keeping systematic inflammation at bay during the holidays
Ever wonder how to enjoy the holiday season and stay healthy? What is inflammation and how does it affect our health? How can we make simple changes to still live a healthy life while navigating the temptations of the holiday season?
Inflammation is such a buzz word these days. Not to say that it is not important because it is. But what exactly is inflammation? In this article, I will go through the physiology of inflammation, discuss why it matters and what we can do to keep it in check, particularly during the holiday season. Inflammation is a natural process in the body. It is usually invoked as a response to physical trauma, and it is a normal part of the body’s healing response. Imagine spraining your ankle. What happens? Swelling (edema), redness (erythema), heat and pain. Everything the body does meets two criteria: 1. It is a logical response (usually to trauma) and 2. The body works with what it has. But why this particular response? We’ll stick with the ankle sprain analogy, but it applies to many processes in the body. When you tore (partially or completely) that ligament in your ankle (sprain), the body launched into repair mode. Certain chemical signals were released to trigger “inflammation.” These signal molecules – called cytokines – cause the blood vessels to enlarge and brings in white blood cells to kick off the immune response. These white blood cells scavenge damaged tissue. They literally eat up injured tissue, so the body has a chance to repair the area. This increase in blood flow causes redness and swelling. Pain is caused by damaged tissue sending out certain pain-producing chemicals.
Pain is an essential warning system in the body that alerts you that something is wrong and requires your attention. If we did not feel pain, we could do ourselves more damage. Now that your ankle hurts, you will favor it, rest more, and allow the body to heal, so you will not further injure the area. Swelling discourages normal use and further encourages the affected individual not to use the damaged area. All of this speaks to #1 above: what the body does makes sense. This process will eventually resolve. The damaged tissue is removed, the body remodels as best as possible, and the anti-inflammatory process clears up the mess. However, sometimes this process is so out of balance that the inflammation continues and now acts like a wildfire instead of a controlled burn. This speaks to #2 above. If the body is skewed toward inflammation, we may not possess the resources to resolve the inflammatory response. Now we can look at pro- and anti-inflammatory influences. The biggest, of course, is food. You know those things we put into our bodies all day, every day? Pro-inflammatory food sources include anything high in Omega-6 fatty acids – grain-fed beef, vegetable oils (peanut, safflower, rapeseed, corn oil, canola, etc.) as well as refined grains and sugar (white flour, white sugar, high fructose corn syrup). Certain food additives (most notably MSG) also cause a level of neurological inflammation. Anti-inflammatory foods are higher in omega-3 fatty acids: wild-caught fish, grass-fed cattle, free-range chicken and eggs, green leafy vegetables, avocados, as well as whole-grains, fruits, and vegetables.
A protective double layer of fat surrounds every cell in the body. What we eat primarily determines the composition of this fatty shield. So if we are eating a pro-inflammatory diet, there are more omega-6 fats in this outer layer, and the body is primed to exhibit excessive inflammation. If we are more balanced, there are enough omega-3 fats in this layer to counter the omega-6s and help the body successfully resolve the inflammatory process. This greater balance also means we avoid the initial excessive inflammatory response. The average American today eats approximately a 15:1 ratio of omega-6:Omega-3 fatty acids. But evolutionarily, we formerly had a much more balanced diet, closer to a 3:1 ratio or even a 1:1 ratio. So, it’s all about getting back to a healthy amount of anti-inflammatory fats because they are the ones that put out the fire caused by the omega-6s. omega-6s are not the enemy because they perform a necessary bodily task. But unchecked inflammation can lead to cardiovascular disease, neurological issues, metabolic dysfunction, and many chronic health issues that plague modern society. The first thing to remember is that we are seeking balance. No one will see “no inflammation” in their body. It is a normal process that serves a purpose, just like it is impossible to have no toxic exposures or an “immaculate” diet. Chasing impossible ideals leads to a dangerous rabbit hole, making it very difficult to live a normal life. But working towards a more balanced diet and lifestyle is a very reasonable goal.
A common guideline I recommend to patients is to visualize their plates. Half should be vegetables. ¼ should be a healthy protein source (animal or otherwise) and the remaining ¼ should be fruit and healthy complex starches (sweet potato, quinoa, brown rice, squash, etc.). Cooking with avocado oil instead of vegetable oil will introduce more healthy fats and less inflammatory fats. Ensure that the meat you buy is grass-fed and grass-finished, the chicken is free-range (and organic if possible), and any fish is wild-caught instead of farm-raised as this will increase the number of anti-inflammatory fats. Grass-fed beef is more expensive than conventional beef, but the benefits to your health are well worth it. Another guiding goal I use is the 4:1 ratio. For every four servings of vegetables, eat one serving of fruit.
The ultimate goal is 5-9 servings of veggies and 1-2 servings of fruit every day. Just to clarify, corn and potatoes in this scheme are classified as starches and not vegetables.
Now have a quick side note about salads. A great pet peeve of mine is the idea that salads are not going to taste good. This is such a terrible misconception. Food should be enjoyable, and if you are eating plain spinach or lettuce with no embellishments, no wonder you hate salad. My salads look enticing. I start with a bed of greens (spinach, arugula, lettuce, romaine, spring greens, etc.), and then I add a variety of delicious toppings. I might add some feta, Parmesan, or goat cheese for the savory nature of cheese. I usually sprinkle on some chopped nuts (pecans, walnuts, almonds, etc.) for crunch. Sometimes a chicken breast or cooked salmon filet will top it all off. I make healthy dressings from balsamic and olive oil, or I do a 1:1 ratio of a classic dressing (bleu cheese, ranch, or Caesar) and extra virgin olive oil. My salads are delicious, varied, and contain a myriad of fun ingredients. This way, I do not get bored with them, and I can eat a large salad as a meal. This definitely helps get me closer to my daily goal of consuming 5-9 servings of vegetables.
Americans classically struggle with portion sizes. First of all, understand that a serving size of animal protein is 3 oz or about the size of the palm of your hand or a deck of cards. So, if you are truly eating only one serving size of grass-fed steak, even though it is more expensive per pound, the math generally works out because you are no longer eating 10-12 oz steaks. Another great “life hack” is to serve holiday meals on smaller plates. Satiety or feeling full is an interplay of food filling our stomach, the caloric content of the meal, as well as visual cues. Most humans keep eating until their plates are clear, and they will fill a plate with food. So smaller plates can lead to better portioning.
One of my favorite phrases is “balance is the hallmark of adulthood.” So much can be navigated by finding a balance instead of trying to live in the extreme. I like dessert, I frequently enjoy dessert, and I don’t view a “balanced life” as one devoid of dessert. I could say the same about coffee, pizza, alcohol or any number of “treat foods.” But I know that if I eat dessert every day or after every meal, I am not going to feel my best. So I seek a balance. I do not always make it to my goal of 5-9 servings of veggies each day. Balance is about knowing that some days I will eat better than others. I often educate patients about the 80:20 principle. If you stick to your health goals 80% of the time, then the other 20% won’t derail you. We do not have to be perfect to live a good life. As my husband likes to say, “Progress, not perfection.”
Balance at the holidays means adding healthy options. It is important for us humans not to feel deprived, or we are less likely to stick to our health goals. So think about pairing less healthy holiday foods with healthier holiday foods. Have a free-range organic roast chicken breast next to the honey-baked ham. Take a small portion of each. Have a fruit-based dessert next to the famous family fudge. Perhaps try out a low-calorie beer or wine this holiday season. Have a glass of water in between consuming other beverages. Place the pasta/potato casserole next to the green bean casserole and take a scoop of each. Also, give yourself some grace to relax and enjoy the holidays. Be more vigilant with your food consumption, exercise plan, hydration, and sleep in the days leading up to the big holiday work party or family dinner. Keep in mind that adding healthy choices to your plate is best, but don’t sweat the small stuff. In the grand scheme of things, one day is typically not going to make or break your health journey. Our habits determine the ultimate trajectory of our health. So view the holidays as a time to stick to your habits and try out some suggested swaps and compromises, so the holiday season is still enjoyable. Life is about balance; enjoying the season while still pursuing your health goals is definitely a worthwhile balance to seek.