The Med Diet and Inflammation

Believe it or not inflammation starts as a good thing. It happens when your immune system sends white blood cells and compounds like eicosanoids to attack invading viruses, bacteria and toxins. This can result in a classic example of totally normal inflammation:  Pain, heat, redness and swelling around a wound or an injury.

According to Barry Sears, PhD,  creator of the Zone diet, “there’s a separate response called resolution that is the first phase of inflammation that causes cellular destruction and the second phase resolution that begins cellular repair.  As long as those phases are balanced, you stay well. But for more and more of us, balance never happens. That’s because sugar, refined grains and saturated fat can also trigger an inflammatory immune response and the typical US standard diet is packed with them, meaning every time we eat, we are inflaming our bodies over and over. Meanwhile, the average American gets way too little of fruits and non-starchy veggies which are packed with antioxidants that help cool things down as well as fatty fish with omega-3 fats that can reduce the intensity of the initial inflammatory response and can help move your body into the second phase of resolution (cellular repair).

But the plan with the most research behind it is the traditional Mediterranean diet. Several large studies have found that people who follow a Mediterranean pattern of eating have lower levels of the inflammatory markers, C reactive protein and interleukin 6, in their blood compared with those who don’t. “This may be one of the reasons the Mediterranean diet is linked to so many health benefits, from keeping weight down to slashing heart and stroke risks, says Frank Hu, MD , professor of Nutrition and Epidemiology at the Harvard TH Chan School of Public Health.

“Air pollution and environmental toxins also trigger your immune system this way but most of the chronic, extra inflammation in our bodies is diet related” says Sears  “in arteries chronic inflammation can lead to heart disease, in the brain it’s linked to anxiety and depression, in your joints, it causes swelling and pain, in the gut inflammation throws off balance of helpful bacteria and causes direct damage to the lining of the intestines.”

“You don’t have to follow any specific anti-inflammatory (AI ) diet to make a big difference; a healthy body is built to handle the occasional onslaught of inflammation;  It’s the regular, consistent consumption and over-consumption of inflammatory foods like sugar and saturated fat that’s linked to serious disease” says Sonya Angelone, RDN, a spokesperson for the Academy of Nutrition and Dietetics.

A 2012 study of nearly 2000 people, for example, found that those who ate the most sweets over two years had significantly higher levels of interleukin-6  (an inflammatory marker) than people who ate more veggies fruits and whole grains.

Follow these guidelines on most days

Limit added sugar and sweet drinks. A small study in 2005, people who were fed a high-sugar diet for 10 weeks compared to controls had significantly elevated blood levels of an inflammatory marker that in high concentrations is associated with diabetes, heart attack, stroke, and obesity.

 Aim for half to 2/3 of your plate to be non-starchy vegetables as they are packed with gut balancing fiber and powerful antioxidants.

  Eat fatty fish (salmon, tuna)  or take omega-3 supplements (at least 1000 milligrams daily).

“Cut out white flour and limit flour-based foods. Focus on whole grains like quinoa, brown rice, and bulgur wheat. Even 100% whole grain flour will cause a spike in blood sugar that exacerbates inflammation, especially for people with insulin resistance, metabolic syndrome, prediabetes, or diabetes,”  Dr. Sears says.

Choose fats carefully. Limit saturated fats like butter and skip vegetable oils that are high in omega-6 fats, such as safflower oil and corn oils. (Read ingredient labels). Go for olive oil, avocado oil, or walnut oil instead.

NOTE: Americans came to consume more than 18 billion pounds of soybean oil by 2001 – more than 80 percent of all oils eaten in the U.S – and most of that soybean oil was partially hydrogenated, containing a hefty load of trans fat (not heart healthy).  It is mainly used in processed foods. Source: Nina Teicholz. “The Big Fat Surprise,” 2014,  page 237-238.

You Are What Your Ancestors Ate

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Epigenetics and DNA

Why is what pregnant women eat before, during, and after pregnancy so important to the development of the unborn embryo/fetus? Recent evidence indicates that environmental factors may play an important role during early life development with potential long-term effects on health in later life. How do these factors influence the genes we already have in place?

There is an emerging concept called “early programming” that simply states that the fetus adapts to its existing environment when it is less than optimal, e.g., when the diet is lacking in essential nutrients for its development. This results in suboptimal development with long-term implications leading to increased risk of diseases such as heart disease, obesity, metabolic syndrome, glucose intolerance, or insulin resistance in adulthood. We now know that genes are switched on and off leading to functional physiological differences between individuals.

How are our genes modified? The most common alteration is a change in the nucleotide called single nucleotide (polymorphism (SNPs). For example, a SNP may replace the nucleotide C (cytosine) with the nucleotide T (thymine) in a certain position in a person’s DNA. This change is permanent.

Another way is through epigenetics. Epigenetics is the study of any change to our DNA that modulates a gene’s activity by turning them on and off. They result from exposure to the world – everything we eat, drink, breathe, feel and do, i.e., our environment. They are temporary so it is possible to correct our previous behaviors such as smoking cessation, exercising more or improving our diets to provide a more favorable health status.

The nutrients we extract from food enter metabolic pathways where they are formed into the molecules the body can use. One such pathway is responsible for making methyl groups. The methyl groups are epigenetic tags that attach to our DNA to modulate its activity to silence genes. Another epigenetic process is the production of acetyl groups (acetylation) to DNA histones that enhances the expression of the gene. So one pathway “turns off” the gene and the other “turns it on.” These modifications are particularly important during development of the fetus. Some modifications continue to have an effect into adulthood.

Nutrients like folic acid, B vitamins, and others are key nutrients in these processes. Diets of pregnant women high in these nutrients can rapidly alter gene expression, especially during early development when the epigenome is first being established.

What foods are rich in epigenetic nutrients? The list may sound familiar.

Leafy vegetables, seeds, nuts, liver, meats, whole grains, egg yolks, red wine, soy, broccoli and garlic provide methyl groups or are involved in acetylation. For example, sulphoraphane in broccoli increases acetylation turning on anti-cancer genes. Butyrate (a compound produced in the intestine when dietary fiber is fermented) turns on protective genes. Folic acid, vitamin B6  and vitamin B12 provide methyl groups.

Animal studies have shown that a diet with too little methyl-donating folate or choline before or just after birth causes certain regions of the genome to be under-methylated for life. This can produce permanent changes.

For adults too, a methyl-deficient diet leads to a decrease in DNA methylation, but the changes are reversible when methyl is added back to diet. So changes in the diet can create a healthier environment to help to prevent chronic diseases, but the behaviors need to change.

To fully illustrate the epigenetic process, one must tell the story of the agouti gene. All mammals have a gene called agouti. When a mouse’s agouti gene is completely unmethylated, its coat is yellow and has a high risk for obesity.  When the agouti gene is methylated (as it is in normal mice), the coat color is brown,  the mouse has a normal weight and less disease risk.   The mice are genetically identical but the fat yellow mice are different because they have an epigenetic “mutation.” in this case the presence or absence of methyl groups in its DNA.


In a study pregnant yellow mice were  fed a  a methyl-rich diet;  most of her pups were brown and stayed healthy for life. These results show that the environment in the womb influences adult health.

The Emerging Field of Nutrigenomics

Possibly in the future of diet and nutrition there may come a time when we can use the concept of nutrigenomics to better understand why one person reacts to a particular dietary intervention more than another does. This may also explain why nutrition research is so erratic with studies reporting conflicting results and conclusions.  In the future, there is the potential for genetic testing that will result in genetic profiles that can aid in forming personalized diets and fitness plans, which will help minimize risks for disease.

We all know that a nutrient-rich diet is healthy and it is becoming increasingly clear that it  is not only what we eat in a lifetime but what our parents ate before our conception that can make a difference in our health status in adulthood.


Eating certain foods may weaken or help boost the immune system.

In general, try to avoid diets that are low in fiber and high in refined carbohydrates, sugar, and processed foods. These foods may suppress immune function.

On the other hand, eating foods that contain zinc, citrus fruits, garlic, ginger, and cruciferous vegetables may contribute to healthy immune function.

These foods have antioxidant and anti-inflammatory properties, which may help keep a person healthy and reduce disease risk.

Eating a healthy, balanced diet can help maintain a person’s immune system so that it can fight disease while reducing chronic inflammation.


Why We Have Large Brains?

Key Points:

● New research paints a picture in which the population of large mammals declined resulting in an increase in human brain size.

● Evolution, the theory argues, favored large brain humans who could successfully hunt smaller, faster animals for food.

● Brain size has grown significantly over the past 2 million years, but there is controversy over why this is the case. Some say the increase was the result of many small environmental changes over time. Others argue there might have been one major change, like this one.


Shopping For Health


A great body of evidence shows that this way of eating plant-based foods, healthy fats, lean proteins, whole grains in modern amounts of wine may help you live longer and stave off chronic disease such as heart disease and diabetes. One key component of the Mediterranean diet is the emphasis on foods that may thwart inflammation and oxidative stress which is at the root of many chronic diseases. These foods include omega-3 rich fish, fruits, and vegetables, nuts and seeds and healthy oils. The dietary pattern is particularly rich in monounsaturated fats which can help decrease bad LDL cholesterol and raise good HDL cholesterol – a win win for the cardiovascular system plus, the heightened emphasis on plant-based foods ensures a bounty of fiber and phyto- nutrients.

EXTRA VIRGIN OLIVE OIL is at the core of the Med Diet. It is rich in tocopherols (vitamin E), carotenoids (vitamin A), and polyphenols. Alternatives include avocado oil and walnut oil.

FRUITS AND VEGETABLES) (from any source – fresh, frozen, canned). Emphasize kale, beet greens, mustard greens, collard greens, artichokes, beets, broccoli, cucumber, eggplant, mushrooms, onions. Garlic is a mainstay in cooking.

Common fruits include apples, apricots, avocados, berries, citrus, dates, figs, stone fruit and pomegranate. Lemons are often used.

FRESH HERBS AND SPICES are staples. Their use reduces the need to add excess salt plus provide many antioxidants. Most common are parsley basil, oregano coriander, bay leaves.

FRESH AND CANNED SEAFOOD provide necessary protein and healthy fats. Omega-3 rich fish such as tuna, sardines, and salmon as well as mussels, clams and shrimp. Consumption is encouraged about twice a week.

WHOLE GRAINS. Wheat is the most common, but other grains like farro, bulgur, couscous, and barley are also favorites. Look for the term “whole” or “whole grain” that should be the first ingredient listed on the ingredient label.

LEGUMES.  One of the most prevalent pulses in  Mediterranean cuisine is the chickpea, which is often whipped into hummus, formed in falafel and tossed into salads. Lentils are also commonly used in soups and stews.  Other meals can include black Eyed Peas, kidney beans and cannellini beans that often are tossed into salads.

NUTS AND SEEDS are enjoyed as a satisfying snack thanks to their fiber, protein, and fat content. A common condiment on the coastline of the Mediterranean is tahini , which is made from ground sesame seeds . Most famously used in hummus this versatile condiment can be used  in sauces or dressings to spoon over roasted veggies or grain bowls.

OLIVES AND CAPERS are enjoyed as a simple snack and are among the most popular as Kalamata olives often tossed into Greek salads and pasta or into a tapenade. Olives are rich sources of antioxidant polyphenols and heart healthy fats. Brined or dried, capers are praised for their briny bite and the way they effortlessly punch up the flavor of pasta, baked fish and dressings.

CANNED TOMATOES Whole, diced, stewed or concentrated into a paste, both canned and fresh tomatoes are everyday staples in the Mediterranean . Canned tomato products are particularly rich in lycopene due to the heating process which may help protect against certain cancers. A few tomato centric staples in the Mediterranean include stuffed tomatoes, baked fish with tomatoes and of course, marinara sauce.

GREEK YOGURT AND ARTISANAL CHEESES The Mediterranean diet encourages savoring small amounts of full fat dairy, in addition to providing extra protein. Yogurt can provide healthy probiotics for the microbiome. Be sure to watch the labels and avoid those with a lot of added sugars. The Mediterranean regions spotlights traditionally cultured cheeses made from milk and natural cultures as to some of the more processed varieties (Velveeta) commonly available in the US. The French are famous for their love of hard cheeses eaten in moderation (not added to fast foods). They offer cheese with fruit as a dinner course.

Beyond being used in the classic Greek salad, feta cheese often accompanies stews and fish dishes. Halloumi cheese is known for its firm texture, which makes it suitable for grilling and frying. Harder cheeses like Pecorino Romano and Parmegiano Reggiano are often grated into pasta., while manchego can be baked into egg dishes.

RED WINE. Vine is a common accompaniment to Mediterranean meals, but it’s generally consumed in moderation (a five ounce pour is the standard.) Red wine, in particular, contains antioxidant polyphenols and the flavonoid resveratrol , which will help increase HDL cholesterol (good) and decrease LDL (bad) cholesterol levels.


  • Obesity, high blood pressure, and type two diabetes may raise the risk of hospitalization and death from COVID-19, research suggests.
  • Eating a whole foods diet and monitoring blood sugar may help maintain metabolic health.
  • Diet and metabolic health can strengthen the immune system to fight COVID-19 and other viral infections.


NOTE: There are so many diet books out there as well as information on the Web. Most are focused on weight loss (fine for many us), but not the whole picture of why we need sound diet and nutrition advice. I found an excellent book written by people I trust to offer this advice – with its main goal of not just weight loss, but our nutritional health. Check out: How to Eat: All Your Food and Diet Questions Answered by Mark Bittman and David L. Katz, MD. 2020. Its format is Question and Answer form, so it is easy to find just what you may want to know. Sally J. Feltner, M.S., PhD.

In the News: Calorie restriction

Caloric restriction protects against liver disease, animal studies suggests. Liver Cancer. 2020 Sep;9(5):529-548.

Consuming fewer calories has a protective effect against developing hepatocellular carcinoma ( primary liver cancer)  associated with hepatitis C virus infection, and non alcoholic fatty liver disease, according to a rodent study published in the Journal liver cancer.

Editor’s Note:  Recently, worldwide increases in obesity and metabolic syndrome have raised the prevalence of primary liver cancer derived from non alcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH), Indicating a close relationship between overnutrition and liver tumorigenesis, the authors stated.

The study used mice with the liver cancer core gene that spontaneously developed fatty liver and tumors. For 15 months, the animals were given either a control diet that allowed them to eat as much as they liked, or a diet that contains 30% fewer calories than the controls.

At the end of 15 months, animals that received calorie restricted diets had fewer and smaller liver tumors, less liver oxidative stress, lower inflammation, downregulation of pro- cancer mediators, increased autophagy(cell self degradation), as well as other improvements, compared to the control group.

In the News: Lower Alzheimers’ Risk with Flavonols

What are Phytochemicals?

Phyto chemicals are biologically active substances in plants that have positive effects on health They are also called phyto- nutrients. They perform a variety of functions including these roles:

  •  Antioxidants
  •  Inhibitors of inflammation
  •  Preventers of infectious disease

Flavonols act as antioxidants in the body and the good news about flavanols has made chocolate a health food. Cocoa, the main ingredient in chocolate is a rich source of flavonols.. Regular intake of flavonols such as a daily consumption of a cup of hot chocolate made with cocoa powder is related to improved blood flow, reduced blood pressure, and decreased risk of heart disease and stroke. Flavonols are also found in good amounts in foods such as berries, wine, and tea.

Lower Alzheimer’s Risk Linked to Greater Flavonol Intake. Neurology, 2020 Apr 21:94(16):e1749-e1756.

An article in the Journal Neurology reported an association between consuming more compounds known as flavanols, and a  lower risk of developing Alzheimer’s disease. Flavanols are found in many fruits and vegetables as well as in tea and chocolate.

The study included 921 participants with an average age of 81. The subjects the subjects did not have Alzheimer’s disease at the beginning of the study. Questionnaires that were completed at enrollment and then annually during a six year average follow-up period, provided data on dietary intake that was analyzed for flavonol content. Participants were also evaluated yearly for the presence of Alzheimer’s disease. Over the course of follow up , 220 individuals developed the disease. Participants were then divided into five groups, according to their level of flavonol intake. Among those whose intake was highest, at an average of 15.3 milligrams per day, 15% developed Alzheimer’s disease , compared to 30% whose intake was lowest, at approximately 5.3 milligram per day.

The authors stated that “eating more fruits and vegetables and drinking more tea could be a fairly inexpensive and easy way for people to help stave off Alzheimer’s dementia.”

A Timeless Way to Eat: The Mediterranean Diet

There is no real Mediterranean Diet – you know, the ones you read in diet books that offer set meal plans and do’s and don’ts with endless lists of breakfasts, lunches, dinners and of course, let’s not forget the snacks. (or maybe we should). The more recent habit of the American Diet is the increased eating opportunities fueled by the fact that we can eat just about anywhere and that mainly was the desire of big food companies (for more profits). But more about that in a future post.

“Over the span of more than eight decades, clinical research has continued to confirm that eating the Mediterranean way is a sound strategy for lifelong health. At its heart, The Mediterranean diet is precisely the way nutrition experts have been urging us to eat. It’s built on a foundation of whole, mostly unprocessed foods like whole grains, beans, and nuts. It embraces fruits and vegetables with abandon while being stingier with red meat and sweet treats. It includes moderate amounts of fish, eggs and dairy products though vegan and vegetarian versions are doable. It’s sprinkled with heart healthy vegetable oils , mostly olive oil, rather than saturated fat rich butter or lard and it can even include, if desired, a little alcohol traditionally red wine, enjoyed in moderation as part of a meal.”

“People who follow a Mediterranean diet also tend to live longer and perhaps age more gracefully. A recent meta analysis of four studies involving elderly patients found that those who adhered most closely to a Mediterranean style eating pattern had significantly less risk of becoming frail, an important measure of quality of life for older adults.”

The components of the diet are generally plant-based that give us ample vitamins and minerals, antioxidants, anti-inflammatory compounds, fiber, and good fats and carbohydrates. Long-term studies have shown lower rates of heart disease, diabetes, and a reduced risk of some cancers (breast, prostate, and  colorectal).  

“Encouraging research suggests that a Mediterranean pattern of eating may also have benefits for the brain. Several studies have linked the eating patterns to lower rates of depression, others notice a small but significantly lower risk of developing mild cognitive impairment and of progressing to Alzheimer’s disease.”

Source: Joyce Hendley. Mediterranean Diet: A delicious path to lifelong health. Eating Well Magazine.

For more….. CLICK HERE.

The Mediterranean Diet At A Glance

The Realities of Calorie Restriction

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Calorie restriction is not an easy thing to do in our obesigenic society. However, based on the the following study, even small changes seems to be able to result in not only weight loss but the beneficial effects on our overall health.

The debate about calories has continued for quite some time.

In 1918, Dr. Lulu Hunt Peters wrote the first diet book, “Diet and Health, With Key to the Calories.” The book was a best seller. She explained the new concept of calorie reduction for weight loss. To see her book CLICK HERE.

In 1958 Dr. Richard MacKarness published “Eat Fat and Grow Slim”. The title speaks for itself.

In 1971, Dr. Herman Taller wrote another best seller, “Calories Don’t Count”.

More recently, author Gary Taubes wrote a provocative book entitled “Good Calories, Bad Calories” and Nina Teicholz espoused the health benefits of calorie dense butter, meat and cheese, in her book called “The Big Fat Surprise.”

No wonder people are struggling with obesity and will continue to do so until we figure out the physiological, psychological, sociological and environmental complexities of weight gain, weight loss, and weight maintenance.

The following article emphasizes the health benefits of calorie restriction whether due to weight loss or the calorie deficit itself.