2. (Today there are researchers looking into whether there may also be a number of intermediate forms between diabetes 1 and 2, but we’ll leave that aside here for the sake of simplicity.)

To sketch out a simple explanatory diagram for this process, when you eat sugar and your blood sugar level rises, a signal is sent to the pancreatic gland, which releases insulin. The insulin is sluiced out and ‘opens up’ the cells in order to sluice in the broken-down sugar, along with proteins and fat.

When the body constantly takes in large amounts of sugar and insulin levels have to stay elevated in order to shuttle the sugar out of the bloodstream and into the cells, it creates a so-called insulin resistance. In other words, there is insulin in the blood that’s supposed to deal with the sugar, and that makes the insulin attach to the cells, but something goes wrong in the communication between the insulin and the cells. The cells simply lose their ability to react to the presence of insulin. The number of people who have metabolic syndrome is growing rapidly, because more and more people eat the wrong kind of food, have a sedentary lifestyle, and/or suffer from stress and other psychosocial problems.

The above-mentioned triple combination, with diabetes/belly fat/high blood pressure, used to be a medical condition that affected mainly older people. But now it’s increasing even among younger men and women. Altogether it’s estimated that one quarter of the adult population in the United States, Canada and Europe have metabolic syndrome. In short, we are talking about an epidemic that is increasing like an avalanche in the Western world, an enormous threat to public health.

In the past, each of these diseases was studied separately. But Inger Björck and many other researchers worldwide are now beginning to realise that the diseases are in fact connected.

‘Then you have to wonder, how can suffering be prevented?’ she says.

Inger Björck is carrying out innovative research in this area. For example, she’s studied mice that have been fed either a high-fat or a low-fat diet. In addition to that diet, the mice were given different berries and fruits like lingonberries, raspberries, prunes and currants. It turned out that the mice who ate berries – especially lingonberries – maintained the same weight regardless of whether they ate a high-fat or low-fat diet. The lingonberry group actually lost some weight, even with a high-fat diet.

Björck believes that the risk of diabetes 2 and coronary artery disease can be decreased by means of an entirely new method, a new category of food in which berries are part of a larger food group.

‘These foods are called anti-inflammatory,’ she says.

I make a note of the name. It calls to mind what I read about in Dr Perricone’s books ten years earlier.

Then Professor Björck begins to explain how these new foods can affect the whole person, not only blood pressure and cholesterol levels but also cognitive ability, or the brain function that includes a person’s intelligence, in the broad sense of the word – our capacity to think, remember, solve problems and learn new things. This research sounds both creative and worthwhile, and so far I’m following her presentation with interest. This is worth supporting, my professional self acknowledges in an observant yet slightly distant fashion.

But when she shows us the list of the foods the researchers have been using to achieve these results in people, I get a shock. A slow-motion lightning bolt strikes my brain, and I sit at the very edge of my chair, suddenly wide awake.

First, there are things like decreasing sugar, doing away with white flour, increasing the intake of all kinds of berries, increasing the amount of vegetables and fatty fish, and adding vinegar and probiotic supplements. But then comes a concrete list of foods, and it looks like . . . Rita’s food list?

My heart does a quiet leap of recognition and time stands still. I gaze around me at the old meeting room, with its view of the university library’s stepped gable in brick. The great linden trees shimmer with fresh new leaves in the spring evening.

What is this? Have I unknowingly been eating anti-inflammatory foods and thus affected my body much more deeply than I had realised?

The effects I’ve felt are exactly the ones that Inger Björck describes in her test subjects. They grew stronger, reduced their waistlines, expanded their mental capacity and developed more of a zest for life.

Or is it just an amazing coincidence?

After the talk, we are served an anti-inflammatory buffet that the researchers have designed themselves. They’ve even baked their own bread, similar to Danish rye bread, using whole barley. There are salads, fatty fish and nuts, and everything is delicious. Over one of the salads, I share my insight with another woman. I lean forward confidentially, almost a little embarrassed.

‘I’ve actually been eating like this for a few months. Or at least trying to.’

‘I thought you looked energetic, somehow,’ she says, looking at me appraisingly.

I go up to Professor Björck and tell her that there are in fact people who live like this every day but who haven’t quite made the scientific connection to anti-inflammation that Björck’s team has. They just do it because they’ve discovered that it works.

‘Who are they?’ she wonders.

‘Well . . . fitness people in the United States and Canada,’ I say.

She looks surprised. We agree to stay in touch. And that’s where my own journey of knowledge begins.

Inflammation and anti-inflammation. What is this all about? I have to learn more.

I begin racking my brain for long-ago facts from my university studies in immunology. I think I took that course in the red building at the old Veterinary College in Frescati in Stockholm, if I remember correctly, and we learned something about the two forms of inflammation – because inflammation is not always a bad thing.

The first type of inflammation is purely positive, a helping process. Imagine a cut from a kitchen knife, a finger squeezed in the car door, a urinary tract infection or a sore throat. When you’re injured or infected, your immune system starts producing inflammation as a defence mechanism. A teacher I once had used this image to describe it: imagine a land that is being attacked by an external enemy and wants to defend itself. That’s how the immune system works. The outer injury is the external enemy, the immune response is the country’s government and defence, and the inflammation is part of what you have to do to defend yourself. There are a number of different foot soldiers who help. These soldiers in turn have many different specialist functions, just like in a regular army, with bridge builders, telegraph operators, explosives experts and intelligence agents.

In human blood, the blood platelets constantly wander around looking for problems in the blood. The blood platelets gather around the problem – the cut, the bruise or the infected body part – and then send a chemical signal to the immune system.

‘Problem at g, come here right away,’ say the blood platelets.

The signal is intercepted by the white blood cells, who answer, ‘On our way.’

An advanced line of defence is set up, with many different types of foot soldiers. They’re called cytokines, leukotrienes, prostaglandins, chemokines, thromboxanes and so forth, and they function like support troops, where each one sets out with its own task. They expand the blood vessels at the site of the affected tissue and make the area around it more ‘transparent’. This means that more cells from the immune system can reach the injury, attack enemy bacteria, clean out old junk and then repair and build up new and fresh tissue.

In medical training around the world and through the centuries, students have had to learn to recognise an inflammation the traditional way, which originates with the ancient Roman Celsus, who wrote great reference books about the body. Celsus’s favourite treatment was to simply open the veins and empty out the ‘extra blood’, a procedure he recommended for many types of health problems, as well as for people ‘with big heads’. Celsus also described the signs of inflammation in Latin: rubor, tumor, caldor, dolor. Redness, swelling, warmth, pain. Which is exactly what you feel in your throat when you have a sore throat. These signs of inflammation can in turn be counteracted by RICE, or rest, ice, compression, elevation. (Exactly what you do with a sprained ankle.)

The whole point, in short, is that inflammation works like a kind of fire department. It rushes out, attacks the enemies, cleans out and repairs. Then the system goes back to resting status.

This acute type of inflammation has a rhythm. There’s an ebb and flow, a clear beginning and an end, and the rhythm signals a healthy and active immune defence. It isn’t this type of inflammation that’s problematic but rather another one, which seems to be affected by food and contributes to illness. I wondered who might be able to tell me more about it.

I investigate some more, and after a while I find a new trail. There’s a researcher in the United States, Barry Sears, who has been on this track for a long time and founded an organisation for research in that area, the Inflammation Research Foundation. I’m not able to travel to meet him, but I don’t want to just send him an email, since there’s so much that I don’t understand. We need to actually talk.

I’m able to reach him by phone, and he gets right to the point.

‘This is a new area for most doctors. I’ve been working in the field for a while, but in general way too little research has been done.’

He mentions how many different kinds of diseases the low-grade systemic type of inflammation is linked to. We’re talking about heart disease, high cholesterol values, diabetes, joint problems and neurodegenerative disease, but also certain forms of cancer.

‘But what exactly does this low-grade systemic type of inflammation do?’ I wonder.

He begins to explain very fast, and it’s hard to follow him since the connection breaks several times during our call.

‘Okay, how about this: I’ll send you a scientific article,’ Dr Sears says.