Anti-inflammatory Diet

[Guest guest]

I am curious how long one should be on the A-I diet before re-introducing certain foods.

What's the experience of all of you out there?

Thanks.

Allie Tanzer NDSeaside, OR

[Guest guest]

Article from this morning's Los Angeles Times

BATTLING INFLAMMATION, DISEASE THROUGH FOOD

Though it's an emerging field, proponents of anti-inflammatory diets

point to growing evidence that foods like vegetables and fish can

ease an overactive immune system.

By Shara Yurkiewicz

August 17, 2009

If you want to live longer -- avoid heart disease, Alzheimer's

disease and cancer -- then pick and choose your foods with care to

quiet down parts of your immune system.

That's the principle promoted by the founders and followers of

anti-inflammatory diets, designed to reduce chronic inflammation in the body.

Dozens of books filled with diets and recipes have flooded the market

in the last few years, including popular ones by dermatologist Dr.

Perricone and Zone Diet creator Barry Sears.

Those who frequent message boards that discuss arthritis or acne

trade tips on which pro- or anti-inflammatory foods may help or

trigger their symptoms -- urging co-sufferers to try cherries for

their rheumatoid arthritis or avoid gluten for their psoriasis.

But proponents claim the benefits go far beyond that, fighting not

just pain from inflamed joints or skin flare-ups but also

life-threatening diseases.

" If your future currently looks bleak because of high levels of

silent inflammation, don't worry, because you can change it within

thirty days, " Barry Sears promises in his book, " The Anti-Inflammation Zone. "

There's still a lot of science to be done. And should you try such a

diet, you probably shouldn't expect any 30-day miracles. But there

may be something to eating in an anti-inflammatory way.

" [Chronic inflammation] is an emerging field, " says Dr. Heber,

a UCLA professor of medicine and director of the university's Center

for Human Nutrition. " It's a new concept for medicine. "

The point of an anti-inflammation diet is not to lose weight,

although it is not uncommon for its followers to shed pounds. The

goal: to combat what proponents call " chronic silent inflammation " in

the body, the result of an immune system that doesn't know when to shut off.

The theory goes that long after the invading bacteria or viruses from

some infection are gone, the body's defenses remain active. The

activated immune cells and hormones then turn on the body itself,

damaging tissues. The process continues indefinitely, occurring at

low enough levels that a person doesn't feel pain or realize anything

is wrong. Years later, proponents say, the damage contributes to

illnesses such as heart disease, neurological disorders like

Alzheimer's disease or cancer.

In general terms, following an anti-inflammatory diet means

increasing intake of foods that have anti-inflammatory and

antioxidant properties. (Antioxidants reduce the activity of

tissue-damaging free radicals at sites of inflammation.) The diet

includes vegetables, whole grains, nuts, oily fish, protein sources,

spices such as ginger and turmeric and brightly colored fruits such

as blueberries, cherries and pomegranates.

Foods that promote inflammation -- saturated fats, trans fats, corn

and soybean oil, refined carbohydrates, sugars, red meat and dairy --

are reduced or eliminated.

It would seem logical that a diet that could dampen an overactive

immune system could help prevent or slow diseases that are caused or

exacerbated by inflammation. And evidence is certainly mounting that

such diseases include heart disease, cancer and Alzheimer's.

Studies with animals suggest that the diet's followers may be on to something.

" If you feed rodents different diets, you can very strongly modulate

inflammation, " says Dr. Greenberg, the director of the Obesity

and Metabolism Laboratory at the Human Nutrition Research Center on

Aging at Tufts University in Boston. " Fish oil, for example,

ameliorates inflammation in rodents. "

Reservatro, found in grape skin and red wine, has been shown to

improve blood vessel function and slow aging in rats.

Pomegranate juice decreases atherosclerosis development in mice with

high cholesterol. Garlic improves blood vessel functioning in the

hearts of rats with high blood pressure.

And curcumin (an antioxidant chemical found in turmeric) improves

ulcerative colitis, rheumatoid arthritis and pancreatitis in mice and

has anti-cancer effects in the animals too.

Curcumin has also been shown to ease the symptoms of rheumatoid

arthritis in people, reducing joint swelling, morning stiffness and

walking time. In India, turmeric is used to promote wound healing and

reduce inflammation. But though curcumin's effects are being tested

in several clinical trials addressing various diseases, rigorous

human results are lacking -- as is the case for most anti-inflammatory foods.

Large, careful human clinical trials are expensive and few have been

designed to test dietary interventions. Small trials on individual

supplements have been done, though. And scientists have learned a lot

from studying populations -- chronicling the natural habits of people

and seeing what diseases they get and which they don't.

THE DRUG FACTOR

It makes sense that anti-inflammatory methods might help the heart,

says Dr. H. Eckel, a past president of the American Heart

Assn. and professor of physiology and biophysics at University of

Colorado Denver's Health Sciences Center.

Statin drugs, for example, are known to cut heart disease risk by

reducing cholesterol levels -- among other things, these meds fight

inflammation.

" We don't know how much of statins' effect are due to their

anti-inflammatory effects, " Eckel says. But, he adds, a growing

number of researchers suspect that this property is important.

Fish oil, rich in anti-inflammatory omega-3 fatty acids and derived

from oily fish such as tuna, salmon and mackerel -- is already

recommended by the American Heart Assn. to help prevent

cardiovascular disease. It has been shown to reduce blood

triglyceride levels and slightly lower blood pressure, lowering the

risk for heart attacks and strokes.

There is also reason to believe that anti-inflammatory substances

would help to ward off cancers. Non-steroidal anti-inflammatory drugs

have been shown to prevent tumors with people with inherited

colorectal cancer, for example.

And population studies have shown that people who had been taking

non-steroidal anti-inflammatory meds for other conditions were less

likely to develop Alzheimer's disease.

In trials, such drugs have failed to treat already-developed

Alzheimer's, but the studies suggest that it might be possible to

prevent the disease by reducing inflammation, says Greg Cole, a

professor of medicine and neurology at UCLA and associate director of

the UCLA Alzheimer's Disease Research Center.

But it is not safe to take non-steroidal anti-inflammatory drugs for

years because of harmful side effects, such as gastrointestinal

bleeding. What about anti-inflammatory foods? Several clinical

trials, in the U.S. and abroad, have shown that people with mild

memory complaints related to aging (not necessarily Alzheimer's

disease) showed significant improvement when given the omega-3 fatty

acid docosahexaenoic acid, Cole says.

And in an 18-month study released in June sponsored by the National

Institutes of Health, treating Alzheimer's disease with

docosahexaenoic acid slowed its progression in a subgroup of the

study population.

There are other trials with positive results for fish oil in early

Alzheimer's cases, but they are not large enough to be definitive, Cole says.

But, he adds, " the real utility is not to slow the progression of

someone who's already demented, but it's to treat before dementia

happens. We'd like to turn off or keep down [the inflammation] with

something that doesn't cause gastrointestinal bleeding or other side effects. "

Cole's laboratory is looking at the potential for Alzheimer's

prevention by controlling inflammation with omega-3 fatty acids and

curcumin. Other food substances -- such as resveratrol in red wine

and flavonoids in fruits -- may have anti-inflammatory effects by

acting along the same pathway that curcumin does, he says.

Cole suspects that people are more likely to take a supplement or two

than to radically change their diets. " Nutritionists, they'll tell

you to eat right. It is good, sound advice, but you can't always get

people to do it, " he says. " The question is, can you find an easier

supplement approach that doesn't require a restricted diet? "

Supplements do have their drawbacks. " Many Alzheimer's researchers

were prescribing vitamin E [an antioxidant] to all their patients, "

says Debra Cherry, a clinical psychologist and the executive vice

president of the Alzheimer's Assn. of the California Southland. " But

some data came out that people had high bleeds and suffered from

cardiovascular problems. "

DIETARY REVAMP

Perhaps a complete diet overhaul -- difficult though that may be --

would be a better strategy. The Mediterranean diet, named for the

region in which it originated, has many anti-inflammatory features.

It includes fruits, vegetables, nuts, fish, whole grains, alcohol,

and healthful fats like olive and canola oil. It has been shown to

lower LDL cholesterol and triglyceride levels and reduce the risk of

blood clots. Studies have shown that diets high in fish, olive oil

and cooked vegetables reduce the symptoms of rheumatoid arthritis. A

Mediterranean diet or elements of it seems linked to reduced risk for

a number of chronic conditions, including cardiovascular disease,

cancer, diabetes and Alzheimer's. (See related story online.)

" If people noticed they're slightly overweight, or if blood pressure

is starting to creep up, or if blood sugar [increases], and they went

on a Mediterranean-type diet, they might be able to decrease

inflammation and stop the progression of disease, " says Dr. Wadie

Najm, a clinical professor of family medicine and geriatrics at UC

Irvine who directs an integrated medicine clinic at UCI that focuses

on complementary and alternative medicine.

Many patients visiting his clinic have chronic inflammatory

conditions, including autoimmune diseases such as arthritis and

gastrointestinal problems such as Crohn's disease. Patients begin a

specialized diet and exercise, and make other lifestyle changes to

decrease inflammation.

" In three weeks, if [patients] follow the protocol, we see great

results in improvement in symptomology and reduction in flare-ups, "

says Bianca Garilli, a naturopathic doctor at the clinic.

Of course, these dietary and other lifestyle changes might help treat

pain conditions through the placebo effect -- a belief in a treatment

rather than the treatment itself, says Dr. Chao, an associate

professor of medicine at Oregon Health and Science University and

director of clinical guidelines development for the American Pain Society.

" You're giving something for people to focus on and do something good

for themselves, " Chao says.

At the end of the day, there is evidence to suggest that your best

bet at curbing inflammation is to eat a healthful diet -- and keep

your weight in check -- without specifically thinking about

anti-inflammatory foods.

" There is no doubt that if you lose weight, inflammation is

dramatically improved, " Greenberg says. When a person is overweight

or obese, body fat breaks down into fatty acids, which circulate in

the blood. These fatty acids promote an immune response in the same

way that infection does, increasing inflammation.

It will take time to tease apart the effects of anti-inflammatory

diets and supplements. But Cole thinks the effort is well worth it.

" The alternative to these kinds of things aimed at prevention is to

pay for treatments, " he says. " And we can't always afford them. "