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Wednesday, July 20, 2011

How to Avoid Inflammation of Your Arteries

Inflammation of the blood vessels and other bodily tissue has become increasingly recognized as being complicit in heart disease, arthritis, and decline of mental capacity. Fortunately, the choices we make concerning what and how much we eat and drink, and how much exercise we do, can dramatically influence the degree of inflammation we experience. The information presented herein concerning lifestyle factors that affect inflammation, comes from a review article by O’Keefe, Gheewala, and O’Keefe in the Journal of the American College of Cardiology (vol. 51, no. 3, 2008).

Meals that are high in calories, and/or contain easily digestible, quickly absorbable, calorie-dense processed food and drink result in spikes in blood glucose and triglycerides (blood-borne fats), overwhelming the body’s ability to process them. Oxidative free radicals are then produced which attack the lining of the arteries (endothelium), inflaming them, causing them to constrict, and building up fatty deposits (atherosclerosis). In contrast, smaller meals containing ingredients that digest more slowly (e.g. fiber) produce smaller surges in blood sugar and triglycerides, and are thus not inflammatory.

Even a single meal high in saturated fat results in an increase of triglycerides, oxidative free radicals and inflammation, which negatively affects the function of the endothelium, causing constriction of the arteries, and raising systolic blood pressure.

A high glycemic meal is one that causes a spike in blood glucose. The Glycemic Index rates foods in comparison to glucose. Foods scoring closer to 100 cause relatively large spikes in blood sugar, while foods scoring closer to zero produce relatively small spikes. See a table listing the glycemic index of various foods from Harvard medical school. The body often responds to high glycemic index foods with insulin surges that remove sugar from the blood and can actually result in low blood sugar (hypoglycemia), an ebb in energy, and hunger. Regularly eating this way predisposes one to excess fat on and around the organs below the abdominal muscles (visceral fat) which, in turn, leads to inflammation and insulin resistance and raises the risks of diabetes, high blood pressure, and cardiovascular disease.

Dietary changes that reduce the magnitude of the triglyceride spike following meals by 20% and 40% respectively have been shown to reduce the risk of coronary artery disease by 30% and 40%. In addition to avoiding foods with a high glycemic index, adding certain foods to the diet can slow down digestion and reduce the spikes in glucose, insulin, and triglycerides. For example, nuts eaten along with a high-carbohydrate meal slow digestion and reduces blood sugar spikes by 30-50%. This both reduces oxidative stress, and provides antioxidants that combat such stress. In fact, a Mediterranean diet supplemented with either 30 grams of nuts or olive oil was found to reduce systolic blood pressure, blood sugar, and biomarkers of inflammation significantly better than a low-fat diet. Eating nuts 5 times per week was found to reduce risk of diabetes and cardiovascular disease by 20-50%. Quality protein sources low in saturated fat have a similar beneficial effect. These include egg-whites, lean meats, fish, casein, and whey protein, among others. Fish oil lowers triglyceride levels by 16-40%.

As expected, physical exercise has a positive effect, reducing post-meal spikes in blood sugar and triglycerides. Exercise is most beneficial in this regard if it is done within 2 hours before or after a large meal. Loss of body fat by diet control and/or exercise can also reduce post-meal spiking of blood sugar and triglycerides.

Alcohol consumption shows a J-shaped relationship with inflammation and blood sugar spiking, in addition to various other health problems such as coronary artery disease, diabetes, stroke, dementia, and all-cause death, with the lowest levels of these problems at 1-2 drinks per day for men and 0.5-1 drink a day for women. The J-shape means that drinking no alcohol increases the risk of these problems somewhat, while drinking in excess greatly increases the risks of these problems.

Characteristics of Inflammatory Meals

  • High in calories
  • High in calorically-dense foods
  • High in saturated fat
  • High in refined carbohydrates
  • Contain foods with high glycemic index

Characteristics of Diets That are Not Inflammatory
  • Smaller meals spread over the day
  • Low in saturated fat
  • Low in, or free of trans fats
  • Low in processed carbohydrates
  • Low in foods with high glycemic index
  • High in unprocessed fruits and vegetables rich in antioxidants
  • High in nuts, seeds, and whole grains
  • Contain vinegar (1-2 tbsp eaten with a meal high in refined carbohydrates reduces the blood sugar spike by 25-35% and reduces hunger)
  • Moderate amounts of lean animal protein
  • Moderate amounts of beneficial fats such as fish oil and monounsaturated oils (e.g. olive,canola)
The following Foods High in Antioxidants Help Prevent Oxidative Damage to the Endothelium
  • Berries
  • Red wine
  • Chocolate
  • Tea
  • Pomegranates
  • Cinnamon (also reduces glucose spike caused by high-glycemic-index meal)
If you are concerned about the possibility of inflammation in your arteries, you can ask your doctor about testing the C-reactive protein level in your blood when you get a checkup. However, if your total cholesterol level is below 200 and your HDL level is above 55, it is very unlikely that you have a problem with arterial inflammation. If your C-reactive protein level is above 1.0 or the ratio of your total cholesterol level to your HDL level is above 4.0, you would likely benefit from following an anti-inflammatory diet and exercising regularly.