Foods and Inflammation

Certain foods can trigger systemic inflammation in certain individuals. While we sometimes describe this as “allergies” to foods, the term doesn’t always cleanly fit. Some reactions to foods don’t look like an allergy because the inflammatory response is subtle or slow, and awareness can lead to significant benefits from reducing or even sometimes fully avoiding certain foods, depending on who you are. Let’s dive in…

Processed Ingredients of any sort

I both hesitate to include this category and feel compelled to list it first — clearly the latter impulse won. I hesitate because these are not foods at all, and that is the point. However, it takes top billing because humans regularly consume these as though they are food, and they inevitably lead to inflammation, however subtle.

In fact, it is the subtle nature of the reactions, due to the tiny quantities of processed chemical ingredients in any given “food”, that leads to the most common chronic diseases plaguing Western civilization today, from diabetes to cancer. Our bodies detect these chemicals when we consume them; however when consumed in small amounts, only small immune responses are deployed.

Subsequently, as tiny but consistent amounts of chemicals continually mount small responses, eventually micro-spikes of inflammation are more the default rather than the exception when eating anything — leading to chronic systemic inflammatory conditions, often described as “autoimmune.” On top of repeatedly triggering the immune responses when chemicals are first consumed, cellular components also eventually become constructed from the very chemical invaders that have been subtly and chronically consumed over the course of years… which leads to the body attacking itself. In other words, “you are what you eat,” and as a result, “you are your own worst enemy.”

It is also worth noting that immune responses are so small and subtle at the time of consumption that we barely notice them, mostly because the response is dwarfed by a flood of dopamine. We certainly don’t choose processed foods because we are on a mission to consume chemicals. These selections are garbed with bright colors, creative logos, and inspiring images, and they are carefully engineered to trigger immediate happiness in the form of sweet, salty, creamy or crunchy goodness. Despite what the packages declare what a food might be “free” from [e.g., beware “fat free pixie sticks” or “gluten free energy drinks”], these options are NOT engineered to provide you with wellness and longevity.

I personally don’t believe in strict long-term elimination of any foods from any diet. Every type of food has a potential role for any person‘s experience; but it is critical to understand the benefits AND risks, then frame it accordingly. I love ice cream and cookies, and I always will. But the role of these foods in my diet is NOT wellness or longevity: it is momentary happiness. It comes with the risk of moderate-term bloating and weight gain: whether or not I acknowledge it at the time of consumption, this is a reliably inevitable consequence of eating ice cream or cookies, and I can’t expect to be in control of my long-term health if I never take control of my short-term impulses.

Some examples of processed chemical ingredients:

1. Preservatives: These additives prevent spoilage and extend shelf life.
2. Flavor Enhancers: These intensify or improve the taste of food without adding a distinct flavor of their own. 
3. Artificial Colors: These add visual appeal to food products. 
4. Sweeteners: These replace or add sweetness to food. 
5. Emulsifiers: These help mix oil and water-based ingredients, preventing separation. 
6. Stabilizers, Thickeners, and Gelling Agents: These improve texture and stability. 

NOTE: Many of these additives are identified by “E numbers” in Europe and internationally, while in the US, they are often designated as GRAS (Generally Recognized as Safe). 

Dairy

Dairy has become a confusing food category because it used to refer exclusively to foods derived from milk, usually from cows, and milk-based products. Apparently, fortified soy milk, was included in the dairy group with the 2015-2020 Dietary Guidelines for Americans, but that is a strictly American designation, as other countries do not acknowledge this categorization of soy products, so for our purposes, we will stick with discussing Dairy as a category of foods coming from animal milk.

The key fact to acknowledge here is that no milk product was engineered by nature to be consumed by humans, meaning that it is not naturally inclined to optimize our wellness. The vast majority of milk and dairy products on the market today are derived from a food source intended to optimize development of young cows. The benefits and risks of integrating this nutritional intention into a standard human diet are ripe for discussion, but beyond this it is critical to consider, once again, the industrialized treatment that milk and dairy products typically receive in the interest of human safety also with its own interesting and complex benefits and risks.

This all dials us back to examining how the human body might respond to this input, both with respect to milk components that not might go well for some (or most!) people, as well as the potential for a “happiness-triggering” dopamine response associated with creamy, comforting yumminess of mac-n-cheese or gelato that dulls awareness to the body’s rejection signals. In the end, the wisest approach entails raising questions as to the nutritional importance of including this food group in the diet, as opposed to including it for enjoyment and comfort. Knowing all this still probably won’t stop me from eating ice cream. But where it doesn’t lead me to my goals, I might want to reassess those choices.

Gluten

There has been a lot of buzz over the past 10-20 years over gluten in foods and associated potential bad effects, leading to a fascinating outburst of food products that declare themselves “gluten free” as if that makes them intrinsically health-promoting. Consequently, foods that are understood to be associated with gluten, largely cereal grains like wheat, barley and rye, have also earned themselves a bad rep.

Frankly, gluten in food is a result of processing grains into a powder (to make flour), typically in a factory setting particularly for mass-produced, packaged foods with a stable shelf-life, and used as a binder, texturizer, and flavoring agent in many products. In such cases, they clearly belong in the category listed at the top of this page (processed ingredients), and as a result, they warrant careful consideration.

It is also important to note that some individuals have an overt immune response to gluten leading to severe gut issues; this is known as Celiac Disease. Others have a similar but lower-grade response and find themselves benefitting greatly from reducing or eliminating gluten intake, even with negative results on diagnostic testing for Celiac Disease. But given other potential nutritional features of foods that contain gluten, it isn’t necessarily appropriate across the board for everybody to completely avoid these foods.

Some quick points:

  • While a gluten-free diet is necessary for individuals with celiac disease and non-celiac gluten sensitivity, it’s not necessarily healthier for everyone. 
  • Many people who don’t have gluten-related conditions may feel better on a gluten-free diet due to other factors, such as reduced intake of FODMAPs. 
  • A balanced diet, including gluten-containing foods, can be part of a healthy lifestyle for many individuals. 

A couple of straightforward Q&As about gluten from trustworthy resources:

Sugar

Despite being a critical nutrient that our bodies cannot function without, sugar has developed the worst rep in the 21st century. Unfortunately, rather than understanding HOW sugar is used by the body, WHEN it is necessary and WHY it has the effects that it has, we have gone full-scale into demonizing it to the point of aggressively replacing it with alternatives that are, in fact, more harmful than sugar itself.

I remember early in my primary care career, more than 10 years ago, frequently hearing diabetics during medical appointments insisting that they “can’t eat fruit because it has sugar and I’m diabetic.” Yet they would have a bagel with cream cheese for breakfast every day. Point being: misconceptions about dietary sugar have been circulating for a while, and I’ve learned over the course of my career that the confusion continues to evolve until we have completely opposite camps shouting from rooftops at the top of their lungs to thousands upon thousands of viewers and scrollers who are just trying to figure out the best way to eat.

There is not only a lot to understand about how and where glucose is used in the body, the variety of metabolic processes that make glucose available for use in the body, and the variety of food sources that get metabolized into usable glucose, but the differences in how each individual body engages these factors is worth understanding before deciding its role in someone’s diet.

At the end of the day, because there is so much misunderstanding and controversy, all I can say is what I authentically believe, and just like everything else available on the internet, it is up to the audience to decide for them/yourselves what makes the most sense for you. So here are my basic tenets regarding sugar as a dietary category:

  1. Refined sugar of any sort (e.g., table sugar, corn syrup, fructose) is a processed ingredient. It provides dopamine and enjoyment but in spite of providing an option for glucose as an energy source, it is far from nutritionally beneficial in any way, for all sorts of reasons that are probably common knowledge at this point.
  2. There are a few varieties of chemical sugar (monosaccharides or disaccharides) found in different foods (e.g., sucrose vs fructose vs galactose) and arguments have been made regarding the virtues and vices of different ones, but the BEST type of sugar in my opinion under any circumstance is whatever exists naturally in a minimally processed food. The sin is not in the chemical itself, but in a chemical that has been artificially isolated from the food where it belongs. My personal favorites for natural sweeteners are maple syrup and honey. And, by the way, if you are a diabetic, please eat fruit with all its natural sugars if it can in any way limit your cravings for bagels with cream cheese.
  3. Any food that includes a refined (white) flour is as good or as bad as eating sugar. No matter how healthy a baked good made with refined flour looks or pretends to be, it is in your diet for happiness, not for nutrition.
  4. When you are craving sugar, it is generally because your faculties that require glucose for energy are begging for fast fuel. Particularly under these circumstances, the WORST thing you can do is consume artificial sweeteners in place of sugar. They DO trigger the insulin response (which leads to downstream insulin sensitivity), and they DO NOT PROVIDE ANY REAL FUEL because the body cannot break them down into usable glucose. These substances may help reduce your intake of sugar, but they also increase your intake of chemicals the body has absolutely no use for. To address cravings, keep foods with natural sugars at the ready, like fruits, nuts or honey (I’m a personal fan of honey on bananas for this sort of thing). To prevent cravings, maintain a diet rich in complex carbs with foods like sweet potatoes or squash.
  5. Lastly, most of the foods that we consider problematic for being high in sugar are problematic because of what the sugar comes WITH… which, by the way, is often more sugar. For example: cake… with frosting (that also contains food coloring). Or, bread… with jam (that also contains pectin or guar gum). Ice cream… topped with whipped cream (packaged with nitrous oxide). How’s this one: …a sugar-free donut!!!! That one just makes me want to cry: they make donuts with super-refined white flour then add sucralose instead of sugar then label it as though it is health-conscious. I honestly just can’t. Perhaps sugar itself isn’t the problem. It’s the QUANTITY and concentration of sugar, along with the carcinogens that aid in the dopamine burst.

Bottom line: Most of us can stand to cut back on our sugar intake. But education and awareness will go a long way at achieving balance rather than swinging us to extremes that eventually become their own problems. To quote Sting, “I never saw no miracle of science that didn’t somehow go from a blessing to a curse.” Nature is still the go-to resource for all the best answers. And that’s all I have to say about that.

Lectins

Lectins, a type of protein found in many foods, can potentially contribute to inflammation in some individuals, although the extent and mechanisms are still being researched. While lectins are generally deactivated by cooking, some individuals may still experience adverse effects, especially if they have existing gut issues or sensitivities. 

Lectins are found in many plants, and certain foods contain higher levels than others. Common foods that are high in lectins include beans, lentils, peanuts, tomatoes, potatoes, eggplant, and wheat. Lectins are also present in other legumes, grains, and some vegetables. 

Some individuals may be more susceptible to the inflammatory effects of lectins, especially those with existing gut issues, sensitivities, or autoimmune conditions. 

How to reduce potential inflammation from lectins: 

  • Cooking: Cooking, especially boiling, baking, and pressure-cooking, can deactivate many lectins. 
  • Fermentation, sprouting, and peeling/seeding: These methods can also reduce the amount of active lectins in food. 
  • Individual sensitivity: Some individuals may need to explore a low-lectin or lectin-free diet if they experience negative effects after consuming lectin-rich foods. 

Great info from a trustworthy source:

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-what-are-dietary-lectins-and-should-you-avoid-eating-them/

Approaching an Elimination Diet

Food selections are individual and situational. Identifying foods that most effectively fuel activities that are most meaningful to us is a worthwhile pursuit and can be achieved by applying a little discipline and using the right approach.

  • Elimination of foods can be done simultaneously or in sequence, but the key is to permit at least a week (ideally 2-3 weeks) of elimination to give time for the body to readjust to being without the food type.
  • Consider careful food journaling, anticipating a 3-5 day delay between consuming a dietary component before experiencing associated symptoms.  This can be especially helpful when adding foods back after elimination.