Inflammatory Foods

Science is uncovering close connections among food, inflammation and heart disease. Here's what you should know.

As a nutrition professor, I thought I was up to speed on which healthy habits can help you prevent heart disease-until a few years ago when my University of Vermont colleague Paula Fives-Taylor, Ph.D., rattled my thinking. In a riveting lecture, this professor of microbiology and molecular genetics explained that something as simple as flossing your teeth regularly could make a big difference in reducing heart disease risk. (That's when my jaw dropped.) Since flossing keeps plaque-forming bacteria from invading gum tissue, she explained, it helps prevent the body's immune system from launching into defense mode-a process known as inflammation. Inflammation, she added, was now understood to be both a warning sign and a trigger for a number of medical conditions including heart disease.

Fives-Taylor was onto something. Today, inflammation is so widely linked to heart disease, many physicians routinely order tests for a key marker of inflammation, C-reactive protein (CRP), as readily as they do cholesterol tests.

Heart Healthy Recipes and Menus
Healthy Chicken Recipes
Healthy Recipe Collections

How Inflammation Harms the Heart
It seems counterintuitive, but inflammation begins with the body's way of defending itself against harm. We've all experienced it as part of the normal healing process after a scrape or cut. Waves of immune cells rush to the injury, combatting threatening pathogens and sometimes causing heat, redness and swelling. But the new thinking is that serious health problems begin when inflammation overstays its welcome, persisting in a chronic, low-grade state in which some immune cells remain activated even though they're not needed.

We used to think heart disease resulted from deposits of fatty plaques in our arteries, like the buildup of rust in a water pipe. But we now know that heart attacks rarely happen simply due to this buildup. Far from being mere "pipes," arteries are active participants in the progress of heart disease, both attracting and harboring cells that release inflammatory substances. The result is a fatty plaque that forms within the artery walls and is a target for yet more inflammatory damage. According to my friend Penny Kris-Etherton, Ph.D., R.D., distinguished professor of nutrition at Penn State, "inflammation plays a key role in weakening arterial plaque, causing the deposits to rupture-which can lead to sudden coronary death, heart attack or stroke.

Anything you can do to lower your level of inflammation, then, can go a long way toward reducing your risk for heart disease. Your doctor may recommend a daily dose of aspirin, the original anti-inflammatory drug. Also, since body fat is itself a source of inflammation, losing extra pounds can help-as can increasing your fitness level. And exciting research is showing that what we eat can make a difference too.

How Diet Can Help
Numerous studies show that individual foods and nutrients can either stoke or subdue the inflammatory process. The foods that inflame aren't new villains: they are saturated fats and trans-fatty acids, along with high-glycemic-index carbohydrates like refined starches and sweets, which the body quickly converts to glucose.

It's old news that saturated fats and trans fats increase LDL ("bad" cholesterol) in the blood, but we now know that too much LDL can start a cascade of inflammatory events. When it accumulates in artery walls excessively, LDL undergoes chemical changes, including oxidization; the body interprets these changes as "danger" and responds by drawing inflammatory compounds into arteries. This process ultimately results in both the buildup of plaque and chronic inflammation.

The anti-inflammatory prescription, then, begins with avoiding anything that increases LDL, and it's a familiar refrain: Limit intake of full-fat animal products and read labels to avoid common trans-fat sources like commercial cakes, cookies, crackers, pies and breads. Focus on getting more omega-3 fats, which the body converts to substances that decrease inflammation. And, since elevated blood sugar can stoke some of the chemical changes that render LDL more dangerous, it makes sense to limit your intake of refined grains and other high-glycemic-index carbohydrates like white bread and potatoes.

Instead, try to get more of what I call "inflammation soothers": foods that inhibit LDL and help prevent reactions that spark inflammation. The list is long and includes foods high in healthy mono-unsaturated and omega-3 fats (like extra-virgin olive oil and canola oil, fatty fish, nuts and seeds-particularly omega-3-rich walnuts and flaxseed), along with antioxidant-rich fruits and vegetables. (A few surprising "extras" like red wine, cocoa and turmeric have shown promising anti-inflammatory activity in some studies.) Whole grains and legumes are also key. And phytosterols, cholesterol-lowering plant compounds that are turning up in some brands of low-fat yogurt, orange juice, butterlike spreads and granola bars, also may help reduce inflammation.

But rather than just concentrating on individual foods, Kris-Etherton and other experts recommend focusing on an overall dietary pattern that combines these foods for additive and/or synergistic effects. The renowned Mediterranean Diet pattern, rich in plant foods and seasoned with olive oil, is one of many healthy models that fit this description.

Of course, lowering LDL cholesterol remains the cornerstone of reducing your risk of heart disease. But it's clear that inflammation plays an important role, too, and soothing the flames of inflammation is within our power.

So lose weight if you need to, take a daily aspirin if prescribed and make sensible food choices. As you can see, there's plenty of common ground between anti-inflammatory eating and healthy eating in general. You've undoubtedly heard this advice before, but now there are new reasons to act on it.

Oh, and don't forget to floss.

Recipes

Penne with Braised Squash & Greens
This chunky sauce is laced with chard and accented with smoked tofu. Convenient packages of peeled and diced butternut squash are available in most supermarkets in the fall and winter.

Makes 4 servings, 1 3/4 cups each

ACTIVE TIME: 40 minutes
TOTAL TIME: 40 minutes
EASE OF PREPARATION: Easy

2 teaspoons extra-virgin olive oil
4 ounces cubed smoked tofu
1 medium onion, chopped
3 cloves garlic, minced
Pinch of crushed red pepper
1 1/2 cups vegetable broth
1 pound butternut squash, peeled and cut into 3/4-inch cubes (3 cups)
1 small bunch Swiss chard, stems removed, leaves cut into 1-inch pieces
8 ounces whole-wheat penne, rigatoni or fusilli
1/2 cup freshly grated Parmesan cheese
1/4 teaspoon salt, or to taste
Freshly ground pepper to taste

1. Put a large pot of water on to boil for cooking pasta.
2. Heat oil in a large nonstick skillet over medium heat. Add tofu and cook, stirring, until lightly browned, 3 to 5 minutes. Transfer to a plate. Add onion to the pan; cook, stirring often, until softened and golden, 2 to 3 minutes. Add garlic and crushed red pepper; cook, stirring, for 30 seconds. Return the tofu to the pan and add broth and squash; bring to a simmer. Cover and cook for 10 minutes. Add chard and stir to immerse. Cover and cook until the squash and chard are tender, about 5 minutes.
3. Meanwhile, cook pasta until just tender, 8 to 10 minutes or according to package directions. Drain and return to the pot. Add the squash mixture, Parmesan, salt and pepper; toss to coat.

NUTRITION INFORMATION: Per serving: 386 calories; 7 g fat (2 g sat, 3 g mono); 9 mg cholesterol; 66 g carbohydrate; 17 g protein; 10 g fiber; 715 mg sodium. Nutrition bonus: Vitamin A (340% daily value), Vitamin C (80% dv), Calcium (25% dv), Potassium (22% dv).

More Heart Healthy Recipes and Menus

Baked Cod Casserole
The combination of wine, Gruyere cheese and toasty bread in this fish casserole evokes the flavors of fondue...a perfect winter food. Choose Pacific cod, it's an ocean-friendly choice. Make It a Meal: Serve with steamed broccoli and a glass of Sauvignon Blanc.

Makes 4 servings

ACTIVE TIME: 20 minutes
TOTAL TIME: 40 minutes
EASE OF PREPARATION: Easy

2 tablespoons extra-virgin olive oil, divided
2 medium onions, very thinly sliced
1 cup dry white wine
1 1/4 pounds Pacific cod, cut into 4 pieces
2 teaspoons chopped fresh thyme
1/2 teaspoon kosher salt
1/2 teaspoon black pepper
1 1/2 cups finely chopped whole-wheat country bread (about 2 slices)
1/2 teaspoon paprika
1/2 teaspoon garlic powder
1 cup finely shredded Gruyere or Swiss cheese

1. Preheat oven to 400°F.
2. Heat 1 tablespoon oil in a large ovenproof skillet over medium-high heat. Add onions and cook, stirring often, until just starting to soften, 5 to 7 minutes. Add wine, increase heat to high and cook, stirring often, until the wine is slightly reduced, 2 to 4 minutes.
3. Place cod on the onions and sprinkle with thyme, salt and pepper. Cover the pan tightly with foil; transfer to the oven and bake for 12 minutes.
4. Toss the bread with the remaining 1 tablespoon oil, paprika and garlic powder in a small bowl. Spread the bread mixture over the fish and top with cheese. Bake, uncovered, until the fish is opaque in the center, about 10 minutes more.

NUTRITION INFORMATION: Per serving: 328 calories; 13 g fat (4 g sat, 7 g mono); 69 mg cholesterol; 16 g carbohydrate; 29 g protein; 4 g fiber; 414 mg sodium. Nutrition bonus: Calcium (25% daily value), Zinc (20% dv), Fiber (17% dv). 1 Carbohydrate Serving. Exchanges: 1 starch, 1 vegetable, 4 lean meat.

More Heart Healthy Recipes and Menus

Spicy Vegetable Soup
Fresh basil adds a bright spark to this vinegary, vegetable-stuffed soup, full of the traditional flavors of the Mediterranean. Alternatively, pesto adds a nutty richness to the soup.

Makes 4 servings, about 2 1/4 cups each

ACTIVE TIME: 30 minutes
TOTAL TIME: 40 minutes
EASE OF PREPARATION: Easy

2 tablespoons extra-virgin olive oil
1 large onion, diced
1-3 teaspoons hot paprika, or to taste
2 14-ounce cans vegetable broth
4 medium plum tomatoes, diced
1 medium yellow summer squash, diced
2 cups diced cooked potatoes (see Ingredient note)
1 1/2 cups green beans, cut into 2-inch pieces
2 cups frozen spinach (5 ounces)
2 tablespoons sherry vinegar or red-wine vinegar
1/4 cup chopped fresh basil or prepared pesto

Heat oil in a Dutch oven over medium heat. Add onion, cover and cook, stirring occasionally, until beginning to brown, about 6 minutes. Add paprika and cook, stirring, for 30 seconds. Add broth, tomatoes, squash, potatoes and beans; bring to a boil. Reduce heat to a simmer and cook, stirring occasionally, until the vegetables are just tender, about 12 minutes. Stir in spinach and vinegar; continue cooking until heated through, 2 to 4 minutes more. Ladle soup into bowls and top with fresh basil or a dollop of pesto.

NUTRITION INFORMATION: Per serving: 253 calories; 8 g fat (1 g sat, 5 g mono); 0 mg cholesterol; 40 g carbohydrate; 9 g protein; 10 g fiber; 485 mg sodium; 1032 mg potassium. Nutrition bonus: Vitamin A (270% daily value), Vitamin C (60% dv), Folate (44% dv), Potassium (30% dv), Calcium (20% dv), Iron (20% dv).

Ingredient Note: Convenient cooked and diced potatoes can be found in the refrigerated section of the produce and/or dairy department of the supermarket.

MAKE AHEAD TIP: Cover and refrigerate for up to 2 days.

More Heart Healthy Recipes and Menus

From www.eatingwell.com with permission.  © 2008 Eating Well Inc.