The Warning Signs Of Chronic Inflammation & The Top Foods To Reduce It | Dr. Shilpa Ravella

a lot of what is causing this low-level chronic silent inflammation today is our environment our dietary habits our lifestyle now most people kind of get information well I have a source Road okay that's inflammation or you know I have an autoimmune disease or I have allergies or I have asthma people sort of get that's inflammation but most people don't really know that other diseases that I mentioned like heart disease cancer obesity diabetes aging itself depression autism um are all either caused by or somehow affected by inflammation in our bodies and by the way just to say everybody the reason why Americans were only four percent of the population but suffered 16 of the cases and deaths from covid was not because we have a bad Health Care system is because we are all pre-inflamed because we were living and eating and doing things in a way that make us pre-inflamed so when covet hits us it starts a wildfire it's like dropping a match in a dry forest you know so it creates a wildfire and that's exactly what covid was it was a wildfire in our bodies that killed so many of us so kind of take us through why why are we having so much inflammation and what what is it how do we kind of identify it sure we're just going back to the basics inflammation is actually an ancestral force that evolved to protect us from things like pathogens and poisons and traumas all of these ancient Killers so it's actually a good thing in our bodies to have inflammation when we need it but the problem is that because we've evolved these strong robust immune responses we also tend to pay a price for it and this is called the biological price of having a strong immune system and we can see that with autoimmune diseases for example like rheumatoid arthritis or inflammatory bowel disease but now what we're seeing is that we've also transformed our modern environments from the food we eat to the air we breathe to how we move how we interact with others in terms of social connections so our immune systems are constantly triggered at a low level and this leads to Chronic silent inflammation in the bodies and we know today that this type of inflammation can actually be an independent cause of disease and and it is tied to a variety of modern chronic diseases the majority of our top Killers is tied to heart disease cancer diabetes and neurodegenerative disorders some psychiatric issues obesity so what we're seeing today is that the majority of us in the modern world are inflamed yeah most people don't walk around going oh I'm inflamed like if you if you've got a rash or you have a sore throat you know I'm in a flame right we have a arthritis in your knee and it's swollen up you're like I got a problem but most people who are overweight or have heart disease or high blood pressure diabetes or depression they're not walking around thinking oh I'm inflamed I better deal with that right right absolutely so explain how inflammation plays a role in there because we think of inflammation typically as being something that is there to fight infection or immune system that gets activated to fight cancer but and then can get just regulated without immunity analogy but we don't think of it in terms of sort of this General state of being kind of low-grade inflammation which we're all suffering right and I think that's a great point is that that we don't tend to think of inflammation as being so broad for example we when we think of inflammation we think of autoimmune disorders typical autoimmune disorders or as you said when we have a cold or a flu but now what we're seeing is that low-level inflammation can actually cause some of these disorders or it is tied to nearly all of these modern chronic disorders and you're right that if you go into your doctor's office your typical Western Physician's office you're unlikely to be offered a test for inflammation so the question is how exactly do you know that you are inflamed and I think there are a lot of things that are coming up these days for example in cardiology clinics doctors might test you for something called C-reactive protein High sensitivity C reactive protein and and that's a marker of inflammation in the body it's made in the liver in response to areas of inflammation and there are a variety of other markers as well but some of the problems with these tests is that they may not be that specific so if you have elevated C-reactive protein you may have that elevation from the cold you have and you cannot be sure where it's coming from in your body how long it's been there for but you know there are new markers being developed there are inflammatory signatures for example there was a Stanford study a couple of years ago on aging and an inflammatory signature comprised of several markers that can help to predict healthy aging and you know there are so many different things that are in the works I think from tests like CAT scans and MRIs that can pick up inflammation around blood vessels for example and predict which plaques are most likely to rupture so so those are some of the things and one of the proxies for being inflamed that we can all look at when we go to our Primary Care Physician's office is is just you know things like high blood sugar or diabetes if you have pre-diabetes or diabetes you're most likely to have some amount of inflammation in the body because high blood sugar does tend to create inflammation and if you have that belly fat for example then you also know that you most likely have some level of inflammation in the body because we know that the belly fat is a marker for the fat that wraps around your internal abdominal organs yeah I mean that's that's by the way that fat right is a source of a lot of inflammation because it's not just you know the belly fat is not just holding up your pants it's actually a very active immune hormonal organ that's spewing out all kinds of inflammatory signals if you get this excess belly fat and I think most people don't realize that if you have a big belly you've got a smoldering fire inside of you and and that is really important to understand and the reason we get the big belly is because of what we're eating so you know let's talk about you know you know the um some of the things we were talking about like how do we know right so we can do a CRP but it's not very specific it doesn't tell us why it uh you know there are other markers we mentioned the Stanford research I think that was David furman's work on the thousand immunomes project where he looked at cytokines or inflammatory markers in the thousand people from little kids to old people and he found they were like things that we probably never heard about medical school these cytokines that you know that we don't test for in a normal lab result but that actually are probably more predictive and and more correlated with various age-related diseases than other markers that we actually do measure right so we may we're kind of learning about how to test for this uh and you mentioned high resolution scans Imaging tests we now for example with Alzheimer's we know that Alzheimer's is an inflammation in the brain we can see through through various MRI and and high technology scans we can see inflammation in the brain we can see for example a new AI driven heart scans we can see inflamed plaque where rather than just looking at oh and angiogram or you know even calcium score which gives you a rough idea of the the calcified plaque it doesn't tell you how inflamed your plaque is so we're getting more and more sophisticated but you know are there are there tests that we should all be doing to check for inflammation and are there tests that help us figure out the why like what is the why behind why we're so inflamed I think that's a it's a certainly a tough question for sure and I think it's also very specialty dependent you know for example in my own practice I I tend to see inflammation all throughout the intestinal tract and so depending on what sorts of symptoms a patients come in with I may do endoscopic testing I may do an upper endoscopy and a colonoscopy and I may catch microscopic inflammation in the intestines as well through that way and there are also stool tests that we do in our practice to measure inflammation like lactoferrin which is one of the stool tests and these are very situation dependent and again if you if you go to your physician in general you're unlikely to be told hey let's just check you for inflammation and then let's try to treat it and we're not quite there yet but I think we're getting there and I think one of the interesting things too with testing is that you know perhaps we should be measuring inflammatory responses to challenges rather than just like a baseline snapshot of inflammation I think that's something that could be very interesting as well because we want to know that the immune system is doing its job when it should be and not overreacting as well so I think there are a lot of great things that will come up in the future regarding testing and hopefully we'll see more and more specific markers and we'll see more trials in this space but I think when we go to our Physician's office in the Modern Age I you know we have some proxies that can tell us if we're inflamed and we have specialty specific diagnostic tools that we can use as well interesting so so you mentioned sort of the sort of a challenging immune system can you talk more about that because we know for example if you want to check for diabetes you do a glucose tolerance test where you give people a bunch of sugar and see what happens to their blood sugar if you want to check someone's heart you know just check an EKG you put them on a stress test or do a stress echo to stressor system so tell us what you're talking about I think this is a really interesting concept of how do we how do we test our immune system's function and are we overreacting or under reacting yeah I think it can be as simple as injecting you know a molecule like a lipopolysaccharide and and trying to figure out what the immune system's responses is the immune system one responding appropriately uh and two is it overreacting are we having too much inflammation to a stressor and I think that could tell us more than perhaps just a snapshot of the blood markers that we have currently and this is something that I think maybe that we will see in the future yeah now we've all heard about this cytokine storm from covid and cytokines are basically the messenger molecules of your immune system and a lot of the you know work by David Furman things were measuring like CRP CNF Alpha il6 cytokines they're just they're just the the uh symptoms of inflammation they're not the cause they're the body's response to something that's irritating it right so my question is you know is is you know why Always why is the immune system pissed off in the first place right it's easy to measure look at you know you can look at scans you can look at a colonoscopy you can look at CRP you can look at all these other biomarkers but it's not going to tell you the why and so you know my joke always is that a functional medicine doctor is really an inflamologist like I'm an inflamologist I like made in my life's work to understand inflammation to understand what causes it how to actually remove the causes and how to get the body's own immune system to calm down and to to reduce the inflammation naturally so can you talk a little bit about from your perspective what do you see as the main drivers of this epidemic of inflammation and inflammation which we talk a lot about I think I think first of all that you know this idea that all of these disorders share a deep biological link from heart disease and cancer to some cases of depression and neurodegenerative disorders uh that length being inflammation it forces us to to look at all of these things and really try to figure out what these root causes are and it forces us also to look at patients and to treat patients not only from specialty perspectives but also holistically in some ways as well and a lot of what is causing this low-level chronic silent inflammation today is our environment our dietary habits our lifestyle and we know that chronic inflammatory disorders and when I talk about chronic inflammatory disorders I'm talking you know not just about rheumatoid arthritis and inflammatory bowel disease but all of these different modern diseases because these are inflammatory disorders and and so we know that our lifestyle factors play a very very important part so so talk talk more about you know specific typically what is it about our diet that's driving the inflammation and and then I want to get into potentially exploring other causes that may not be immediately obvious to people that are driving inflammation sure your book is really silent fire talks about diet as a Big Driver of inflammation so exactly what are we talking about here there are so many different factors and I think one of the biggest ones is the Western diet and this type of diet is loaded with an excess amount of sugar or salt inappropriate fats processed foods processed Meats refined carbohydrates and the problem with this Western diet is that our immune system actually tends to respond to it as it would a germ you know your immune system tries and tries to to kind of fix things in your body and it realizing that keeps getting these hits you know maybe three times a day or six times a day however many times a day you'll have a meal and when you're eating this Western type of diet we're also starving our gut microbes of their most beneficial nutrient which is fiber and fiber can manipulate all arms of the immune system from the innate immune system to the Adaptive immune system and it's an incredibly powerful powerful nutrient that we that we need to be eating more of but on 95 of Americans today do not meet the recommended daily allowances of of fiber it's 28 grams for females and 38 I think for males so we are really starving at microbiome then the microbes change their behaviors causing inflammation they'll inch closer to the mucosa they will create more inflammatory molecules like lipopolysaccharide those molecules will go out into the bloodstream causing body-wide inflammation so it's changing you know who the microbes are the species in your gut and also what their behaviors are so the Western diet one of the biggest losses is also the fact that we are depriving our bodies and our guts our Androgen microbes of their most essential nutrient so diet is certainly a very big component of creating this low-grade inflammation and I would also say that the other main not just something fiber though right is probably other things in our diet right plenty of other things and you know the other thing too I would say is that we we tend to think of foods as uh dampening or creating inflammation but there's also a reversal going on this whole process by which inflammation tends to die down in the body is not a passive process it's an active process and immune cells like macrophages and neutrophils will secrete new mediators and we need to feed that process and so we need to eat healthy fats like Omega-3s and I think that's something that we don't do enough of nearly enough of so that potential to resolve inflammation in our bodies we need to really be able to create those molecules and that also comes from diet because of precursors of these lipid signaling molecules are actually Omega-3s which we find in a variety of foods yeah I mean these are called the icosa noise right this is what we learn in medical school there's Pathways of regulate getting cytokines inflammation and they're highly regulated by the fats in our body particularly the omega-3 fats I want to look back to what you earlier talked about I think it's really important I want to skip over it which is the role of the microbiome and as a gastroenterologist I think this is your area which is the microbiome plays a huge role in regulating our immune system and most people don't know that 70 of our immune system or 60 of anything you're talking to is in our gut and it's because it's the first place where we interact with the outside world right we put all these pounds of foreign stuff on our mouth every day and it goes down there and has to be sorted through and then you've got all those bacteria and bugs and poop in there and it you know you have to light in the right stuff but keep out all the bad stuff and when we get a problem with the microbiome we tend to get damage to the gut and more inflammation so can you kind of walk us through that whole story of uh what we're doing to damage our micropomme besides just not eating fiber and and what changes happen in a microbiome and how that starts to upramp the inflammation cycle in our body right so so when you look at the microbiome when you see for example a mouse who grows in a sterile bubble with no microbiome no germs on that Mouse whatsoever you find that this mouse actually tends to develop all kinds of abnormalities like a deformed heart and lungs and a shrunken brain so so microbes actually train our immune system they help our immune systems to develop our microbes are having conversations with our immune cells at all hours of the day and this is a process that begins even before we're born and once we're born of course and all throughout life so we need to be having those essential conversations and how do we Foster those conversations and again it comes down to Lifestyle what kinds of foods are we eating I had mentioned fiber but there's so many other foods that are great for the gut microbiome because we know also that a lot of the fats that we eat can make their way some of them can make their way down into the colon and we have that proportion of fats for example being metabolized and we know that you know there are spices and herbs and all of these wonderful foods with polyphenols which are amazing compounds for the gut microbiome because again some of those make their way down and are metabolized by the microbiome so so it's not just about the fiber but all of these amazing nutrients that we find in foods and what we know today too is that a dysbiotic microbiome or a microbiome that is an imbalance is very often an inflammatory one so so when you have microbial dysbiosis when you're eating a poor diet and not exercising you know stressed out and not getting enough sleep or social connections and you have a dysbiotic microbiome we do know that you most likely have low level chronic inflammation coursing through the body in those States so our microbiome is incredibly important for the inflammation picture as a whole and our immune system shapes the microbiome as well we know that microbes do so much in the body from digesting nutrients we cannot digest to changing gene expression to modulating the inflammatory response yeah your your specialty has definitely got a new Renaissance the microbiome Revolution I mean I remember speaking to gastroenterologists like I don't know 20 plus years ago and they were like really you think food has an impact on what's happening in the gut and I'm like uh yeah I mean what a concept right and I think now it's finally like you know I mean it just amazes the doctor say well one UE has nothing to do with your health like it just you know your autoimmune disease your colitis or your whatever it is it's like it's not connected and it's just it's kind of absurd but food is the biggest signal transducer we are interacting with every day and it's either driving up inflammation or calming it down inflammation and what we eat every day shapes our microbiome for better or worse and so you know when you can have an inflammatory microbiome or an anti-inflammatory microbiome and and it regulates everything from autoimmune diseases to a heart disease to obesity to cancer to alzheimer's to autism I mean the list goes on and on and on and so it maybe it's probably one of the central things when I'm actually treating patients for any problem I mean that it remotely could be inflammatory and pretty much every chronic disease we have I always start with thinking about the gut I always like well how is their gut do they have any symptoms what's their microbiome like you mentioned lactoferrin that's one test you can measure but you can also look at the immune system and they got you've got the bacteria in there you can look at calprotectin other eosinophil protein X all kinds of biomarkers that can tell you there's like stuff cooking and and causing trouble and you might it might not be a full-blown autoimmune disease in the gut but actually it's something you need to pay attention to so I think that's really important the microbiome I think is one of the key factors driving inflammation and the challenge of their microbiome what are some of the other things you found that might be driving inflammation not not things that make people people typically think about well I think one big thing also is just the stress in our lives and you know when we look at stress we typically think of a bad boss at work or you know bereavement and things like that one big big stressor since the pandemic though has been just uh loneliness just or or lack of social connections and I think this has been a huge and increasing stressor being lonely you know can can be very detrimental to to the health and loneliness is tied to all different kinds of diseases from heart disease and cancer to obesity and if the stress on the body and inflammation can be one mechanism by which stressors like loneliness can cause illness and what happens is you know it's not the acute stress I mean if if you're faced with a saber-toothed tiger as an ancestral times you know you want to kill that tiger and you know go away right and and it's not the acute fleeting stress but it's the it's these chronic slow going stressors that occur day after day and for a lonely individual you know their bodies are going to react to that stress as they would to a germ and it's kind of paradoxical because when you look at these hormones going through our bodies and acute stress like cortisol and norepinephrine and epinephrine uh it's you actually have a dampening of the immune response initially but but chronically you actually have increased inflammation and you have increased cells immune cells being made in your bone marrow you have an expansion of white blood cells in the body so this is what chronic stressors like loneliness do and I think also it's a systematic problem it's a societal problem it's not necessarily just an individual problem and problem that needs systemic Solutions yeah for sure um that's just I mean the social issues are huge and I think in the blue zones they live so long partly because they have such a deep connected community and that helps calm down inflammation um you know I think it's really actually biologically really plausible um I I um also want to ask you about uh things that people don't necessarily think about connected inflammation for example environmental toxins um what have you found around the role of environmental toxins and inflammation because it's something we can't really control as well as our diet or exercise or stress levels even our social relationships but it just seems like we're we're in a sea of toxic chemicals and what role is are they playing in our immune system you know uh I I've been seeing more and more data just the studies coming out on on some of these chemicals just in Daily household goods from everything we use from our cleaning products to the clothes we wear and you know connections to inflammation in the body through those things as well so and then also just pollution in the air and pollution we know is is very detrimental to health linked to a variety of disorders and inflammation could be one mechanistic pathway by which pollution also causes disease but I certainly think that environmental toxins are a big part of the picture as well you know it's the food we eat that's a very very big part but it's also the air we breathe and how we live and our household goods and our habits in that sense so some of these chemicals in plastics for example or even in your exercise clothes I think there was a new study that just came out on on chemicals in a polyester clothes that folks were for exercise and so you know I I really do think there there is utility to really thinking about everything that you're bringing into your house and trying to stick to Natural clothing materials like maybe cotton and linen over you know this kind of cheap and fast fashion for example uh which has other issues associated with it as well and and I'm not saying someone has to be a hundred percent and avoiding every single chemical they've ever heard about but I do think that it's prudent to really think about what you're bringing into your home and and this also allows us to live a more sustainable and environmentally friendly lifestyle in a lot of ways yeah it's true I mean I'm on the board of the environmental working group and there's all sorts of wonderful guys there ewg.org for how to reduce your exposure from household products from skin care products from food from pesticides you know all the things that are are really uh causing potential harm and you know even autoimmune disease there's now links to for example environmental toxins and autoimmune disease through the mechanism they call autogens you know rather than antigens we call them autogens or obesity or cancer so all of these inflammatory problems can be triggered as well um also you know from the diet perspective what's your what's your take on sort of the increasing rise of true food allergies as well as sort of food sensitivities and why we're seeing this and and you know is there Merit to it and you know and as a gastrologist you deal out with celiac disease you know what's your perspective on the sort of increasing rates of gluten sensitivity I mean there was a 400 increase in true celiac disease based on a our study of 10 000 pool blood samples from 50 60 years ago to those now showing them real true increase so can you kind of talk about that whole realm because I think people really are confused about it and people think you know maybe a little crazy about who sensitivities but I I think it's an important thing to think about yeah I think you know there has been an increase in incidents of autoimmune disorders across the board including celiac disease and even the last few decades we're seeing a steep rise in all of these disorders and we know that many of these disorders have a genetic component some more than others but we also know that we've transformed our environments so it's not just the genes and it's largely environmental factors it's also driving this increase not just in autoimmunity but also allergies as well and food sensitivities part of the problem is that when we are born and as we go through childhood as we go through our lives and the pandemic is a great example of this we are not exposed to the microbes that we need to be exposed to what we need to do is to be finding these microbes that evolves alongside humans in ancient times these microbes that are found in the air and mud and the ocean you know those are the microbes that we need to be keeping in contact with all throughout our lives and there is a critical window during the first few years of life when we especially need all of these microbes to help to train our immune system not to overreact against harmless particles like dust and dander but to actually accept what it should accept and to react against infectious deadly germs so we need an immune system that's balanced and I think to have that balance in the immune system you know we do need to be exposed to germs much much more than than we have been and that means that we have to go outside we have to be outside much more than we are and it also means not being too too clean in the house means trying to bring nature into the house as well maybe trying to drop food on the floor you should eat it um well you know what I say not wash your vegetables well you know and and this is the hard part right because there's a balance and it's it's it's tough because during the pandemic we were so so clean and we were washing our hands a million times a day and I think it's a fine balance but one that can be struck because if you're if you're going hiking you know in in a a place that you're very accustomed to then maybe you don't have your kid you know do like a complete hand wash after that you know it's not essential but if you're in like a perfectly manicured lawn then then you sort of know that there's other things in there that you may not want your kids to have on their hands before dinner time so it's really a balance and of course if we're living uh through a pandemic then it's important to to keep all those measures intact and to wash our hands and and and to be very cautious but at the same time when we go outside interact with those microbes you know in the forests and parks and Hikes we're actually boosting our immunity as well so we do net we do need that interaction even through pandemics and such so I think it's a fine balance but you think there's a real truth to the increase in these food sensitivities and gluten sensitivity they're not just in people's head I do because if if you look at this rise you know it's been in the past few decades and if you look at how much these chronic disorders have risen you know the incidence of cancer heart disease and autoimmune disorders diabetes I mean across the board you see you know a huge rise in all of these disorders and and you know our genes cannot transform so quickly in our environments meanwhile are continuing to transform and you know just with the Advent of processed foods even if you look at the 1950s a dinner plate in the 1950s you would not find the amount of processed foods that you find today and these foods are you know they're kind of like Franken Foods they have so many additives that you know we do not understand and and it's it's tough also in healthcare and in medicine to try to prescribe lifestyle medicine and lots of folks are working on that and that's you know the goal of all health and wellness practitioners but the system is set up so that it is just harder and more time consuming to implement these things um so that's a process an ongoing process as well but I absolutely think that we do have a rise in all of these disorders including autoimmunity because of our lifestyle in part yeah it's true I think there are some things that you know are are you know out there now that I think are driving inflammation and create a lot of chronic and sort of issues and I think we've seen this with covid for example you know we saw this sort of wave of covid but you know now that's calmed down there's a whole aftermath of what we call post-covet syndrome or long covet or long-haul covet and and that is an inflammatory condition that's real and it's making people feel like crap you know brain fog fatigue muscle aches all sorts of symptoms and and so you know the other the other thing I think that you know I think is driving inflammation for people are some of these low-grade chronic infections and it could be things like Lyme disease or other tick-borne illnesses certain viruses they get activated if your immune system's not regulated well you know covet is a great example of something that kind of persists you know so what's your take on how we sort of think about looking for those roots causes of inflammation well I think you know especially as we age it becomes harder for our immune system to fend off pathogens and it's more likely that we may have some of these low-level sort of infectious issues so I certainly recommend you know go into your position and go into your specialist and getting a full work up for whatever it is that you do need um you know just just being mindful of signs and symptoms at home uh clinical signs and symptoms as well and I think that's one of the best things that you can do yeah you know um in terms of another sort of take on this um the the you know inflammation that we're we're getting is is an issue right we've talked about diet we've talked about stress we've talked about toxins we talked about allergens we talked about the microbiome we talked about infections all things that are trigger inflammation so as a physician you have to be really good at being a detective about all these things right how do you analyze diet exercise stress sleep obviously lifestyle factors but also how do you look for hidden infections how do you look for hidden toxins how do you look for what's going on with the microbiome how do you you know measure what maybe the root causes but we also kind of have an opportunity once you've done that to live an anti-inflammatory lifestyle to reduce inflammation so how is as a physician you think about addressing this because it's not like take Aspen or Advil or take an immunosuppressive drug I mean I read one study for depression when they were using you know basically these tnf alpha blockers these powerful biological immune suppressants to treat depressions because they thought it was inflammation in the brain I'm like that is the worst idea I've ever heard about so can you talk about how how we can start to think about you know um reducing inflammation in the body what are the tools we have to treat it and how do we how do we start on that process I think for one you know if I see a patient coming into my clinic you know the first thing I want to establish is their Baseline what sorts of comorbidities do they have and then also what kinds of GI comorbidities you know if you have for example intestinal bacterial overgrowth you may have sensitivities towards certain foods that may resolve entirely after that overgrowth is treated if you have things like microscopic inflammation of the colon you may need to treat that first if you are very very stressed out and have had major stressors in your life then that could play a part in the types of foods you tolerate in your General Health as well so I think just looking at the Baseline health of an individual is is kind of my first step and then from there I I do prescribe empiric lifestyle therapies so I empirically prescribe dietary and lifestyle therapies for patients that can actually help them to live a more anti-inflammatory life I think everyone is different and you know I have patients I have a huge population of patients at one point who were missing most of their intestines so instead of having a 20 feet of small bowel they had 20 centimeters and of course dietary recommendations have to be tailored but looking at all of these different you know food sensitivities and allergies and food intolerances you know you really have to tailor the diet in those situations to each individuals and when you're looking at a global sort of a diet a population-wide diet because these are population-wide problems when we're talking about these chronic inflammatory disorders like heart disease and obesity and cancer and and I prescribe you know diets like the Mediterranean diet or the Okinawan diet I I think there's no single size fits all type of answer sometimes but but the dietary patterns that we have today that are rooted in Tradition or absolutely wonderful and that's something I use to sort of personalize the diet for each patient because I think in so many of these These are cultures the ancient Traditions do really support a diet that is very anti-inflammatory it's true and a lot of the diet that's the most inflammatory is the amount of sugar right in the diet and I think sugar and starch are probably the most inflammatory foods and they drive that belly fat which is a very different kind of fat that we talked about earlier and I think that's the fat that's driving so much the inflammation and and uh is a problem you know one of the most powerful things as a functional medicine doctor that I've done and I think if I had like one tool as a doctor if I only had like one prescription to give people for everything it would it would be um an anti-inflammatory diet but a particular kind of one we call an Elimination Diet and typically this has been sort of dismissed by most of traditional medicine but but I'd love your perspective on the idea of removing all the inflammatory foods and adding in all the anti-inflammatory foods as a strategy for treating you know wide host of chronic diseases I think certainly you know in in certain conditions you know for example with uh chronic food allergies and such where some immediate reaction there are food elimination diets that you can do and in my population I have patients with irritable bowel syndrome and those patients have a certain elimination diets as well um so uh so I do think that elimination diets do play a role in several conditions when I I see a patient in my clinic and I want to prescribe a broad anti-inflammatory diet yes of course I take out all those Western Foods those processed foods and I start slowly adding in some of these other foods that are higher in fiber and I think one thing also to keep in mind is that it's a process it doesn't happen overnight you know your gut can alter its secretions and its contractions over time to better process fiber and that's something that for most people uh you know if if they start from a low fiber diet to 100 fiber diet then they then they kind of get discouraged and and so that's one thing that I tell people to be mindful of um but certainly I do use some elimination diets in my practice and you know for a variety of disorders and I think it can be useful to keep a food journal to really try to figure out which of these foods are causing issues for you so for eosinophilic esophagitis which is an inflammation of the esophagus uh we know that there is a type of Elimination Diet that can actually help that condition and you can eliminate six Foods at once or a single food at a time so I try to go with the single food at a time and then reintroduce it back in a couple of weeks to see if that food is actually causing problems and I think uh you know patients can benefit from that as opposed to just starting steroids or you know starting a medication immediately after such diagnoses yeah you know I just recall a patient I had from Cleveland Clinic a number of years ago who's sort of had a terrible autoimmune disease psoriatic arthritis uh and had you know just you know miserable with joint pain inflammation and terrible skin lesions but she also had you know pre-diabetes she had depression she had migraines she had severe reflux she had severe irritable bowel with bloating and you know rather than like and she was seen by the best physicians getting the best drug she was on you know a 50 000 a year medication for autoimmune disease she was you know on a reflux medication she was on antidepressants she was on Metformin she you know it was she was a mess and um she came in to see me and she she was you know these were managed but they weren't better and I said Gee well it seems like you have a lot of inflammatory diseases right depressions inflammation insulin resistance inflammation psoriasis inflammation arthritis is inflammation your gut stuff is inflammation right and I'm like why don't we just try to deal with the root cause based on your symptoms which I I sort of deduced to be her gut and so I gave her she had really bad bacterial overgrowth or sibo she had fungal overgrowth from all the steroids and antibiotics she'd been on and so I gave her any Fung an antibiotic an antifungal I cleared out a bad bugs and her God I repopulated with healthy bugs I put her on Elimination Diet got real gluten dairy sugar processed food and gave her some probiotics and vitamin D and fish oil and she came back six weeks later and I thought you know I didn't tell her to stop any remember meds I just said why don't you try this yeah you do you came back six weeks later and she stopped all her medication she had no more psoriasis no more arthritis no more depression no more irritable bowel no more reflux no more migraines and her weight dropped by 20 points and she reversed her in some resistance and you know um I was like wow this is powerful and most you know doctors would not think about doing that but it was just basically an Elimination Diet and a reboot of her gut that dealt with all these issues and you know many of us walk around with things that are you know not as severe but that would really respond to a travel Elimination Diet actually that's why I wrote a book called the 10-day detox diet it's basically an Elimination Diet and I I've used it over and over and it's remarkable like 70 percent reduction in all symptoms from all diseases just using that approach and it's almost like a reboot and you know I find it so powerful and you can like eliminate one thing at a time but I I My Philosophy is to try to like reboot like I like your computer just not working it's not you can't just shut off one program you got to kind of restart the whole thing and it's amazing the level of inflammation that goes down the fluid comes out of their body uh they feel better their skin gets better and it's and something that I think you know most doctors should know about and learn about but we don't learn anything about it my daughter's in medical school now and you know she's not learning anything about nutrition nothing about what's it doing that's very common very common I'm not even learning it not even learning about the microbiome which is like you know it's not exactly like alternative medicine anymore and well you can teach her about nutrition so I try trust me I can't get her read one of my books oh no it's okay she's coming around I think she'll come around but she said she's she's learning I mean it's it's it's a it's it's tough because it's like we're so outdated in our practice as we don't haven't Incorporated a lot of this emerging science in your work you know your book The Sound fire your article in Time Magazine Wall Street Journal were really great because they help people to see that we need to really think differently about these problems that we face as a society thank you we appreciate that so um you know one of the other suggestions you have for people in terms of how to address inflammation what are the sort of suggestions you have in your book what are the kind of guidelines you use to help people think about this so so one of the other things too that we haven't talked about is just trying to do some exercise as much as you can uh every day and this doesn't have to be going to a gym and doing two hours of exercise a day and lifting hard weights I tend to think of it as a blue zones folks who would think of it where you incorporate exercise naturally into the day and we know today that exercise actually can dampen inflammation in the body we have dozens of clinical trials to back this up and even in the absence of weight loss the exercise can decrease the amount of immune cells that are infiltrating your fat tissue and to me that's an amazing fact because you know we're not we're not just looking at the end result weight loss we're actually changing our bodies on a biological level even if we are not able to see it on the outside and so just getting out and moving every day even if you do it in small bursts that tends to add up you know for example if you if you take the train you know if you take your bike instead of the train or if you try to go up the stairs instead of taking the elevator all of these different things can actually add some exercise in your day some movement in your day and when you think about the blue zones folks This Is How They Incorporated some movement into their days and I think it's a very seamless way to do it nothing wrong with going to the gym and exercising or anything like that but for most people it's it's this a difficult thing to begin exercising when they have not done any of it especially some of my patients who come to me saying you know doc I don't have time to incorporate exercise into my day and this is something I think that anyone can do just by making some simple lifestyle changes and it can actually dampen the inflammation in the body and another thing too I think uh is to just be mindful of the times at which you're eating because fasting has been shown to dampen inflammation in the body to fortify your body against a variety of of uh diseases and and just something as simple as trying to consume your calories in a 10 hour window it doesn't have to be anything complicated and of course if you have comorbidities then you should you know speak to your physician and a nutritionist before attempting a fasting program but we do know that stressors like exercise and fasting are good stress in our life because we have to have the good stress and also maintain the bad stress that we don't want and those things I think are very important for inflammation yeah I think that's really important to think about I think exercise is so key and I think we we you know we we don't realize how powerful it is a is a trigger for all the beneficial things we want to have happen with aging and it it works for depression it works for heart disease for cancer for diabetes for Alzheimer's you know for or every kind of inflammatory disease is pretty amazing and yet you know uh less than eight percent of Americans get the recommended amount of exercise I think maybe 20 some if you take a like a broader view of what's minimal but I think most people don't even get close to that um I think you know what about the role of um supplements or phytochemicals or other things that we can be taking help regulate our immune system do you have any perspective on that I mean I I do love uh to tell patients to get their phytochemicals from uh from the foods first so so I basically you know I have my patients eat lots and lots of colorful vegetables and we know that polyphenols are incredibly important phytochemicals for inflammation they're antioxidants they help to tone inflammation down in the body they are also metabolized by the gut microbiome in part and more beneficial compounds are created so I certainly think that polyphenols have a major role and when I think about supplements I think it's more the exception than the rule so when you you look at you know supplements like curcumin supplements some of which have been shown to be efficacious in diseases like inflammatory bowel disease you know that's a great thing you can also use curcumin in your cooking for example so I think with supplements is one is you you have the data behind them then that could be something that is potentially beneficial depending on your disease process as well you know the thing that I I tend to sort of recommend people to eat are certain foods which have anti-inflammatory compounds so what are your top anti-inflammatory foods that people should be focused on well I really love greens I think kale is one of my favorite greens it has the immune modulating potential of our ancestors or ancestral plants and it's it's very versatile very easy to cook so we want to try to get to foods that are more like those ancestral plants like scallions instead of onions for example because the ancestral iterations are actually much more powerful from an inflammation damping standpoint berries again are a wonderful food you can have frozen berries for example just in your in your freezer and eat them whenever you want and they are filled with a variety of phytochemicals including polyphenols and when you think about inflammation you really want to think about the very very colorful foods not just the iceberg lettuce and the bananas and in my pantry I have a variety of whole grains and by whole grains I mean actually whole so I love quinoa it's one of my favorite grains um and I I think it's something that is very easy to use and you know whole intact grains are actually much better for your gut microbiome than processed grains so that's just something that's a Nuance that that can be helpful when it comes to talking about inflammation and also fermentation yep um a fermentation of those grains so I think that when we were talking about grains in general or certain foods we really do need to be looking at the nuances so you know if you have a hearty bread that's fermented and baked in the ancient tradition without you know any flour say that's a very different response um in in terms of your immune response than a bread that you buy at the supermarket and and so that's something to be very mindful of and I love beans as well and lentils there are dozens of you know randomized control trials showing that beans can help to dampen inflammation and beans have a good amount of soluble fiber and you probably know all of this already so I'm just regurgitating what you already know here so three people need to hear it people need to you know uh for me it's for everybody listening yeah yeah so that soluble fiber is very important for the gut germs and that's uh you know they metabolize that fiber and see how much calories that way you make beneficial compounds that go throughout the body and calm the immune system down and one thing I think that I'm gonna I don't want to skip over that feeding your microbiome is so important right it's incredibly important yes and also those polyphenols which is a new discovery yeah so they they they're not using even fiber they're eating all the colorful plant compounds that can improve their their bacterial content in there and they're also eating some fat like healthy fats from nuts and seeds that's another food that I prescribe for patients um you know all those healthy mono one shot monounsaturated fats uh and just a handful of nuts a day is a great thing to add into the diet and then something I think that people tend to forget about the spices and herbs I mean there are so many different spices you can use and and in my family's Traditions you know the Cuisines that my parents and grandparents cook they're just an array of spices that I can't even I have I still have to learn all the names of everything so um but spices and herbs are just filled with polyphenols and just very very beneficial nutrients you know if you look at something like cumin which has salicylic acid in it you're actually getting kind of some anti-inflammatory Potential from that which also helps to resolve inflammation because aspirin is one of the few medications that actually not only dampens but also resolves inflammation and you know just like uh thinking of things a lot of people are talking about using black cumin seed oil like as a cumin seeds are a really different kind of a cumin and it's a very powerful immune modulator and anti-inflammatory potential antiviral yeah so these these spice and herbs we sort of neglect you know we use a lot of salt a lot of sugar a lot of a process for fine oils to kind of make food taste good and we don't actually use the spices and then you don't really need that much of those other things when you actually have a yummy spicy yummy diet I mean I I love to cook Indian food at home I actually make it scratch stuff so like I actually get the actual spices I grind them I get the peppers yeah and it's like oh it's so good it's like and and it's a lot of hard work it's a lot of hard work uh well I have I have a little it's good for you you know I have a little like a Brawn like thing it's just like I just pushed the button and goes so it's like it's fine but it's it's it's so important to start include these in your diet on a regular basis absolutely and the one thing I want to mention the last thing is also seaweed because I love seaweed and it's kind of like a superfood in some ways and you can find fibers and seaweed that you don't find in terrestrial plants and you know and the goal is just to have a diverse array of you know some of these plants and we know that simply by increasing the diversity of plant Foods in the diet that can actually predict lower inflammation so not it's not just about the quantity but also the diversity so just kind of thinking about all these different types of foods that you can get I think can be pretty useful I mean people do eat sushi and they maybe a little seaweed but tell us about seaweed because I think people don't talk enough about it I'd love to sort of drill down on that a little bit if you can yeah um so you know if you if you look at the Okinawan tradition what you can do is just make a simple miso soup and put some dolls or other types of seaweed in that and seaweeds have a variety of fibers that basically you don't find anywhere else and you can use it as a condiment you can just uh sprinkle some seaweed flakes on on anything you want really and it's very very versatile and easy to use in all kinds of cooking and it's something I think that I eat probably on a daily basis uh and and I I had not grown up eating it but something I sort of added into my diet after a while and I find that it's very easy to use overall and yeah it also contains all these polysaccharides and compounds that have anti-cancer properties immune modulating properties we also are great you know sorts of minerals and and things that you can get other places so definitely seaweed fermented foods you know you mentioned a lot of spices these are these are all things that are in the plant kingdom that are phytochemicals that regulate our biology and people don't use enough of so it's also it's not just what you don't eat right it's like get rid of all the starred sugar processed foods so far that we talked about and low fiber foods and but also it's increasing all the foods that are that are anti-inflammatory and that's a really powerful strategy for people I mean but I would say that like if you have something like a bad microbiome or you have uh you know some low-grade infection or you're exposed to some toxin or you know you have some real significant food sensitivity or gluten sensitivity you know you kind of have to deal with the cause because you can do all you can eat all the kale you want if you've got something going on you've got to deal with that and I I'm also sort of shocked like I had one patient with colitis years ago who was um you know doing everything right I put them on all the right stuff and anti-inflammatory diet Elimination Diet probiotics everything and he just was getting worse it wasn't getting better I was like what's going on it's like well maybe you know or something else and so I said let's check for heavy metals and we checked and he had super high levels of mercury we got the Mercury out of his system we chelated out and his colitis went away and he was good as new and I've seen this multiple times another one with lead who uh the woman who had Crohn's disease really bad lead toxicity and so you know we don't think of these things but we have to kind of be really good detectives as Physicians and think about you know why is the immune system so pissed off in the first place right not like not you know what's the name of your disease and let me give you the drug for that disease but actually how do I think differently about the root causes of what's causing this yeah I think that's absolutely true and we have sort of a break and fix model of medicine often instead of a preventative model or even a digging into the root cause type of an evaluation so I think it's something that's evolving and we'll see more and more tests come out in the future hopefully to test for inflammation and also for other issues as well that may be root causes all of that inflammation what are you most excited about that you're seeing in this field that's coming around the band around how we begin to assess and treat inflammation in a different way in medicine I think I am very excited about the microbiome research I think you know just as a mechanistic for inflammation to be a mechanistic link you know because when you look at the microbiome and disease studies a lot of these are associated studies and uh to really kind of you know understand a little bit more about the mechanism and to see the science behind that I think would be very interesting I think the immune system is sort of ripe for investigation in that area um and I would love to see more large-scale clinical trials like cantos or heart disease and uh you know see if there are treatments potentially for certain conditions um the FDA approved this year colchicine which is an anti-inflammatory drug for patients with heart disease to me that's a bit backwards because it's like well what about you know getting rid of the cause of the inflammation absolutely yes and I agree with I I do agree with you know looking for the root cause and addressing those issues first and I think one of the exciting things for me uh is just looking at you know the fact that modern medicine has so much to offer from these multiple organ transplants to cancer immunotherapies so I think we definitely should be focused on the preventative side and also try to be focused on the anti-inflammatory diet and lifestyle on the therapeutic side as well because we know for example that when you have transplant patients like kidney transplant patients who who take in the Mediterranean diet they have a lower risk of graft projection so we know that even when you have some of those conditions you may have a lot of benefit from managing your lifestyle and I think as we age in this current environment many of us are going to have artificial organs maybe prosthetic organs you know and also immunotherapies and and really learning how to manipulate our immune system through diet and lifestyle which is a what is the type of gene therapy will be very important because we are all turning into these new humans in some in some ways and and we're facing ecological disasters like climate change and pandemics and this type of Lifestyle will also be beneficial resilient absolutely yeah I mean you know it's pretty clear that people who died from covet were the ones who were inflamed when it hit them yeah you know I mean if you were healthy you generally were pretty okay you might have gotten sick but you weren't gonna die or end up in the hospital and so I mean it's important for us to think about as a society you know what do we need to do to kind of reset and to learn from this I mean I I was super frustrated with the you know the NIH director that we recently retired Francis Collins is an amazing guy I love him in so many ways but you know I said why don't you use covet as a teachable moment to help people understand the role of of diet in in driving so much of the morbidity and mortality from covet he's like well you know we don't want to blame the victim I'm like well this is not their fault I mean we live in a toxic food environment that's caused by our food policies and food system and and we need to educate people on how to fight against that and so uh you know it was a little disappointing but I think we really are at this teachable moment where we um we have this opportunity to really change how we're thinking about things and I really applaud your work I'm glad you're doing this in mainstream medicine at Columbia University and and working hard to bring awareness around this I don't know how you're being received by your colleagues are they are they still talking to you they are yes I think you know honestly I think there are so many more practitioners today who are very interested in diet and lifestyle and there is just a gamut of evidence you know it's hard to ignore the evidence of you know what nutrition science has taught us throughout history and also all of the new research on the microbiome as well so I think they're more and more folks and and also students in medical school who are very interested in lifestyle medicine and inflammation you know which we've been talking about for a very long time because I remember when I was a medical student I think I came across your work and uh you know it's a topic that has been talked about for a long time and and I think finally Western medicine is is starting to take note as well and I think it's great that you do work to bring awareness about this topic and and uh I think it's important for health and wellness professionals to band together because I think that is how the world is going to be changed it's it's not about um you know if if you look at paleo versus vegan versus vegetarian diets any of those diet labels tell you nothing about the actual diet and you can have a responsibly designed diet in each of those categories that that supports planetary health and that supports microbiome health and I think that's key and that's how I think we're all going to move things forward if you loved that last video you're going to love the next one check it out here 45 of adults and 25 percent of children not obese adults not obese children all adults all children now have a disease that didn't even exist 50 years ago

Channel: Mark Hyman, MD

Views: 16,940

Keywords: Mark Hyman, Mark Hyman interview, Mark Hyman live longer, Mark Hyman diet, how to live longer, how to age in reverse, nutrition tips, healthy foods, health tips, health theory, fasting tips, how to never get sick again, prevent disease, self help, self improvement, self development, personal development, inspiration, motivation

Id: oLR24u4PP38

Length: 58min 29sec (3509 seconds)

Published: Wed Aug 09 2023