Inflammation and the Mediterranean Diet

09/02/22 • 5 min

The Mediterranean Diet is the most anti-inflammatory diet studied.

The inflammatory response is the body's mechanism to fight infection, repair itself and rid itself of cancer. Inflammation is a coordinated response to trauma, infection, and cancer. Without inflammation, we would be dead within twenty-four hours.

Too little or too much

Too much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need.

Does diet play a role with inflammation? The answer is "sort of."

Short Course about Inflammation

Inflammation is involved in:

Wound healing, removing dead cells - breaking them down into components so they can be recycled
Removing and destroying bacteria
Inactivating and eliminating viruses
Destroying cells that have changed into cancer cells
Repairing injury from infection
Destroying parasites
Removes toxic chemicals
The immune system is one branch of the inflammatory response.

Five Signs of Inflammation

The five signs of acute inflammation and their Latin names:

Redness - in Latin this is called rubor.
Swelling - in Latin this is called tumor.
Fever - in Latin this is called calor
Pain - in Latin this is called dolor
Secretion - in Latin this is called fluor

Medical school teaches inflammation as one of the first series of lectures.

Simple Inflammation

Your finger was hit with a hammer. You have an injury to your finger. Some cells are injured. The cells send a distress signal, and immediately white blood cells begin to swarm into the area to help the injured cells. All that extra blood flowing to the area will lead to redness (rubor) and swelling (tumor). Soon, the finger will feel a bit hot (calor) and will have pain (dolor).

Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area.

Unwanted Inflammation

I love nature walks but like to avoid Poison Ivy.

Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy. We reduce the immune response by reducing hives and itching.

Rheumatoid arthritis is another example of unwanted inflammation. Rheumatoid arthritis is an auto-immune disease. The resulting inflammation leads to pain, fever, and joint destruction. The aim of the treatment is to reduce the inflammatory response that saves joints and improves well-being.

The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin.

Acute Disease and Inflammation

Heart disease is partially the result of inflammation. When you have a heart attack, the coronary arteries are blocked. As a result, a part of your heart muscle is without oxygen. The cells send out inflammatory signals, and you begin to feel pain (dolor). If the blood flow is restored, your cells can heal, but if it takes too long, some of those cells will die. Then your body will get rid of those dead cells and replace them with scar tissue. The result is that your heart becomes less effective.

Cardiovascular disease and inflammation

Plaque formation in the arteries is the result of genetics, diet, and inflammation. The increased cholesterol, either from the genetics or from a diet high in saturated fat, is deposited in the arteries. When cholesterol enters the artery wall, the body's inflammatory response tries to get rid of it, causing inflammation in the arteries. Did you know that 18-year-olds already have signs of early plaque formation in their arteries?

Chronic Inflammation

Chronic inflammation is when your body continues to send inflammatory signals, even when there is no acute injury or danger. This is what happens in rheumatoid arthritis, lupus, long Covid, and is involved in diabetes, obesity, dementia, and premature aging.

Western Diet and Inflammation

It is easy to obtain calories in western societies. In human history, we have gone from people on the verge of starvation to being overfed. We have also increased lifespan because of sanitation, vaccination, clean water, availability of food, and modern m...

Inflammation and the Mediterranean Diet

The Mediterranean Diet is the most anti-inflammatory diet studied.

Too little or too much

Too much inflammation results in wanton destruction of tissues, pain, fevers, and misery. It is associated with heart disease, cancer, aging. It is that delicate balance of inflammation we need.

Does diet play a role with inflammation? The answer is "sort of."

Short Course about Inflammation

Inflammation is involved in:

Wound healing, removing dead cells - breaking them down into components so they can be recycled
Removing and destroying bacteria
Inactivating and eliminating viruses
Destroying cells that have changed into cancer cells
Repairing injury from infection
Destroying parasites
Removes toxic chemicals
The immune system is one branch of the inflammatory response.

Five Signs of Inflammation

The five signs of acute inflammation and their Latin names:

Redness - in Latin this is called rubor.
Swelling - in Latin this is called tumor.
Fever - in Latin this is called calor
Pain - in Latin this is called dolor
Secretion - in Latin this is called fluor

Medical school teaches inflammation as one of the first series of lectures.

Simple Inflammation

Some cells are so badly injured that they are no longer viable. Your inflammatory reaction breaks down these cells, removes the debris, and recycles the parts to create new tissue in the area.

Unwanted Inflammation

I love nature walks but like to avoid Poison Ivy.

Sometimes, we want to decrease the immune response. Inflammation is the response of our skin to poison ivy. We reduce the immune response by reducing hives and itching.

The inflammatory response of COVID, influenza, or the common cold is reduced by the use of non-steroidal anti-inflammatory drugs, such as aspirin or Motrin.

Acute Disease and Inflammation

Cardiovascular disease and inflammation

Chronic Inflammation

Western Diet and Inflammation

Previous Episode

Cancer and The Mediterranean Diet

Adherence to the Mediterranean Diet decreases the risk of cardiovascular disease. The Seven Country Cohort Study clearly showed this.

But what about cancer? Does the Mediterranean Diet impact cancer or cancer prevention? To study this, another cohort study began called the EPIC study. Uniquely, the EPIC showed not only a decreased risk of cancer but also mortality from cancer.

All vegetables, even the green ones, have nitrates. It turns out that the components of The Mediterranean Diet decreases the risk of cancer, decreases the risk of cancer recurrence, improves survival from cancer, and decreases overall mortality.

EPIC Study

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a large cohort study involving over 521,000 individuals from 23 centers from ten countries.

Adherence to the Mediterranean Diet and Longevity

The EPIC researchers developed a simple scoring system to determine adherence to the Mediterranean Diet. Greater adherence to the Mediterranean Diet was associated with longevity.

The Scoring System

The Mediterranean Diet is scored on a scale of one to nine. Nine being a perfect Mediterranean Diet Score, and zero being poor. Great adherence to the Mediterranean Diet is a score of seven points or more.

Eating more of these foods gives you points

The Mediterranean diet is rich with vegetables, legumes, fruits and nuts, whole grains, and fish.

You get a point for consuming 9 ounces or more of vegetables a day. If you consume less than nine ounces, you get a score of zero.
Legumes will net you a point if you consume two ounces or more per day.
Fruits and nuts are one point for nine ounces or more.
Likewise, whole grains are worth a point for nine ounces or more.
Fish is an average of an ounce a day, or two main meals per week. Thus, by consuming a diet rich in these five components can score five points.

The weight is based on pre-cooked food.

Lentils are a legume, and if you consume more than 2 ounces per day, you will score one Mediterranean Diet point. They are high in protein and fiber and low in saturated fat.

Eat Less for More

People from the Mediterranean didn't eat much meat or dairy. By consuming less of these, you can achieve Mediterranean Diet points.

Eating less than 4 ounces of meat a day is worth one point
Consuming 1.5 ounces of hard cheese a day or LESS is worth one point
Consuming less than 8 ounces of dairy is worth one point (mostly consume yogurt).

Thus by eating less dairy and meat, or none, you can score two additional points.

You might think that 6-ounce burger is small, but if you eat less than four ounces of meat a day, you get one Mediterranean Diet point. Eat more than four ounces, and you get zero points.

Alcohol

Alcohol is a component of the Mediterranean Diet but in moderation.

For ethanol, a value of 1 was assigned to men who consumed between 10 and 50 g per day and to women who consumed between 5 and 25 g per day. This corresponds to 5 ounces of wine for women or 10 ounces for men.

Olive Oil

Olive oil is an important component of the Mediterranean Diet. The type of fat in olive oil is mainly monounsaturated. The ideal ratio of olive oil or monounsaturated fats to saturated fats should be at least 60%.

The best olive oils come from the US.

Interventions in the Mediterranean Diet

Increasing the score in the Mediterranean Diet by two points in the Mediterranean diet led to an 8% reduction in mortality.

Imagine a simple dietary intervention leading to a decrease in mortality.

Colorectal Cancer and the Mediterranean Diet Components

In a recent update of the Mediterranean Diet they found a higher consumption of fruits and vegetables combined led to a decrease in colorectal cancers. But just eating fruits alone or just vegetables alone didn't do it. Proving again, the entire dietary pattern is important.

A Mediterranean Diet score of 6-9 led to an 11% decrease risk of colorectal cancer!

If you eat a lot of red meat but eat a lot of vegetables, your risk of colon cancer decreases.

Breast Cancer and the Mediterranean Diet

The Mediterranean Diet was ...

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Mediterranean Diet - Fats

Perhaps the most important part of the Mediterranean Diet is this plant.

Olive oil is the single ingredient most associated with the Mediterranean Diet. It is the one single food substitution you can do that will improve your health immediately and have great consequences. But not all olive oil is the same.

Olive oil and your heart

There are many types of fat that you can find in your diet. Saturated fat will raise your LDL level, increasing your risk of heart disease and stroke. Olive oil, which is unsaturated, decreases the risk of heart disease.

Types of Fat

Fats are confusing. You will hear saturated, poly unsaturated, monounsaturated, and trans fats. First, we won't look at the chemical structure of fats. Second, we will look at the evidence that the food is associated with fat and how it influences our bodies. Finally, we will dismantle some bad arguments against certain fats.

Saturated Fats - it's the source, not the ingredient

Sources: butter, red meat, dairy.

What the Mediterranean Diet showed us what that the total diet mattered more than the individual ingredient. In spite of the revolutionary approach to using cohort studies with complete diets, many have insisted on pulling that apart to find out if one ingredient is "bad." For years, saturated fat was considered the "bad" part of what we ate. The American Heart Association recommended limiting saturated fat to just ten percent of what you eat. The AHA recommended changing from saturated fat to polyunsaturated fat or monounsaturated fat. There has never been a question about olive oil, but a few concerns have been raised about some polyunsaturated fat.

But it isn't as simple as the saturated fat molecule. We don't eat pure saturated fat, it turns out we eat food containing that fat. Depending on the food, it depends on how saturated fat affects you.

Dairy and Fish vs Red Meat

Adding more fish and dairy to your diet decreases the risk of heart disease. Adding more red meat to your diet increases your risk of heart disease. This study, from the EPIC group, was impressive in its size, and its ability to factor out other issues that might increase heart disease. Once again, cohort studies show it isn't as important.

Cheese

Besides heart disease, cheese decreased the risk of dementia among a cohort of Finnish men followed for 22 years.

Perhaps the greatest snack of all time (my opinion - not science).

Another cohort study found that cheese was associated with a lower risk of pre-diabetes. Other forms of dairy products did not have this same benefit. This flies in the face of some vegans, who insist diabetes comes from saturated fat.

Finally, non-dairy cheese is not a great source of nutrients. I know my fellow vegans want to find a good alternative for cheese, but there simply isn't one.

Proving again that the whole food is greater than its parts, fish.

Fatty fish have been shown to decrease not only cardiovascular mortality, but all causes of mortality. But not fish oil.

Who doesn't love a good salmon?

Fish consumption has been associated with a lower risk of heart disease. Further, fatty fish decreases the risk of all-cause mortality.

Fatty fish contain high quantities of omega-3 fatty acids. Our body cannot make these fats, we must get them from our diet. Here are the fish that are high in omega-3 fatty acids:

salmon
sardines
mackerel
herring
lake trout
canned light tuna

Even tilapia has some omega-3 fatty acids, in fact, it has about four times as much omega-3 fatty acids as grass-fed beef. However, tilapia has ten times less omega-3 fatty acid as salmon. Some have discouraged the consumption of