The Doctor’s Kitchen - Eat to Beat Illness. Dr Rupy Aujla

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,⁷⁸ high blood pressure⁸⁰ and insulin resistance which is linked to the development of poor sugar control and ultimately Type 2 diabetes.^{81, 82} 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.⁸³

      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.⁸⁴

      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.^{85, 86} 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.⁸⁵

       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.⁸⁷ 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.⁸⁸ 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,⁸⁹ 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.⁹⁰ 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.⁹¹ 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 ^{92, 93, 94, 95, 96, 63} 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).^{63, 97} 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.^{98, 99, 100} Whole sources of fats from plants such as walnuts, macadamia, pumpkin seeds, sunflower seeds and of course extra-virgin olive oil¹⁰¹ 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). I tend to use olive oil liberally in cooking and I use the highest quality, cold-pressed varieties where possible for flavour