"Nutrition to Fight Inflammation" Presented by Lara Rondinelli-Hamilton, RD, LDN, CDE

wonderful I'm very happy to be here thank you for coming on this blustery Chicago day I'm excited to talk to you about nutrition to fight inflammation because it's really important to me and I just love talking about it so hopefully you'll love hearing about it before I start I thought I'd tell you my personal story as well I am a dietitian and ironically I didn't realize how I would come to use nutrition for my life I became a dietitian first and then kind of had these health issues come along that nutrition became a very important role in so just kind of give you a brief history of my medical history started off with autoimmune thyroid disease many many years ago dealt with that and then about 10 years after getting that diagnosis I got diagnosed with celiac disease while I was dating my hub would soon be my husband so celiac disease some of you probably are aware of is an autoimmune disease where you can't tolerate gluten gluten is this trigger in the autoimmune disease and it basically destroys your small intestines so symptoms of celiac disease can be you know weight loss and diarrhea and malabsorption of food and nutrients so got that diagnosis and was told follow gluten-free diet and you'll be good to go you know so I did that as a dietician I actually went and met with the dietician that specialized in celiac disease since that wasn't my specialty at the time follow the gluten-free diet and actually started getting worse which was really concerning because I was pretty sick at the time I got diagnosed so I went back to my gastroenterologist and said something's wrong I'm following the gluten-free diet they're like are you sure you're following the gluten-free diet I'm like I'm a dietician I can barely leave anything I'm following the gluten-free diet so then got diagnosed with an odd another autoimmune disease at that time was about two weeks after my celiac diagnosis which was microscopic colitis so got that diagnosis took me a while to get better got some medications and then was doing fairly well I would say got married had children and it was after my second child my daughter where I just felt like some of these health issues were coming back as we know a lot of triggers for certain diseases can be hormonal shifts so pregnancy can be a big trigger menopause for women can be a big trigger so I think that the pregnancy was my trigger and during that time that was a pretty big health crisis because I just felt at that point it was like multiple problems happening not only was it my GI system but I was having muscle spasms and neuropathy and numbness and tingling and back pain debilitating where I couldn't move so I went as I'm sure many of you in this room have too many doctors and specialists and got referred to many different specialists rheumatologists neurologists neurosurgeons orthopedic doctors and honestly has left left with not many answers so nobody could really tell me what's wrong with me the GI doctor said what are you doing here we refer our patients to you for help so that was a compliment but also scary at the same time because I needed help so at that point it was a kind of a low point and I just delved into nutrition even further I mean I studied this this is my life my career but I needed more from my degree I guess and so I really started researching nutrition to heal and fight inflammation and started seeing you know improvements in my health and can definitely say that it was really the power food and and some supplements as well that really helped me get get my life back where I'm was you know that time I was scared am I going to be able to take care of my children because I my my health was failing me and so definitely things have changed and definitely this is this experience has helped me help my patients so I have no doubt I am supposed to be a dietitian and talking about nutrition to people so just want to give you that little background because I'm very passionate about nutrition and feel strongly because I see the power of it in my life and in my patients life so before I get into the actual talk about nutrition and flu information I thought it would be important to talk about what's out there on diet and spondylitis and I'm sure all of you in this room have tried to find and maybe conflicting information about that but I was looking at the research and one of the research articles comes from 2013 and this is a core set of recommendations for patients with AAS and this was just a very general article but it did say they recommended reduction and meat consumption which I'm sure some of you have heard that before they recommended increased consumption of fish and vegetarian meals and sufficient intake of calcium and vitamin D so calcium or vitamin D is something that most people I see especially in this area are very deficient in and most of my patients with immune immune diseases are deficient in so you know we definitely can check those levels easily and recommend a calcium and vitamin D supplement so that was just again an article from Rheumatology and international from 2013 moving on to 2017 this was a systematic review on relationship between diet and spondylitis and this was interesting this article suggested that there could be intestinal bacterial flora that may be affected by diet and diet could influence the intestinal flora and might have a positive effect on disease activity so this is a really interesting area in the medical world right now if any of you have read or you know heard about the microbiome which is we all have a microbiome made up of trillions of good and bad bacteria in our gut and sometimes that bacteria can get affected differently by infections or environmental factors and throw off that gut bacteria and they're linking certain gut bacteria with certain diseases so it's really interesting we start talking about the microbiome so this article is kind of acknowledging that involvement possibly and talks about this is a different article also talking about the microbiome involvement talking about 70% of patients with a s have subclinical gut inflammation so I'm not sure if many of you in the room experience any gut issues or if you've heard that it is associated with more irritable bowel disease or irritable bowel syndrome so really interesting when you start having you know issues and your joints that but then a lot of my patients even with other autoimmune disease I'll ask well do you have any other GI issues do you have constipation do you have diet yeah do bloating and a lot of these people are having these signs so you think they're unrelated but they can be related kind of thing so leaky gut is very popular topic right now as well it's found to be greater in a ass patients and this leads to more inflammation so if you don't know what leaky gut is it's basically there's in our intestines there should be these tight junctions kind of sealing our intestines and when the gut is damaged there can be too much space in between those tight junctions and things that are not supposed to get out of the intestines are getting out of the intestines and causing health issues so you know there's it's proposed that this is creating a lot of chronic diseases or leading to chronic diseases is this leaky gut in this article they did say that probiotic use and treatment of a s is inconclusive so probiotics are very popular there the good bacteria that you can buy in a supplement form I don't know if anybody's taken those or familiar with those but in this study they did find it to be inconclusive I will say in my practice I do use probiotics a lot in various disease states so going back to this article from 2016 it said a number of studies have demonstrated that Klebsiella pneumoniae plays a role in the disease of a s so this specific disease are not sorry the specific bacteria has been found to be higher in is patients so in this study they said a possible alternative treatment could be aimed at eliminating this Klebsiella to improve or stop some inflammatory damage so really interesting I think and it goes on to say that they proposed a low starts diet as a means of reducing Klebsiella bacteria in the gut so they did a study on 36 patients with a s who benefited from a low starch diet so they actually looked at markers and saw a significant drops and said sed rate anti-inflammatory medicines and patients reported decrease in pain and symptoms so I don't know if anybody has ever tried like a paleo or a lower carb diet before and noticed improvement in symptoms and it could be related - possibly this low-starch connection so it's really interesting stuff the systematic review from 2017 came up with this conclusion evidence of a possible relationship between a s and diet is extremely limited and inconclusive due to the weakness of the studies so that's kind of discouraging I know to read at the end of a research article that's looking at all the data out there currently but it's no surprise quite honestly the the information on diet and disease is very limited there's not a lot of funding for quite honestly for diet and disease because we don't have the the companies backing up you know broccoli and spinach and things like that so and then it's hard to control a diet diet let's study right it's hard to get people to follow the exact diet we want them unless we have them in a lab and are feeding them three times a day so hopefully that you'll and feeling encouraged after this presentation about some positive effects of nutrition to fight inflammation but right now the research - just quite honestly isn't that great specific for the disease okay so moving on to inflammatory foods and we're gonna delve into each of these but what foods do we know are inflammatory their sugar starch refined starch I should say processed foods red meat processed meat some oils and then I have this category of possibly dairy gluten in nightshades okay so we're going to talk about all of these in a little bit more detail keep my eye on the time here - so sugar is the first thing we're going to talk about that is known to be inflammatory the Nurses Health Study was a large research study that found a westernized diet high in sweets desserts french fries and refined grains resulted in higher inflammatory markers in the blood so sugar can definitely be inflammatory and sugar is everywhere in the American diet so it's you know it's in things that you see on the slide your packaged sweets and treats and cookies and donuts and sprite the use of high-fructose corn syrup over the years has dramatically increased and they are adding it to everything so take a look at what you're eating and look at your food labels you know high fructose corn syrup is in applesauce it's in pickles it's in things that it just doesn't need to be innocent could be the first ingredient barbecue sauce so you don't even think you're eating sugar and you're getting it and it's really inflammatory in and in my patients once we kind of get them on a you know a good diet and they do have something like sugar sometimes they'll actually say to me you know I noticed after that birthday party and I had a ton of cake and ice cream that my joint pain was worse or I'll notice that my neuropathy my nummis and tingling and stabbing pain and my legs is worse after I've sugar so it becomes very apparent and obvious to people once we kind of clean up a diet what this food is doing to your body so the other thing is sugar is very addictive we know that so it's hard to limit you know it's hard to say well I'm just gonna have one cookie you know because our body wants more so I get it nobody's perfect but if you are gonna treat yourself I always tell people maybe go out and get the treat don't bring the whole pie or the whole cake or the whole box of cookies in the house where you're going to be more tempted to to eat them so that's sugar moving on to refined starch and processed foods so refined starch is basically anything with made with white flour so it's going to be your cookies and your bright white bread and your pretzels and Pop Tarts donuts all these things like nutrigrain bars that kind of stuff are all gonna contain this refined starch and they're also gonna contain a lot of sugar many of these foods as well so it's kind of a double whammy not only are getting the redline starts we knew we know that can be inflammatory you're getting the sugar and then processed foods you know we just know these in general which is a lot of the American diet right now because people are looking for convenience foods not a lot of people have time to to cook or make things and so these processed foods are becoming staples and really causing a lot of inflammation and so I just encourage you if you're looking to start eating healthier start eating real food more real food you know stay on the outside of the grocery store and the of the grocery store where there's your fruits and your vegetables and your meats and your eggs whereas the middle of the grocery store is where you have most of your processed foods so you know I use the example of sweet potatoes sweet potatoes something we make a lot in my house my kids love sweet potato fries I think they're very easy to peel cut sweet potatoes toss them with some olive oil maybe some seasoning so there's maybe three or four ingredients to my sweet potatoes so fries so if you go look at sweet potato fries at the store and you go in the freezer section there can be an ELISA this log of ingredients in something like that and from my standpoint I've even found gluten in sweet potato fries so sweet oats are naturally gluten-free food but they're putting wheat in there so just examples of why you should be paying attention to what you're eating and what can be you know contributing to more inflammation in your body okay moving on to the red and processed meats I know you know we all many of us probably love our red meat but red meat is associated with higher inflammatory markers in many studies it may increase AXA date of stress and inflammation so we're talking about red and processed meats we're talking about beef and then we're talking about your whole class of you know kind of brats hot dogs salami dapple class ham is going to be a processed meat so really limiting that I mean there was one more slide on that we know also that red meat is associated with higher rates of cancer I did a big colon cancer presentation a couple years ago and that that was huge red meat and processed meats are definitely linked to colon cancers and more cancers so you can become just a healthier person by probably eating less red meat and processed meat as well okay so oils oils also can be inflammatory for us so there's different types of fatty acids you might have heard that there is omega 6 fatty acids there make a three fatty acids and basically the American diet is too high in omega-6 so the ratio of omega-6 is very high compared to Omega threes and we know when we have this increase in ratio of Omega omega-3 that this can increase inflammatory processes and consequently predispose or exacerbate many inflammatory diseases so we think this is just contributing to more inflammation in the disease State when you have more omega-6 so what does that mean this next slide just kind of shows you the oils that have higher contents of omega-6 so you'll see your sunflower oil your safflower your core and oil your soybean oil here and most of these oils are not going to have any omega-3s the one you don't see up there is olive oil olive oil doesn't add doesn't have a lot of omega-6 it doesn't necessarily have a lot of omega-3s it kind of has more omega nines so olive oil would be probably one of the better oils to be using you can see flaxseed is very high in omega-3s so omega-3s are good for us we're going to talk about that a little bit later more in detail but flaxseed and fish have some of the highest content of these omega-3 these good fatty acids that we want okay so moving along still talking about which foods are inflammatory dairy so I do have a question mark here this is kind of starting or possibly can be inflammatory foods and dairy is going to be under that so I know people love their dairy and love their cheese so many people don't want to hear about that dairy can be inflammatory but basically diets high in meat and red means meat in general and dairy are higher in arachidonic acid and that's a precursor to some of these pro-inflammatory prostaglandins and I've kind of show I'm a slide on a little bit to explain that so meat and dairy can be associated basically with more inflammation diets low Interac Adana Casson have shown to improve clinical signs of inflammation and patients specifically that study was looking at patients with rheumatoid arthritis so and that's the arachidonic acid that's higher in meat and dairy dairy can also be high in saturated fats I'm sure a lot of you have heard about saturated fat saturated fats are not good for our heart health they're found in dairy your high-fat dairy products like cheese and cream and whole milk these are gonna be sources of saturated fat as well as your high fat meats like bacon sausage hot dogs that whole group is high in saturated fat and we believe that saturated fat is also inflammatory as well so kind of dairy could be getting you know in causing inflammation from both those stand points there was a study published in the Journal of nutrition in 2015 found that in eating dairy and foods increased low-grade inflammation and in a small sample of adults so there's your limitation the end of the sentence there is in a small sample of adults right but that's why they can say that the the research for dairy isn't necessary conclusive because there needs to be more research because maybe the research studies currently are too small and may be problematic but there was a study in 2015 showing that increase eating of dairy foods caused inflammation okay so leading we're moving on to gluten gluten as I talked about earlier is a protein found in wheat rye barley and oats are contaminated with gluten because oats are grown in the fields next to wheat so they do have gluten and gluten can be a hard to digest protein for a lot of people and make increase inflammation and those who are gluten sensitive so there's celiac disease which we have out there celiac disease is an autoimmune disease I you know that I have that you know is definitely we know the trigger is gluten but there's people out there there's people out there that I screen that I think are going to be positive for celiac disease because they are presenting very classic celiac disease wise but they come up negative so maybe those patients are more just gluten sensitive and just do better on a gluten-free diet even though they don't have celiac disease so we definitely know celiac disease is more common in people who have autoimmune issues they say if you have celiac disease you're more likely to have more autoimmune diseases so anytime I start somebody on a gluten-free diet I want them to be screened it's just a blood test I want them to have the blood test for celiac disease before we start the gluten-free diet now the reasoning for that is because once you eliminate gluten from your diet and to say you come to see me six months later and tell me you're on a gluten-free diet and I say oh darn I wanted to screen you for celiac disease I wanted you to get the blood test to see if you has celiac but we can't know because you're gluten free and the test won't be accurate the blood test is inaccurate if you're already gluten free so that's why I want to rule out celiac disease before I try a gluten-free diet for anybody because celiac disease avoiding gluten is I mean very strict you have to avoid the crumbs and you know cross-contamination at restaurants becomes a very very challenging so living with that disease is is a total lifestyle change for Sur so we do want to screen for that it has been proposed people with immune related diseases may be more gluten sensitive so I have kind of come across that in my patients with more immune related diseases that they they just seem to do a little better without gluten so that's not surprising and just again talking about the importance of screening for celiac disease and so just to review gluten is found in breads and pastas and you know cereals it's everywhere gluten is everywhere there are obviously a lot of gluten-free alternatives now and then there's just naturally gluten-free foods such as potatoes and sweet potatoes are naturally gluten-free rice and quinoa are naturally gluten-free and beans and lentils and legumes or gluten-free so there's plenty of gluten-free options out there and it kind of if you do it right I tell people if you do gluten-free right you can eat a really healthy diet if you start eating real foods but you know there's gluten for everything now there's going free donuts or spoon free pop-tarts so it could be a Justice of a junkie diet as their standard American diet now because there's so many options I mean it's nice it's nice for people with celiac disease and kids to be able to get a treat but we just don't want to be choosing those gluten-free treats more than the real food okay nightshades I don't know if you guys have heard about nightshades but we have the wrong slide all the time there we go sorry so nightshades are plants such as tomatoes eggplants peppers and potatoes so this class of vegetables is not research proven to cause inflammation but nightshades may be problematic for some people with immune related diseases due to their elected and saben and content which may cause an overactive immune response so I'll have to tell you a few years ago when I started getting into functional medicine and I read about nitrates causing issues and people as a dietician I thought this was the craziest thing I had ever heard because these are healthy foods and these are real foods and these are vegetables and how could something so natural be causing inflammation in people and I won't say it's common but I have had patients react to nightshades to tomatoes peppers and and really notice their symptoms kind of they feel their symptoms get a little worse with these foods so it's nothing I ever eliminate at the beginning I never want to overly restrict people on their diet and I want people's diet to be you know as full as the many food options as they can but if somebody's coming to see me and they're it made so many diet changes and they're not seeing much improvements that might be an option we look into is possibly seeing if the removal of the nightshades helps so it's interesting interesting kind of area there's the nightshades okay so that was all the inflammatory foods now we're going to kind of move over to the anti-inflammatory foods and we're going to be focusing a lot in this section on vegetables and omega-3 fatty acids okay so vegetables are superfoods for sure I'm sure you've heard this before and we've all been all whole life to to eat our vegetables but what I find is that Americans really aren't eating their vegetable we're eating everything but or maybe a serving a day but if these are superfoods and these are something that can be very helpful for us this really needs to be a huge part of our diet and if you have a chronic disease even more reason to try to include more vegetables in your diet so we're gonna delve into that a little bit more it's not the answer people want you know I feel like people come to me and they want to either lose weight or help their chronic disease or have more energy or better manage their diabetes and usually you know I'm always talking about eating more vegetables and it's people want the end product they want the reward they want all the benefit of go to health and weight loss and energy but they're very disappointed when we talk about vegetables and tell me how much they don't like vegetables or how they only like certain vegetables or you know that kind of stuff so I think working with a good dietician that can help you figure out how to get a vegetables in your life is really important so we know that vegetables contain vitamins and minerals and phytonutrients and these things can strengthen your immune system in mitochondria improve your nervous system promote healthy gut bacteria we talked aloud early on about the importance of good gut bacteria and help decrease inflammation so if you look at this slide and see all the things that vegetables can do it's really pretty amazing if I had a pill if I had a pill that can do all these things I would probably be a millionaire right so really really talk focusing on how you can get more vegetables in your diet so we're gonna start with leafy greens leafy greens examples can be arugula bok choy chard kale spinach mustard greens lettuce but not iceberg lettuce we're looking at more of the dark leafy green lettuces or red lettuces we know these are high in phytochemicals and these have anti-inflammatory and properties in these vegetables so there's tens of thousands of phytochemicals have been identified and researched researchers speculate that there's likely many more that we haven't even discovered in the food that we eat so these phytochemicals are often thought to help help different pathways and help in disease prevention so what they're saying is there's so much nutrition and vegetables we probably haven't even discovered all the nutrition and the benefits of it so leafy greens are a good source of these Fido phytochemicals okay they're also a good source of vitamin A and vitamin C we know definitely in vitamin C is very involved in your immune cell function skin and gums and healthy skin and gums and these are high in antioxidants as well antioxidants you've heard probably about our natural substances that may prevent or delay some types of cell damage and protect against diseases so antioxidants are really important to be including in our diet leafy greens are also a huge source of vitamin K so that does become an issue if people are on coumadin no medication where you have to kind of watch how much vitamin K you're taking in it's also a great source of B vitamins such as folate which is important for your nervous system so mixing up your vegetables you know kale is very popular right now as being a superfood and kale is like this is a great vegetable but it's not the only healthy green vegetables so making sure you're getting in different vegetables you know your spinach your tart and your different lettuces are can be some examples in a root way I love arugula and I think it's often an overlooked batch to bone the next class is going to be your colored vegetables so the deep color in these vegetables is a sign of their different vitamins and antioxidants and phytonutrients so asparagus and beets and your peppers things like red orange and yellow peppers red cabbage carrots tomatoes zucchini and squash all would be a part of this colored vegetable family and again we know that antioxidants help stop free radicals from doing damage to ourselves and if you have a disease there's constantly damage going on into your cells that we're trying to stop so studies prove that antioxidants are protective against cancer dementia and cardiovascular disease phytonutrients help decrease inflammation and improve the health of ourselves and strengthen our immune system so such so good for you trying to get in a variety of these different vegetables and you know it's like what I tell people maybe you didn't like cabbage or you didn't like peppers when you're a kid but that doesn't mean you don't like them now so really being open to trying new new types of vegetables and foods I think is really important the next class of vegetables is your cruciferous vegetables this is a very popular category your broccoli your brussel sprouts cabbage and cauliflower make up this group this group has been very studied to be anti-cancer so these are always recommended for patients for anti cancer prevention they're also high in sulfur compound called glucosinolate which may play an important role in disease prevention by triggering antioxidants and anti-inflammatory responses and contributing to the maintenance of solid balance so basically helping keep your cells healthy these vegetables contain this specific sulphur compound glucosinolate that can help with that so I think these vegetables are some of the most popular vegetables and they can prepared in lots of different ways you know you can do broccoli salad you can do roasted broccoli you can do Brussels sprout Brussels sprout slaw with raw vegetables roasting roasting all these vegetables if you're not crazy about them I feel like it's one of the ways to just bring out maximum flavor and vegetables just roasting at like 400 degrees with a little olive oil salt and pepper and if you take broccoli cauliflower florets and do that and make it roast very quickly in like 15 minutes and they crisp up a little bit and my kids just like pick them up and eat them like french fries so there's a lot of different ways to prepare this cauliflower is very popular in trendy food right now I don't know if any of you guys have tried the cauliflower rice or heard about this you can use cauliflower rice as a substitute there's cauliflower pizza crust so lots to do who knew cauliflower could be so versatile so being open-minded to trying some of these things you know people are like when I tell them about cauliflower rice I'm like yeah you could do instead of using you know rice in your stir-fry you could use cauliflower and I realize it kind of sounds until you try it you know you got to mix it and get flavors in there to kind of make it taste good but I think it pulls your brain because I can be eating it and like feel like I'm eating rice but it's really cauliflower so minimum we say at lunch and dinner your plate should be half vegetables half your plate should be vegetables as a minimum okay so the cruciferous vegetables these ones we almost talk or just talked about are gonna be high in folate vitamin C K potassium selenium calcium and phytonutrients so tons tons of nutrition here moving on to our salt or vegetables so soulful rich foods nourish the cell and the mitochondria the mitochondria is referred to as the powerhouse of the cell and helps get the body get rid of toxins these sulfur rich foods sulfur is also involved in protein synthesis and for making collagen and collagen makes up the connective tissue which helps strengthen our joints sulfur also help strengthen the line of our blood vessels so these are you know really great foods these sulfur rich foods cabbage broccoli cauliflower so it's that whole cruciferous vant family those foods as well as onions leeks garlic in mushrooms and one I forgot to add here is radish as well radishes are on there too so great foods you know these can be in raw or cooked I always kind of this is one thing we teach to families and parents is when we're trying to get kids to eat healthy because people will always tell well I ought to make this meal but then I got to make another meal for my family because they won't eat this food and we're always encouraging that there's one healthy meal for the family so when we talk about how to trying to get kids to eat more fruits and vegetables things like that we say get the kids involved in grocery shopping take them to the store let them pick out a new fruit or vegetable maybe that they haven't tried before you know get them involved in preparing it and then have them try it and they might like it so an example I think probably when my daughter was five you know we did that at the grocery store and she picked out radishes and radishes like I didn't really eat much of we never bought them I just never really thought about radishes ever except if they were in a salad maybe at a restaurant so we bought those and just served him with hummus and she loved I was like thinking in my head okay yeah cut it up you know let's see how you like it and thinking she's never gonna like a radish because they're kind of strong flavor and she likes them so now if she has vegetable with her lunch or something she picks radishes I eat them with guacamole now so it just goes to show you you know that when you all need to be open to trying new foods and and you can really enjoy them and I'm I'm a firm believer and I see this in my practice that the more vegetables you eat the more your body craves I think when you start giving your body the proper nutrition and the vitamins and minerals and all these phytonutrients that we're talking about that your body actually starts craving those foods especially when you get rid of the sugar and the processed foods that are addicting so when you start giving your body the proper nutrition I swear my body will start craving vegetables so try it and see and you'll get a lot of benefits out of this if you do but this group is really healthy as well so how many vegetables should you eat per day so for the average American the recommendation is 3 to 5 servings for somebody with chronic disease and battling inflammation I would say 8 to 9 cups a day so I realize that's a ton of vegetables right I know 8 to 9 cup sounds like it's not possible how can you possibly eat that much vegetables but it is and that's where I think sometimes working one-on-one with the dietitian can be helpful too to help you get these vegetables in your diet ok so there's some tips on the next slide here of how to how to do this so how to eat more veggies raw veggies with hummus or guacamole are some of my favorite ways and guacamole we always think of serving it with tortilla chips I know which we all love but try it with a vegetable dip I mean I love guacamole and it makes every vegetable taste better I think so and now they even have for people's lunches these little convenient packs of individual hummus and guacamole so it can be you know something quick and easy to pack as well so raw veggies with this can be great roasting vegetables I already talked about that I think roasting is a great way to bring out flavor and vegetables steamed vegetables you know is quick and easy you just don't want to steam in a lot of water right you just want a little bit of water because you're gonna lose nutrients if you if you have too much water you see if you boil vegetables you see the the water turn like green or turn the color that's the nutrition coming out into the water so you're losing some of that if you if you use too much water salads can be obviously a great way to get in a lot of vegetables if you can make a huge salad for a meal and add in you know peppers and mushrooms and cucumbers and then you know add in some you know healthy things like guacamole or avocado slices sunflower seeds that kind of stuff and can be great in salads veggie based meals in general just trying to make a more veggie based meal things like a veggie chili or maybe a veggie based taco where you take some black beans and mushrooms and make that into a taco instead of a meat based taco and then veggie base smoothies has anybody tried any veggie base smoothies at all some of you a couple of you have okay so when we're talking about trying to get eight to nine cups of vegetables a day one of the greatest ways I found is to try to get smoothies so I try to use this this is what I call my starter smoothie recipe because I don't try to go too overboard but it has about two to three handfuls of spinach I start with spinach because that can be a little bit more mild than kale or some of the other greens that can be a little more bitter so two to three large handfuls of spinach one to two carrots and even if you wanted to not try it with carrots the first time you could half a banana a cup of frozen fruit like mango pineapple or berries the banana really helps mask the flavor of the greens so I do think that if you like bananas put it in there because it's going to help the smoothie taste better this also has some flaxseed in it you want to get the milled flaxseed not the actual whole flax seeds and then fill up your blender and fill up about half your blender with a liquid of your choice that could be or almond milk coconut milk whatever your liquid you would like to use and then blend that for one to two minutes so this can be a great way to get in three cups of vegetables or more it can be a great way to start your day I have a smoothie a vegetable base smoothie every day and now it's like my body wants that so highly recommend that if you are looking to up your veggies and to help with the inflammation okay so moving on from the vegetables to other anti-inflammatory components of foods and that's the omega-3 fatty acids how many people have heard about omega-3 fatty acids before a little bit most of you right okay so we know as we talked about earlier there's both omega-3 and omega-6 essential fatty acid we know the American diet probably has too much of the omega-6 right so this next slide is going to show you the differences here so we have the Omega six on one side that's made up of a lot of vegetable oils margarine nuts seeds and some conventional meats also kind of make up this omega-6 component as well the omega-6 then converts to linoleic acid then gamma linoleic acid and there's that arachidonic acid that we saw earlier if you guys remember in the presentation when we talked about that being high in meat and dairy and we can see that these lead to more pro-inflammatory cytokines so this is just kind of a cascade of reactions happening that's promoting more inflammation when you have more omega-6 now in the flipside if you look on the other side we have your omega-3s which are going to talk a little bit more in detail where you get that but it's like your salmon your to know your mackerel the flaxseed that we're putting in the smoothie that's going to be a source of the omega-3s that converts to what we call ala then to EPA and DHA and these have anti-inflammatory effects so the majority of DHA and EPA are found in our cold water fatty fish like flax and flax seeds and salmon and we're going to kind of talk about the other types of fish as well so we definitely know the American diet too high in omega too low in omega-3s so how can you kind of up your intake of omega-3s here you have your salmon your anchovies your herring Pacific mackerel Matt king mackerel sardines - kind of an easy way if you do like those trout and then flaxseed these are also lower in mercury so these sources of omega-3 are kind of your best sources of omega-3s but also being your lowest and mercury one thing I don't have on here is the fish oil supplement how many people if you don't care sharing or taking a fish oil supplement okay so the fish oil supplements obviously can be a great source of the omega-3s as well so both animal and clinical studies support the use of omega-3 fatty acids in treating autoimmune diseases such as RA inflammatory bowel disease and others so another slide here just talking showing you the different content of the mega threes the salmon being the highest herring sardines trout also giving you some of the shrimp it's low okay omega-3 studies advocate a lower intake of a mega six compared to omega-3 in reducing inflammation we've talked about that the American Heart Association also does recommend eating fish particularly the fatty fish that's high in the mega threes at least twice a week and they concerned consider us serving three and a half ounces of cooked fish or about 3/4 cup of flaked fish and again they're referring to fatty fish like salmon mackerel herring lake trout sardines albacore tuna and those are your highest in omega threes I didn't have the tuna on the last slide just because it can being have some mercury content we do recommend that you talk to your doctor or dietitian about dosage for fish oil supplements the FDA does not recommend exceeding supplements with greater than 2 grams of combined epa and DHA daily so if you are taking a fish oil supplement you can kind of it's kind of confusing because it says like on the front a thousand milligrams of omega-3 or something like that but then when you turn it around what you really want to look at is the amount of epa and DHA and the supplement and so the FDA does not recommend going over two thousand two thousand milligrams or two grams of each EPA and DHA combined daily but you know there are some people on higher doses you just have to talk with your doctor about that of you you are so that's the problem with a lot of studies talking about the benefits fish oil supplement supplementation they do vary and their dosing so there's no kind of standard dose recommendation and what's going to be helpful for inflammation but we definitely know it is it can and I have seen a lot of people see and some improvements with fish oil okay so that's kind of the basics about nutrition to fight inflammation I wanted to kind of end on a note about a couple doctors that have inflammatory diseases and they've used nutrition to really help heal their diseases so Brooke goldner is one doctor she has this book called goodbye lupus and she talks about her story with lupus she I think she's had lupus and she was sixteen years old it got pretty serious in medical school it started affecting her kidney and also kind of caused a blood disorder as well she uses a vegan diet enlarge and take on veggie based food smoothies with flaxseed I think she is about 64 ounces of smoothies of these veggie based smooth this is smoothies a day she is now not on any medications she's had two pregnancies where that can as we talked about earlier that can kind of be a flair for people with autoimmune disease and her disease has not fledged she has many followers I'm in one of her groups of many followers with autoimmune disease not just lupus that are also reporting improvements in symptoms and reduction in their labs currently she does not have any research that I'm aware of I don't know if she will conduct any in her future but the book kind of talks about her diet and what she did so it's always nice to hear these positive stories and the power of nutrition and and it's interesting to see if the followers too because you think well she's one person but then when she has other people following these recommendations and getting good results it's nice to see the next person I don't know if anybody's heard of is Terry walls has anybody heard about her so she is a doctor and she has progressive MS and she said she was was treated with at the top hospitals with all the latest medications and her and ask have getting worse so at that point she was taking all these medications and just that well what else what else can I do so she delved into nutrition research and started changing her diet drastically and took supplements as well and she went from being wheelchair-bound to being able to ride a bike and she now is mobile and no longer needs a wheelchair and has a great book out talking about her story and the diet it's it's really interesting she has a TED talk as well if you just google Terry Wells TED talk and there's millions of people have probably watched it it's really good cuz she tells her story of she said when she started out in her search she wasn't hope she didn't even think that she could possibly reverse some of the damage that was done because that just wasn't that wasn't talked about that was possible with ms she was just looking to stop the progression of the disease of she kept getting worse despite all the medications so the fact that she started getting better she was just really really surprised by so her book is called the walls protocol and she talks about her story she is a paleo based diet I don't know if you guys are familiar with a paleo based diet but it is a low starch diet because it's a grain free and dairy free diet but she also promotes a high vegetable intake so you can see the common denominator of a lot of these diets is extremely high vegetable intake as I said she went from being wheelchair-bound to bike riding and thriving she still has MS but her symptoms have dramatically improved and she is conducting research so that's what's nice is she has done a research study and I know she's got more in the works the the title of it was the effect of a Paleo diet on management of a mass the Paleo diet they used in the study included 9 cups of vegetables and they did the three cups of greens with 3 cups of colored vegetables and the 3 cups of salt or vegetables included meat including protein and organ meats she had no gluten in the diet no dairy in the diet no potatoes in the diet or legumes so that was beans lentils or peanuts so it was a high intake of vegetables with all of those components she did a randomized controlled study and found that the Paleo diet may be useful in the management of MS in reducing fatigue which we know is very common in these immune related diseases increasing mental and physical quality of life and increasing hand and leg function and they kind of talked about you know they were trying to pinpoint why these results were happening and one of the things they linked it to was that there was an increase in vitamin vitamin K levels in these patients that followed this diet ok and that may indicate reductions in oxidative cell and mitochondrial damage along with reduced inflammation perhaps contributing to improve cognitive and motor functions quality of life so they were they were possibly thinking but couldn't really say maybe it was the vitamin K that's a high intake of the vitamin K that was helping some of the symptoms and the improvements that they saw in the study but again we've talked about all the nutrition and these phytonutrients in these vegetables and these diets that I'm sure can be contributing to a lot of these things as well so I thought we would end on a positive story like hers like I said she does have that TED talk if you guys want to learn more about that and then I am going to open it up to questions thank you so much for a big applause for Laura thank you so much for this fantastic presentation [Applause]

Channel: SPONDYLITISdotORG

Views: 133,177

Rating: 4.784091 out of 5

Keywords: ankylosing, spondylitis, spondyloarthritis, diet

Id: SQZbj7cAy70

Length: 48min 25sec (2905 seconds)

Published: Mon Nov 05 2018