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Hey Doc! What's the best diet for me?

Many people ask me what diet they should follow.

Paleo diet? Keto diet? Mediterranean diet?

My answer is, it depends what you want to accomplish, but many of these diets have a few key health benefits in common.

What we are trying to accomplish with good nutrition is to decrease the driver of chronic disease which is inflammation.

Inflammation contributes to the development and progression of many diseases such as diabetes, metabolic syndrome and heart disease.

The goal of an appropriate diet is to balance dietary macronutrients - that is balancing the protein and the glycemic load (how much a food raises blood glucose after ingestion).

When you do that, you decrease overall inflammation in the body.

An anti-inflammatory diet has been shown to be of benefit in other chronic diseases like asthma, COPD, Alzheimer’s disease, rheumatoid arthritis, eczema, and inflammatory bowel disease among others.

For this reason, I am a proponent of the anti-inflammatory diet and teach my patients at Vermont Integrative MD about this diet.

The essence of an anti-inflammatory diet is a diet containing lots of fruits and vegetables, minimally processed foods, healthy fats such as omega 3 fatty acids, whole grains and healthy plant-based or meat-based proteins.

Good foods to incorporate in your diet include foods rich in omega 3 fatty acids (containing EPA and DHA), polyphenols which are powerful anti-oxidants, and non-starchy vegetables.

Think LOTS of color on your plate! (and No, Skittles don’t count!).

Omega 3 fatty acids are in foods like fish (tuna, mackerel, salmon) walnuts, and avocados and help decrease overall inflammation in the body by affecting gene expression involved in inflammation.

Alpha-linoleic acid is another form of omega-3-fatty acids that is found in plants such as flaxseed, hemp, chia seeds, and walnuts; however, only 1% of the original ALA is converted to the physiologically effective EPA and DHA.

Polyphenols are compounds rich in anti-oxidants that are found in a variety of fruits and vegetables. Anti-oxidant rich foods (like berries) can help protect our bodies against free radical damage. Free radicals are produced by our bodies to help fight off infections but in excess can cause significant inflammation and tissue damage.

What about grains?

When choosing grains, it’s important to select grains with a low glycemic index. That means those foods cause a lower spike in blood sugar levels after ingestion. Foods that cause the fastest and most drastic rise in blood sugar levels include white bread and glucose.

Examples of low glycemic index foods include oat-bran bread, rye bread, lentils, mung beans, apples, cashew nuts, peanuts, semolina, beetroot, carrots, strawberries and yogurt. Pastas and potatoes generally have high glycemic load so these foods should be eaten in limited amounts.

Glycemic load is a more accurate way to account for how quickly a food’s carbohydrates are converted to glucose and also calculates the relative amounts of carbohydrate in the food in an average serving.

Several studies have show that eating a diet high in glycemic load has been associated with a greater chance of developing type 2 diabetes, heart disease and certain cancers.

High glycemic load leads to larger and faster release of insulin, which can eventually cause blood sugar levels to fall below fasting levels several hours after eating. This causes a rebound Hypoglycemia or low blood sugar which can often lead to fatigue.

In contrast, eating foods with low glycemic load can help with individuals with insulin resistance lose weight and can help decrease the risk of developing diabetes.

When choosing fruits and vegetables, be sure to buy at least the following foods organic (The “Dirty Dozen” list):

Strawberries, spinach, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes and sweet bell peppers. These foods contain the highest amount of pesticides when grown conventionally.

Make sure to get at least 5 servings of fruits and vegetables to ensure you are getting adequate beneficial vitamins and minerals. More than 5 servings / day has been associated with lower levels of inflammatory markers. It has been shown in numerous studies that individuals who consume more fruits and vegetables have lower rates of inflammatory disease such as heart disease, stroke, and cancer. Blueberries and cherries have been shown to decrease the amounts of inflammatory molecules called cytokines in the body.

Protein is also important, but the source of protein matters too.

When purchasing meat, you should get grass fed beef is best because that meat is higher in the good omega-3 – fatty acids versus cows fed conventional grain whose meat is high in omega-6-fatty acids which are pro-inflammatory.

Fish can contain high levels of mercury and wild caught salmon has less pesticides than farm raised salmon.

Generally big fish like swordfish and tuna have higher levels of mercury. Check out the FDA website for the amount of mercury in fish and aim to eat seafood that has lower mercury content

Free range eggs have a much more favorable omega 6/ omega 3 ratio than conventionally raised eggs.

What about herbs and spices?

Certain herbs and spices like Tumeric and nutmeg can suppress or inhibit inflammatory markers that can contribute to inflammation.

Ginger, oregano, rosemary, clove, cumin, and cayenne also have anti-inflammatory properties.

So go ahead and flavor your food!

Magnesium intake is also critical. Magnesium is a mineral that is necessary in the function of over 200 important enzymes in our body including in mitochondrial energy production (the powerhouse of the cell).

Magnesium can be obtained in the diet by eating leafy green vegetables, fruits, nuts, legumes, and whole grains.

It has been shown that diets containing low magnesium intake below the recommended dietary allowance can be linked to higher levels of an anti-inflammatory marker called C-reactive protein.

SO what’s the bottom line?

The more inflammatory foods we eat (like red meat, high fat dairy, trans fats and refined carbohydrates) the more inflammation that can occur in the body increasing our potential for developing chronic illness.

Eating more whole foods, minimally processed foods, more fruits and vegetables, healthy fats and whole grains can help decrease overall inflammation in the body keeping us healthier and limiting the potential to develop chronic diseases.

You'll find that if you are able to incorporate these concepts into the way you grocery shop, cook and eat,

you'll have more energy, feel better and improve your health!

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