Inflammation and diet

st-peters-sunup.jpg

On the flight from London to Rome I read an article on the immune system and cancer. It got me to thinking about the immune system and a whole lot of other health problems.

It’s sunrise in The Eternal City right now. I’ve been up early watching the dawn break over St. Peters, which is a couple of miles below the hotel. I figured everyone was getting tired of travel disaster stories, so I thought this would be a good time to sketch out my views on the inflammatory basis of heart disease.

If you read enough in the medical literature you will perceive a change in outlook on the underlying cause of many of the so-called diseases of civilization, especially heart disease. Most authors – mainly, I suspect, out of desire to keep their academic positions and reputation with their peers – throw a bone to the lipid hypothesis before admitting that it probably isn’t the only cause of coronary artery disease. Over the last decade or so the progression has been thus: elevated cholesterol causes heart disease – elevated cholesterol and maybe a little inflammation cause heart disease – elevated cholesterol and inflammation cause heart disease – inflammation along with elevated cholesterol cause heart disease – and now, among the more enlightened – inflammation causes heart disease. In my opinion, it probably is inflammation by itself that is the driving force behind the development and progression of most cardiovascular disease.

When the cholesterol-causes-heart-theory was in its infancy the question became ‘what causes cholesterol levels to go up? Of course this question led to the anti-saturated-fat hysteria that pretty much still has us by the throat. But the same question needs to be asked of anyone who claims inflammation to be the cause of heart disease: What causes inflammation?

Before we address that issue, let me add that in much the same way saturated fat has been demonized as a cause of almost everything, inflammation is thought to be the catalyst for much more than simply heart disease. There has grown up a theory called the ‘common soil’ theory that implicates inflammation as the underlying problem, or the ‘common soil’ from which spring heart disease, diabetes, obesity and the other diseases common to modern man.

No one much talks about the cause of inflammation – most seem to think it is a natural part of the aging process. As we all get older, we become more inflamed. As we become more inflamed, we tend to develop heart disease, diabetes, etc., all of which are diseases that usually strike later in life.

I have a little different opinion.

Before I can argue my theory, I have to make sure we’re all on the same page about what inflammation really is.

Inflammation can’t be understood without at least a rudimentary understanding of the immune system, specifically the innate immune system, so let’s start there.

We humans along with the rest of the animal kingdom have two immune systems: an innate immune system and an adaptive immune system. The adaptive immune system is the more sophisticated of the two, and it’s the one that seems to have inspired the most research interest. The adaptive immune system is the one involved when you have hay fever, an allergic reaction, or get an immunization. It is the immune system that gives you resistance to measles or mumps once you’ve had them. It is the part of the immune system that remembers and can mobilize vast forces quickly when it discovers an invader that it has seen before, say, the measles virus. It is programmable by what it has dealt with before. The TSA would be comparable to the adaptive immune system. After we were inoculated by the events of 9/11, we grew our national immune system to protect against a threat we didn’t know existed until it hit us.

The innate immune system is a different animal. The innate immune system is a primitive, hard-wired immune system that reacts the same way to every threat. Unlike the adaptive immune system that takes a while to activate and get responsive, the innate immune system is always on the prowl and acts immediately. To carry the 9/11 metaphor further, the innate immune system was what acted immediately after 9/11: all flights canceled, all airports patrolled, no cars could stop, etc. It was an immediate, knee-jerk response to an unknown threat.

The innate immune system is pretty much the same. It lays in wait for any invasion and reacts immediately while the adaptive immune system is just getting out of bed.

If you are an animal in the wild or a Paleolithic man (or woman) and you want to survive, you’ve got to worry about two things: infection and trauma. You can get a virus, fungal or bacterial infection or you can get seriously injured. Both can do you in. The innate immune system was evolved to deal with both. (You can also starve, but that’s another matter. Starvation doesn’t happen to you in the same way infection and/or trauma do. Starvation is a prolongation of the typical feast/famine cycle, and is dealt with hormonally in ways we’ve discussed in previous posts. Plus it takes a lot longer to starve to death than it does to be killed by infection and/or trauma. The innate system deals with immediate threats.)

The innate immune system protects you against infection and trauma. It works the same for both. If you get a cut, throngs of immune cells make their way to the cut almost immediately. They begin sending signals putting out the call to other immune cells to head for the injury and join the fray. The blood clotting system is revved up to minimize blood loss. Any bacteria that enter the cut are immediately swarmed on, surrounded, and killed. The area becomes red, swollen, and painful. It is hot. All of which are the cardinal signs of inflammation known since ancient times: rubor, calor, tumor and dolor. Redness, heat, swelling and pain.

If the infection or trauma is serious enough, the cells of the innate immune system signal to the liver for help. The liver springs into action by what is called the acute-phase response, which is the production and release of even more substances to help deal with the threat.

As the injury or infection is dealt with, the innate immune system completes its work and fades into the background, lying in wait for the next exposure.

The innate immune response is something you’ve got to have to survive, but not something you want actively working all the time. You want it when you need it, but you want it to stay in the background when you don’t.

Problem is that the innate immune system can be chronically active, and when it is, you have a set up for heart disease: increased blood clotting, inflammatory cells and their products attacking blood vessel walls, the liver drifting into and out of the acute-phase response, etc. In other words, the lab picture of someone who has heart disease.

But why does the innate immune system become chronically active instead of just springing into action when needed?

What follows is my opinion and is purely speculative. But I think it makes sense.

We know the innate immune system is primitive and primed for action against infection and/or trauma. It’s the only immune system we have with first-strike capability and is primed for any immediate threat.

We now have a threat we didn’t have during our Paleolithic days. Now we have the threat of overnutrition. We are eating types of foods we didn’t eat in the past and in amounts we didn’t eat in the past. This overnutrition is a threat to our survival and it stimulates an innate immune response because that’s the only response we have. The innate immune system senses danger, reacts, but unlike the cut that heals or the bacteria that gets destroyed, the overnutrition continues. So the innate immune system remains chronically active.

Let me give you one example before I end this already overlong post. (You’ll be begging for more travelogues and tales of airline snafus after this)

When we overeat, the body has to dispose of the excess calories. (I’m talking about the typical high-carb overeating here.) The logical place to stuff them is into the fat cells, which is the first place they go. They go into the subcutaneous fat, the fat under the skin, but outside the body cavity. This is the place nature intended excess fat to go. Subcutaneous fat isn’t particularly aesthetically pleasing, but it’s also not particularly unhealthful. It’s fat where fat is supposed to be.

When the subcutaneous places to store fat are filled (or, for example, when fructose is a large component of the diet) the excess calories go looking for other storage places. The next place these calories go is into fat inside the body cavity – around and within the organs themselves. This is not a good place for fat to be.

The innate immune system regards this fat – called visceral fat – as a foreign invader and attacks. Multiple studies have shown that visceral fat is crawling with macrophages, one of the foot soldiers of the innate immune system, whereas subcutaneous fat isn’t. Once these macrophages invade the visceral fat, they begin signaling – as is their wont being on the front lines of the innate immune system – to other macrophages to join the battle. They also release toxic substances to damage and kill the foreign invaders. These substances reach the blood and are carried throughout the circulation.

Normally these macrophages and other cells of the innate immune system do their jobs, getting rid of the invaders, and mopping up. In the case of visceral fat, the fat just keeps on coming. And the innate immune system keeps on working. And the heart and blood vessels keep on getting damaged.

But it’s not just overnutrition in terms of overeating; it’s also overnutrition in terms of constants eating.

Overeating leads to the fat accumulation that stimulates the chronic inflammation, but simply eating does it as well. Eating is an inflammatory process. A number of scientific studies have shown that eating a meal, regardless of the macronutrient composition, causes acute inflammation, which makes sense when you think about it. Food coming into the body is a foreign substance that fires up the innate immune system – but it does so briefly until the food is digested and the various fats, proteins and carbohydrates are broken down into their basic units and absorbed into the blood stream. (Although it might seem strange that food that we absolutely need to live could cause inflammatory problems, it makes sense when you realize that the very oxygen we breathe and that we would be dead in about four minutes without is slowly killing us also.) When the average American noshes along throughout the day snacking on first this then that the inflammatory response becomes chronic.

Over the past couple of decades just two of dietary changes – eating more and eating more often—have led to a state of chronic inflammation. The changes in diet composition have had an additive effect as well. Numerous studies have shown that while carbohydrates in general cause more of an inflammatory response than other macronutrients, fructose specifically causes the most rapid and intense inflammatory response of all. Polyunsaturated vegetable oils of the omega-6 variety (the majority) are inflammatory, trans fats (all of which start out as vegetable oils) are the worst, and most of the fat of animal, fish and dairy origin are actually anti-inflammatory. Sadly, we’ve been busy replacing the latter with the former. We find ourselves as a nation in the situation where most of our population is overfed the wrong kinds of food all too often with resulting high rates of obesity and chronic inflammation.

This post will probably raise more questions than it answers, which is good. I’ll expand on these themes in later posts and flesh out my ideas a little more.

Please note: I reserve the right to delete comments that are offensive or off-topic.

Leave a Reply

Your email address will not be published. Required fields are marked *

111 thoughts on “Inflammation and diet

  1. Thanks for a very interesting post. I’d like to read more on the subject, but I take issue with two points. 1) about food being inflammatory. Food doesn’t actually get into the body proper until it has already been processed quite a lot in the gut which would give the body time to prepare it so it doesn’t look threatening – no evidence to offer here – just a hunch. 2) eating more often. I imagine that without agriculture or other control over our environment we’d have had to eat whatever we found whenever we found it, hence little and often. Other apes certainly do it that way, and in fact just about all animals I’d guess. The whole low-carb low omega-6 story comes from the perspective of us being neatly suited to the world we evolved in. Being challenged by the stuff we depend on seems inelegant. I agree that the oxygen (even water) parallel is appealing in that too much kills, but the right amount is not at all harmful, while you seem to suggest that the right amount of food is a bit harmful.

    Regards

    Ned

    Hi Ned–

    The literature supports the idea that food is inflammatory.  Although it is processed, so to speak, outside the body, some does get through tight junctions between the cells lining the digestive tract.  Numerous studies have shown increased inflammatory findings after eating high carb diets.

    The literature on early man seems to show that when man existed primarily as a hunter, he gorged on large meals that were not particularly regular.

    Cheers–

    MRE 

  2. Very interesting post, Doc.

    So, would one of the implications of your theory be that IF-ing might be even more beneficial than previously thought?

    Hi John–

    It’s a major implication.  I would have written that in the post, but I ran out of time before I was dragged off to do tourist duty.

    Cheers–

    MRE 

  3. Very interesting stuff indeed Dr. Eades. I too think it makes sense for the most part. And thanks for the primer on the innate and adaptive immune systems.

    Scott Kustes
    Modern Forager

    Hi Scott–

    Good to hear from you.  I’m glad you enjoyed the post.

    Cheers–

    MRE 

  4. Hi Dr Mike,
    Welcome to our side of the pond! I hope you enjoyed your short break in London. If you have time whilst in Italy, I can fully recommend a visit to Florence. It is a very beautiful city.

    I read your article on inflammation with great interest. One question I have is that as fructose causes a rapid and intense inflammatory response, should we limit the amount of fruit we eat on a daily basis? Given fruit’s seasonality, I would imagine that it would not have been readily available to paleolithic man throughout the year!

    Regards,

    Hi Chris–

    Were heading to Florence next.  We’ve been there many times, but never with MD singing.  It should prove fun.

    There is a misconception about fructose and fruit.  Fructose was called fructose because it was first identified in a fruit (I can’t remember which one), not because there is a lot of it in fruit.  Most fruits contain a little, but are not a major source of fructose, so don’t worry about them.  As long as they are relatively low-carb fruits, that is.

    Cheers–

    MRE 

  5. What follows is my opinion and is purely speculative. But I think it makes sense.

    Wow. It makes sense to me, too.

    I was thinking the other day that we all (most North Anericans, anyway) probably eat more than we need.

    I was also wondering when the idea of three squares a day came about. In all likelihood, some days the hunter-gatherers didn’t catch anything (protein) to eat, so they weren’t sitting down regularly to breakfast, lunch and dinner — and snacking in between.

    My husband and I have been on the Protein Power plan since February of this year. He’s lost about 40+ pounds (20 to go) and I’ve lost 20 (10 to go). We are feeling so much better in general and we’ve reached the point where we really don’t miss the high carb foods, with occasional exceptions, of course!

    One thing we’ve noticed is that our meal portions have become smaller — not intentionally, it’s just happened. Our meals are still very satisfying. The hardest thing for my husband was stopping the snacking. It was like he had to be grazing all the time (habit? or ??). However, even that has become less of an issue over time and a handful of nuts or a sliver of cheese does the trick.

    It really is a big deal to completely change one’s way of eating and toss out lifetime ideas about food. In doing this, we began to realize the world around us is totally carb-centric. It’s eye popping. If the US population actually gave up sugars and grains, the impact on the economy would be enormous.

    Thank you for this interesting post.

    Hi Barbara–

    Glad you enjoyed the post, and I’m glad you and your husband are doing so well on the PP plan.  Your experience of meal sizes going down is pretty typical.

    Cheers–

    MRE 

  6. I LOVED this post in so many ways! Not only do you make a very complex system interesting and easier to understand, you clearly separate and make the case for the ‘facts’ and your ‘speculation.’ You inform while leaving a thirst for more information, and room for more speculation and discussion. BRAVO!

    Hi Bob–

    Thanks for the kind words.  I’m glad you enjoyed the post.

    Cheers–

    MRE 

  7. “ When the average American noshes along throughout the day snacking on first this then that the inflammatory response becomes chronic.” So this then becomes an argument for intermittent fasting, does it not?

    Hope this gets through since the blog software you are using causes me to not to be able to see what I have entered.

    Hi Larry–

    It indeed got through.  The post is indeed an argument for intermittent fasting.

    Cheers–

    MRE 

  8. I have read several times about the hazards of fructose. Are you referring specifically to high fructose corn syrup containing foods, or the fructose found naturally in fruit or both. And if the latter, how much fruit do you suggest should be eaten in a given day?

    Hi Maria–

    Fructose is an interesting substance.  A little of it – a few grams per day; the amount found in a typical hunter/gatherer diet – actually makes the body more sensitive to glucose.  More than a few grams, though, and the opposite happens.  Avoid foods containing HFCS and regular table sugar (which is itself half fructose), but don’t worry too much about low-carb fruits and vegetables.

    Cheers–

    MRE 

  9. Excellent post, although it would have been nice for you to reference most of what you write. I’ve looked for saturated fat being anti inflammatory and not found much, although I have found lots of studies on Olive oil being anti inflammatory, as too omega 3.

    I’ve seen quite a few studies now link ‘white blood count’ with heart disease risk, and cancer, and all-cause mortality. Due to the normal reference range being taken from 95% of a healthy human cohort wbc range, due to most peoples diets the range might not itself be optimal. In fact, people who tend to have white blood counts that are near the bottom of the normal reference range are healthier according to various studies. See pub med or google. If not, I can post again to provide references on this.

    Hi Matt–

    I dashed off this post in the predawn hours while on vacation and admitted that it was speculative.  I didn’t write it for publication in a peer-reviewed journal, so I didn’t really see the need for a list of references.  They do exist, however. 

    Give a guy a break.

    Cheers–

    MRE 

  10. Dr. Eades, this is a very enlightening speculation–genial.

    I like how it adds up. Especially the part about the unstable polyunsaturated fats (cis and trans) as inflammatory, with the increase of heart disease practically rising in parallel with their consumption.

    This is why C-reactive protein is a good marker for heart disease (and other illnesses).

    Thanks for taking the time to post this while on vacation!

    Regards,

    Alex
    Dallas, TX

    Hi Alex–

    I’m glad you enjoyed it.  And it is why C-reactive protein is a good marker for the diseases of modern man.

    Cheers–

    MRE 

  11. hi

    am i to understand from this post and many others you have done that Polyunsaturated fats really are the work of the devil? and i should probably stay away from mayonnaise since its poly fat count is quite high.

    im quite a big fan on hot chille peppers that are loaded with Capsaicin from which is suppose to have good anti-inflammatory properties, and was hoping if you had some insight into this?

    Hi Jase–

    In my opinion polyunsaturated fats are the work of the devil.  I feel myself summoning up ol’ Beezlebub  every time I eat them.  I try to avoid them as much as possible.  Therefore, I do stay away from mayonnaise as much as possible.  I want to try making it sometime with medium chain triglycerides, which are liquid at room temperature (a requirement for making mayonnaise), but I don’t have a clue as to how it would taste.

    Capsaicin is supposed to be an anti-inflammatory, but I’ve got to confess that I haven’t really read much of the data on it, so I can’t comment intelligently.

    Cheers–

    MRE 

  12. Excellent post and I think it might be right on the money in a lot of respects.

    I can’t say I’m thrilled with the concept that eating frequently is going to put you in a worse inflammatory state. I was hoping that simply eating the right kinds of foods (LC) would minimize inflammation. Now I have to worry about eating my snack of nuts at mid-morning? Crap, I’m back to fighting hunger for the betterment of my health. I guess a little hunger is worth it.

    Here’s an alternative viewpoint on eating causing inflammation. Eades points out that any food elicits a certain amount of immune response that is going to cause damage to normal tissues. I don’t have a problem with this, but I do think a certain amount of this is not going to cause any great harm to our circulatory systems. Its like carcinogens, we are exposed to them all the time but there are mechanisms in place to effecetively combat such insults. I think there are probably similar mechanisms in place such that eating like our ancestors did, we are going to be maximally protected.

    I think we all agree that Paelo man ate the equivalent of a LC diet. This much seems obvious when you consider the foods he had easy access to, as well as how well LC diets work for people’s weight and general health. The question then becomes, how often did Paleo man eat? I personally think primitive man ate frequently and plentifully. Whenever he found a food source, he would sit down and have a good meal. And the cradle of civilization was a great place for man to find food, warm climates meant a generous and fairly constant supply of plant foods. Game animals were also plentiful. I don’t think the idea that man only ate once a day, something like the Warrior diet, seems logical.

    For this reason, I don’t see that frequent meals is necessarily something artificial to our systems. Our hunger is designed to tell us when we need more food, it is our adaptive mechanism to tell us to get busy and hunt/gather up some grub.

    Hi Leonard–

    If you read the reports of the Europeans who encountered the first free living hunting peoples, you will find them full of reports of these people gorging after a kill, almost to the point of not being able to move.  Then they wouldn’t eat for a day or two.  If everything you ate, you had to kill first, you wouldn’t eat nearly as often.  Life then wasn’t just wandering around grazing.

    Cheers–

    MRE 

  13. I do suppose our hunger mechanism might be altered/damaged from that of our ancestors, such that we are hungry more often than we used to be. It is possible that this was thrown off as early as the womb, where prenatal exposure to large swings of carbs could have put us on the wrong path. Being a feed-forward mechanism, this would be a tough thing to overcome as a group. This idea was discussed on a recent Charlie Rose TV program on diet.

    There is indeed fetal programming.  When the mother eats a lot of refined carbs during the first trimester – when the cells of the fetal pancreas are being laid down – it makes for a larger pancreas in the baby and a tendency to insulin resistance, obesity and diabetes later in life. 

  14. I beg to differ!

    All the airline snafus, etc., are entertaining, but this is why I keep coming back. Sir, may I have another?

    The whole constant-eating-is-inflammatory idea is very interesting and seems to support intermittent fasting. At the very least, it’s a reason not to munch on things all throughout the day — I knew there was a reason I felt bloated on days when this occurred… and eating when actually hungry makes the food taste SO much better!

    Hi Eran–

    I hope I don’t have any more airline snafus to report.  If it’s all the same to you, I would prefer my flights without incident and on time.

    Cheers–

    MRE 

  15. Dr Mike,

    Excellent post. I’ve been encountering an influx of information about inflammation, but this primer is very helpful in understanding the overall picture of its functions and characteristics. Thank you.

    I look forward to more posts and explanations. One of the things you do well (that keeps me reading the posts and re-reading the PP literature) is explain the science (i.e., interpret the data) for me, and place it in a framework wherein I can access a strategy to deal with the issues in a practical way.

    Richard

    Hi Richard–

    I’l do my best to keep serving it up.

    Cheers–

    MRE 

  16. Is their anything one can do, in addition to a low carb diet and exercise, to reduce inflammation?

    Yep.  First, don’t over exercise.  Too much exercise causes inflammation just as does too little.  Watch for areas of chronic infection and get them fixed.  A major culprit is periodontal disease.  Any infection that smolders along untreated adds to the inflammatory burden.  Eat your low-carb meals widely spaced and don’t snack throughout the day.  It’s late at night Rome time, and that’s all I can think of on short notice.

    Cheers–

    MRE 

  17. The question that springs to my mind is about the role of Vitamin D in inflammation and disease processes. As surely as we evolved to eat meat we were also nourished in a steady supply of sunshine. Your thoughts please?

    Marilyn

    My thoughts on vitamin D in a few words…  Take it daily if you don’t get sun exposure.  I think it’s one of the most important and most overlooked vitamins of them all.  I’m working up a major post on vitamin D.  Probably when I get back so I’ll have all my references.

    Cheers–

    MRE 

  18. Dr. Eades,

    Your insightful analysis seems to support the concept of intermittent fasting on which you posted awhile back. (I recently read another in a science magazine article that discusses the benefits of calorie restriction, and the gist, if I remember, was the overall reduction of inflammatory activity.) It also kills the notion that one must eat 4-6 small meals a day to “regulate” metabolism. That concept makes no sense when, as you’ve stated, one views it through an evolutionary lens.

    I ran across a website devoted to something called “resistance starch” which I thought you might be interested in looking at: (http://www.resistantstarch.com). From the site:
    “Resistant starch is starch that “resists” digestion in the small intestine. In fact, resistant starches have been defined as “the sum of starch and products of starch digestion not absorbed in the small intestine of healthy individuals.” In general, carbohydrates can be divided into two groups: those that are digested in the small intestine and those that are not. Sugars and most starches fall into the first group. They are rapidly digested and absorbed, and subsequently used for short-term energy needs or stored. These are referred to as available, digestible or glycemic carbohydrates. Resistant starch and dietary fiber constitute the second group. By definition, they pass through the small intestine and provide no short-term energy but have a variety of physiological effects in (and emanating from) the large intestine. Natural resistant starches are fermented like some dietary fibers and provide long-term energy. These are referred to as non-glycemic carbohydrates.”

    Hi Thomas–

    I’ve read quite a bit about resistant starches, and I’m not sure I liked all of what I read about them.  They sound good in the abstract: eat a lot of carbs; don’t pay the price.  But some people do pay the price.  It’s a subject for a longer post sometime.

    Cheers–

    MRE 

  19. This may not be the right forum to ask this, but I’ve been following your posts lately (also love the intermittent fast theory), and I respect your knowledge. Very low carb has always worked best for me in terms of cravings and satiation, but I’m currently struggling off the wagon with an extra 15 pounds on my hips. What advice do you have about lack of energy upon transitioning from high to low carb, perhaps to ketosis levels? I work long shifts on my feet (11 hours bartending) for 4 days in a row weekly, and I’m concerned about the temporary total lethargy I always experience for a week plus until my body acclimates to the new diet. How do I get around this? I simply cannot be fighting energy levels at work. But just lowering my carbs a bit never seems to work as well as total and immediate commitment. Again, so sorry if this isn’t the right place to ask this.

    No problem.  The best strategy is to take some potassium.  A low potassium level is probably the most common cause of fatigue during the first week or so of switching to low-carb.  The reduced carb means lowered insulin.  Lowered insulin means less sodium retained by the kidneys.  As you urinate more, you release a lot of potassium in the process.  You can get potassium at any health food store.  I usually have my patients take about 5 of the 99 mg ones per day during the first week.  You need to check with your doctor to make sure you’re not on any meds or have any problems that would preclude you from taking the supplement before you take it, however.

    Cheers–

    MRE 

  20. Dr. Eades

    Heart disease is caused by insulin. Insulin attacks the muscle tissues in arteries and causes the buildup of scar tissue in the arteries, thereby narrowing them. I consider the definitive study of heart disease one conducted by Nestor Flodin called “Atherosclerosis: an insulin-dependent disease?” Here is the link:

    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=3537074&dopt=Abstract

    Just remember that diabetes in associated with higher rates of heart disease (they are injecting themselves with insulin). Or think of the “French Paradox”. Higher fat, lower carb diets mean less insulin and have been correlated with less heart disease. The American Heart Associations bread, pasta, and potatoes with every meal usually sends people back for a second coronary bypass within several years.

    Hi Freddy–

    I, too, believe that insulin is a major driving force behind the progression of heart disease as well as the other diseases of civilization.  But, I think inflammation probably sets the stage for the insulin problem to develop.  I should do a longer post on this when I have the time.

    Cheers–

    MRE 

  21. Hi Mike–very interesting and it seems to make intuitive sense. But what about those of us who are hungry every few hours no matter what we eat? I get hungry (I mean real hunger) every 3-4 hours. The only way for me to stay full for 6-8 hours after a meal is to absolutely gorge myself on protein and fat, to the point of discomfort. Maybe that’s what I should do? Or maybe I’ve just created this tendency with frequent meals over the years?

    Hi Paul–

    Without more info it would be tough to answer your question.  As for me – and MD too, for that matter – the fewer carbs I eat, the less hungry I am, even if I don’t gorge on fat and protein.

    Cheers–

    MRE 

  22. Great post! I agree with your premise. I also had the same question about fruit and I am glad to see that my dish of strawberries is not something that I have to worry about (or the sour cherries that I love so much.)

    Funny, it looks like a lot of us had IF spring to mind when reading this post. I’m seriously considering giving it another go, I’m not too sure why I stopped in the first place.

    Beautiful picture! Did you take it? Viewing it was a nice way for me to start the morning here. I can only imagine that starting the day seeing the real thing must be totally awesome.

    Hi Esther–

    I did indeed take the picture.  Took it at dawn yesterday morning just before I got to work on the post on inflammation. I took a lot more later in the day that I’ll try to post when we get back in tonight.

    Cheers–

    MRE 

  23. great stuff, couple things:
    does caffeine increase inflammation?
    and, i’ve read all your books but it seems like the more you investigate the more you are leaning toward lower and lower carbs, do you have a new ‘number’ that you feel is ideal? would zero be ideal?
    one more, doesn’t a good amount of protein also cause significant insulin response?
    thx, susan

    Hi Susan–

    I think caffeine is actually a little bit of an anti-inflammatory.

    You’re right; the more I investigate, the more I tend toward lower carbs. 

    Protein causes some insulin response, but it’s not a problem unless you have type I diabetes because it stimulates a glucagon response as well.

    Cheers–

    MRE 

  24. Would your understanding of fibromyalgia fit into this inflammation concept – since I did not have a physical or emotional trauma prior to the onset of the fibromyalgia 12 years ago… I’ve often wondered if my diet brought about this chronic state of inflammation.

    Many things I’ve researched over the years pointed to many things brought up here but for the first time for me – you have presented something that pulls it all together into one concept.

    Hi Tammy–

    MD and I have both had many patients who came to us to treat their obesity who also had fibromyalgia.  They almost all improved their fibromyalgia when they started low-carb dieting.  I’m sure it’s because a low-carb diet is much less inflammatory, and because the low-carb diet helped rid them of visceral fat, which is an inflammatory foci.

    Cheers–

    MRE 

  25. Hi Dr Mike,

    Thanks for this wonderful post, it really makes a lot of sense and you craft it so that it is so easily understood. I am gradually getting to eating just once per day (so far four times a week) and so far I am finding those days are far and away the best for controlling my type 2. I guess its not very intermittent but would you classify eating once per day in that light, though I do drink coffee with a splash of cream during the period of not eating?

    I have tried making mayonnaise with Avocado oil and it is very delicious, though not quite as firm as the bought ones but this makes it great to spoon over steamed beans and the like. Because the egg is raw though you can only keep it in the fridge for several days.

    Glad you are enjoying Europe.

    Glenice

    Hi Glenice–

    MD has made mayonnaise with all sorts of oils, including avocado oil.  Fortunately, I’m not a big fan of mayonnaise (other than in small amounts here and there), so I don’t really miss it if it’s not around.

    Cheers–

    MRE 

  26. Hello,

    regarding insulin, this study found not too much difference in feeding 50g glucose versus 50g protein (97 vs. 83 micro units/ml area during 4 hours). However, interesting was response after combination of the two, which was higher then when summed alone. Other study found that insulin response to protein (given with glucose) is not dose dependent (various amount of protein = roughly same amount of insulin). This would support the idea of eating more (protein) at once to decrease insulin secretion per gram of protein.
    In this rather old study, there is measurement of insulin for up to 8 hour after protein meal. When we compare data from Table I with glucose line on Figure 4 in the previous study, there is clearly visible that ~100g protein response is slower and lesser (peak after 60 minutes at 33 units) than 58g glucose (peak after 30 minutes at ~45 units). Hope this would not be considered comparing apples and oranges :)

    Best regards,

    Martin

    Hi Martin–

    It is sort of comparing apples and oranges.  The first study was of diabetics; the second of young, healthy subjects; the third I didn’t pull down because it was a large pdf and I have a slow connection here in the hotel.

    You can’t really look at insulin all by itself.  If you’re looking to the effects of protein consumption, you’ve got to look at insulin’s counter-regulatory hormone glucagon.  Everything that insulin does, glucagon does the opposite.  Both are released from the pancreas, but from different pancreatic cells.

    The important thing is the insulin to glucagon ratio.  It’s not really a matter of how high insulin is, but if it is high while glucagon is low.  If insulin is high and glucagon low, then there is a vastly increased insulin effect that is unopposed by glucagon.  If both go up in tandem, then the insulin effect is negated.

    Typically dietary protein raises both insulin AND glucagon so the ratio between the two doesn’t change much.  The physiological reason for this is as follows:

    Protein stimulates an increase in insulin levels because insulin is a storage and anabolic hormone.  Insulin wants to get the amino acids that make up the dietary protein driven into the muscles and other tissues that are protein dependent.  So, when you eat protein insulin goes up.  If insulin goes up, it not only drives the amino acids into the cells, it drives glucose into the cells as well, which reduces blood sugar levels.  Eating protein, therefore would lead to a substantial decrease in blood sugar.  But it doesn’t.  Why?  Because dietary protein also stimulates the release of glucagon.  Glucagon raises blood sugar levels.  So, the consumption of dietary protein stimulates a release of insulin to drive the amino acids into the cells and a release of glucagon to keep the blood sugar stable.

    Hope this helps clear things up.

    Cheers–

    MRE 

  27. Hi Doc;
    I haven’t commented recently but continue to read and enjoy regularly.

    I personally discovered my ability to eat large meals / gorge, then “fast” for ~24 hours painlessly, when I discovered LC while living in ‘Vegas. I always loved the weekend champagne brunches, but thought that I might die of obesity if I indulged more than once a month. In 2000 I began LC and would enjoy the buffets with abandon. What I discovered is that although the meal may be off the scales for a single meal, I could indeed eat one meal and experience no desire for more food for 24 or more hours. This became a weekend habit for me and I was able to enjoy the feasts and lose weight simultaneously!

    I cannot help but suspect that the insulin/inflammation argument is much as the chicken/egg argument. I suspect a vicious circle is the more likely explanation.

    Enjoy your time in Europe!

    Hi George–

    I, too, experience the same buffet effect.  If I gorge on a good buffet that has plenty of different kinds of meat and low-carb fruits and vegetables, I don’t feel like eating for at least 24 hours.

    Cheers–

    MRE 

  28. Mike, thanks for this discussion and I don’t think you’re being too speculative. I’ll just offer a different twist to add to your ideas. Ever since we recognized that the adipose tissue is more than just a dump for fat accumulation, its role as a true endocrine tissue has been shown over and over.

    With respect to inflammation, I would offer the role of leptin as a key hormone that has a lot to do in the way our immune response works. Besides its role in appetite and all that, leptin happens to active immune cells as well. It’s effect is at least partially mediated by its direct action on T-lymphocytes, although macrophages
    and natural killer (NK) cells also appear to be responsive to leptin.

    I’m sure you’re acquainted with the concept of Th1 and Th2-like immune responses, which in short, drives the response into a more cellular and inflammatory (Th1) or more humoral (i.e. with production of lots of antibodies), Th2-like response.

    With that in mind consider these two scenarios, one in which there is a lot of adipose tissue, result of both, overeating and overeating frequently; the other with very little adipose tissue, result from not eating enough (malnutrition). In the first scenario, there is, as you mentioned, a lot of evidence of a chronic inflammatory state that can be associated with obesity. In the second scenario, when adipose tissue is not very abundant, the individual is susceptible to infection. Thus, oversimplifying here, in the first scenario there is susceptibility to inflammation and in the second scenario, there is susceptibility to infection.

    There is quite a bit of evidence that suggest that leptin may be one of he pivotal factors mediating which state is the prevalent. Not very suprising, really, since leptin is produced by the adipose tissue, so the more adipose tissue, the more leptin being produced and the more chances to actiate immune cells, which in turn can produce more cytokines that mediate inflammation. On the other hand, very little adipose tissue means very little leptin being produced and in this case, the inflammatory response is impaired, which in turn increases susceptibility to infection. So leptin is required for a normal immune response but when in excess, it could lead to chronic inflammation.

    A former colleague that studies Tuberculosis and is doing vaccine research noticed that a group of people that he was studying didn’t have a reaction against BCG. He also noticed that those that couldn’t mount a reaction against BCG were also infected with worms. Worms induce a Th2-like immune response (with lots of antibodies being produced), which counteracts a Th1-like response. So he thought that worm infections were responsible for the inability to mount a proper inflammatory response. When I heard that, I asked him if he had any data about malnutrition in the population he was studying. Because I knew a little about the region where the study was being conducted (a rural area in Ethiopia if memory serves), it wouldn’t be surprising to find malnutrition together with worm infections, so the inability to mount a proper immune response may also had to do with not having enough fat tissue, therefore not enough leptin to help induce a proper response. Like you, I was also speculating. I didn’t hear more about that but I have always wondered if there was a link there.

    So, to me there is a clear link between nutrition and inflammation, not necessarily looking at the inflammatory effects of food per se, but the effects after food has been processed and excess nutrients stored away.

    I’ve hear/read/witnessed and I’m sure you have too, how people prone to allergies, migranes, and hyperreactivity (immune hyperreactivity) find those conditions dramatically diminished after they control their carbohydrate intake. There is also evidence that just mere weight loss improves inflammatory markers, though according to Jeff Volek, it doesn’t matter how weight loss is achieved. So, when we control our carbohydrate intake and lose weight without starving (i.e. making sure there is an adequate protein intake, which comes with its already moderate fat intake), our fat tissue also decreases. My speculation here is that by doing so, leptin levels also decrease but not to a point in which our immune response would not work properly, but to a point in which there is just enough to make it work effectively, and that translates into less hypersensitivites and allergies and less conditions associated with chronic inflammation.

    Of course, the raw materials to be used in the making of inflammatory or anti-inflammatory intermediates (eicosanoids) also plays a role but their use comes after a ‘decision’ has been made to mount a particular type of immune response.

    I have a few articles that review the role of leptin in inflammation and the connection between nutrition and inflammation. I could e-mail them to you if you’re interested.

    Hi Gabe–

    I’ve probably read the leptin/inflammation articles, but send them anyway just in case.  But don’t send them until after I get home because I’ve got slow connections here in Europe (at least so far) and it would take forever to get the pulled down.

    I agree 100 percent with your comment.  I just didn’t want to get into that level of detail in the first post on the subject. I’m especially glad you addressed the opposite of too much fat and the affect it has on depressing immune response. Thanks for doing it for me.

    Cheers–

    Mike 

  29. I wonder if the inflammation hypothesis is compatible with the stress hypothesis. It’s my primitive understanding that cortisol suppresses the immune system. If that is the case, then stress ought to combat inflammation. One would expect to find that people with presumably stress-induced cardiovascular disease, metabolic syndrome, or Type 2 diabetes have reduced inflammatory markers, which I don’t think is the case.

    Hi Jen–

    There is a big difference between acute stress and chronic stress.  Acute stress does more or less suppress inflammation; chronic stress does just the opposite.  The diseases you mentioned can all be a function of chronic stress.

    Cheers–

    MRE 

  30. Dr. Mike: Here’s some more “food” for thought about causes of inflammation while you have raised this important topic. (Great post, BTW)

    I stumbled across this one by chance; maybe you have already seen it. Here’s a link.
    http://www1.wfubmc.edu/articles/Pancreatitis+from+Statins

    It’s an abstract of some research by a Dr. Sonal Singh at Wake Forest U concluding that statin drugs increase the risk of pancreatitis. A key quote from the abstract is as follows:

    “We found that all statins can cause pancreatitis, so switching from one to another will not help,” said Singh. “The data also suggest that pancreatitis can occur after several months of statin use, suggesting that this is usually not an immediate reaction. We also found that patients on both low and high doses developed pancreatitis. Hence starting at a low dose of statin may not be sufficient to prevent the side effect of pancreatitis.”

    If this research is credible (and I suspect it very much is), I’d like to know how any physician (esp. cardiologists) can in good conscience keep on telling their patients to take this stuff. And even if Dr. Singh’s findings aren’t sufficiently worrisome yet in the eyes of some medical professionals (“the reaction is mild and the occurrence rare”??), when there’s smoke in the air, maybe we should be looking for the fire (or the source of inflammation?).

    Perhaps you could comment on this at some point. But in the meantime, no hurry – enjoy Europe!

    Best,

    Wil

    Hi Wil–

    The reason cardiologists aren’t worried about the potential for pancreatitis when they put their patients on statins is that they (the cardiologists) figure that the odds are so much greater of getting heart disease without the statins than getting pancreatitis with, that the risk reward ratio is in favor of the statins.  What the cardiologists have failed to do is to critically read the literature on statins, which shows virtually no benefit to anyone other than possibly young males who have documented heart disease.

    Cheers–

    MRE 

  31. According to Dr. James Johnson (JUDDD Diet), a not-yet-published study by the IF researcher, Mattson, showed that “eating once a day within a four-hour period had no effect on oxidative damage.”

    Johnson’s own trial (asthma patients), using alternate day caloric restriction (20% of normal) and no special food timing, showed dramatic reductions in markers for both oxidative damage and inflammation.

    Hi athelstan–

    Thanks for the heads up.  I’ll be on the lookout for this study.

    Cheers–

    MRE 

  32. I think it is not a foregone conclusion that primitive man only ate intermittently. We are injecting too much of our own experiences when we make this conclusion (hunting is hard, fruit only comes ripe in August). Yes he may not have made a kill everyday, on the other hand if game were plentiful he might have been able to. Plus, a large animal may have made for several days of feasting. Also, numerous fruits and vegetables may have been more or less constantly available since the climate was always warm to tropical. Apes and monkeys don’t eat sporadically do they? They spend their days “grazing”, and I see no reason to think that man might not be similarly adapted. If you consider that hunger is our body’s way of telling us something, then frequent hunger is proof that we are designed to eat frequently.

    I think the hunter-gatherers that were observed, might have eaten more sporadically only because they lived in a climate that had more defined seasons. When you have spring, summer, fall and winter to deal with, yes I could see that there is a time of plenty and a time of fasting. But consider that the great majority of time, man developed in Africa right?

    Hi Leonard–

    You wrote:

    If you consider that hunger is our body’s way of telling us something, then frequent hunger is proof that we are designed to eat frequently.

    I think hunger as experienced by most people today is a learned response.  I doubt seriously that early man had breakfast, lunch and dinner at specific times as most ‘modern’ people do.  And because most of us have these meals at set times, we learn to be hungry at set times.  I doubt that early man was bombarded by food advertisements everywhere he looked; nor do I think he has access to snack foods everywhere he turned as we do.  If you don’t have it and have never had it, you don’t miss it.  I seriously doubt that early man focused on his hunger to nearly the degree many people do today.

    As to the apes and monkeys…

    Gorillas, like Pandas, are vegetarians (not by physiology, but by cultural learning) and, consequently, are obliged to graze all day long to get enough of the low-caloric-quality food they eat to meet their energy needs.  Early man, who ate meat, could get a greater amount of high quality calories in a much shorter period of time.  There is no valid comparison between the great apes and man in terms of grazing and hunger.

    Cheers–

    MRE 

  33. If food is inflammatory then is a bigger meal not more inflammatory? A bigger meal presumably results in higher blood levels and longer elevation of said levels. So why would it be better to have higher levels for a shorter time, versus lower levels at more frequent intervals?

    I don’t know.  It should be studied at some point.  Based on my own experiences with intermittent fasting, the ‘big’ meals aren’t all that big.  Overall caloric intake – at least for me – dropped considerably.

    MRE 

  34. Great post. So maybe the baby aspirin per day is a good idea since it is an anti-inflammatory?

    That’s why I think it works.  That, and its affect on platelets.

    Cheers–

    MRE

  35. Anecdote re: Vit. D3 and insomnia

    My chronic (and I do mean chronic, as in years and years) insomnia completely resolved after two weeks of D3 supplementation. 2000 IU per night. I now sleep through the night–at least 7 hours straight.

    Incidentally, although I live in southern California (plenty of sunshine) I spend all my time indoors.

    I look forward to you post on Vitamin D

    Hi Kathy–

    Interesting story.  I’ve heard others report the same thing.  I haven’t seen anything in the medical literature about this effect, but I haven’t read every paper on vitamin D.

    I take 5000 IU per day on days when I’m not in the sun.

    Cheers–

    MRE 

  36. Thanks for the info, Dr. Mike. Just a question regarding auto-immune diseases such as Hashimoto’s thyroiditis. Does this effect the inflamation process? If so, does thyroid medication alleviate any inflammation?

    Hi Diana–

    I don’t think the thyroid hormone itself decreases inflammation.  It replaces the hormone that the damaged thyroid isn’t making.  Any sort of auto-immune disease increases the inflammatory load, which is why people with auto-immune diseases tend to have higher rates of cardiovascular disease.

    Cheers–

    MRE 

  37. Don’t forget that animal fats contain a good porportion of mono- and polyunsaturates. We are adapted to eat these fats, just as surely as we are to eat satfats. I’m sure if they cause any inflammation at all, it is something for which there is a counter-acting mechanism in place.

  38. IF sounds great, and I’d love to eat less times per day, but I’m not sure IF would work for everyone. I know why I stopped IF – I felt horrible. Is that something that you (or any readers) find is a problem? I felt sick (tired, weak, nauseaus and hungry at the same time) and couldn’t function well mentally. Maybe I didn’t stick with it long enough to get over that sort of food withdrawal?

    As a related but different point, when eating my several small meals a day, I often feel really awful in the morning – even on LC – weak, tired, etc. Perhaps I’m not keeping control of my carbs? Or could that just be hunger or blood sugar out of whack due to eating too much the day prior? It’s similar to the feeling I get on IF.

    Hi AT22–

    Or it could be a low potassium level.  Try taking a potassium supplement if your doctor doesn’t have a problem with it and see what happens.

    Cheers–

    MRE 

  39. Hi Dr. Eades,

    I love reading these types of posts. Easy to understand and it supports my diet. I actually had my doctor prescribe a low to zero carb diet for me and I’ve lost 50 lbs in the last year. Because of this post I’ve gone back and read what you wrote about IF. AMAZING!! This all really makes sense and if a low carb diet decreases inflammation all the better. I do have two questions for you if I may… 1. How does caffeine affect ketosis? I was told to lay off all caffeine. 2. How does alcohol affect losing weight on a low carb diet and is alcohol an anti-inflammatory?

    Thanks so much!
    Dave

    Hi Dave–

    First, you ought to give us the name of your doctor so that anyone else in your area who wants a doctor with good sense could seek him/her out.

    I don’t think caffeine particularly affects ketosis.  Caffeine is sort of a mild glandular stimulant (or so some say), which could cause the pancreas to release a little insulin.  A little insulin can shut down ketosis.  So, if it is true, caffeine could reduce the production of ketones.  That’s the theory.  The reality – at least my reality – is that it doesn’t make much difference.  You could always try eliminating it to see what effect it has on you.  There is biological variability, so what doesn’t bother me may bother you and vice verse.

    Alcohol…

    I don’t have a problem with a little alcohol on a low-carb diet, say, a glass of wine per day.  A lot of alcohol is an other matter, however.  I would avoid large amounts.  Alcohol is an anti-inflammatory in the sense that it is calming, and if one suffers from chronic stress, the alcohol can reduce that – at least temporarily – in which case it would reduce inflammation.

    Cheers–

    MRE 

  40. G’day Mike

    “Protein causes some insulin response, but it’s not a problem unless you have type I diabetes because it stimulates a glucagon response as well.”

    Could you expand on this a little bit? I am a type 1 diabetic and have recently been reducing my protein intake to prevent spikes up to 200 two – three hours after meals. Could this be a result of glucagon and not protein being converted to sugar? I follow a low carb diet (30 grams a day) but find my insulin needs climb if I go over about 120 grams of protein a day.
    Thanks, Clint

    Hi Clint–

    Here’s what I wrote in an earlier response to a comment:

    Typically dietary protein raises both insulin AND glucagon so the ratio between the two doesn’t change much.  The physiological reason for this is as follows:

    Protein stimulates an increase in insulin levels because insulin is a storage and anabolic hormone.  Insulin wants to get the amino acids that make up the dietary protein driven into the muscles and other tissues that are protein dependent.  So, when you eat protein insulin goes up.  If insulin goes up, it not only drives the amino acids into the cells, it drives glucose into the cells as well, which reduces blood sugar levels.  Eating protein, therefore would lead to a substantial decrease in blood sugar.  But it doesn’t.  Why?  Because dietary protein also stimulates the release of glucagon.  Glucagon raises blood sugar levels.  So, the consumption of dietary protein stimulates a release of insulin to drive the amino acids into the cells and a release of glucagon to keep the blood sugar stable.

    In your case you have unopposed glucagon.  The pancreatic cells that make insulin are nonfunctional in those with type I diabetes, but the cells that make glucagon work just fine.  When you eat protein, it stimulates ONLY the glucagon part of the response, which makes your liver produce more sugar.  That’s why you have a problem.  If you eat more protein – as you’ve discovered – you need more insulin.

    Hope this helps.

    Cheers–

    MRE 

  41. This is just thank you for detailed explanation on my comment. With every post I learn something new about human body.

  42. Hi, Dr. Mike!

    I enjoy reading all your posts, but this one knocked my socks off. A lot of people want to intermittent fast to get rid of excess weight (me included), but the health benefits are absolutely overwhelming.

    Thank you for sharing your knowledge with us. You are appreciated more than you will ever know!

    By the way, are you planning on writing a book on intermittent fasting? I sure wish you would!

    ~ Carol Ann

    Hi Carol Ann–

    No plans right now for a book on IF.  But who knows…

    Cheers–

    MRE 

  43. Hi Dr. Eades,

    In an earlier response, you wrote that “Too much exercise causes inflammation just as does too little.” How can we know what’s too much? Do you cover that topic in your “Slowburn” book, by chance?

    Best Regards,
    Keith

    Hi Keith–

    To tell you the truth, I can’t remember if it’s in Slow Burn or not.  I think so – at least a mention.

    Long endurance exercises are too much.  A standard resistance training workout – even a non-Slow Burn one – shouldn’t be enough to cause inflammatory problems.

    Cheers–

    MRE 

  44. What evidence is there that hunger is learned? I can see there being a psychological component, but there are also basic physiological aspects present. The fact is, we do need periodic fuel inputs of some sort. What period is proper, might depend on the individual.

    I see your point about apes and their largely vegetarian diet. What animals would we look to then? An omnivore, possibly with an emphasis on hunting for meat. Would chimps be a better comparison?

    Thanks for starting this discussion, it is bringing up some very interesting topics and givign me a lot to think about.

    Hi Leonard–

    Here’s one for you: I don’t really believe there is such a thing as a natural omnivore.  I think an omnivore is basically an adaptation of a true carnivore.  Along with a lot of other subjects, I’m working up a long post on that as well.  It requires more than I can write in just a response to a comment.

    Cheers–

    MRE 

  45. Dr. Mike.

    Once again you provide us with a great insight into a very relevant and complex susbject. And you explain in such a way that we get it!. You are my hero!. I have an unrelated observation to share. Since following the PPLP lifestyle, when I go out in the sun I get red, but no sun burn. I have stopped using sunscreen. I believe it is the Cod liver oil I take. I have been taking 2 tablespoons of Cod Liver oil daily, plus some extra fish oil pills. Also, my strength has increased very quickly. For a long time I was stuck at the same lifting weights. But since following PPLP since Feb, 07, I have dropped 27 lbs. Thank you for your wonderful work, I try to spread the gospel, but to no avail.

    Carlos

    Hi Carlos–

    I’m glad I’m somebody’s hero.

    Interesting story about the cod liver oil and sunburn.  That’s one I hadn’t heard before.

    Cheers–

    MRE

  46. Hate to really flog this post and the long comments – but I just love your take on this.

    I was thinking. With this hypothesis, so many modern diseases start with today’s unhealthy nutrition.

    If a plain old GP, who realized this, came to you and said, “how do I get educated, while still keeping my practice going”, what would you say?

    In other words are there good post-med-school courses where alert MDs can shore things up?

    Hi Connie–

    I learned it all while actively pursuing my regular practice.  All it takes is to treat a few patients and see the almost miraculous results that low-carb brings to really get you fired up.  Any doc with good sense can read PP or the PPLP and figure it out.  It just ain’t all that hard.  It does take a little bit of a brain transplant to make the jump, but once you have, it’s pretty easy to do.

    Cheers–

    MRE 

  47. Dr Eades, many thanks for another interesting and well-written post. This blog is truly an invaluable resource.

    A propos the eating patterns of our ancestors: the following passage concerns the Andanamese negritos, perhaps the most ancient population on Earth in that they’ve been isolated from genetical and cultural influences for at least 30,000 years, and perhaps much longer. They are thought to be descendants of the first modern homo sapiens who left Africa. Some of them still live the hunter-gatherer lifestyle of the ice age.

    Quote:

    The amount of fatty meat consumed daily during the rainy season when pork was at its fattest was large and could on occasions rise to the truly gargantuan. People with an average adult body weight of around 40 kg (88 lb.) could, on occasion, eat up to 1.8 kg (4 lb.) of food. This could rise to a staggering 4.5 kg (10 lb.) during a 24-hour period on special occasions. At major feasts , during colossal honey-and-pork orgies, participants stuffed themselves to the bursting point, leaving everyone barely able to walk and with severe indigestion for days. Such “food pig-outs” are known from many primitive societies that are precariously dependent on an insecure food supply. Comparable “pig-outs” involving intoxicating beverages are also known in rather more advanced societies. In a hunter-gatherer group, a single day’s unsuccessful hunt could lead to a night on short rations, while a failure lasting for more than three days could be the beginning of a life-threatening famine. An attitude of let-us-enjoy-when-and-what-we-can is understandable in such circumstances.

    But on the other hand:

    If the rains did not fail (which they rarely do on islands surrounded by a warm sea), food was plentiful, available in variety and not difficult to find. Only food storage was a constant source of worry, a problem that the Andamanese shared with all human societies prior to the invention of refrigeration. Thanks to the bountiful nature of their environment, traditional Andamanese ate well, on occasion almost too well, as long as the rains did not fail them.

    The diet consisted of wild pigs, turtles, sea cows, fish, crustaceans, eggs, wild fruits, tubers, seeds and honey. A low-carb paradise…

    Link: http://www.andaman.org/BOOK/chapter15/text15.htm

    Hi Magz–

    Thanks for the info.  It’s a pattern you see repeated almost everytime European or American explorers come upon an group of unWesternized hunter/gatherers.

    Cheers–

    MRE 

  48. Hello Dr. Eades,

    In regards to inflammation, I had read that cooked food causes a ‘higher’ immune response, that being said, do you advocate a higher percentage of raw foods (specifically protein) if possible?

    What have been your observations for people who consume more things like raw eggs, steak tartare, etc…

    Do you have an personal experience in regards to the above question. I am aware that in general it is best to avoid cooking with high heat to avoid forming toxic compounds. Thank you for your time.

    Hi goooraam–

    I actually believe that cooked plant foods are LESS inflammatory than fresh ones.  Why?  Because plants are prey of herbivores, insects, and other predators.  Plants can’t run away, so over time they have developed their own methods of defense, one of which is to produce toxins or resistant starch to keep from being eaten.  Most of the defensive substances plants produce can be detoxified by cooking.  And since many of these toxins are inflammatory, cooking destroys them and makes them less inflammatory.  Many people who have allergies to certain plant foods when eaten raw often don’t have the same allergies when these same plant foods are cooked.

    With meat it’s one one other one other other one other one  one other other (that’s six of one and a half dozen of the other).  Sorry, it’s late and I couldn’t resist.

    Cheers–

    MRE 

  49. First try didn’t go through right. Trying again.

    The literature supports the idea that food is inflammatory. Although it is processed, so to speak, outside the body, some does get through tight junctions between the cells lining the digestive tract. Numerous studies have shown increased inflammatory findings after eating high carb diets.

    But is it food in general doing it, or the specific TYPE of food – those high in carbs?

    I agree with you regarding caffeine and ketosis. It doesn’t seem to effect ketosis in most people, but it does in others, so go figure. I need caffeine to feel human and function so I won’t give it up.

    Hi Victoria–

    It’s pretty much any kind of food, but high carbs are the worst.

    Cheers–

    MRE 

  50. If we agree that IF is the way to go and we say have 1 meal per day, should we be concerned about not getting enough calories if we continue this practice of 1 meal per day over 3 months or so. How many calories per day is too low? Or, if as the name suggests “intermittent fasting” it should be random.

    In regards to low calorie of about 500 daily over 3 months or longer combined with low fat, RDA protein, and very low carb – what are your thoughts on whether this sets people up for vitamin and mineral deficiencies and muscle loss?

    Hi Sue–

    I do think 500 calories per day average over 3 months (or even less) is too low and will lead to protein deficiencies and lean tissue loss.  Don’t do it.  Keep your caloric intake up on your eat days.

    Cheers–

    MRE 

  51. I have resisted posting because, Gosh Darnit, you’re on vacation! But sorry, can’t resist. Please don’t reply… go eat some meat instead.

    I suspect that a large portion of food-oriented inflammation is caused by grains. We Homo sapiens have even named the disorders caused by excessive grain consumption… CAD, Type II, IBS, Celiac, Crohn’s, cancers, MLS, ALS, ALZ, Parkinson’s, etc, etc, etc. In my little mind, it is completely logical that Homo sapiens will develop illness after being fed poison over the long term. Grains are no different that arsenic… process them, and they are even more poisonous.

    You wrote:
    “Here’s one for you: I don’t really believe there is such a thing as a natural omnivore. I think an omnivore is basically an adaptation of a true carnivore.”

    I agree 100% with that statement. To further that, I think that the adaptations are a response to a shrinking food supply coupled with punctuated equilibrium. It is not optimal, but facultative. I am a Koi (fish) hobbyist who has seen time and time again the damages that an artificial (Man Made) diet causes in those poor little fish. People are feeding them corn and wheat… they want meat, for goodness sake! The algae and plant material they eat is just automatic. There may be bugs in that junk after all.
    However, they will adapt to artificial food if that is the only food available. Sad.

    Anyway, You and MDMD look fabulous and healthy next to those works of art.

    Have a great vacation!

    Hi Karen–

    Thanks for the compliments.  I agree with you 100 percent about the grains.

    Cheers–

    MRE 

  52. Dr Mike
    When you are looking for a true animal carnivore please consider the pig. A pig will eat practically anything, including other pigs.

    True. 

  53. Good point about plants and inflammatory substances as a defense mechanism. This would suggest that inflammation may not be something caused by food’s components, but by specific types of plant foods. It may be that our correlation between high carb and inflammation, is actually a correlation to inflammation and wheat, corn and the like. There do seem to be reactions to actual chemical consituents like fructose though.

    I like your idea of people basically being carnivores who can utilize plant foods if necessary. I believe that to be the case, and I look forward to a longer treatment of that subject.

  54. Dr Mike,

    Would a LC diet help someone with
    lupus.

    Thanks

    Carlos

    Hi Carlos–

    I’ve never treated anyone specifically for lupus with a low-carb diet, but I have had a number of overweight patients with lupus who went on the LC diet for weight loss and had their lupus improve.

    Cheers–

    MRE 

  55. As my cholesterol has run in the 240 + or – for several years, and my insurance kept going up, I followed the diet of your nemesis for 2-3 years around 1992.
    The cholesterol may have dropped 1 or 2 points, but I’ve been dealing with health issues since that I believe are directly related.
    I developed adrenal fatigue and Hashimoto’s thyroiditis. I’ts taken the last 6 years to come back from chronic fatigue, low body temp, very low blood pressure, and so many symptoms I could have been in my doctor’s office every day trying to get relief.
    I’ve taken digestive enzymes faithfully for 2 years, plus a closet full of other nutrients. This, I believe, has brought my thyroid back. My antibodies came down from 615 to 167 as of Feb., and I no longer need thyroxin.
    To me all this is a sign of the immune system run amok. No doubt from all those good carbs.

    No doubt.  I’m glad you’re on the mend.

    Best–

    MRE 

  56. Another great post Dr Mike!!

    I have questioned the wisdom of eating every few hours, continuing to exercise with injuries and overexercising. I’m also now convinced that inflammation is the cause of many of our problems. I also feel that the high amount of chemicals and the extreme processing of foods is a major health hazard. Adding processing to the high carb intake is deadly!!

    I’ve also found that a nice big meal that is high in protein and low in carbs keeps me full for a long time!! Add in carbs and I’m hungry in a few hours, but keep them out or very low satisfies me more and for longer periods of time.

    RE: D3 and insomnia. I noticed several weeks ago that my insomnia was gone. I was the type that would lie in bed until at least 2 or 3 and sometimes even later! Now I go to bed and I’m asleep within 20 min. I didn’t make the connection with taking D3, but that is a supplement I started. I’ve been taking 4000IU and found my level is still low (normal but low, had been taking D3 for 3 months), so I’ve increased my dose. I can only imagine what it was before I started supplementing!

    “I think an omnivore is basically an adaptation of a true carnivore.”
    Oh I so agree!! Dogs are an animal that comes to mind. Dogs are carnivores, but will eat almost anything…to stay alive as well as for pleasure. But to say a dog doesn’t need meat is wrong, just like saying we don’t need meat is wrong.

    Hope you have a great time on vacation! A friend and I have decided to go to Rome next spring. It will be my first trip (first off the continent!), her third. Seeing your pics is just making me more excited!!

    Hi Cindy–

    You will have fun in Rome.  I’m going to be posting some travel tips that you won’t find in the guidebooks that will make your trip easier.  And you’ll be able to eat low-carb without any trouble.

    Cheers–

    MRE 

  57. Hi,

    If the “foreign food” itself is a major cause of inflammation, the inflammatory response would result only from the amount of food energy consumed and not necessarily to the times (meal frequency) eaten. I fail to see what timing has to do with anything.

    I suppose, there is an assumption that eating more often translates into eating more total calories. What if it doesn’t?
    Is it still of any benefit to eat less often?

    I know some research shows IF is beneficial even if calories are not reduced, but I don’t see how this can be at all related to the notion that eating food itself causes inflammation. I would expect IF (without calorie restriction) to work because of the mild stress and increased tolerance associated with not eating for long periods of time.

    I’m not arguing that IF has benefits… just pointing out that the idea (food is inflammatory) doesn’t necessarily provide rationale for the advice (to eat less often) because it’s not necessarily true that eating more often = eating more total.
    I end up eating more calories if I do that blowout thing. Much better off taking a few grams of fats and pros every so often.

    Also, just wanted to butt my 2 cents in to the really interesting response from Gabe: it may be that leptin modifies the immune system, increasing susceptability to illness, but I don’t think it is the primary actor when it comes to malnutrition/underweight. Evidence of this fact is that underweight without malnutrition usually results in a normal, if not stronger immune system. If you measured the leptin levels of people who CRON you would probably find a relative deficiency (assuming normal weight pre-CRON)… but because the CRON diet is not deficient in critical nutrients like protein, and vitamin c, and b vitamins and zinc etc… they do not suffer the same problems with vulnerability to illness observed with underweight but severely malnouished people.

    Thanks for another interesting post :)

    I based my notion that eating itself causes inflammation on a number of papers in the literature looking at inflammatory parameters as a function of diet.  When subjects are given protein, fat or carbs, they’re inflammatory markers go up.  Even if given these macronutrients individually.  This tells me that eating is an inflammatory event just as breathing is.  I don’t know that anyone knows whether eating more at fewer meals results in less inflammation than eating less at more meals, but I suspect it does because the IF literature shows a decrease in inflammatory markers while subjects IF.

    Cheers–

    MRE 

  58. Good day Dr. Eades,

    Wow. Awesome post. I’ve read most on your blog – skimmed some posts and read others in depth – and I continue to glean significant insights into the best avenues to health. The wonderful thing about it is that outstanding health is NOT difficult to achieve; your clear explanations go a long way to helping the layperson see that.

    Two posts I was intrigued by were the ones from Sep 06 on intermittent fasting (IF), and now this one on inflammation is the third. I finally committed to IF this spring after reading the posts and the Fast-5 website referenced by Dr. Bert Herring in a comment to one of them. I can’t fully describe how wonderful I have felt since I passed the initial adjustment phase. Now with your “speculation” that eating less often lowers inflammation (or doesn’t provoke inflammation the way eating frequently does), I know IF is the way I’ll live my life.

    Your blog – and books – have encouraged me to follow a lower carb diet, too. Weight isn’t much of an issue, though between LC and IF, I’ve dropped from 117 to 111 in a couple of months, but worry-free health is. LC and IF may not form the fountain of youth, but I believe they are the best way to healthy living for the time we are here. To me, that’s significant. Also, there is a great payoff for less time and money spent on food, leaving our lives open to fully explore the world, develop ourselves, volunteer, and see that, unlike what marketers would have us believe, joy doesn’t come solely from food.

    Please tell me the inflammation post here – and how LC and IF are healthy alternatives – is the basis of your next book, or at least part of it. I think it is time the world at large knows about this!

    Thanks for sharing your knowledge and expertise – and I gotta say, your sense of humor (you really crack me up sometimes with your comments!) – with us all via this blog.

    Kelli

    Hi Kelli–

    Thanks for the kind words.  At this point I haven’t even thought of a next book yet.  When I do, I’m sure that it will contain much material on inflammation.

    Cheers–

    MRE 

  59. Dr Eades,

    Great blog – interesting theory – bumped into it entirely by accident – will return.
    A few observations.

    Taking it to the limit, it implies that old age (with its associated ills) is essentially the result of having taken too many bites and breaths. Or more succinctly, you’re old and sick ’cause you’ve been around too long. Can one argue with that?

    Why stop here, though? Sex (at least for women and without condom) should also be inflammatory (no pun intended), due to the unwelcome foreign antigen. Babies are also a known immuno-allergic problem for the mother. So have less of both.

    In general, live less to live longer (the basic quality vs quantity compromise) until you are immortal without having experienced anything. Except, of course, the catch is the course: if you have none, you starve.

    How does the CR and sirtuin theory stack up against IF? At least theoretically, it should be superior because it results in less input. There is a catch, too: the chronic stress of being on diet may add to inflammation (unless anorectics, such as rimonabant, are used).

    So far, you’ve addressed ways of minimizing inflammation. It looks very hard. What about methods of counteracting it?
    NSAIDs, etc. Can’t we eat the cake and have it too (pun intended)?

    About the oft-mentioned Paleo person: was s/he as enviably healthy in the his/er “old” age? Should we strive to imitate a diet with unknown long-term results?

    Also, how can one reconcile this theory with the fact uncovered by various studies that a higher than normal BMI (not quite in the obese range) fared better (survival-wise) than a normal or lower one?

    Finally, I couldn’t resist a comment on a reply of yours:
    “All it takes is to treat a few patients and see the almost miraculous results that low-carb brings to really get you fired up”. Does your job really cause inflammation, too :-)?

    I also noticed a bit of subliminal intelligent design. You said (notice the first letter of the 5th word is “w”, not “h”):
    “The innate immune system was evolved to deal with both”

    Hi Stephan–

    Glad to have you as a reader.  I think you’re right on the money, too.  Aging is the accumulation of the effects of too much breathing, eating, and sex.  More’s the pity.

    As to the longevity of Paleolithic man…he lived a lot longer than most people think.  Skeletal remains show many people surviving into their late 60s and even 70s in an era that was pretty bloody and brutal.  When Stephan Austen made the calculations on longevity among primitive man, he found that it wasn’t much different than today’s man.  It makes sense to me that if one follows  a diet that promotes health, one should probably live longer.

    I suspect my job does cause inflammation because I find myself “fired up” often. 

    Good pickup on the ‘has’ vs ‘was.’

    Cheers–

    MRE 

  60. Dr. Eades,

    I have greatly enjoyed your teaching as well and would like to echo the others about writing a book on Inflammation.

    Inflammation Nation encourages us to take fish oil. The Anti-Inflammation Zone takes it a bit further saying to take higher levels of fish oil (3,000 and up), but there is not much out there helping us who are dealing with major food intolerances about combating inflammation. When one can’t eat casein, gluten, and fructose of any variety, and trying to reduce inflammation levels, any help you can give us would be appreciated.

    Thanks.

    Hi Deb–

    I approached a publisher about a book on inflammation, but, alas, there is no interest.  A number of books on inflammation have been published, including Inflammation Nation, but none have been successful.  Therefore, in the minds of the nimrods in publishing, inflammation books don’t sell, so they’re not interested.

    I didn’t realize there was so much interest in inflammation among readers of this blog.  I’ll post on inflammation from time to time, so that ultimately you’ll have all that I know.

    Cheers–

    MRE 

  61. Hi

    Today I found your site when I was researching inflammation. Thanks for all the good info! I have struggled with obesity all my life-48 years. Obesity and all it’s related illnesses run in my maternal family. I’ve done the weight loss-weight gain yo-yo for years. About 4 years ago I lost about 80 lbs on a low carb diet. I felt good, looked good- I also exercised. However, why is it that I can never stay on the low-carb life style. Typically I am a very self-disciplined person with strong will power. Can a person lack certain enzymes that make them crave carbs? Is there a genetic abnormality that can cause certain people to crave carbs? It was a constant battle not to want carbs- even after I had been eating low carb, high protein for over a year. I’ve gained back 60 of the 80 lbs. lost and my health is poor- although I have continued to work out 3 times per week at Curves, which is probably my saving grace. I want to get back to low carb eating but I need some help to know how to deal with my carb addiction in the long term. One taste of carbs does me in. Any suggestions you can give would be appreciated.

    Sally

    Hi Sally–

    A number of people I have treated are in the same boat with you.  You’ve got to regard carbs as an addiction.  Many alcoholics are goners after just one drink, so they have to avoid alcohol forever.  It’s the same with some people and carbs.  Sounds like you fall into that category.  You know what you have to do.  Now you just have to do it.

    Good luck.

    MRE 

  62. I’ve just put up a link on my blog

    http://conditioningresearch.blogspot.com/2007/07/intermittent-fasting-reduces.html

    to a recent article in a journal which indicates that intermitent fasting – Ramadan syle – reduces the markers of inflammation.

    Interleukin-6, C-Reactive Protein and Biochemical Parameters during Prolonged Intermittent Fasting
    Fehime B. Aksungara, Aynur E. Topkayab, Mahmut Akyildizc

    Annals of Nutrition and Metabolism 2007;51:88-95 (DOI: 10.1159/000100954)

    This is fascinating stuff and makes a lot of things fit together! Thanks

    Chris

    Hi Chris–

    I pulled this paper just before I left for Europe.  I intended to take it with me to read along the way, but somehow it got left at home.

    In my quick once over it looks like more evidence that an IF-type diet structure reduces inflammatory markers, and, one assumes, inflammation.

    Cheers–

    MRE 

  63. How does C reactive protein relate to inflammation?

    C-reactive protein is a substance that is elevated in the inflammatory state.  Elevated levels of C-reactive protein indicate that some kind of acute or chronic inflammatory process is underway.

    Best–

    MRE 

  64. I just could not read through all the comments, so this may have been mentioned…I heard, and I believe it, that one of the reasons Americans eat so much, “three squares a day” and all that, is because the corporations have more food to sell than the population can eat. So they “push” it, by advertising, marketing and so forth. Scaring people into buying, or else “something bad” might happen to them. I hate what I see and hear in commercials on tv and in print. It is one of the reasons I believe tv kills.
    I am a fast-5er, and really love the way it makes me feel. I can tell when the inflammation devil starts to get after me!
    I enjoy tour blog, and appreciate how you make yourself accessible to people.

    Hi harmonious1–

    Food producers have it in their best interest to encourage people to eat more, so they give it their best.  The easy accessibility of calorie dense, high-carb foods (snack foods) goes a long way toward increasing the obesity epidemic.

    Cheers–

    MRE 

  65. If the macrophages gobble up visceral fat cells (I presume by ensnaring the entire cell via the pseudopodes – wouldn’t know how to just suck the fat out -), then in time, once the person embarks on a sensible diet (this time resulting in the depletion of fat cells of their contents), the net result over time would be a person who’s lost both weight (fat from shrunken left-behind cells) and actual fat cells (via the prior inflammation).

    Doesn’t that come counter to the fact that one can only lose fat cells through liposuction?
    Could it be the macrophages attack something else associated with visceral fat or that they possibly have become ineffective at the job due to some damage they themselves suffered during the high on the hog times?

    Hi Stephan–

    The macrophages don’t “gobble up visceral fat cells;” macrophages invade the fat cells and reside not actually in the fat cells, but beside and among them.  While there, they recruit other macrophages and release all kinds of inflammatory substances.  It’s these inflammatory substances making their way to the bloodstream that result in the inflammatory problems.

    Cheers–

    MRE 

  66. Hello Dr Eades.

    first comment for me…
    I just wanted to say that I found this site by researching about saturated fat and cholesterol, and their relationship.
    I started reading some of your posts and I have been reading it for about 4 hours.
    Im a nutrition and microbiology student with a lot of passion for the fields and just after reading this post I decided I had enough for today, but your now on my favorites.

    anyway… I liked your ideas about inflammation, and analogies about 9/11, it makes sense, though I must say Ill have to read more about how food causes inflamation, cause even though it sounds logical, I had never heard it before.
    Im still an undergraduate, so Im aware theres many things I havent heard of.
    anyhow… Im glad I found your blog… you will hear from me soon, probably asking questions!…

    Hi Pablo–

    Welcome to the fold.  Question away.

    Cheers–

    MRE 

  67. This made me think of a Mayo Clinic study I read about a while back that looked at the higher risk of early death among rheumatoid arthritis patients due to cardiovascular disease. [http://www.mayoclinic.org/news2005-rst/2657.html]

    (Since I have RA, you can imagine that this phrase really caught my eye: “Heart disease in rheumatoid arthritis patients can manifest for the first time as a cardiac sudden death.” )

    “The researchers were surprised to find that the increased cardiac events in rheumatoid arthritis patients could not be explained by an increase in traditional heart disease risk factors such as elevated cholesterol, blood pressure and body mass index, diabetes, and alcohol abuse…”

    Inflammation, of course, affects RA patients 24/7 to a greater or less degree. Researchers ventured a “we suspect”: “We suspect that the systemic inflammation that characterizes rheumatoid arthritis also promotes cardiovascular disease and cardiovascular death…”

    Another little piece of the puzzle.

    Thanks for taking the time to ‘think out loud’. Interesting stuff.

    Cheers!

    Hi Karen–

    Yep, it’s long been known that RA and the other inflammatory diseases predispose to coronary artery disease.  I’ve had a fair amount of success with RA patients on low-carb diets.  The diet doesn’t cure their RA, but it seems to give a lot of symptomatic improvement.

    Cheers–

    MRE 

  68. I am a Type 2 diabetic that has been on a Lantus/Humalog routine for several months, just recently switching to Lantus/Regular. I eat around 50g carbohydrate/day and somewhere in the range of 80-100g protein and was doing that for over a decade before I went on insulin subsequent to a pancreatitis attack.

    I have found if you are low-carbing, you *do* have to account for protein in your bolus dosages, even as a T2.

    I know most of the literature says you don’t, most doesn’t even admit that T1s need to look at protein. This is because they just want you to eat a high-carb diet where the increase due to protein is just noise in the carb signal. One book I recently read admitted you could get a bg rise from a large protein meal and their advice was to consult with a nutritionist so as to learn how to not eat those meals!

    If you check out how Bernstein calculates initial insulin dosages for his patients, you’ll see that a larger proportion of the dose is for protein than for carb… even for T2s. He’s the only one I’ve found who admits protein needs to be covered with insulin.

    In order to get postprandials under 140, I have to bolus for BOTH carb and protein with my meals. I expect this is because I eat so little carb that the majority of my bg is from protein.

    I have developed rules empirically that work for me in calculating bolus doses that stay within my postprandial targets. The 4 variables are whether it’s breakfast (Dawn Phenomenon effects), what my preprandial reading is, amount of carb in the meal and amount of protein in the meal.

    Hi Jacki–

    You are absolutely correct. Type II diabetics who require insulin need to cover their protein intake as well as their carb intake. I would strongly encourage anyone who is a diabetic and who wants to learn the most up-to-the-minute info about diabetes should read Dr. Richard Bernstein’s books. He is a good friend of mine that I’ve known for years, and he is totally dedicated to his patients and to all of the latest research in the field of diabetology.

    I’m glad you’ve found his books.

    Cheers–

    MRE

  69. I LOVE IF’ing and that was a great article on inflammation! Good comments too. I’m really surprised though, that with so much talk no one ever mentioned the gluten/casein issue. Gluten, at least, is known for triggering the release of zonulin, which opens up the “tight junctures” and so releases more undigested food into the blood than *should* get there. Dr. Fasano has been researching this. That zonulin might be the smoking gun for T1 diabetes and other auto-immune diseases. And inflammation.

    Gluten also affects the gluten-sensitive portion of humanity (10% by blood markers) way more than the rest. And for 1% of the population, gluten triggers an IgA immune response that is bad enough that it destroys the digestive system.

    But given that one is going to eat the stuff, having it only once a day is a lot less harmful than having it all day long, and leaving the gut permeable constantly. I also think that eating once a day paradoxically allows food to be digested better … the enzymes “save themselves up” maybe, in the gall bladder? I don’t know, but I don’t need digestive enzymes since I started IF’ing. Food that is more thoroughly digested by HCL and enzymes would be less inflammatory than food that is only partly denatured.

    — Heather

    Hi Heather–

    I’m sure your right. Bad stuff every other day isn’t as bad as bad stuff every day.

    Cheers–

    MRE

  70. I have just been diagnosed with lymphocytic colitis. Articles tend to suggest limiting fat in the diet as it causes, they say, an inflammatory response. Is this suggestion borne of the anti-fat bias of most doctors, or do you think fat aggravates the condition? — Another suggestion, limiting gluten, is easy to accomodate on my low-carb diet.

    Hi Marjorie–

    I think that fat has such a bad reputation among doctors – undeservedly, of course – that their knee jerk reaction is to always condemn it. I don’t see any way that fat could be responsible for any kind of colitis because virtually all of the fat you eat is absorbed in the small intestine and never makes it to the colon in the first place.

    Cheers–

    MRE

  71. Fascinating. It certainly makes sense to me. You know, people with chronic hives/anaphylactic shock (like me) are told to watch out for the most common triggers: eating, exercising, temperature changes to the skin. All of these are inflammatory, no?? I have not had hives once since starting a very low carb diet and also lengthening the time between my meals. (I only eat twice a day now, too.) Thanks for your blog. I have been enjoying it immensely!

    Hi Kristi–

    Both MD and I have noticed in our years of practice that a whole host of allergic and inflammatory problems get better in our patients once they start low-carb diets. I’m glad it’s working for you as well.

    Cheers–

    MRE

  72. Hello. A very interesting topic for me as i suffer from chronic inflammation, mostly sinus. I have had no luck with meds or treatments, even surgery didn’t come to the rescue. recently i came across a description of vasomotor rhinitis which hit more to home in its description of symptoms rather than that of allergic rhinitis (which i also definitely have). Vasomotor appears to be more mysterious and reactive to odd stimuli like changes in barometric pressure, and i know this all too well. Now one thing i have always done is over eat. And by over eat, i mean really over eat. To the point where i gave myself a hietal hernia. Now i don’t do it anymore and in fact i eat fairly healthy but, about 30min after eating i still get what i like to call food coma, severe fatigue, and inflammation. Maybe i just have a very over reactive immune system, but I definitely think that being raised on mcdonalds has been the leading contributer to my chronic disorder. Also, when i starve myself, I feel great. Well, i feel good for a while anyway. I also would like to mention that i have chronic fatigue and that my inflammation and fatigue go hand in hand.

    Hi Mike–

    Over many years of clinical practice I’ve found that many allergies seem to improve greatly on a low-carb diet. And I’ve discovered that magnesium supplements help with vasomotor rhinitis and with chronic fatigue syndrome.

    Good luck–

    MRE

  73. Dr.

    Great post. I have Ulcerative colitis (UC) and the doctors want me to have surgery to remove my large intestines. I have been ignoring them for now hoping medical science will improve or that I can find some alternative means to combat this condition. Will switching to a low fat diet help UC? I have only heard of a couple cases where people were “cured” from UC and did have to keep taking medication. They went on strictly raw food diets. I was also under the impression that raw fruits and vegetables worked to reduce inflammation in the body. What else could you suggest to help combat this type of inflammation? Where is a good place to learn about low-carb living?

    Hi Matt–

    I’ve had many patients with UC do spectacularly well on low-carb diets. It’s also good to supplement with some L-glutamine. The powder form is the best. I usually gave patient 4-8 grams (1-2 teaspoons) of it per day. Jump on the free offer for the Protein Power LifePlan and you’ll learn most of what you need to know about low-carb living.

    And, BTW, in my experience raw foods made UC worse.

    Cheers–

    MRE

  74. Hello Dr,
    I just stumbled onto this site while attempting to learn more about foods that do and do not cause inflammation. I found your post very interesting and informative, even if part of it was only speculation.

    I’m not familiar with “IF” nor “low carb diet”. But I would like to learn more.

    I wonder if you have heard of a condition called necrobiosis lipoidica (diabeticorum)? According to test results I am not diabetic, but do have a severe, or advanced case of NL(D). I tend to develop recurring ulcers in the lesions on my lower legs, (which appear more as a very widespread rash at this point). The lesions or rash are said to be caused by an “over active immune system”. However, modern medicine is yet to discover the exact cause and cure for NL(D), reportedly.

    Existing treatments for NL(D) are not all that good, consisting largely of topical, injected, and (in worse case scenarios) oral steroids. I’ve tried them all with little or short-lived success and horrible side effects for my trouble. But along the way, one medical professional, a woman I unfortunately met only once, suggested diet change – just for a period of one week. I was to eat only fresh fruits and raw vegetables, drink only their freshly rendered juices and water. And within three days the edema subsided in my legs and feet, the inflammation was subsiding in the lesions, and I was in considerably less pain.

    Given the amazing results of that one week diet change, I later re-visited thoughts of whether diet could improve the NL(D), despite that some doctors had told me otherwise. I began to research information on the internet and in books, so that today, I am (willpower permitting) essentially a vegetarian, who eats fruits and vegetables in their natural, raw form. To those I add grains such as brown rice, nuts, and some baked fish a couple of times a week, (based on information given by doctors of a clinic I was at in early 2006). I avoid packaged and processed foods, refined sugar and bleached flour products, commercial oils, and other meats. I do use olive oil and take fish oil capsules. I take extra vitamin C and a daily multi-mineral multi-vitamin supplement.

    I wonder if you can add any other information, a point to educational websites, ect., that might also be beneficial to improving my health? I am a member of a support group for NL(D) and would also like to pass along any information you might share. It saddens me, in view of my own experience with diet, that many in the group (mistakenly ?) believe diet is not all that relevant to NL(D); that some of our doctors tell us diet is not.

    Thank you for your interesting post, and for any information you might be able to share.

    Mary T.

    Hi Mary T.–

    I’m glad to hear that you are doing so well with the dietary changes that you’ve made. If these are working for you and solving your problem I would stick with them.

    But they are not the dietary changes I would have made had I been in your situation. I would have gone to a whole meat diet instead. Meat is much easier on the human digestive tract than plant foods – it is more easily digested and provokes virtually no allergic or immune response. Plant foods are notorious for causing allergic problems.

    Meat is rich in sulfur-containing amino acids of which plant foods contain almost none. These sulfur-containing amino acids are the backbone of the human immune system, and are heavily involved in the synthesis of our own endogenous antioxidants that are much more potent that any antioxidants we could take in pill form.

    Meat diets are almost by definition very low-carb diets, which lower blood sugar levels. A large amount of research has shown that lower blood sugar levels and lower consumption of foods that run blood sugar up result in less inflammation.

    For these reasons I would have followed a different course than the one you chose, but, as I say, if you are doing well and are happy with your situation, I would recommend that you continue doing what you’re doing.

    Cheers–

    MRE

  75. I love this post. Since I began IF,I have learned so much about inflammation and I think that it is the key. Our health is defined by inflammation. Even diseases that are thought to be incurable, such as parkinsons and ALS, can benefit on diets that address the body’s degree of inflamation. I am not a doctor but I am capable of reading. Thank goodness there are doctors who atleast think like me.I know you are busy. Please don’t feel an obligation to respond to my remarks. I know you will continue to ellaborate on inflammation and I will share my experiences with you.

    Thank You Doc,
    Mary

  76. I subscribed to the high protein diet in 1997 when I first came across your book. I probably took it to the extreme for about 5 years. I was always able to keep good muscle tone, but I always had a little fat that I wanted to get rid of that I couldn’t. I may have been eating too much saturated fat with the high protein diet, not sure.

    Eventually, I felt like I needed to turn away away from the high protein diet, because I was experiencing sore and achy joints, pretty bad constipation, and hemorrhoids. I think those problems were the worst I had from the high protein diet. I think now that those problems could have resulted from improperly preparing the meats by throwing them in microwaves and cooking on the grill. I found out that cooking meats with smoke can lead to stomach cancer too.

    Back in July 07 I fell ill with a a terrible stomach disorder. I consumed a choke cherry slurry that made me feel like I was going to die. Doctors said it was anxiety and heartburn. I cured the heartburn, but my anxiety got worse. Other stomach troubles came out of it, such as hiatal hernia, dizziness, extreme inflammation possible heart problems.

    Today, I think I need to find foods that limit my inflammation and do not cause dizziness and spasming in the lower left side of my stomach. I have bounced around from one food to the next: grains for a few weeks, or all veggies for a few weeks (farting problem), beans, fruits, but nothing seems to help take me out my inflammation problem. My heart can’t cope with stress much longer. I was on a exercise machine for 23 minutes going at a moderate pace when I had to get off because my chest was feeling like it was swelling too much underneath the rib cage. My lips went numb for the first time during the workout. I have to admit that I did eat half a pineapple, half a papaya and pomegranate juice the night before. I read in “Prescription for Nutritional Healing” that papaya and pineapple can reduce inflammation. That night, though, they seemed to increase my inflammation.

    I am thinking about getting more on the high protein diet again. I didn’t like the achy joints and constipation issues. What can I do to reduce the current inflammation in my organs and eventual achiness and constipation that a protein diet can bring.

    Also, you tell people to increase their potassium intake. Could increasing the salt intake help you maintain higher potassium levels too?

    I try to read articles on this website as much as I can:

    http://www.t-nation.com/article/diet_and_nutrition/sodium_your_secret_weapon&cr=

    I will look forward to your response.

    Typically a low-carb, higher-fat, higher-protein diet doesn’t case inflammation. If anything, it reduces inflammation. I don’t know what’s going on in your situation, but it sounds like something you should work out with your physician.

    Salt does not increase your potassium levels – salt contains no potassium.

  77. Journal of the American College of Cardiology study, quotes in MSNBC. Could you comment on this, please? It study concerns me greatly.

    http://www.msnbc.msn.com/id/14229538/

    First, why would you be greatly concerned about the findings in a single study, no matter how bad they appear? It’s only a single study. The medical/scientific literature should be viewed as a whole – what does the entire body of literature show, not just a single study.

    Having said that, here is a post I wrote on this very study when it came out. And here is a follow-up post when they tried to recycle it.

    Cheers–

    MRE

  78. Thank you for your website and excellent insights. During the last few weeks I have greatly enjoyed learning much about the benefits of low-carb. In the past I had been “kind-of” following the South Beach diet, but I have now switched to a stricter low-carb approach. The inflammatory effects of carbohydrates seem to be affecting not only internal organs and blood vessels, but also the skin. When restricting carbs, my usually red-ish acne-prone skin (particularly nose) amazingly transforms into normal looking skin. Many years ago, my doctor prescribed tetracycline to treat the acne, but I did not agree to take antibiotics regularly.

    If carbohydrates can cause such skin inflammation, then this likely would indicate possible extensive internal inflammation as well. Rather worrisome. I’ll be sure to get my first EBT heart scan soon to see if long term inflation may have resulted in plaque build-up.

    Are there any studies that indicate/confirm correlation between carbohydrates and acne symptoms? Surely the hugely profitable skin care industry would have no interest in publishing the findings from any such study.

    Yes, there are a few papers correlating excessive carbohydrate intake with acne. A few are by my friend Loren Cordain. You can check out one here and find the others through PubMed.

  79. Dr Eades,

    I wondered if you had ever come across “Serrapeptase”. In my search for interesting anti-inflammatory compounds this one seems to have a huge amount of anecdotal evidence.

    It comes from the silkworm and based on its enzyme that “eats the cocoon”. There are a number of proponents of serrapeptase, one which can be found at Serrapeptase.info. My personal interest is from back pain and my concern about a family history of crohns etc. I am on a very low carb diet, krill, curcumin, vit d etc. But everything helps.

    Now, a very useful post was put up by Dr William Davis (http://heartscanblog.blogspot.com/2007/04/nattokinase-scam.html) on a related compound saying that someone would need to be “crazy” to take a fibrinolytic. He says they are dangerous and could remove good blood clots! I don’t wish to put you up against Dr Davis so feel free to not comment on this.

    I checked Pub Med and various other places and am amazed at how little research has been done in the last 10 years on Serrapeptase. Most of the research comes from germany and 80s etc. I read but can’t confirm that this substance is widely used in Germany as an anti-inflammatory.

    But with so many forums, reviews etc of Serrapeptase saying so many good things about it, I am intrigued to learn if you have ever seen any use of this compound in your clinical studies.

    many thanks,
    col

    I have to admit that this is one I’ve never heard of. I can’t really comment because I don’t know anything about it. I’ll have to read up when I get the time.

  80. What an amazing, well put together, post. Now I know why inflammation is so bad!! Thank you. So this has given me some questions. Firstly, Olive and Avocado Oils are not inflammatory are they? You are talking about the hydrogenated vegetable oils yes? Secondly, I know that many hunter gatherer groups tend to feast for one meal a day and that’s it. So is this a wise option to try to achieve since eating many more meals will promote inflammation?

    No, I’m not talking about just trans fats. Any fats with a high percentage of omega-6 fatty acids are inflammatory. Olive and avocado oils contain some omega-6, but not a lot. A good rule of thumb in choosing fats is to ask if the fat can be obtained by squeezing or pressing the food in question. Both olives and avocados can be pressed to obtain oil. Same with nuts. But not with corn. If you press corn, you get corn juice. The oils have to be chemically extracted. Corn oil contains a lot of omega-6 and should be avoided. Vegetable oils in general should probably be avoided because of their inflammatory nature.

    Eating every other day or just a time or two per day has been shown to reduce inflammation and promote longevity in lab animals. No reason it shouldn’t do the same in humans.

  81. I never thought I’d see someone so very talented at putting the scientific and complex into laymans terms, with simplicity and common sense. I used to read Dr. Dean Black’s books (out of Berkley) ..did I spell Berkeley right? lol. Wish there were more in the field with your skills of communication and your desire to help others on day to day, non-glamorous basis. Very grateful, and healing,,,, Rachel

    Thanks for the kind words. I’m glad you’re enjoying the blog.

  82. The most interesting point for me is your observation that the innate immune system is responsible for the inflammatory response. This behaviour was already noticed in the study of auto-immune diseases. There is a similar theory (developed by Trevor Marshall) which focus also on the innate immune system producing inflammation but as a result of chronic infection with intra-cellular bacteria. The innate immune system fails to kill them as bacteria have develop defence strategies based on the blockage of the VDR Receptor. Thus the body´s own antibiotica (calcethidin) are not produce and this leads to a response very similar as the one you have described. The innate immune system continue to produce inflammatory cytokine. There is also a way to measure the level of inflammation by measuring the Calcitriol Level in blood (Vitamin 1,25 D3) in comparison with Calcidiol (25D). The innate immune system also produces locally additional 1,25D on a vanish attempt to fight the patogens. The higher the degree of infection, the higher the 1,25D Levels in blood.

    As Bacteria needs also glucose for survival, Low Carb diets are beneficial as well.

  83. This is probably the third time I have read this blog post since it was written. I hope I got it down pat now. Now, what to do!

    I got a big problem. Stent placed three years ago in LAD. I passed out unexpectedly 18 months ago, and after many tests, they did another cath and it showed NO blockage. All was well with the heart, it seemed. Two weeks ago, chest pain. Another cath. Blockage above the first stent in the LAD. Oh, no, I thought I had this heart disease figured out.

    For a year now, I have been very strict eating my LC WOE. I take the supplements you recommend. The only thing I do wrong is over the past year, my job’s stress level is beyond belief. Super long hours, super stressful. And… I drink too much alcohol. Not a sot, not an alcoholic, but when I drink, which has been three to four days a week, I drink 4-8 drinks. Not good.

    So, I can reduce stress and I can reduce or eliminate alcohol. I can do that. But is that enough? I want to beat this and obviously, I’m not. Are you still thinking eating one meal a day could help? I don’t know if I could eat every other day. I suppose I could if it means survival. One meal a day, though, seems doable. I recall Hershel Walker, the running back, when interviewed years ago said he ate one meal a day and I thought how odd is that!

    Are you still thinking this about heart disease? I’m not asking you to prescribe. Just, what is your current thinking on reducing chronic inflammation?

    P.S. My family history is dismal. My dad, both his brothers, CVD got them all.

    I do think stress reduction will help as will cutting down on the drinking. Although alcohol is a stress reducer to an extent it is also causes liver inflammation. Many of the inflammatory cytokines that end up damaging blood vessels can come from an inflamed liver, so I would cut the booze and try to restore liver health. I would also take a lot of vitamin D3. If you are working long hours (I assume yours in an indoors job), you are sun deprived, and, therefore, vitamin D deprived. You should get your levels of 25 (OH) D checked, and take enough vitamin D3 to get them to normal. I might start with 50,000 IU then 5,000 IU per day – assuming your levels are low. Finally, take a look at Dr. Davis’s Track Your Plaque program. You can read about it on his blog (note the most recent one on vitamin D). And, yes, I do still stand by my views on the inflammatory basis of heart disease.

  84. Thanks for the informative post on inflammation! Is it safe to assume that osteoarthritis can be termed an inflamatory disease and can be helped by maintaining a low carb diet? I’ve got a vegan brother who condems my way of eating and tells me that if I went to a vegan diet my arthritis would improve dramatically.

    Your thoughts?

    Osteoarthritis is sort of an inflammatory condition, but not at all like rheumatoid arthritis and other serious autoimmune inflammatory arthritides. People with osteoarthritis typically do do better on lower-carb diets because lower-carb diets are less inflammatory than high carb diets. I suspect that a switch to a vegetarian diet would not be for the better.

  85. A remarkable essay, thank you. I came to same conclusion last week as I emerged from an episode of severe asthma, my worst in 25 years. But in my years of studying the subject, I have never seen this idea– that the act of eating food is inflammatory. Profound.
    My strategy in dealing with asthma (and any kind of cold) has always been eat minimal, soups are best, drink plenty but carefully and NOT sweet drinks, not even juices. Exception: I find that grapefruit juice diluted to half strength helps as an expectorant.
    15 years ago at age 47, I decided I could not go into old age with asthma. I had evolved a pretty heathful, active lifestyle without asthma drugs, after a childhood of suffering mitigated by Tedrals. No asthma drugs educated me, and forced me to improve. But in 1994 I discovered the corticosteroid inhaler and the revelation that my own body makes not only the amazing adrenaline but also the wonder drug(s) corticosteroids.
    Instead of getting hooked of the inhaler, I got addicted to research and read your Protein Power book among many others. This led me into peer-reviewed science.
    Here are a few hopefully pertinent thoughts, and a large question at the end. I’ve forgotten too much of the science lingo, having been otherwise occupied in recent years.

    I too get irritated at the “adrenal fatigue” hokum so prevalent. There is a reality that is obvious in asthma, shown by albuterol-type “rescue” inhalers, very dangerous because their constant use downregulates the number of epi-receptors, creating the need for MORE, not to mention fostering dependence.
    In modern life, even people not born with asthma can develop it through a lifestyle in which adrenals are stimulated constantly by A] horror movies, sprots events, etc in which stimulation and attendant hormones are NOT resolved by physical activity; B] epi and GLUCO-corticoids also regulate (low) blood sugar, so these adrenal hormones are also tapped regularly when carb-addicts cannot get their fix; C] and of course the chronic stress of daily life. Notice that all of these situations were virtually unknown 100 years ago when Joslin stated that diabetes precluded asthma, and vice-versa.
    So yes, adrenal fatigue is real, a result of too much adrenal cranking, with minmal physical “resolution”.
    The remedy: rare Chinese herbs? Goat gland extracts? Hah! The remedy is CALM DOWN your life; get physical, in best condition possible; stay maximally hydrated (more later); eat right, eat minimal calories.
    Of course, the lifelong asthmatic, having struggled for breath so often, learns to CRAVE those high adrenal moments, when breathing is clear, no worries and you feel so good, and so strong.

    In short Dr Eades, my conclusions dovetail with your own, right down to the Slow-Burn exercise. Its an honor and delight to read your material, really for the first time since your book (still on my shelf here!) so many years ago.
    For me physical conditioning and exercise are sine qua non.

    My approach is that asthma is a CONDITION, not a “disease”. My “remedy” is that remedy is a last resort. Apart from your own program (and mine) for optimal health,
    Hydration is critical to everyone, especially asthmatics. The body experiences poor hydration as a stressor and– surprise!– responds with adrenal “stress” hormones. My guess is that the mechanism is to remove INTRA-cellular water gradually to meet the needs intercellular water needs. It has been shown (apparently– cf Stephen Peters, don’t have the cite anywhere closeby) that poor cellular hydration is inflammatory. Who would have guessed?!
    Some experts say, “Poor hydration is rare. We have the thirst mechanism to tell us when to drink. The body self-regualtes water very well.” Maybe in a healthy body in an ideal world. But I think our thirst mechanism can be perverted; and obviously the fluids
    Personally, when my breathing gets a bit tight, first thing I do is drink some water but basically I want to stay a ahead of poor hydration– “catching up” on hydration is harder.
    So just drink 8 glasses of water each day? Nope. I go thru a gallon of water when I work outside in the summer. A small person working in an air-conditioned office may need a quart. And how much “wet” food do you eat? And so on. Highly variable, obviously.

    Leading to my question– I tend to urinate more than is desirable at night. Calcium citrate helps but I’m not eager to get on calcium supplement. I’d like to get a deeper understanding of hydration, major electrolytes and any important minor one. Can you steer me into any book, especially one referencing peer-reviewed studies?

    I’ll read the rest of your site sometime soon, thanks again, J Sandy Hepler

  86. What about the CVD theory of the great Linus Pauling? Het states that the artery walls grow weak when not enough collagen is produced (=subclinical scurbia).

    Next, the liver send lp(a) to heal the weak spot; cholesterol to the rescue!.

    Now the free radicals start to oxidise this cholesterol, and that leads ultimately to inflammation.

    Now, all this doesn’t have to happen if we make sure we produce enough collagen. How do we do this : make sure our ascorbate intakes are sufficient.

    I think there is a lot of evidence that supports this theory. All the mamals that are able to produce their own ascorbate don’t seem to develop CVD, no matter how much they eat.

    I have read quit a lot about the virtues of ascorbate, so you need to have some pretty good arguments to make me doubt Pauling 😉

    P.s. I know you take vitamin C as a supplement, so why not elaborate on this?

  87. P.s. Another argument : if insuline / infammatory foods cause inflammation in arteries, you would expect to find arterial plaque all around the vascular system. We both know that isn’t true. Only the pieces that get the most mechanical stress (like directly after the exit of the hart where the BP is highest,) devolop plaque. I once heard of somebody that thoughtlessly played with the artery in his neck for many years and developped arterial plaque there.

    Not necessarily. If you have a process that damages an artery, the likeliest place for damage is that place that is under the most constant stress.

  88. Thank you for a great topic and post! I am looking forward to more as you devolp your thinking on inflammation, including how insulin and various foods (e.g. grains, dairy) fit into the picture.

    My motivation to change to a LC diet was strictly to avoid blood sugar spikes. Now I have eliminated grains and significantly reduced my 4x a week gym sessions (replaced with Slow Burn) and watched my allergies mostly disappear. I had swelling/puffiness in my legs, feet and face which is very rare now (still cannot pin down what brings it back – milk?). My skin is better and my muscles ache far less.

    Although heart disease is rightly the focus of the discussion, I would love to learn more about other effects inflammtion has on us as well, and how to better recognize what might cause it in each of us individually.

  89. I enjoyed reading your post. I am 40 years old and after many years of stomach problems have discovered I am gluten intolerant. My husband is a family practitioner and not a big believer in getting me tested. I went off gluten and saw an huge improvement in one day. After 2-3 days there was no doubt. I have also suffered from dry eyes and dry mouth for about 10 years now. The Sjogren’s testing several years ago came back negative. My rheumatoid factor was slighly positive about 3 yers ago..no testing since then. Anyway, I have discovered along the way that limiting carbs and pretty much cutting out all grains has improved the dry eye and mouth an incredible amount. Eating this way and being careful about my exercise but not overdoing it has also kept me from being fatigued. Also taking garlic and fish oil has helped tremendously. I no longer get the respiratory infections that were so frequent in my life and I sleep better–with my mouth closed–and wake up feeling rested. I just want to put my story out there in case it helps someone else. Thanks, jen.

  90. I just wanna say that I find soured dough more digestible than regular bread, in my short experience with changing over. Maybe grains have always been healthy for us, but we got so good at keeping everything fresh, we started to tax our digestive systems.

    Souring foods increase yeast content and subsequently Vitamin B. But the best thing about it is the extra flavor that comes from souring food.

    I was on a high protein diet for five years, but I never ate for flavor, it was for health. The protein may have filled me up and left me full for a long time, but I never thoroughly enjoyed the flavor of various meats and protein all the time. Introducing soured grains, milk, and veggies have dramatically helped with my health.

    The high protein diet weakened my digestive system because I took it to the extreme. I ask if sour foods can wreck my digestion in a different way? I dunno, but right now it feels right. However the high protein diet felt right at the time too. I wish I knew. Anyone been on a high sour foods diet for a long period of time.?

  91. What an interesting post! I’m just curious, would you disagree with those that recommend eating five small meals a day as opposed to three large meals? Also is it the calories in food that causes inflammation, or the mass/volume of the food. For example, would a diet that is very high in fresh fruits and vegetables and fiber be as inflammatory as a diet that takes up less space in the GI tract but has a higher calorie content?
    Thanks for such a great topic!

  92. Most interesting!!!!
    I would like to put you a question…in the last few months I gained 4 kilograms of eccess weight. At the sime time I couldn’t resolve an inflammation problem that’s affecting the pinky finger of my right hand.
    Now your article is making me wandering: could the weght gain and the inflammation be related?
    Massimo

    My guess would be that it’s something other than the inflammation in your finger.

  93. Thank You very much for your answer! I wasn’t suggesting that my pain could be due to inflammation only. As a software developer I use my fingers a lot, and my physician said that this pain could be due to the tendon sheat which is loosing flexibility.
    I have been esperimenting this kind of joint problem several times in the last three years. I was wandering if this could be connected (in any way) to my weight problems

  94. Massimo, I would like to share my experience with joint pain. Before I changed my diet from a high carb/lowfat diet. I had pains in my knees and wrists. Soon after changing my diet to low carb/adequate protein/high fat, my joint pain dissipated by, I would say, 80%. Although I lost 30 lbs, I know that it wasn’t the weightloss that releived my pain because I gained the weight back. But my joint pain did not com back. That being said, I gained a little more weight than what I lost….but I continued to experience better joint health. Now, after learning about IF and it’s anti-inflamatory properties I began combining it with my low carb diet, implementing it as a part of my lifestyle. Not only did I lose the regained weight, I also experienced added pain relief. I would consider my joint pain as being 95% gone. Except for some ocasional twinges, I almost feel as painfree as when I was a teenager.

  95. Devils advocate- Exercise induces trauma, minor anyway, w/c leads to inflammation. If inflammation is bad for the heart than exercise is bad for the heart. Naproxen reduces inflammation hence naproxen is good for the heart.

  96. I think there are questions we could have about the early man diet – or just how far back we’d have to go to see actual evolution at work in our bodies (after all, early man wasn’t expected to live that long). But the why really isn’t important, if there is science about our bodies today that show too much inflammation at work.

    In case observations of different reactions I’ve had might be of interest (results may also reflect my high sensitive to acid, somewhat low blood pressure, and pstd/anxiety issues or solutions):

    I once tried the Atkins diet but stayed longer on the jump-start (ketonosis?) portion than recommended, which suddenly led to heart palpitations.

    During non-hodgkins, stage 4 (an immune system cancer) I lost 60 pounds because I was reduced to eating a jar of baby food and drinking a jar of water a day for about 4 months (no vitamins or sunlight). When I was able to eat and drink again, I was most drawn initially to cheese omelets, gado-gado (peanut butter, onion, pasta, ginger), sausage breakfast sandwiches, bean and cheese burritos with extra cheese and chocolate. I remain less drawn to breads and most meats. Most surprising to me has been that I have not returned to liking my diet soda or any soda. I have also found that where before I needed to eat meals throughout the day, particularly first thing in the morning if I didn’t want my stomach to hurt, this is no longer the case.

  97. Dear Dr. Eades –

    I have been utilizing your advice from Protein Power successfully for over 10 years now. Someone I care about has recently been diagnosed with Rheumatoid Arthritis. In a previous post you mentioned that symptoms were lessened on a low-carb diet. Inflammation seems to be a big factor with RA – can you talk a bit more about your experience with patients who have this condition? Any resources you might recommend?

    Thank You Kindly –
    Craig

    • I don’t really have any resources at hand, but since RA is definitely an inflammatory disorder, anything that reduces inflammation is helpful. A number of studies have shown the carbohydrates are inflammatory, and my own experience has shown that reducing carb intake reduces inflammation. The patients with RA that I have treated with low-carb diets for obesity have all shown improvement while on their diets.

  98. Your article is very interesting to me. I recently started the south beach diet (phase 1) for weight loss since i’ve been having a sore hip at night and general stiffness. I should lose about 20-30 lbs. Anyway, the phase one is almost completely carb free and since I’m not a huge meat eater…I was a bit of a doubter about eating so much animal protein.
    Anyway, to my surprise, all my inflammation is going away and my hip pain is gone and I’m no longer stiff in the morning….this is after only 6 days and I cheated one day. !
    I’m thinking allergies to some foods as the reason…however iI was already eating gluten free…so now reading your article…maybe it’s just the sugars themselves…i have to now convince my hubby. Thanks, for the article. ♥

  99. Hi Dr Eades
    Very interesting stuff, particularly as I have just had lunch with a very clever Harley Street doctor friend who has come up with an amazing “vaccine” for many types of cancer. Basically, he has found a way of turning on the adaptive immune system so that it searches for these types of cancer. We had a glass of champagne at lunch because it looks as though he has managed to cure a friend who had bad pancreatic cancer. Amazing x-rays etc….
    Anyway, I digress. I have been on the Dukan low carb diet for about a week and am feeling great whilst losing weight. The problem is that I had just bought a load of low glyceamic product from Usana company in USA and my nutricionist are also recommending loads of vitamin supplements (14 pills per day!!). I am going to try to live a low carb lifestyle in future (which I assume you think is good), but do “power shakes” like Nutrimeal fit into a longterm low carb diet? Nutrimeal looks like a really healthy product to eat as a breakfast (240 cals apparently) full of low GI carbs, proteins and good fats. My question to you is “Should I take all these vitamins and Nutrimeal healthy food if I am going to live a high-protein low carb lifestyle?
    Rather long-winded, but I really am going to try, aged 65, to lose some weight and be healthy! many thanks, Steve

  100. Interesting article! But I have a question or two. Is it not true that proteins are used mainly for cell repair and growth, and therefore you don’t need so much all the time? Also, as Dr. Campbell points out in The China Study, not all food proteins are the same, mammal protein being very similar to our own, with plant protein not having all the components in the right order. He makes the point that some animal proteins are absorbed in fairly intact pieces, and our bodies see them as threats (as you state), but sometimes these pieces are pretty close to our own tissue (like the pancreas) and sometimes the immune system gets confused and attacks our own tissues. I guess my point being that too much protein (particularly mammal protein) keeps everything ‘ramped up’. You might want to check out a TEDtalk on ‘antiangiogenesis’, I found it fascinating. Anyway, I was just curious as to what you thought about our protein ‘needs’ today since animal protein is such a big part of our diet and we never hear anyone discern between animal and plant protein. Thanks for the blog post!

  101. Not a bad opinion, but you lost me at the TSA analogy.

    In actuality TSA IS chronic inflammation… it does nothing beneficial to protect the host, it’s never-ending, and its solitary effect is irritating the country and elevating cortisol levels.