Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Tuesday, July 21, 2009

Low Carbs Lower Triglycerides

Blood Triglycerides Depend on Diet Carbs, not Fats

I don’t know why the medical community keeps pushing the low fat diets to modify blood lipids. The medical literature shows that a low fat, high carbohydrate diet (more than 50 grams of starch/sugar in a meal) produces high triglycerides, and a low carb diet ( less than 50 grams per meal), regardless of saturated fats and meat, produces lower triglycerides.

In seems reasonable that fats in the diet should mean fats, triglycerides, in the blood, but that ain’t so. It’s the rise in blood insulin in response to a rise in blood sugar due to high glycemic index foods in a meal, that yields high blood triglycerides.

The low carb, low triglycerides facts of life were brought to may attention by my wife’s blood chemistry. She knows better, but refuses to follow my preacherly suggestions about an anti-inflammatory diet. She follows most of the use of supplements and prohibitions about vegetable oils, but loves carbs. She eats two thick slices of bread in a sandwich and I cut a thinner slice and eat mine open-faced. I can’t eat her pancakes or French toast. Ok, I eat lots of dark chocolate, but I don’t have flavored syrup in my lattes.

She was stressed by a high triglycerides (292 mg/dl) in her blood work and her doctor wanted to start her on meds. I was sympathetic. Not really. I actually said, “carbs, carbs, carbs,” until she threatened me. I nagged heavily to just junk the junk and wait on the meds. She started counting grams of carbs with each meal. Actually she tried to average over the whole day, I nagged, she finally relented and stuck to the plan. No more than 50 grams of carbs in any meal. (I think 30 grams, would actually be better.)

One month later, her blood work showed triglycerides down 57% to 127 mg/dl. Individual results may vary, but this is pretty straightforward. Carbs are important -- avoid them. The food pyramid is for chumps. The highest glycemic food you will encounter is a French baguette (95), compared to pastas in the 30s or table sugar at 70.

The facts are:
  • Saturated fats in meat are no big deal, and much better than...
  • Vegetable oils (most are rich in omega-6 oils, except olive oil) are inflammatory.
  • Fish oil (omega-3 DHA/EPA) is anti-inflammatory (unless there is also too much vegetable oil.)
  • Starch and sugar increase blood triglycerides and are only needed to gain or keep body fat. Losing weight is much easier without starch/sugar.
  • Most people are deficient in vitamin D and C (even with plenty of solar exposure).
  • High fructose corn syrup is ten times more damaging than starch/sugar, and is especially bad for diabetics. It doesn’t raise blood sugar as much as starch, it just causes damage, e.g. glycation, at an extraordinarily high rate. It also ages skin by accelerating cross-linking of collagen. Very bad stuff even in fruit juices.
  • Eating plant anti-oxidants protects unsaturated fats as they pass through the oxidizing environment of the stomach, so nuts are better unroasted and eaten with veggies.

28 comments:

Jim Purdy said...

Sometimes you get a little too technical for me, but I understand and agree with this.

You said:
"The food pyramid is for chumps."

Anonymous said...

Thank you for your research and writing. It is great. I have a puzzle that you might have some insight to, if you wouldn't mind. I've been very low carb since Oct 2007(Gary Taubes's GCBC being my inspiration), which meant that I mostly ate fatty meat and back then, salads with dressing. Six months later I figured out to eliminate PUFA's. About three months after that I started to have intermittant bouts of bruising. I do karate so I get hit in the arms a lot. I think it might be that from mid to late summer Costco has fresh salmon which I eat about once a week. Could that be the cause?
Melinda

Dr. Art Ayers said...

A puzzle... You have my attention.
Low carbs and lots of omega-3s. Sounds like anti-inflammation to me.

I know karate bruises well. I was on the varsity karate fighting team at UCSD and our head coach was Haditaka Nishimura, the head instructor for the Japanese Karate Federation.

I think that my diet in college was typically inflammatory, which meant that clotting was pretty fast. (All the blood on my ghee was someone else's.)

My impression is that heparan sulfate proteoglycans that orchestrate clotting are reduced in inflammation. That breaks down blood/organ barriers because the integrity of basement membranes that compose the barriers have heparan sulfate as a critical component. That reduction of heparan sulfates in chronic inflammation means that thrombosis, blood clots, and blood vessel blockage is a problem.

In your case, you may have oversolved the thrombosis problems and gone beyond inflamed into immunosuppressed. Happily that means that you are modestly anti-inflammatory. That is a good place to be if you want to be fertile, but it means that you may be flirting with susceptibility to infection. Remember that grains may have been the solution to the problem of dense populations by producing inflammation to protect against epidemics. Salmon runs brought seasonal relief from inflammation and fertility.

I think that anything that you do more similar to the TV diets will moderate your bruising. A Mac with fries should add enough inflammation to make you tolerate blocks with impunity.

You sound like a green belt. I studied shodokan karate starting in 1965. My left footed round house kick could stop our assistant coach. What style are you?

Thanks for the puzzle.

Anonymous said...

Thank you for the thoughtful answer. I'm about your age but I started karate only 4 years ago, Shudokan style, and I've just made the rank of Ichikyu. My kicks could be stronger and they are not much past belt high. This is an area I have to work on.

We live in the Tri-Cities, WA so I think we're in the same time zone.

I never bruised as a kid and now I know why. Ditto on infertility. After reading through all your posts I am moderating my diet to focus on GI track health. I'm going to add 3 tablespoons of yogurt per day. I like the Big Mac and fries idea but I'll think of something less dire.

Melinda

Kevin said...

Hi Dr A,

Earlier you mused on the fats in an Atkins-style diet: where does it go if not in the stool? The bruising of the karate student on a diet of fatty meats made me wonder, considering a high-fat diet increases blood pressure, could the excess fat be getting stored in the arterial walls, making them more susceptible to bruising?

Just a thought,

kevin

Dr. Art Ayers said...

Kevin,
I am of course just speaking from prejudices, since I am not an MD and we don't have any info on clotting times, etc., but my inclination is to assume that the vessels have not changed and the clotting time has increased. If the vessels are weaker, that implies a significant structural change associated with inflammation, e.g. fat depostion. But it is my impression that most fat is striated on the surface and not the more severe, bubble cell deposition, that I associate with mechanical damage and fat deposition at the site of inflammation.

Inflammation will decrease heparan sulfates, weaken the extracellular matrix and increase clotting. Anti-inflammation will do the opposite. Since heparan sulfate is also used in LDL receptor function, I would expect anti-inflammation to enhance offloading lipids, but only until saturation.

So I shift to clotting that is inhibited by intact surfaces rich in heparan sulfate. Blood released by injury compromised vessels will spread through tissue lined with heparan sulfate, i.e. a bruise, unless there is inflammation.

I think it is safest to retain the anti-inflammatory diet and improve the blocking technique to achieve glancing contact with less tissue damage than direct impact. Bruises on forearms = my bad technique, bruises on shins = opponent's bad technique.

Aaron said...

Couple things:

1: does your typical high-fat diet really raise blood pressure after adaption as Kevin has mentioned.

2: i'm with you on the theory that clotting time has increased. People on low polyunsaturated fat diets have longer clotting times. Also, I remember reading on Seth Roberts blog-- that people were really having good results with bruises and gum health by using flaxseed oil (interesting that polyunsatured oils decrease clotting time -- heart disease anyone!!). Also, because polyunsaturated fats shut down immune response-- it might be possible to conjecture that your body isn't even healing the damaged site as fast because of a lack of immune reponse (however, i think it has to do with clotting times). I think theres better ways to handle the problem. Up your K2 intake or foods that contain it like organs/butter/cream.

Also, Dr. Ayers, it would be interesting if you could chime in with ways to improve immunity on anti-inflammatory diets-- these methods would increase white blood cell action while maintaining your anti-inflammatory status

maybe substances like alkylglycerols?

i ask this because many diseases that are bacterial in nature seem to hide around the body and cause insidious things to happen. How can we make sure an anti-inflammatory diet is not contributing to this?

Anonymous said...

Kevin,
Hypertension was one of the main motivators for switching to this way of eating. It worked great. I was able to discontinue all meds after a half year of very low carbs (5-10 per day).

Good advice, Dr. Ayers, I'll work on improving my technique. My karate partner has lean strong arms, not much padding and when we get intense we strike and block hard.

Melinda

Dan said...

While on topic, do you have a view about the additive effect of multiple numerous supplements on bleeding issues? For instance, fish oil (and vegetable oil avoidance), aspirin, turmeric, vitamin D, resveratrol, IP-6, vitamin E, vitamin K2, melatonin, and many foods (garlic, broccoli, cinnamon) all effect clotting (and not all the same way). Some people may indeed take all of these (and more).

I myself take fish oil (and avoid vegetable oils), aspirin, D3, IP-6, K2, and melatonin regularly. I've tried to get good info on any additive effect but it's quite hard to do. I take some precautions, like taking aspirin in the morning and IP-6 at night, but for the most part, I've been guided by the assumption that if I'm not bruising or getting nosebleeds, I'm probably ok.

Dr. Art Ayers said...

Dan,
I think that the anti-inflammatory impact of some of the supplements is only observed when there is a significant contributor to inflammation, i.e. they reduce inflammation, but don't go into suppression. In other cases, perhaps vitamin D?, a deficiency contributes to inflammation but once optimal levels are reached, there is no further reduction of inflammation.

By the way, I no longer recommend routine use of NSAIDS, because of their contribution to leaky gut and an indirect contribution to long term inflammation.

I get a sense of my clotting speed everytime I prune my roses or gather raspberries. It does seem to have slowed over the last year of more faithful adherence to an anti-inflammatory diet. I still don't bruise easily.

So, I guess that I don't know much about synergy.

Thanks for the comments.

Dan said...

Thanks. Also, would you mind giving me a lead for what to look into to learn about aspirin's indirect contribution to long term inflammation? Thanks again

Jim Purdy said...

Art (or anybody else) --

I usually take one over-the-counter 81 mg "Ecotrin safety coated enteric aspirin" each morning as a blood thinner. (I have had two mild strokes and one TIA.)

It is the only med I take, although my doctors would like me on statins, blood pressure meds, and diabetes pills.

Do you think a daily 81 mg aspirin can do much harm?

Dr. Art Ayers said...

Dan and Jim,
Check out Jenny's blog:
http://diabetesupdate.blogspot.com/2009/04/go-easy-on-advil-motrin-ibuprofen-etc.html

Dan said...

Thank you!

TedHutchinson said...

Association of serum n–6 and n–3 polyunsaturated fatty acids with lipids in 3 populations of middle-aged men I think perhaps it's also worth making the point that increasing omega 3 intake while reducing omega 6 intake to about 4% of calories will also help lowering triglycerides.

Evelyn Tribole has a useful gadget to help you see where your omega 6 is coming from.

Stephan Whole Health Source explains more about the dangers of omega 6 in his blog but basically you have to eliminate industrial vegetable oils such as corn, soybean, safflower and sunflower oil, and everything that contains them. This includes most processed foods, especially mayonnaise, grocery store salad dressings, and fried foods

Dr. Art Ayers said...

Ted,
Those are all great resources. We have to push so hard to reduce the dietary onslaught of omega-6 oils, because they are so prevalent and in the modern context that is so deficient in omega-3's, it is hard to reach a balance.

The note in the last reference that emphasizes mayonnaise as being a real villain, caught my attention. I was amazed at how few choices there are for a healthy mayonnaise, and yet how easy these emulsions are to make with a food processor. Just add a quarter cup of good olive oil to the blender with two or three crushed cloves of garlic, give it a quick whirl and then add enough water (or wine or beer, etc.) until it makes a nicely thick emulsion. Then you can experiment with spices and herbs. You can make a nice veggie dip or steak sauce and avoid the omega-6s of typical vegetable oils.

Sue said...

I loved this comment:
"She was stressed by a high triglycerides (292 mg/dl) in her blood work and her doctor wanted to start her on meds. I was sympathetic. Not really. I actually said, “carbs, carbs, carbs,” until she threatened me."

Particularly the - I was sympathetic. Not really.

Did you say I told you so!

Melchior Meijer said...

Art and Ted,

In Sweden, most commercial mayonaisse's are made with canola oil (while here in Holland it's mostly 'heart healthy' sunflower oil). When in Sweden I'm always pigging out on their delicious mayo. From the FA-profile I would say it's quite okay, but many hard core health freaks disagree. Any thoughts?

Thanks,

Melchior.

Dr. Art Ayers said...

Melchior,
Unfortunately both canola and especially sunflower are considered to be inflammatory because of their high omega-6 oil content. I avoid them. With that mayo in my diet, it would be very difficult to balance omega-3 and omega-6 content overall.

Commercial mayo on fries is a killer and should not be permitted for children.

I would consider it much healthier to make my own mayo with omega-3 enriched egg yolks and substitute olive oil. I think that the saturated fats are safer than the high omega-6 that has been associated with chronic inflammation and heart disease.

Sunflower oil is certainly not heart healthy and the shift from eggs and grassfed meat to sunflower, corn and soy oils was, in my opinion a major contributor to the increase in inflammatory and degenerative diseases.

Melchior Meijer said...

Art,

Well thank you ;-). I’m fully aware of the evils of too much n-6, but I hoped canola with it’s ~20% LA and ~10% ALA would be fine (apart from causing cardiac lesions in rats). For some reason I trust you almost completely, so I will minimize the Swedish habit. My wife makes great olive oil based mayo’s anyway...

Sorry for wrongly associating you with Karolinska Institutet in an earlier comment. I read too quickly.

Cristian Stremiz said...

Dear Dr. Ayers,

Doing a recap of you said,we can extrapolate a general scheme:

food is CARBS + LIPIDS + PROTEINS + micronutrients. (OK, DONE).

CARBS: limit them, glucose non so bad, fructose worse, ecc. (OK, DONE).

LIPIDS: saturated fats are neutral, omega-6 are bad, omega3 are good (being the enemy of our enemy, the omega-6) (OK, DONE).

PROTEINS: mix of aminoacids. OK, but are all aminoacids equals???

We have some hints (methionine restriction = caloric restriction) that we (you) can improve the anti-inflammatory diet even more doing some research about the effect of aminoacids restriction/supplementation.

I have a couple of interisting abstract to start from:

Oxidative stress and ageing: is ageing a cysteine deficiency syndrome?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1569588

Oxidative and nitrosative stress and apoptosis in the liver of rats fed on high methionine diet: protective effect of taurine.
http://www.ncbi.nlm.nih.gov/pubmed/19056240

Taurine as the nutritional factor for the longevity of the Japanese revealed by a world-wide epidemiological survey.
http://www.ncbi.nlm.nih.gov/pubmed/19239132

Taurine prevents collagen abnormalities in high fructose-fed rats.
http://www.ncbi.nlm.nih.gov/pubmed/16177476

Stimulation of glucose utilization and inhibition of protein glycation and AGE products by taurine.
http://www.ncbi.nlm.nih.gov/pubmed/15196090

I think taurine deserve to be a pillar in every supplement regime, mine for sure, being also damn cheap :-)

Dr. Art Ayers said...

Cristian,
I agree with your generalizations.

Amino acids are not all equal. The small, hydrophobic amino acids are not very interesting outside of the protein structure context, i.e. leucine zippers or leucine-rich repeats.

The two acidic amino acids, glutamic and aspartic, are interesting in a signaling context, e.g. MSG, monosodium glutamate, binding to neuroreceptors. Rarely, patches of acidic amino acids interact with patches of basic amino acids.

Some of the amino acids, e.g. serine, threonine, are sights of protein kinase activity, i.e. phosphoylation.

Methionine and cysteine are the sulfur amino acids and are involved in protection against oxidation, e.g. as part of glutathione.

The basic amino acids, arginine and lysine, are involved in heparin binding, nucleic acid binding, glycation, NO production, etc.

That just leaves the aromatic trio: phenylalanine, tyrosine and tryptophan. Tryptophan is the most highly conserved amino acid, i.e. the same position in proteins throughout evolution, because it determines folding. These amino acids also bind to the hydrophobic parts of the basic duo and to sugars.

Histidine is involved in metal binding and can replace the basic duo in some acid environments, e.g. the stomach and H. pylori.

Proline is last and causes kinks and constraints in protein folding.

Bottom line: Sulfur amino acids are low in plants and a taurine supplement, especially for people showing inflammation/oxidative stress, makes sense.

Thanks for the comments and links.

Bill said...

Dr. Ayers,
I always prefer to obtain nutrients and anti-inflammatory benefits from natural food sources wherever possible.
I eat mussels 4-5 times a week, around 500 grams in total. I understand they are an excellent source of taurine?
The only supplements I take on a daily basis are vitamin D3 - 6000 units, glucosamine - 1500 units (your recommendation) and 2 gms of leucine (Art De Vany).

brett said...

Hi Art..
Are you familiar with Dr Miricle and his diet? I have only just come across it and would never consider trying it for a second as it is meat and dairy free. He talks about keeping insulin low and glucagon high as being the key to weight loss. He advocates fasting to achieve this which I have always personally suspected is a very healthy thing to do. He says while we might like to eat everyday we were not made to eat all day. One thing though I am unsure about it that he claims that while beef for instance won't cause blood glucose to rise it will still cause an insulin release on par with eating the same weight of pure sugar. This just doesn't seem right at all to me and I was wondering if you are familar with this study?

Anonymous said...

canola oils omega 3 to 6 ratio is so much better than olive oil so why should we avoid it and use olive oil?

golf_gal said...

I have a question, but would like to offer background. In 2008 dx with stage I rectal adenocarcinoma. Had rectal excision. All well for two years, no post op tx. In April of 2011 CEA was 6.8 and metastatic adeno to sigmoid lymph node. Folfox6+avastin three months. 6 week rest, op on node. Dead cancer cells only. Six week recovery. Three more months of folfox w/o avastin. Finished chemo in march. In May, lipids out of wack. Total chol 297, trig 305. Ouch!!!! I am low carb diet since 5/25/12. My cocktail is 300 krill red qd; coq10/lipoic acid/L-carnitine capsule, 200, 250, 250 respectively, qd; K2/mk7 qd; strontium 340 mg bedtime, NOW Full Spectrum Minerals 2 caps bid; lipogen 2 capsule tid for chemo brain, d3 1000iu qd, apart from now product; policosinol 20 mg qd; Wobenzym-n 3 tabs bid. I think that's all I take. I use a lot of extra virgin olive oil. I don't eat three meals a day. I just am not hungry. I do eat with supps that say take with food. I do drink grass fed organic milk. Maybe a glass a day. I eat lots of veggies and fish and two eggs daily. Limit beef. Do indulge in an adult beverage or two, but only on occasion. Know that just turns to sugar.

Do you see anything I'm missing? I've been doing this since May. New lipid profile, full cmp in October. In May my vit d was 50 and calcium was 94. Dexa shows slight to mid osteopenia. Cholesterol is my BIG CONCERN. I'm trying to avoid vytorin and boniva which Dr prescribed but I refused and created the above regamine. Thank u for your precious time. If I've left anything out I'll add to another post.

Thanks for input.
Jamie

golf_gal said...

Oops, lipogen, 1 capsule tid. Couldn't find how to edit after posting. Sorry.

Anonymous said...

As a type 1 diabetic I try to keep the carbs down to a minimum. My recent triglyceride test was 29, AIC 7, LDL 119. What do I do about the triglyceride level?
Thanks, Kris