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Scot: Troy, Mitch, have you ever seen someone in an article or an ad or on social media and they talk about inflammation? Have you ever heard of this?
Mitch: Yes. Yes, I have. On TikTok every so often there will be someone trying to tell me what I should and shouldn't be eating.
Troy: That's funny, because I'm a physician, and I've probably heard about it less than Mitch has. And I'll clarify, I'm not on TikTok.
Scot: All right. And oftentimes, after you heard about inflammation, then there's some story that follows about how somebody stopped eating bread, or using seed oils, or dairy, or red meats, or other foods, and now they feel better. Maybe they were bloated for a long time, and now they're not, or their skin has cleared up, or their migraines have gone away, or they used to be congested all the time and that went away, or they've got more energy, their mood is better.
So the question is, are these health risks and benefits overblown? I mean, is this a legitimate thing, this inflammation, and can the foods we eat really impact us in these ways? And there are a lot of ads online claiming that that's super important. There are supplements or diets that tell you, "This is a legitimate deal." But we want to find out if it's true, and we're going to dive into that topic today.
This is "Who Cares About Men's Health," providing information, inspiration, and a different interpretation to men's health. I bring the BS. My name is Scot Singpiel. The MD to my BS, Dr. Troy Madsen.
Troy: Hey, Scot.
Scot: A guy who is working hard on his health and is always bringing his unique perspective, Mitch Sears.
Mitch: Hey, there.
Scot: And Thunder Jalili, who is a professor of nutrition and integrative physiology at the College of Health at University of Utah. Thunder, how are you doing today?
Thunder: Hey, I'm good. I'm happy to be back on the podcast.
Scot: Is inflammation a real thing? That stuff I talked about at the top of the show, is that what's going on? That's what we want to dive into. Let's just start with that. I mean, is it legit? Because it seems a little crazy to me that changing my diet or getting rid of some of these foods is going to clear up all these health issues that I've had.
Thunder: So to answer your first question, yeah, inflammation is definitely a real thing. It's like a normal physiological process. And it has a purpose for wound healing and immune response and things like that.
But I guess what we're talking about here is kind of a low-grade, chronic inflammation that could increase your risk of unhealthy things, like maybe increase your risk of artery disease, or make your headaches or your arthritis worse, or things like that. So that's how I kind of look at this inflammation as we're talking about it.
Scot: How is the inflammation caused by the foods we eat different than the inflammation that's caused by other causes? I twist my ankle, and that gets inflamed. How is that different?
Thunder: You're talking probably an acute stimulus for inflammation with the ankle twist versus a more low-grade, systemic inflammation that's much lower level. So it takes longer for it to have a physiological impact. That would be my take on it.
Scot: And with a twisted ankle, though, I can look at it and see it's inflamed because it's swollen or it's hot. I mean, can I tell that with food as well, or is the other symptoms that I know that maybe something might be up?
Thunder: No, you can't really . . . I mean, it's different with food. It's a low-grade, systemic type of inflammation. A little bit more cytokine activation, a little bit more oxidative stress.
In the short term, it's not going to do much. In the long term, having it exist month after month after month can exacerbate other things that are already going on. So in someone who has high LDL levels or someone who has diabetes, and now you throw on this systemic inflammation, this low-grade, systemic inflammation, it could accelerate underlying artery disease, for example.
Scot: Yeah. So digestive problems, joint pain and stiffness, skin problems, fatigue, lack of energy, headaches and migraines in some people, even mood changes, anxiety, depression, irritability, allergies, erectile dysfunction, low testosterone levels, increase the risk of certain cancer and other chronic disease. This is all true, huh?
Thunder: Yeah. In a way, it's all true. I mean, maybe not exactly the way most people think of it, like there's a direct cause and effect of these inflammatory foods in every single condition you mentioned. But I think it's more that if you have these conditions, what you eat could exacerbate it and make it more difficult to deal with.
Whether there's a direct cause of eating these foods and then developing all those conditions you said, that's debatable. But they definitely don't help if this is one of the things that you're trying to deal with.
Troy: And I think too, Thunder, you talked about some conditions like coronary artery disease. And there, we're talking about longer-term effects rather than eating something and then an hour later, I have a heart attack because of it, things like that.
I agree, there are definitely inflammatory properties of certain foods. Again, we know certain triggers for migraines from certain foods. But yeah, like you said, it seems like a lot of these you've got an underlying condition, or it's long-term effects of maybe some of the food you're eating or some of the processes that can go on chronically.
Thunder: Yeah. And if we could just pick up the example of the coronary artery disease that you just mentioned, Troy, yeah, it's long-term. It so turns out that these foods that everyone . . . and I'm doing air quotes, okay? You guys can't see the air quotes. These foods that everyone labels "inflammatory," well, they also turn out to be the same foods that may increase your LDL and maybe make you more prone to diabetes. And these are risk factors for developing atherosclerosis, right?
So, in that sense, it's kind of hard to separate out. Yeah, they're inflammatory foods, but they also increase your risk for artery disease as well.
And that's kind of how this goes. It's not like, "I'm going to eat a cookie, and then have a heart attack or develop cancer in the next 30 minutes." But if that's my eating pattern, then by definition, I'm probably eating kind of more processed, high-sugar foods, foods with less healthy fatty acids, etc., which sets me up for all these other chronic diseases over the long term.
Mitch: So if I'm understanding this right, you're saying that having these foods is not necessarily directly causing, say, maybe the inflammation or the whatever, but it is definitely exacerbating problems that you might already have?
Thunder: Yeah, or it causes a very temporary inflammatory response that goes away after the food is processed. So that brief, mild inflammatory response, is that damaging? Probably not. If it happens all the time and the foods that you're eating are more in that processed food category, then yeah, that kind of increases the risk.
And remember at the same time, if you're eating a lot of inflammatory foods, then by definition, you're probably not eating a healthy diet with vegetables and other plant-based products and whole grains and things like that. So it's not just the addition of the inflammatory foods. It's that we're making a substitution of those types of foods and not eating the healthy foods.
Scot: So let's jump in here with some of the foods that are — I'll use Thunder's air quotes here — that are "inflammatory foods." Actually, I shouldn't use air quotes because they are, right?
Refined grains, bread, cereals, white flour, refined sugar, especially that added sugar that we've talked about before on the podcast that you want to avoid, sodium, red and different processed meats. The processed meats because they tend to have a lot of salt and other types of preservatives in them that are inflammatory. Trans fats, ultra processed foods also make the list, and then finally alcoholic beverage.
Did we cover most of the foods that are considered inflammatory, Thunder?
Thunder: Did you mention refined carbohydrates and monosodium glutamate, MSG?
Scot: Talked about refined grains like breads and cereals and white flour, but not MSG.
Thunder: Yeah. So let's just add MSG to that list. That can cause a little inflammation as well.
Mitch: Wait a minute. Didn't I read a study recently that said that alcohol is anti-inflammatory, like red wine and stuff?
Thunder: It depends how you take your alcohol. Is it in the form of Everclear or red wine?
Mitch: Oh, okay. Sure. Yeah, it depends on the night, but . . .
Scot: All right. Which one is inflammatory and which one isn't then? Is red wine is inflammatory and Everclear isn't, or what?
Thunder: So one of the things that we're doing, all of us, is we're oversimplifying this.
Scot: AIt's what we like to do.
Thunder: Yeah. Here's a dose response. If you have a glass of red wine or a small alcoholic drink, that's really not a big deal. If you pound half a liter of vodka a day, or you have a bottle or two of wine a day, that's a different ballgame. So we have to be mindful to dose. So a glass of red wine is actually anti-inflammatory. A bottle of red wine, probably not so much.
Mitch: Okay. All right.
Scot: So with inflammatory foods, it sounds like dose response and time, like how consistent have you been consuming these foods, those things start to add up then to possibly some of the negative effects that we talked about.
Thunder: Yeah, and let's add one other thing to that. How much of the anti-inflammatory foods are you consuming? So, yeah, you may be having some of these inflammatory foods, but are you eating a lot of anti-inflammatory foods? Because it's not like we wake up in the morning and flip a switch and decide which way we're going to go. We're probably all having a mix of inflammatory and anti-inflammatory. It just comes down to what's predominating.
Scot: All right. I mean, it really comes back to this notion of a balanced diet then, right? Pragmatically, in real life, sometimes we want to have some of these foods that might be labeled as inflammatory, but in moderation, that's fine as long as we're not going crazy with the dosage or the time. But we also need to look at how much of the good foods we're eating. What are some of those foods that reduce inflammation?
Thunder: So pretty much anything from the plant world, any plant-based foods. Whether it's a whole grain, or a vegetable, or a fruit, or a plant oil, those will all fall into that anti-inflammatory category.
And remember, really what we're talking about is eating patterns. If somebody is used to eating healthy and is trying to avoid processed foods and going after those plant-based foods, that's kind of an eating pattern, a lifestyle.
On the other hand, you can have an individual that doesn't really cook, they're not much into food preparation, they buy a lot of packaged foods, it's convenient, it's fast. That's kind of how a lot of people eat. And yeah, they may have an apple once in a while, but the dosage of the anti-inflammatory side isn't the same. So the balance shifts towards inflammatory foods.
Troy: See, Thunder, I'm hearing all this and it really makes perfect sense in terms of the balance, and some foods may be more promoting inflammation where others are anti-inflammatory. But then I think getting to what Mitch talked about is . . . Again, he's probably read more about it on TikTok than I have.
Mitch: You don't read TikTok. You guys understand that?
Troy: He's watched more TikTok videos than I have about this. But how much truth is there to that? If someone is saying, "Hey, I eliminated this, and it eliminated my migraines, or I eliminated this, and it eliminated my fatigue," is there something of a placebo effect there? Or is there some truth to saying if you eliminate certain foods, you are going to see a physical effect from that?
Thunder: Yeah, I think we can never discount a placebo effect for sure. But there's definitely truth in there too, because these foods that we do label anti-inflammatory, there's data in cell studies, in animal studies, and even human studies when you eat more of these plant-based foods that have phytochemicals and healthy oils and fiber and things like that, and you measure indices of inflammation or oxidative stress, you see they are lower, right? So there is truth that they have a physiological effect.
Now, the placebo part kicks in, in how good you feel after you eat those foods. I mean, there is probably a role in helping migraines. Definitely if people have gut issues, there's actually a role there in improving that. But how good you feel, I think that's where the placebo part comes in.
So I don't know if you can really separate the two. There's definitely a physiological role, but their mind is a powerful thing, right? So there's definitely going to be placebo in there as well.
Scot: I also feel like maybe some of this effect could be that . . . and I don't want to diagnose people or make assumptions, but when we see these videos on TikTok or hear these stories about people that remove these things from their diet and they felt better, we don't know what life was like for them before.
It might have been really bad. They might have not been eating very well, a lot of inflammatory foods. They might have had other underlying sort of medical things going on that when they eliminated some of these things, that's why they experienced this transformation. Whereas maybe I'm experiencing some bloating or whatever and I quit doing those things, I don't really experience anything, because for the most part, I'm pretty good.
Is that fair? Is that a fair thing to say, or am I just making stuff up?
Thunder: I think that's fair. And throw in "What if people lose a little weight when they're trying to eat the anti-inflammatory foods?" That somehow plays a role, but maybe they don't talk about that. But we know that's in the background.
So, yeah, I think it's all of the above. At the end of the day, I mean, we can try to pin exactly what the reason is, but we do know the long-term effects, right? We know what the result is, and I think that's the thing to focus on.
Troy: I guess so. And that's what I've wondered, too, is if sometimes we can drive ourselves crazy trying to identify every potential piece of our diet that could be causing certain symptoms and eliminating, and adding and eliminating something else, versus just trying to have that balanced diet. I don't know.
I guess if you were to go to someone and say, "Well, whatever symptoms you may be having . . ." Whether it's headaches, fatigue, gut issues, whatever it is, where would you even start? And where would a person even start to try and assess that and eliminate things?
Thunder: I mean, ideally, you would want to have a physician that has patience and is open to dietary experimentation and has time.
Troy: So you're saying not me. No, don't go to the ER for this, please.
Thunder: I mean, our healthcare system in general is not set up for that. Doctors have that 5-minute window, 5, 10 minutes, to talk to you and throw a bunch of things on the computer and then move on. So you've got to have the right healthcare team.
And then you need the dietitian as well who is willing to give you advice, kind of keep a log how you feel after you've taken this out or added this in.
But to get back to your kind of original basic question, "Where do you start?" the easiest thing to start, in my opinion, is try to reduce added sugar as much as possible, and try to increase your intake of vegetables, fruits, whole grain, and oatmeal. Start with that. And then if it comes in a box, try to eat less of it. I mean, that kind of covers a lot of ground.
But if you can do that, you may end up cutting the foods that were giving you problems, and at the same time adding things we know are helpful. And maybe that'll help. Maybe you don't have to go through this systematic thing where you try to identify the one particular food.
I mean, if you want to, great, go for it and have some patience and experimentation. But you can probably get results from just doing that kind of basic across-the-board approach.
Scot: I was going to say I heard one time when you're eating, if you can eat stuff that has one ingredient in it . . . Like, if it does come in a box and it's rice, that's fine, because the ingredient is rice. And that's generally pretty healthy, right? So I started applying that rule.
I know dairy kind of gets a bad rap for being a really inflammatory food, and that has one ingredient. What's your take on dairy in this list?
Thunder: Yeah. I think the dairy story is a little tougher because it could be inflammatory. But when dairy is processed into yogurt, that's actually pretty good. So I think we have to decide what dairy are we talking about? Milk, probably inflammatory. Yogurt, it's actually probably good.
Scot: All right. By the way, Troy, I don't know if you noticed this, but the foods that have the best evidence of being anti-inflammatory are stuff like tomatoes, olive oil, leafy vegetables, nuts, fatty fish, fruits. What does that sound like to you, Troy?
Troy: I was going to say, as soon as Thunder said that, it sounds like the answer is the Mediterranean diet. I just come back to it again and again.
Thunder: It's the answer to everything.
Troy: It's the answer to life, the Mediterranean diet. I do like that, though. It just keeps it simple. Because like I said, that's the thing I worry and I hear people talk sometimes about this. It just seems like they are kind of going . . . it's driving them a little crazy, because they're just saying, "Well, I've got to cut this. Okay, that didn't work. Let me try this."
But it seems like if you can just try the Mediterranean diet, like you said, Thunder, you're cutting a lot of that stuff that could be potentially bad and adding the anti-inflammatory properties of all the great stuff in the Mediterranean diet.
Thunder: Yeah, very well said.
Scot: It keeps coming back to just a . . . This is feeling like a familiar conversation now, right? Try to eliminate some of the stuff that's not great for you. And I think most of us are pretty good at knowing what that is. Are we eating processed foods? Are eating fast foods? Are we eating boxed foods? Try to add in some vegetables and fruits and nuts, if we're not doing that. Try to get rid of some of the red meat, if you're doing that. I mean, this is just the familiar refrain that we hear.
And over time, you'll hopefully start to feel better. Maybe then if you're not feeling better, that's when you might want to talk to somebody to drill down a little bit deeper, because that might get 80% of the people there.
Mitch: Sure. And I guess that leads to a next question. I don't know if this is something that Troy or Thunder could answer. At what point is gassiness, bloating, these different kinds of inflammatory responses, at what point is it something you should probably go see your doctor and not just, "Oh, I had a bad meal," or, "Oh, my diet isn't super great," but you should probably go to a doctor?
Troy: Yeah, that's a tough question, Mitch. It's something I see so often in the emergency department. The most common complaint I see is abdominal pain, and it includes all those symptoms. Maybe it's constipation. Maybe it's other things that are causing it.
But I think if it's becoming a chronic issue there, and more chronic issue is we're talking three months or more, then it's probably worth seeing your doctor, the idea being that you may have underlying conditions. And particularly if you're having any bleeding. I mean, that's a big red flag. Any blood in your stool, you probably need a colonoscopy to look for underlying conditions like ulcerative colitis or Crohn's disease, things like that.
Once you get past that three-month mark, it's a good idea to really go see your doctor rather than trying to figure it out on your own.
Thunder: Yeah. And I would also maybe add to that it depends on someone's personal discomfort tolerance. If it's bad enough, maybe some people after a month, they would want to do something about it. But it can be kind of a lower grade, but lasting more than three months, and I know people who would probably just continue to try to walk it off. It all has to do with your personal tolerance for pain.
Troy: Yeah, exactly. And when I say three months, I don't want to necessarily imply you should suffer for three months with severe abdominal pain, have your appendix burst, or something.
Like Thunder said, and I think like you implied, Mitch, kind of those low-grade symptoms where it's bothersome, and maybe it's some discomfort and some gassiness, things like that, once you hit the three-month mark, it's probably worth just seeing your doctor to get some other input, if not sooner.
Scot: So inflammation caused by the foods we eat, inflammatory foods versus foods that are anti-inflammatory, that's all real.
Thunder: Yep. It's all real, and it can all be traced back to dietary patterns. If you're kind of in that dietary pattern that favors processed foods, you're going to be eating a lot of these inflammatory foods we've mentioned. If you have a dietary pattern that favors more natural plant-based foods, whether it's a Mediterranean diet or a vegetarian diet, or just even omnivore diet, but just choosing healthy stuff, I mean, that's an eating pattern.
So we've got to always remember, at the end of the day, we're coming back to an eating pattern not targeting specific foods, but more a pattern of habitual eating.
Scot: Mitch, takeaway from today's episode?
Mitch: I'm shocked. I've been quiet because I'm sitting here being like, "No, these people on TikTok can't be . . ." They stopped eating bread, and all of a sudden, their skin is better and their mood is better. It just seemed too extreme, right? And it just seemed too simplistic, too everything.
So I guess it's yes, inflammatory and anti-inflammatory food exists. But I do really like that takeaway where if it's part of a larger change in your diet, yeah, maybe you can see these sorts of things, right? But this idea that you stopped eating bread for a week, and all of a sudden, you've got perfect skin, it still feels weird to me.
Thunder: Yeah. If you have celiac disease and you stop eating bread, you'll see immediate effects. But otherwise, yeah, it's not going to happen.
Scot: Yeah. So I think, Mitch, what I take from that is, again, you just can't tell. You don't know what the backstory is there, right? You don't even know if what they're saying is true. Do they have some other sort of agenda why they're saying these things?
Mitch: They're anti-bread.
Scot: Maybe they are. Yeah, I don't know. But my takeaway is it comes back to try to eat more of the good stuff and less of the bad stuff, right? And you're going to be okay. That's where I'm at.
Troy: My takeaway also is just balance. I think, Thunder, you really emphasized that. And I think if you're looking for anything, try to just achieve that balance rather than focusing on very specific foods and I think you'll see improvements by doing that. Again, Mediterranean diet. If you can do that, I think you're going to see improvements.
Scot: Have you ever experienced what we're talking about eliminating some inflammatory foods and you had a sudden change in your health? Do you have a question about the food you eat? Have you found a diet claim on the internet that just seems too bizarre to be true, and you want to know what's really going on? We would love to hear from you. You can reach out to us via email at firstname.lastname@example.org.
Thunder, thanks for being on the show.
Thunder: Yeah. It was a pleasure to be on and talk with you all.
Scot: And thanks for caring about men's health.
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