CHAPTER
5

How the Diet Works

In This Chapter

The seven principles of the anti-inflammation diet we presented in Chapter 4 draw on the best available research about diet and inflammation. The diet emphasizes cutting down on foods that foster inflammation and stepping up those that fight inflammation. It also emphasizes the importance of losing any excess fat, which contributes to inflammation.

In this chapter, we explore how the anti-inflammation diet works.

The Healthy Eating Pyramid

The first principle of the anti-inflammation diet is to eat a well-balanced variety of wholesome foods. We believe the best way to accomplish this is to follow the advice of Dr. Walter Willett and his colleagues at the Department of Nutrition at Harvard School of Public Health (HSPH).

Dr. Willett and company have developed the Healthy Eating Pyramid. This pyramid is different from the U.S. Department of Agriculture’s former pyramid (which has been updated to MyPlate) and is based on sound scientific research conducted at HSPH and other highly respected research centers.

The Healthy Eating Pyramid from the Department of Nutrition at the Harvard School of Public Health.

Notice that Dr. Willett’s pyramid is based on foods that are health-promoting. These healthful foods are the foundation of the diet and should be eaten frequently. The farther a food type is from the base, the more harmful it is for you, and this holds true for its impact on inflammation. The foods on the detached peak are the worst. A good rule of thumb is to think of these foods as being for special occasions only.

Climbing the Pyramid

The pyramid’s food guidelines include several levels. The base, or the first level, is daily exercise and weight control, which greatly promotes health and prevents metabolic syndrome.

On the second level, you’ll find whole grains, healthy fats and oils, and vegetables and fruits. Whole-grain foods, such as brown rice, whole-wheat pasta, and oats, are healthy carbohydrates. Your body needs them for energy, so eat them at most meals. When it comes to healthy oils, opt for plant oils like olive, canola, soy, corn, sunflower, and peanut and trans-free margarine. Because most people get one third or more of their calories from fats, they are on the first floor of the pyramid. However, the fats you eat must be health promoters. Stay away from animal fats and palm, palm kernel, and coconut oils. Next up are vegetables (in abundance daily) and fruits (two or three times daily). Men should eat nine servings of fruits and vegetables a day and women should eat seven servings.

INFLAMMATION INFORMATION

Even when naked (without butter or any other topping), potatoes have a high glycemic index (GI). They cause a rapid, strong rise in blood sugar. Over time, these surges may damage the cells that produce the hormone insulin.

The third level features nuts, seeds, beans, and tofu (one to three times daily) as well as fish, poultry, and eggs (0 to 2 times daily). Nuts, seeds, beans, and tofu are excellent sources of protein, fiber, vitamins, and minerals. Fish, poultry, and eggs are important sources of lean protein, but you don’t have to eat them every day if you eat other wholesome sources of protein.

On the fourth level you’ll see dairy (one or two servings a day) or vitamin D/calcium supplements. Dairy products are great sources of protein, but they can contain a lot of saturated fat. In fact, the developers of the HSPH pyramid point out that three glasses of whole milk have as much saturated fat as 13 strips of cooked bacon! Stick to no-fat or low-fat dairy products, or get your calcium from other sources. Broccoli and soybeans, for example, are loaded with calcium, and many other plant foods are also chock full of the nutrient.

And then there’s the detached peak. Here you’ll find red meat and butter, refined grains, sugary drinks and sweets, and salt. Red meat and butter are on the peak because they contain lots of saturated fat. Refined grains like white bread, rice, and pasta; soda; and sweets can cause “fast and furious increases in blood sugar that can lead to weight gain, diabetes, heart disease, and other chronic disorders,” according to Dr. Willett. The well-loved standby, potatoes, are included in these stay-away-from foods.

In addition, Dr. Willett and his colleagues recommend you take a multivitamin daily. A daily multivitamin/multimineral supplement is “nutritional backup.” Taking a vitamin/mineral supplement can’t replace healthy eating or make up for unhealthy eating. However, “it can fill in the nutrient holes that may sometimes affect even the most careful eaters,” according to Dr. Willett.

Also, drink alcohol only in moderation. Research has found that an alcoholic drink a day lowers the risk of heart disease. However, moderation is key. The developers of the pyramid say, “For men, a good balance point is one to two drinks a day. For women, it’s at most one drink a day.”

The Anti-Inflammation Diet and the Pyramid

The anti-inflammation diet incorporates the building blocks of the Healthy Eating Pyramid. On the anti-inflammation diet, you eat a well-balanced variety of wholesome foods. This means eating a combination of foods from all levels of the pyramid up to the peak, which can include some red meat, white rice, white pasta, and potatoes.

You also eat only unsaturated fats. Opt for those oils listed at the base of the pyramid: olive, canola, soy, corn, sunflower, peanut, and other vegetable oils. Do not eat palm, palm kernel, or coconut oil.

In addition, you eat one good source of omega-3 fatty acids every day. Okay, we added this one. Even though Dr. Willett suggests in his book Eat, Drink, and Be Healthy that you should eat one good source of omega-3 fatty acids a day, he didn’t specifically include them in the Healthy Eating Pyramid. We believe getting enough omega-3s in your diet plays such an important role in preventing inflammation we made it Principle 3. In addition, eat coldwater fish such as salmon at least twice a week.

Also eat a lot of whole grains. Whole grains are on the base of the pyramid. Eat them at most meals. Eat healthy sources of protein, too. Get your protein from nuts, legumes, fish, poultry, and eggs, and eat plenty of fruits and vegetables.

Finally, eliminate refined and processed foods as much as possible. Refined foods are in the detached peak along with red meat and butter. Eat sparingly if at all.

Who Should Follow the Anti-Inflammation Diet?

The anti-inflammation diet is a lifelong approach to nutrition everyone should follow, regardless of age. At the same time, people who are particularly at risk for inflammatory conditions should follow the diet’s guidelines. This applies to you if any of the following are true:

Maintaining an anti-inflammatory lifestyle is important to maximize the effectiveness of the diet.

Maintain a Healthy Weight

Although the anti-inflammation diet is not a diet to lose pounds, controlling body weight is an important weapon in the arsenal to fight inflammation.

Your daily calorie needs depend on how much you weigh and how active you are. There are a number of ways to calculate how many calories you need per day to maintain your present weight. The American Cancer Society offers a quick and easy online calculator that takes into consideration your current weight, gender, and activity level. (See Appendix B for the URL.)

The rule about weight control is the old standby: calories in = calories out. If the amount of calories you take in equals the amount you spend through daily activity, your weight will remain the same. If the amount of calories you take in is more than you spend, you’ll gain weight. The opposite is true if you take in less than you spend. The path to weight loss is eating less and exercising more, or both.

Whether you weigh 115 or 215, 1 pound of body weight is equal to 3,500 calories. If you eat 500 fewer calories per day than the amount of calories you need, you’ll lose 1 pound per week. You could also perform enough exercise to equal another 500 calories per day—such as exercising on an elliptical machine for 30 minutes—and lose 2 pounds. (We cover this topic with more detail in Chapter 17.)

Consume Antioxidant-Rich Carbs

One of the advantages of following the anti-inflammation approach to nutrition is that your diet is full of healthful, unrefined carbohydrates and not empty calories. A diet full of colorful fruits, vegetables, and whole grains supplies a range of important antioxidants. Antioxidant-rich carbohydrates act by blocking free radicals, which can contribute to silent inflammation.

DEFINITION

An antioxidant is any substance that reduces damage due to oxygen (oxidative damage) such as that caused by free radicals. Free radicals are highly reactive chemicals that change chemical structures. Well-known antioxidants include vitamin C, vitamin E, and beta-carotene (which is converted to vitamin A)—all are capable of counteracting the damaging effects of oxidation.

In contrast, the carbohydrates in sugary foods are usually low in antioxidants and contain harmful fats. They also cause overweight and obesity.

The exception is dark chocolate, which is rich in antioxidants (but still high in calories).

Eat Heart-Healthy Omega-3 Fatty Acids

As we discussed in Chapter 4, omega-3 fatty acids are one of the most important weapons against inflammation. They are so important that the American Heart Association (AHA) recommends eating fish (particularly fatty fish) at least two times a week.

WHAT THE EXPERTS SAY

Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna, and salmon are high in two kinds of omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

—The American Heart Association

The AHA also recommends eating tofu and other forms of soybeans, canola, walnuts, and flaxseeds, and their oils. These contain alpha-linolenic acid (also known as linolenic acid, or LNA), which can become omega-3 fatty acid in the body. However, most experts don’t think these sources are as potent or effective as getting omega-3s directly from fatty fish.

Omega-3 supplements are also available. However, if you take more than 3 grams omega-3 fatty acids a day, it’s very important to discuss this with your doctor.

Get Plenty of Phytochemicals

Another advantage of following the anti-inflammation diet is that you consume a lot of phytochemicals, a natural compound found in plant foods. More than 900 different phytochemicals have been found in plant foods, and more are being discovered each year.

Research suggests that phytochemicals, working together with nutrients found in fruits, vegetables, and nuts, may help slow inflammation and related diseases. These protective plant compounds are an emerging area of nutrition and health, with new research reported every day.

Fruits and vegetables that are brightly colored—yellow, orange, red, green, blue, and purple—usually contain the most phytochemicals and the most nutrients. One of the best-known groups of phytochemicals is the carotenoids, the pigments that give fruits and vegetables their bright colors. One carotenoid, beta-carotene, is eventually converted by the body into vitamin A. This phytochemical is found abundantly in carrots, spinach, and sweet potatoes.

Another type of carotenoid is called lycopene, which is found abundantly in processed tomato products such as tomato sauce and ketchup. It’s thought to reduce the risk of prostate cancer.

Eating lots of fruits, vegetables, whole grains, soy, and nuts gives you a good supply of phytochemicals in your diet. Blueberries, strawberries, and other berries are great choices. In addition, apples and red onions are excellent sources of quercetin, which has strong anti-inflammatory properties.

Avoid Eating Trigger Foods

If you have food allergies or intolerances, they can cause inflammatory reactions. Eliminating the foods that trigger these conditions from your diet can bring tremendous relief.

Allergies and intolerances aren’t the same thing, but they both cause inflammation. If you have a food allergy, your immune system reacts to a certain food protein it thinks is poisonous. The most common form of food allergy occurs when your body creates immunoglobulin E (IgE) antibodies to the food you’re allergic to. When these IgE antibodies react with the food, chemicals cause inflammation, hives, asthma, or other symptoms of an allergy.

DEFINITION

An antibody is special protein your body makes to defend you against bacteria, viruses, and other foreign materials. Individual antibodies attack and disable specific foreign materials.

Although it’s possible to be allergic to any food, such as fruits, vegetables, and meats, eight foods account for 90 percent of all food-allergic reactions: milk, eggs, peanuts, tree nuts such as walnuts and cashews, fish, crustacean shellfish, soybeans, and wheat. Beginning January 1, 2006, the Food and Drug Administration required food labels to clearly state if products contain any proteins from these eight major allergenic foods.

Food intolerances do not involve the immune system. A food intolerance is a problem with the body’s metabolism. Milk lactose and wheat gluten are common triggers. If you’re sensitive to these foods, your symptoms can include gas, bloating, and abdominal pain.

When you eat the anti-inflammation way, you take in a lot of omega-3s, antioxidant-rich carbs, and phytochemicals.

Eliminate Inflammatory Foods

Some foods trigger inflammation, such as foods high in omega-6s. Trans fats also trigger inflammation. When you follow the anti-inflammation diet, you eliminate these harmful, inflammation-causing foods:

The Least You Need to Know

Avocado Salad Dressing

This pale green dressing will add a creamy richness to your salad.

1 ripe avocado, peeled, seeded, and mashed

1⁄4 tsp. onion powder

1⁄4 tsp. garlic powder

1⁄2 tsp. chicken bouillon powder

1 TB. lemon juice

1 tsp. honey or other sweetener

1 TB. light mayonnaise

Salt

Water

1⁄4 medium seedless cucumber, finely diced

1 medium tomato, finely diced

1 TB. chopped onion or scallion

  1. In a blender or a food processor fitted with a slicer blade, process avocado, onion powder, garlic powder, chicken bouillon powder, lemon juice, honey, mayonnaise, and salt until smooth.
  2. Add water to desired thickness, and blend again.
  3. Stir in cucumber, tomato, and onion.
  4. Serve with your favorite salad greens.

DIET DO

Make this dressing right before you serve it so the avocado won’t turn brown.

Japanese Carrot Salad Dressing

Ginger gives a kick to this Asian-inspired dressing.

1 small carrot, peeled and shredded

2 TB. mirin

2 TB. rice vinegar or cider vinegar

1 TB. soy sauce

1⁄2 tsp. dark sesame oil

1 TB. grated fresh ginger

3 oz. silken tofu

  1. In a blender or a food processor fitted with a slicer blade, process carrot, mirin, rice vinegar, soy sauce, sesame oil, ginger, and tofu until smooth.
  2. Serve with your favorite salad greens.

DID YOU KNOW?

The silken tofu will thicken this dressing nicely. And mirin is a Japanese cooking wine. You can find it in your supermarket or Asian food store.

Black Soybean Salad

This colorful, crunchy salad makes a terrific light lunch or a simple side dish. Courtesy of the United Soy Board.

1 (16-oz.) can black soybeans, drained and rinsed

1 cup canned or cooked corn kernels, drained

3 medium stalks celery, sliced (1 cup)

1 medium sweet red bell peppers, ribs and seeds removed, and diced (1⁄2 cup)

1 medium green bell pepper, ribs and seeds removed, and diced (1⁄2 cup)

1⁄4 cup sliced green onions, white and green parts

1⁄4 cup ripe olives

2 TB. pickled hot yellow peppers, seeded and diced

1⁄4 cup soybean oil

1⁄4 cup white wine vinegar

3⁄4 tsp. salt

1⁄2 tsp. chili powder

Black pepper

  1. In a large bowl, combine black soybeans, corn, celery, sweet red pepper, green pepper, green onions, olives, and hot yellow peppers.
  2. In a small bowl, whisk soybean oil, white wine vinegar, salt, chili powder, and black pepper.
  3. Pour dressing over soybean mixture, and marinate for at least 1 hour before serving.

DID YOU KNOW?

You can find black soybeans at your local health food store. Their taste is similar to black beans.

Salmon with Capers

Capers add a slightly salty flavor to this rich salmon dish.

1⁄4 cup raw barley

1⁄2 cup water

Salt

Black pepper

1⁄2 to 3⁄4 lb. wild salmon fillets

Olive oil spray

4 cloves garlic, chopped

1 tsp. capers

1⁄2 cup white wine

4 oz. jarred Italian roasted red peppers packed in oil, cut in pieces

1 medium head broccoli, chopped into florets

  1. Preheat the oven to 450°F.
  2. Pour raw barley into a strainer, and rinse in cold water. Place barley in a small bowl. Add water, season with salt and pepper, stir, and set aside.
  3. Spray the inside of 2-quart Dutch oven and lid with olive oil. Place salmon in the bottom of the pot, skin side down if skin on. Spray fillets lightly with olive oil.
  4. Season salmon with more salt and pepper, and sprinkle with garlic and capers. Pour 1⁄4 cup white wine over fish, and top with Italian roasted red peppers.
  5. Pour barley over top, add broccoli florets, and arrange to fit inside pot. Pour remaining 1⁄4 cup white wine over all.
  6. Cover and bake for 45 minutes.

DID YOU KNOW?

Cookbook writer Elizabeth Yarnell has perfected the one-pot meal. Each recipe contains an entrée, grains, and vegetable side for a complete meal with minimal preparation or cleanup. This recipe is from her book, Glorious One-Pot Meals.

Spaghetti with Turkey Meat Sauce

Ground turkey and whole-wheat pasta increase the health quotient of this traditional comfort food dish. This health-promoting version of an old standby is from Heart Health Recipes (National Heart, Lung, and Blood Institute).

1 lb. lean ground turkey

1 (28-oz.) can tomatoes, with juice, roughly chopped

1 large green bell pepper, ribs and seeds removed, and finely chopped (1 cup)

1 medium onion, finely chopped (1 cup)

2 cloves garlic, minced

1 tsp. dried oregano, crushed

1 tsp. black pepper

1 lb. whole-grain spaghetti noodles, uncooked

  1. Coat large skillet with nonstick spray, and preheat over high heat. Add ground turkey, and cook, stirring occasionally, for 5 minutes. Drain and discard fat.
  2. Stir in tomatoes with juice, green bell pepper, onion, garlic, oregano, and black pepper. Bring to boil, reduce heat to low, and simmer, covered, for 15 minutes, stirring occasionally.
  3. Uncover and simmer for 15 more minutes.
  4. Meanwhile, cook whole-grain spaghetti in unsalted water according to package directions. Drain well.
  5. Serve sauce over spaghetti noodles.

DID YOU KNOW?

For creamier sauce, give the cooked sauce a whirl in blender or food processor before topping spaghetti.

Green Tea Slushie

This slushie is a refreshing way to start your day, or relax in the afternoon, while getting a dose of good-for-you green tea.

1 tsp. powdered green tea

1 TB. brown sugar

1⁄8 tsp. vanilla extract

3⁄4 cup low-fat or skim milk

1 cup ice

  1. In a blender, combine powdered green tea, brown sugar, vanilla extract, and milk.
  2. Add ice last, and blend to your desired consistency. Add more sugar if needed.

DID YOU KNOW?

Green tea is a popular antioxidant. The ingredient that separates this treat from other iced green tea drinks is powdered green tea, which you can find in health food or specialty tea stores.