Nutrition Professor: How inflammation could age you | Philip Calder

inflammation is always harmful is a misconception it's there for a purpose inflammation is really the first thing that happens when we get exposed to something harmful a little bit is good and in fact necessary if you cut yourself and you don't stop bleeding or anything you eventually die I guess Philip cder is a professor of nutritional immunology and the head of the school of human development and health at the University of Southampton in the UK and an expert on how our diet influences our immune system and inflammation if it's not regulated properly or if it's happening in the wrong place at the wrong time that's when it becomes harmful to us dementia heart disease arthritis multiple sclerosis type 1 diabetes maybe even some cancers these are diseases that clearly involve inflammation gone wrong I mean Philip you're painting a slightly terrifying picture things we eat trigger inflammation so you're saying that your body is actually attacking itself but you can do something about that with your diet foods that will trigger inflammation include that is not how long you live it's how many healthy years you have so I think there two things welcome to Zoe science and nutrition where World leading scientists explain how their research can improve your [Music] health so we have a tradition here at Zoe philli um and the tradition is that we always start the podcast with a quick fire round of questions and we have some very special rules that professors always find really difficult which is that you can say yes or no or if you absolutely have to you can have a one- sentence answer mhm are are you willing to give it a go I I'll try my best to stick to the rules all right could inflammation make me age faster yes can long-term inflammation cause serious diseases yes are inflammation and Immunity the same thing no can the food I eat cause inflammation after meals yes I'm nearly 50 is it too late to change my diet to lower my inflammation no that's good I was going to get really upset if you'd say something different so that's good now as someone who likes to get quite scientific with many of the things I do I find this fascinating YouTube is showing me right now that 67.9% of you who watch this channel haven't hit the Subscribe button I want to ask you a quick favor hit subscribe now it really helps us and I promise I'll make it worth your while more subscribers enables us to make the show even better as more World leading experts and ultimately further our mission to improve the health of millions so if you enjoy the show all I ask is hit subscribe I've been talking about inflammation with Scientists for seven years now since I first got involved with Zoe and I still find it really hard to understand I know it's something to do with our body's defense mechanisms I understand that the food we eat can influence it and I'm really excited to have you here to help me and the listeners sort of to understand more can you explain in simple terms what exactly is inflammation how it's different from immunity and while you're saying it's not necessarily always a bad thing yeah so immunity our immune system is the way we defend ourselves against harmful things in our environment particularly things like bacteria and viruses now immunity is very complicated very complex it's very sophisticated and it involves many things happening in the body many different cell types and uh events occurring inflammation is the first little part of the immune response so immunity is sort of like an umbrella of very complicated but joined up events and inflammation is just part of what's under that umbrella so we shouldn't mix up inflammation and Immunity now because inflammation is part of immunity it's actually designed to help us it's designed to be part of our protective mechanism so inflammation is really the first thing that happens when we get exposed to something harmful and that could be an infection it could be an insect bite it could be you know a paper cut so the things that people experience when they get a paper cut or even a more serious Cut You Know The Pain um the redness the swelling that's inflammation so that's designed to help us okay so it's something that happens in a helpful context but it turns out if it's not regulated properly or if it's happening in the wrong place at the wrong time that's when it becomes harmful to us got it so a little bit is good and in fact necessary so I can you know obviously if you cut yourself and you don't stop bleeding or anything you eventually die I guess but it needs to cut out we've covered that a little bit on some of you know some of our other podcasts if you imagine you cut yourself and I use paper cut as a really simple example but any sort of cut a more serious cut you have a problem with bleeding so you have to turn bleeding off but also you have the possibility of getting exposed to bacteria that might be living on your skin for example or on the thing that cut you so you need to be protected against those that's what inflammation does but as you say it has to turn itself off and we call that resolution so the resolving of inflammation the turning off and lot of problems happen uh for example when we age or in certain diseases if inflammation doesn't turn itself off so we we don't have this resolution of inflammation it's like a lot of things in life a little bit might be good but lots is not so good correct and in theory it should be getting switched off and I guess that sort of raises the question so what's going on therefore that we can end up with this sort of bad inflammation where it hasn't been switched off yeah so I think there's two two things one is if you get continuous exposure to the thing that initiated the response in the first place so a good example of this would be a disease that's known to be driven by inflammation so something like arthritis for example so arthritis is where inflammation is attacking the person's joints and you get all the hallm marks of inflammation you know you get the redness the swelling the pain all those things so what's happening there is actually the inflammation is responding to the person's own body and you just you know that's not going to go away so you get this continuous exposure so you never get the opportunity to turn the inflammation off because it's always being driven forward the other is a loss of the signals that turn inflammation off and this is actually where some dietary components which we're probably going to talk about later on come into play we need to actively be able to turn off the inflammation and if we lose the capability to do that obviously it just keeps going it's like a runaway car if you like got it and so I mean guess in your first example with the arthritis you're saying that your body is actually attacking itself it's actually sort of being triggered in that situation so it's feeling like that actually your own body is is like one of the sort of Alien Invaders you were describing you know when you cut yourself and you get bacteria that's right so so that's exactly what a disease that it's called an autoimmune disease but it's actually an inflammatory disease like arthritis multiple sclerosis there are others that we know inflammation is Central to actually causing the disease and it's because your body's actually made a mistake it's seeing itself as somehow harmful and it shouldn't do that of course now there's a genetic predisposition to that so you need the combination of the genetics and something else to trigger that sort of response can that be triggered by the fact that you have a lot of this like long-term inflammation from other causes and then that makes it more likely that you end up having the arthritis it could be so if you have um a series of events that can trigger one of these autoimmune inflammatory diseases so a good example of that actually is type 1 diabetes which is believed to be triggered actually by some sort of viral infection of the pancreas so you get an initiating sort of trigger from something that is foreign that does need to be dealt with but then the body starts misinterpreting what's going on and the body starts attacking itself and that of course destroys the the pancreas and you get type 1 diabetes not type 2 diabetes type 1 diabetes I'd love to talk about like the before we sort of talk about the food just other things that this chronic inflammation can can do so you were say saying like if it's switched on permanently it can start to have a lot of negative effects what what does that actually mean given that I understand most of us living a sort of Western lifestyle today probably have higher levels of inflammation than we should what is this what's the risks as a result yeah I think we have to think of different levels of inflammation so I've used some examples already like arthritis I mentioned multiple sclerosis I mentioned type 1 diabetes these are diseases that clearly involve inflammation gone wrong and if you measure um chemicals in the blood of people that are indicators of inflammation in those patients the levels of those chemicals are very high in the blood so this is you can measure the inflammation of somebody with a blood test that gives you a real answer there are chemical readouts in the blood that are elevated that are higher in someone with an inflammation in the joints for example like arthritis is there one particular thing you look at or is it a set of things so so the most common marker is a protein called C reactive protein or CRP that's a very good indicator that someone is inflamed but there are others as well so in these disease scenarios we would consider that to be highgrade inflammation so the levels are very high but we also have other conditions where there is elevated inflammation so too much inflammation but not at this really high level so we call that low grade inflammation okay of course the inflammation in arthritis and so on has been known for for decades now but this phenomenon of low grade inflammation has really only been known for about 20 years I guess now and it turns out lowgrade inflammation is part of many common diseases that people wouldn't think of has inflammatory diseases so things like heart disease for example heart disease heart disease um obesity um type 2 diabetes even dementia so these common diseases are linked with this lowgrade but persistent inflammation so that's part of the risk profile if you like for these conditions so just to make sure that I've got this you're saying okay you can have this sky high level of inflammation and then and that you see for example with people with arthritis or multiple sclerosis but actually quite recently scientists have now seeing that when you have this raised level not skyh high but higher than it should be so not switched on then actually that's really increasing your risk of I guess you know the diseases the most of us are most worried about whether that's heart disease or Dementia or or diabetes yeah that's right the conditions where inflammation is really high those patients will be feeling or seeing all the things of the Hallmarks that I mentioned swelling redness pain all of those things you know someone with arthritis has very painful joints for example but this lowgrade but chronic so sort of persistent inflammation in the blood vessel walls for example underlying heart disease in the brain underlying Dementia in fat tissue underlying obesity that's not associated so much with these hallm marks so you don't feel you don't the pain maybe that's because the level isn't as high but it is persistent and ongoing so this has really opened the doors to interest in inflammation a a wider interest but also what are the factors that maybe are causing that inflammation and what are the factors that can be used as interventions that would mitigate the inflammation and you know diet and other aspects of Lifestyle are part of that picture when we're thinking about inflammation you're giving these examples of sort of these cuts on the I can definitely imagine you know we've all hurt ourselves and you see it go red and swell but blood vessels you know they're really tiny what what what does that mean for for there to be inflammation in the blood vessel yeah I'll use um heart disease as an example so heart disease is really a disease of the blood vessels I think as people will be familiar so you get what people will call narrowing of the arteries for example so the arteries are a type of blood vessel and that narrow growing so that's actually a physical reduction in size is caused by things that are happening in the blood vessel wall so if you think of the bloodstream as like a drain this is this is the drain pipe we're talking about okay and what can happen is these same cells that are involved in arthritis in someone's joints can also get into the blood vessel wall and they will produce the same chemicals in the blood vessel wall that is being produced in the joints of someone with arthritis or the lungs of someone with asthma so you have exactly the same inflammatory processes happening in the blood vessel wall now people will already have gathered that when inflammation is happening in the wrong place or at the wrong time it's damaging okay it causes damage to the tissue and this happens in the blood vessel wall over many years because this is lowlevel inflammation and this is part and parcel of what increases the risk of heart disease and so what happens in that wall as a result of that can you like paint me a picture of what sort of yeah so cells go into the blood vessel wall and they shouldn't be there because there's there's nothing happening there for them to be interested in but one of the things that makes them do that are other things that people might be familiar with like high levels of blood cholesterol the problem with cholesterol is not that it's in the bloodstream it's actually that the cholesterol also goes into the blood vessel wall and it starts building up fatty tissue in the blood vessel wall now we shouldn't have that okay maybe a way to think about this is the body sees that is well that's not right I need to do something about it so the body starts sending in these inflammatory cells a bit like as if you got an infection or B like if you've got an infection infection is that you had too much cholesterol because of your diet it's ending in the wall and now your body's like well that looks wrong sending the Marine I think that's that's a very good way to think of it so now you've got these inflammatory cells in the blood vessel wall they shouldn't be there okay but they start doing what they think they're meant to do so over time and this is a very slow process I mean this built this this process occurs over decades but you get this inflammatory buildup in the blood vessel wall cholesterol is associated with that all sorts of things are happening so actually you start getting damage in the blood vessels so it's again the end result is is damage part of that damage is this narrowing that we mentioned cholesterol is involved in this narrowing as well I I've heard quite a few people both on this podcast and else where I talk about like ultimately narrowing these blood vessels or making them stiff as a problem yeah the inflammation here like the response is actually what ends up narrowing so the the the inflammation is part of the response that causes narrowing yes because what happens is in an attempt to protect the body against this cholesterol that's gone on to the blood vessel wall some of these cells actually engulf the cholesterol right okay so these cells are called macro fages that's a Greek word that means big eaters okay macro is Big Fage is eat okay so these are cells that actually eat cholesterol but when they eat it they don't do anything more with it and they become they just sit there they just sit there and they become uh very large and full of cholesterol Okay so the narrowing is the buildup of these fat filled cells in the blood vessel wall over many many years so I'm listening to this and thinking a bit like um you know when I cut myself I get a scab over that right which sort of protects me and that's my body's response and eventually that falls off and I've got like my fresh skin underneath and if if I understand rightly there's something a bit analogous happening but the difference is like the scab never leaves inside my blood vessel and I'm sort of slowly building this thing up over years so I really like this analogy okay and I like it for a couple of reasons so firstly I'm going to just divert a little bit so the scab formation that you mention inflammation normal inflammation actually is part of scab formation because it's actually involved in healing but again we know if there's too much inflammation you don't get that healing okay so one of the problems in type 2 diabetes is wounds that don't heal so this is things like ulcers foot ulcers for example that don't heal and part of the reason they don't heal again is too much inflammation going on so the body's response not working properly so what you're saying I just want to make sure I've understood that is a bit of inflammation like helps your healing but actually if it's too high it's not like it heals twice as fast it actually that's correct that's correct it's exactly the same scenario a little bit as good too much as bad now I mention these fat cells that just sort of get stuck in the blood vessel wall and contribute to the narrowing what the body does to protect itself is actually a little bit like the scab formation that you mentioned other cells called smooth muscle cells they make their way actually from the other side of the blood vessel so not the blood side but the tissue side into the blood vessel wall and one of the things they do is release proteins that try to put a app on this thing that's growing in the blood vessel wall the process is different but it's exactly the same as a scab formation and it's a bit like a netting trying to keep this growing thing in so you can imagine a net a really big problem right is if that fibrous cap breaks okay because what happens then is all the stuff that's underneath that it's trying to keep in is now exposed to the bloodstream and that actually can cause a massive blood clot the body is attempting to keep everything under control by making this fibrous cap and if that cap breaks that's called rupture if it breaks you get clot formation so that actually is one of the causes of a heart attack it's also one of the causes of stroke okay now the really interesting thing is if you get inflammation in the fibrous cap that weakens it and promotes this rupture so inflammation and under lies this whole process of buildup but inflammation also underlies what might be the end result which is the rupture the breaking of this vious cap so if you like making a hole in the net so everything just spills out and then you get a blood clot but it takes a long time you're talking about 20 or 30 years in this example with the heart disease so so we know that if you look in some children you can already see evidence of the buildup of this fatty material in the blood vessel walls but we know heart disease in most people isn't diagnosed until they Beyond middle age for most people so this might have been building up for 60 years in some of those people one of our problems in in public health if you like is for people to understand that things they do now could have an effect in 20 30 40 50 years time so you know they need long-term buying if they're going to do anything about it I'd love to follow up on the Aging point you mentioned at the beginning because uh I think lots of people will be really shocked to hear that inflammation has anything to do with aging and in fact lots of people listening to this I think will have the same view that I had a few years ago that like aging is just something that happens but it's just a sort of a fact of life and here you are saying well actually no your inflammation can affect your aging what does that mean yeah so of course the clock is ticking for all of us so so we are all aging so we have a you know people call this chronological age you're just moving forward progressively but I think you know people will be aware that some people seem to age more quickly than others in other words they show the effects of Aging sooner so you know you might take 10 people who are all 65 for example and some of them seem to look and behave and have the attitudes of a 35 45 55 year old and and some of them you know seem to be prematurely rather old so you know they're more like um 75 or more and you know some of them will have some conditions already and might be on medication and others won't won't so we have to differentiate between your chronological age so 60 61 62 whatever and your biological age so people's biological age can be quite different from their chronological age and part of the reason for that of course is there may be some genetic aspect to it so some people might be genetically programmed to age more slowly than others but also um you know lifestyle is really important so you know I think it's obvious that things like cigarette smoking very high use of alcohol can be damaging to the individual and that actually hastens aging and part of that actually is probably inflammation but you know diet is also important being overweight is important physical activity is important probably sleep and stress are very important inflammation is part of the process of making aging faster and the reason for that remember inflammation is there as a response to insults we talked about simple insults like you know cutting your skin we talked about more serious insults so if you have a lot of insults over your I'm talking about physiological insults physical insults over your lifetime you will accumulate if you like more damage in the body and you will accumulate sort of the net result of this inflammation which is triggered each time something happens you know it may not go away so what we know is two things one is if you look at markers of a inflammation in the blood so we mentioned C reactive protein before but there are others and we just take a whole lot of people who are let's say age 70 and a whole lot of people who are aged 40 let's say and just measure CRP all other things being equal the older people have higher levels not massively High unless they have a condition like arthritis or whatever uh but they have a higher level so aging is considered to be a state of this chronic lowgrade inflammation so we've already talked about the import of lowgrade inflammation and increasing the risk of heart disease and in passing we mentioned you know type 2 diabetes dementia and so on so one of the reasons some people are more likely to get some of these diseases than others probably is they have a higher level of this lowgrade inflammation and one of the drivers one of the reasons they might have this higher lowgrade inflammation is just the accumulation of damage that's occurred during their life life because of this constant level of inflammation yes and some of that will be aspects of bad lifestyle including diet so you you're just continually driving the process and that process is sort of continually eating away at your bodily systems like the blood vessels and what have you I'm trying to think of an analogy here and I'm thinking a bit about like maybe driving with a you know like a petrol car over many years and is this analogist a bit to like somehow you're using a really cheap and dirty fuel or something like that and that you know it's not going to break the car right away but it's like steadily sort of wearing away and therefore this collapses at 50,000 miles whereas if you put it all with like this really clean fuel you might have made a 100,000 I think that's a reasonable analogy yeah so you just get this uh slow buildup of of damage and inflammation as part of that and you don't really notice for a long time everywhere this is like all the cells all over your body that are affected by this information the answer is in general yes but the nature of the insults might make it more likely that that inflammation is in particular locations than than others we also know that obesity also increases low-grade inflammation and actually people's fat tissue can become very inflamed and again that's actually similar to what we were talking about in the blood vessel walls where you have inflammatory cells going in into the fat tissue to try to they think they're going to protect but things kick off you get spill over these chemicals into the bloodstream and then they can have effects in other places so obesity can be part of the problem you know a minute ago you said also that obesity can be a disease that's caused by the low grade inflammation so is there sort of vicious cycle here where you're saying it both starts to cause it and then it's also increasing the inflammation and making it yeah actually I I do but I don't think inflammation is the initiating factor for obesity but I think once we get an increase in body fatness inflammation becomes very important and it makes the likelihood of an even greater increase in body fatness uh increase and the reason for that is inflammation can induce what we call insulin resistance so that means people don't respond to insulin properly anymore um essentially what means is your metabolism gets messed up your sugar metabolism your fat metabolism actually your protein metabolism all get messed up and inflammation causes that messing up and as a result of that you're actually driven to accumulate more body fat so that's a sort of a causal role of inflammation and obesity I don't think it's the primary cause to start with but what happens is exactly the same process that we talked about for the blood vessel War the body senses something that's going on in fat tissue that's not entirely normal and it sends in the troops and again the same cells that I talked about in the blood vessel wall these macro fages they also go into the adapost tissue that's the fat tissues yeah yeah into the fat tissue yeah and actually these cells involved in inflammation and the fat cells because fat tissue is made of cell cells and those cells are full of fat start communicating with one another uh so they send signals to one another and this seems to amplify make the inflammation worse so if you look in the fat tissue of somebody living with obesity and look for inflammatory cells but also inflammatory chemicals they have more inflammatory cells and they have more inflammatory chemicals than the fat tissue of someone of normal weight so the tissue is definitely inflamed okay so you've got inflammation within the fat tissue but some of that inflammation is exported because chemicals will leave the fat tissue and go in the blood and then they can actually have effects elsewhere in the body and this I think is one of the reasons why being obese makes it more likely that people will get heart disease more likely to get fatty liver disease more likely to get other maybe even some cancers could be important because cancer seems to like an inflammatory environment as well so I think this exporting of inflammation from fat tissue explains why being obese increases the risk of lots of other diseases and I guess another story about how if you do end up sort of as you said living with obesity it's just gets harder and harder to get out of that this is like another example you're describing where this is just a Cascade mechanism yeah so there's one other thing we started talking about aging and and I sort of went off a little bit and talked about obesity which I think is relevant but the other really really interesting things that can happen as people age is they lose muscle people call the sarcopenia it's loss of muscle mass okay and it turns out inflammation is also involved in loss of muscle mass is that right so this is inflammation in muscle so again this could be accumulation of damage over time and again you can think of it as like a slow eating away so you get the slow eating away of muscle tissue you asked a question before about whether inflammation was everywhere and I think it is but it might manifest itself a little bit differently in different people depending upon other factors but certainly in older people I think inflammation in muscle is one of the drivers of why they lose muscle that's really really bad and you could have a person which has become more common now where they have obesity but they also have not enough muscle so people call that sarcopenic obesity so sarcopenia is loss of muscle and obesity of course is buildup of of of fat tissue so there's this new sort of clinical phenotype that's emerged you know maybe in the last 20 years of some older people who have this curious mixture of too much fat tissue and not enough muscle tissue it's really interesting I mean Philip you're painting a slightly terrifying picture about the way in which um this sort of lowgrade long-term inflam can affect almost everything that people are worrying about that interestingly can really affect aging which I think many of us care a lot about because I think all of us I think are really aware now that it's not how long you live it's how many healthy years you have and I think anyone listening to this podcast anyone is's a member of Zoe is really interested in like trying to make sure that they have as many of those healthy years as possible so I think you painted this picture that inflammation is this huge um really enemy I guess of trying to achieve that I'd love to switch to to food which of course I know is your passion in terms of how it fits into inflammation how can the food link be causing this inflammation and then I would love to end up talking about okay let's talk about all the some actionable things we can do to hopefully reverse this tale of misery and people can go away feeling uh positive enough to face the rest of the day in 2022 we took a huge risk we put our reputation on the line to prove that Zoe membership could improve the health of Millions our team commissioned a randomized control trial it's the most rigorous test that science has to offer which means you commit to sharing your findings good or bad the results of this study have just been published in nature medicine which is basically the Oscars of the Science World and these results show Zoe to be more effective in improving Health than government advice participants doing Zoe saw larger reductions in blood fat body weight and waste size they had better blood sugar control and saw an increase in their good bacteria crucially those doing Zoe also felt better they were twice as likely to report improved mood and feeling less hungry and four times more likely to report better sleep and more energy compared with the control group results like these are why more than a 100,000 members trust Zoe to help them make smarter food choices each day to achieve their health goals so will you give zoee a try the first step is easy take our free quiz to find out what Zoe membership could do for you simply go to zoe.com podcast okay back to the show so actually it is possible for things we eat to trigger inflammation there is this phenomenon of people call it postprandial inflammation so inflammation that happens after you eat a meal so again if you measure these inflammatory chemicals in the bloodstream an hour or so after you eat a meal you see a rise a you know it's not massive this is we're not talking arthritis levels but you get a little rise in these inflammatory markers in the blood so that's telling us that there's some inflammation happening this is probably some little inflammation of the blood vessel walls again it could be stuff happening in adpo in in fat tissue and then you know after some hours that goes away and and people have demonstrated that there's an association between repeating this inflammation in response to meals and risk of heart disease for example that's been quite well described so what are the things in meals that cause this inflammatory response so one of them is simple sugar okay so if you have a high simple sugar meal you have more inflammation than if you have the same meal with less simple sugar okay another one is total fat and of course fat could come in many forms but I'm using it in a in in a general sense so a high fat meal causes this inflammatory response following the meal and in fact in research people typically use a high fat challenge to cause this process to try to understand about it and how it can be mitigated yeah we're very familiar with that at Zoe because everyone who does soe actually eats um this standardized meal it's now cookies but goes all the way back to what Sarah Barry originally designed with our first study which sort of challenges our metabolism in this standard way that we you know did originally with twins with both this fat and the sugar yeah because I think one of the things that's really interesting which you haven't I guess touched on yet Philip is there's huge variation isn't there in this response so you you can use sugar and fat to challenge people's metabolism if you like challenge their resilience and part of that challenge is to their inflammation so I think the this inflammatory response we're talking about as part and parcel of an adverse metabolic reaction to to a meal as you might imagine there's been a lot of interest in can we tweak what's in the meal to try to reduce this inflammatory response that occurs after a meal and you'll be relieved to know that there are a lot of things at least in experimental settings that can mitigate this response so so I mentioned fat caus es this postprandial inflammation if you replace saturated fat or a source of saturated fat with extra virgin olive oil for example you don't get such a big response okay if you include nuts in the meal you don't get such a big response if you include vitamin C with the meal you don't get such a big response so maybe oxidative stress is part of this as well if you include omega-3 fatty acids in the meal you don't get such a big response what you're saying I think is that it's not just like how much fat or how many carbs you eat that is going to cause whether or not you have this inflammation actually you're getting down to the type of food is having a very different response just before we talk about this specifically could you just link through for a minute between what happens when you eat this meal like this isn't just in the first hour one of the reasons we do these these tests in Zoe and some of these are like sort of 6 hours after you eat is that can be like there's a sort of process yeah that means that one person and one meal you might be fine and another person or another meal you could start to cause this inflammation so you're right that there is a lot of variation in the metabolic response to a meal there's also actually quite a lot of variation in the inflammatory response to a meal as well so you could give a whole lot of people the same amount of fat and actually they don't all they will all show an inflammatory response but it is quite variable so I think part of that is you know what is the condition of those people beforehand so I think if you do it in someone who's generally more healthy they might be able to deal with it better so they will show a smaller response but there are also as you mentioned there are these more long-term effects I mean we think of a meal having an effect in a couple of hours after you eat it but actually there are these longer term effects and there's interesting work showing that what you have in one meal can actually affect your response to the next meal and people of struggle to really understand how that can be so we have cells that line our gut wall and they're involved in the uptake of the products of digestion and passing them out onto the bloodstream and some years ago researchers actually at University of reading did a study where they were able to trace what happened with things that were in the first meal and of course most of those things passed into the bloodstream but they didn't all and when you you had a second meal some hours later you actually got things that were in the first meal coming out into the bloodstream so they interpreted this to be actually the gut cells hang on to some of the stuff from a meal and release it later on so I think there there might be mechanisms to explain the sort of carryover effect into later meals maybe to share a little bit of of some of the the the science has comeing zo because I think it's it's really to me fascinating so we had a lot more than 100,000 people now do these tests everybody who becomes a a member starts by doing these tests to help to to personalize and and what's really interesting is we see like roughly a third of people really struggle with the fat in a meal which means that you know it's sort of 6 hours later for example you can still see these raised levels of fat and about two-thirds of people even with this L clear it all away so in my case for example I clear that all away which is great and then we look at the blood sugar responses to this meal and we see there very very very white like 10 foot amazingly wide variation and interesting for example there some people like me whose blood sugar control is very poor despite the fact that like their ability to deal with the the fats is quite high and what I understand in that case is where people are struggling to deal with this this can lead to more inflammation over time is that yeah and therefore that that's like sort of saying to you quite directly you need to change the way that you're eating if you want to lower this level of inflamation so I think from from what I've said you might gather that both this prolonged well even a short elevation but a prolonged elevation of blood sugar is harmful to inflammation but also too much elevation or prolonged blood fat after meal is also bad for inflammation so both scenarios would be bad but I don't think we know why different individuals can be so different you know some of it obviously is how well do we respond to insulin but also how is our system adapted to us having a lot of fat one of the things we're hoping to see over time with Zoe members is you can see that if by shifting your diet you might actually start to see sort of longterm improvements in some of these and we definitely see already some improvements let's talk about what you can do if you've listened to all of this I mentioned some things extra virgin olive oil Omega-3s having nuts having vitamin C all help control at least in an experimental setting um in a group of people but also fiber in a meal and you know maybe part of that is just slowing down the process of digestion so you know you're letting stuff come into the bloodstream more slowly so you're better able to handle it and is it like one magic pill like if I take you know we often talk about extra virgin olive oil as being very good for you does that mean if I'm taking a shot of extra virgin olive oil three times a day like that will solve my inflammation Like a Pill from the doctor is it as simple I would prefer to think of it like that I mean know I would I would prefer to think of a long-term dietary shift away from things that are considered to be less healthy and I mentioned in general what they might be in the context of this post paranal inflammation and a move towards things which we think are more healthy and you know olive oil particularly extra virgin would be part of that more micronutrients I mentioned vitamin C that would be part of that more Omega-3s uh would be part of that more fiber people know what extra virgin is they know what nuts are that was really clear and I know your own research you've done a lot of your own research around omega3 yes could you may just tell us what omega3 is cuz I you know I don't see that on the Shelf like I see olive oil yeah so you do see it on the Shelf it's just you have to go to a different shelf because you'll find salmon on a shelf in the supermarket so when I talk about Omega-3s I'm mainly talking about the fish sourced Omega-3s EPA and DHA so omega-3 is a is a general term for for a group of fatty acids EPA and DHA are a type of Omega-3 okay they are as I mentioned sort of uniquely linked with with fish and other Seafood they seem to have quite pronounced anti-inflammatory roles both if you put them in a meal they will help to mitigate this meal driven inflammation if you have this inflammation already going be it high grade but that's a disease like arthritis or this low grade persistent inflammation associated with aging are their dietary components that can dampen that inflammation more importantly are there dietary components that can help you resolve the inflammation there's lots of things in the diet that are anti-inflammatory they include Omega-3s which I'll come back to shortly but also some of the vitamins vitamin C vitamin E or an inflammatory lots of the polyphenols from plants so the things that give fruits vegetables berries and so on their colors they're also anti-inflammatory uh things in nuts are anti-inflammatory Gap microbiome is also a driver of inflammation but also could be anti-inflammatory if you get it right so there's lots of things in the diet that we can use to mitigate ongoing inflammation I think these Omega-3s EPA and DHA that come from fish and that also in fish oil supplements by the way um so people can go to a different shelf and get some EPA and DHA and we might want to consider that in the context of people who choose a vegetarian or vegan approach we've been working on EPA and DHA for 30 years now they are anti-inflammatory okay that's clear lots of experiments show that but the really interesting thing has been discovered in the last 15 years or so this process of resolution of inflammation the turning off you know flicking the light switch off if you like involves chemicals again so everything in the body is involving chemicals sending signals researchers in Boston discovered that some of the key chemicals in resolution of inflammation are actually made from EPA and DHA in the body so EPA and DHA are the the substrates the starting point for making chemicals that turn off inflammation people have studied omega-3s DPA and DHA and arthritis actually since the 1980s and it's well described that high levels of EPA and DHA as a supplement can help people with arthritis in terms of painful joints tender joints stuff like that morning stiffness and everyone always said this is an anti-inflammatory effect but actually if you think these are people have already got high grade inflammation I think what's happening is EPA and DHA are acting to resolve the inflammation so actually to take that high grade and bring it down a bit and that's why people with arthritis benefit from EPA and DHA imagine someone's listening to this and saying I want to understand how to make some shifts to my diet in order to um reduce this inflammation maybe starting with the sort of Omega-3 and oily fish I know that's your big Focus how strong is the evidence in your opinion that you know yes if you're willing to eat fish you should be adding oily fish to your diet will it make a difference for me the evidence is very strong okay okay yes we have animal studies we have all sorts of studies but you know I'm mainly interested in human evidence right because you know doing something in a laboratory in some mice is one thing but we we need human evidence and in human research in nutrition we really in general we have two types of research one is where you look at diets Foods nutrients levels of nutrients in people's blood and you track what happens to those people over time so you know we call that epidemiology the epidemiology of Omega-3s is extremely strong in other words people who eat more fish or people who eat more EPA and DHA or people who have more EPA and DHA in their blood have a much better long-term Health outcome less heart disease less dementia some cancers less cancer less metabolic disease all that stuff so the epidemiology is very strong the other type of study we have is you know treating Nutrition a bit like a pharmaceutical so a randomized control trial typically these are smaller in size and shorter so they might involve tens or hundreds of people but I think if you step back and look at the really important things like heart disease disease for example even from randomized control trials there's pretty good evidence that higher intake of EPA and dhaa reduces risk of heart disease and mortality from heart disease and certainly they impact beneficially lots of the biomarkers that tell you about risk so I think for me the evidence is quite strong and I personally would recommend that people should incorporate these sort of fatty fish in their diet if if they can I've been part of quite a few conversations with Tim and Sarah talking about the fact that a lot of oily fish today would come from salmon which is now Factory farmed and very different from the sort of fish that we would have got in the past and I know that Tim is quite skeptical about this because he feels that like there might be a lot of um other reasons to feel that this is not really so good how do you think about sort of the sort of factory farm salmon that you would actually probably get if you went to the grocery store yeah I think I think that great question and salmon I think is the is the is a really good example because salmon farming is a massive industry and probably most of the salmon that's available in the supermarkets is is farmed salmon people will be familiar with fish oil which is you know they'll think of an omega-3 supplement that they can get from a chemist shop or you know a supermarket or online and you know fish oil contains EPA and DHA these really important Omega-3s okay now in the wild salmon eat other fish and they get EPA and DHA from their diet by eating other fish so if you farm salmon traditionally you had to give salmon EPA and DHA in their food otherwise they didn't grow well and they didn't stay healthy and the biggest user of fish oil is the salmon farming industry that uses something like 75% of global fish oil is actually used in Salmon farming okay now first of all that is a limited resource and you could argue if it's so important why don't we give it to people instead of to fish but the fish need it if we're going to farm them so it's a limited resource and it's also expensive okay it's a commodity it's much more expensive than vegetable oil for example and that's because it actually comes from other fish F so so you've got to invest in the production of fish oil the research behind fish farming has been trying to find out what happens if we give salmon less for sh oil and replace it with vegetable oil so it's well described that salmon can still grow and do well if you give them less for oil than they used to be given okay and you replace that with vegetable oil the consequence of that is farm salmon have less EPA and DHA in their flesh than wild CT salmon a farm salmon now will have less EPA and DHA than a farm salmon did 20 years ago so that farmers have figur out ways to make this more the industry the industry has found out a way to reduce its Reliance uh on EPA and DHA and therefore reduce the cost of of farming salmon I guess so one interpretation would be the overall health benefit is less from a farm salmon now than it used to be let's say 10 15 20 years ago and less than a wild salmon okay however farm salmon still is a good source of EPA and DHA it just doesn't have as much as it used to salmon and other fish are not just about EPA and DHA they do bring other healthy nutrients and they are I think a good replacement for red meat which you know red meat has its place but we shouldn't have too much red meat so I think there are other things in there but if you're if you're focusing just on EPA and DHA I think this argument you're making is is a viable one and so if someone was listening to this and they weren't saying hey this is my swap for red meat but more I'm thinking do I need to add fish into my diet which maybe doesn't you know have have a lot of it otherwise what would you be saying them so so I think there are a lot of other fish around like mackerel for example which is all wild CT actually has more EPA and DHA than salmon ever had sardines very rich in EPA and DHA and very inexpensive and very easy to prepare so I think there are other Alternatives that people could choose we talked a lot about what you can add add in if you were saying what were the three things that people should be looking to sort of try and reduce in their diet to reduce this inflammatory impact what what would you say simple sugar simple sugar meaning soft drink or whatever but you know also people add sugar when they're making stuff y so I think that that would be one thing yeah I think saturated fat red meat um you know fat meat but also you know there's a lot of saturated fat for example in the for form of palm oil you know even things like pastries for example so I think sources of saturated fat uh be they animal or plant uh sources would be a second and that can really make a difference to your inflammation therefore really can it's not just about your weight here you're talking about no it would have an impact over the long term and I think you know replacing those things with more plant sourced foods that will bring vitamins and minerals you know these polyphenolic compounds that are in Plants but also you know I do still think that the Omega-3s are really important and we need to think about you know plant sources and plant Alternatives of these fish sourced Omega-3s I think that's going to be a big area of future research we are definitely time I would like to try and do a um a little summary of of what we've gone through and please correct me where I um have um have gone wrong so I think today we've had this fascinating explanation about the way that inflammation sort of affects all parts of our body that it's a good thing basically if we had no inflammation we would die so you needed in this response but we seem to be um in this modern world where it's not getting switched off and you talk quite a lot um about that that what happens is that cells create chemicals that sort of trigger this inflammation it's very much what we think of when like cut our hand and swelling and redness but interesting that can happen anywhere and you talked about examples where um when this inflammation goes sort of Sky High you end up with these diseases that we talk of as sort of autoimmune diseases because it means just your body is attacking itself you talked about arthritis and multiple sclerosis and you're saying you know we can measure this inflammation in the blood with something called um CRP and you can see that Skyhigh but interestingly what you see for people who don't have those diseases is many of us have higher levels of inflammation than we should do and this is a sort of long-term sort of lowgrade chronic inflammation and what's new is the realization that this increases our risk for many of the diseases that actually end up taking away our quality of life you mentioned heart disease um which has come up on on these podcasts quite a few time but interesting you said dementia for example it's also related to this inflammation diabetes um and that obesity can both be um increased through this but that obesity itself is also one of the causes of this inflammation so there's this terrible sort of vicious cycle that can happen you explained how this inflammation happens and I thought that the the example that that I I found like most straightforward is in our blood vessels this idea that you have this high cholesterol because you're probably not eating a diet that's very good it ends up stuck stuck in the um in sort of the wall of this blood vessel on your body's like well that's not right it triggers this inflammation and then there's this sort of cascade of actions where your body's trying to protect you a bit like you know when I've cut myself on my finger but it's not good and I love this i' never heard this word before fibrous cap seems pretty clear to me that you don't want your body to be stuff full of fibrous caps everywhere if it's supposed to be this nice smooth tube and interestingly you explained that the inflammation itself over time can mean that those fibrous caps are more likely to break so it's sort of like it's the full story it's both creates the problem and then makes it more likely that ultimately you have the the stroke or the or the heart attack you then explained how this ties also to aging and I think this was really new for me and I think for most people and that I think you said you know aging is a state of chronic low-level inflammation is that a um which is not I think how we think about it I think I always thought about it's just what happens every birthday but actually it helps to explain why you can see people look so different you know as they age or even identical twins look so differently as they age and again the point is we will have inflammation but for some reason you know we're not getting this inflammation to switch off and then you did the sort of grand reveal which is you know what the diet that we're eating is having this profound impact on our inflammation because every time we eat you can cause a very low level that's normal we're designed to deal with it but the sorts of foods that we're eating Time After Time year after year start to have this impact where this inflammation is just getting raised constantly the good news though is that there is something you can do about it and just as the food is a big important component by changing what we eat we can do something about it and maybe I start with what you can reduce I think you were very clear so food with added sugar in it so you know um the coca-colas all these things like that the sweets and all these other sorts of particularly Ultra processed foods I guess that have lots of sugar in it red meat um because you said it's not just the sugars here it's also these sorts of saturated fats you mentioned a lot of pastries that have have palm oil in it I think you said was also bad so again you sort of see the overlap with these sorts of more Ultra processed foods but then I think much more positively cuz rather than saying what you take out out what can you add in extra virgin olive oil nuts um you talked about fiber in our meal and polyphenols from plants which we didn't spend a lot on today but we talked about where it's sort of supporting the microbiome and helping to reduce this inflammation and then I think we had this really fascinating conversation about omega-3 which I know is a big area of your research for a long time and you explained that it's not just generally omega-3 it's like these particular things EPA and DHA are in particular are known to have these anti-inflammatory roles and uniquely you know we only get them in normally in our diet through these particular sorts of oily fish that you can also get them as fish oil capsules that there are just starting to be I think some vegan Alternatives if I if I understood and then we had a discussion a bit about like what is the pro and cons today of um factory farm salmon because there is this debate about as always what changes when we start to make something that's very manufactured and you said well there's still quite a lot of EPA and DHA in it and it's true that it's less than there was before and I thought interesting you said both mackerel and sardines actually have significantly higher level so this is not the only place you can go net net I think you are clear if you were advising me on what to eat or what I should be asking my children to eat you would be saying put these oily fish in my diet is that is that air that's a perfect summary yeah wonderful that was a lot that we covered today I think it's really interesting and I think one of the things I noticed is just how much the science is moving really fast here I feel like many of those things are much clearer you know than you know even a few years ago so it feeled though this is an area where a lot of research is happening fast yeah for sure it was a real pleasure thank you so much for taking the time with us yeah thanks for having me it's been great I hope you've enjoyed learning about inflammation from philli as much as I have today especially regarding how important what we eat is to keeping inflammation in check if you want to go one step further and get personalized advice and support on how you can eat the best foods for your body to help you feel better now and live healthier in the years to come then you can learn more about Zoe and get 10% off your membership simply go to zoe.com [Music] podcast I'm your host Jonathan wolf zoy science and nutrition is produced by yellow huin Martin Richard Willen and Sam Durham as always the science and nutrition podcast is not medical advice and if you have any medical concerns please consult your doctor see you next time [Music]

Channel: ZOE

Views: 114,001

Keywords: inflammation, gut health, gut microbiome, arthritis, zoe podcast, zoe science, tim spector, health interview, science interview, health podcast, science podcast, plant based, reverse inflammation, reverse aging, foods for inflammation, plant based diet for beginners, plant based breakfast, philip calder, how to reverse inflammation, best diet for inflammation, healthy living lifestyle, plant based protein, gut microbiome test

Id: LKzDsmdxen8

Length: 61min 23sec (3683 seconds)

Published: Thu May 16 2024