Western diet and inflammation

COMMENTARY

WESTERN DIET AND INFLAMMATION

by John Neustadt, ND

Integrative Medicine • Vol. 5,No. 4 • Aug/Sept 2006

The prevalence of chronic, degenerative diseases

attributable wholly or in part to dietary patterns is the

most serious threat to public health in the United States.

These diseases include cardiovascular disease (CVD), can-

cer, type 2 diabetes mellitus, and overweight/obesity. The

numbers are truly staggering. One third of American

adults (more than 71 million people) have one or more

types of CVD, including 13.2 million cases of coronary

heart disease (CHD) and 65 million cases of high blood

pressure (HBP, defined as systolic blood pressure ≥140

mm Hg and/or diastolic blood pressure ≥90 mm Hg ).1

CVD, the number-one cause of mortality in the United

States, accounted for 37.3% of all US deaths in 2003, and

was “an underlying or contributing cause” for approxi-

mately 58% of deaths in 2002.1

Cancer is responsible for 25% of US deaths and is the

second leading cause of mor tality.2Research suggests

that about one-third of all cancer deaths are attributable

to poor nutrition, physical inactivity, and overweight or

obesity;2and these risk factors may account for up to 80%

of large bowel, breast, and prostate cancers.3,4

Overweight (defined as body mass index [BMI] of 25-

29.9) and obesity (BMI ≥30) are at epidemic levels, with

65% of US adults classified as overweight or obese.5

Nearly one-third of US children are either at risk for

being overweight or are already overweight or obese.5

Obesity contributes to more than 280,000 deaths each

year in the United States,6and in the coming decades

may erode the national gains in life expectancy.7

A common factor that may contribute to the develop-

ment and progression of these illnesses is chronic inflam-

mation, which can be caused and modified by diet.8-13 In

fact, several pathologies that were once viewed as unrelat-

ed are now grouped by some researchers and clinicians

into the category of “inflammatory disease,” including ath-

erosclerosis, dementia, arthritis, vasculitis, diabetes, and

autoimmune diseases.14 This article reviews the role diet

plays in creating inflammation in the body.

THE WESTERN DIETARY PAT TERN

Since the Agricultural Revolution approximately

10,000 years ago, dietary and lifestyle patterns have dra-

matically changed. Prior to the revolution, people con-

sumed an enormous variety of wild plants and animal

foods. This diet, commonly called the Paleolithic diet or

Hunter-Gatherer diet, had predominated for about 2 mil-

lion years. According to AP Simopoulos, a leading

researcher into the effects of polyunsaturated fatty acids

on health and disease, the Paleolithic diet contained 19%

to 36% protein and 22% to 46% carbohydrates; daily

intakes of 520 mg cholesterol, 100 to 150 g fiber, 690 mg

sodium, 1500 to 2000 mg calcium, and 400 mg vitamin C;

and a polyunsaturated-to-saturated fatty acid ratio of

1.41.15,16 Additionally, this diet contained a potassium-to-

sodium ratio of approximately 10:1.17 The Paleolithic diet,

of course, was devoid of all processed foods.16,18

In contrast, the post-Agricultural Revolution

Western diet, also called the Standard American diet

(SAD), is radically different from our ancestors’ diet.

Today’s Western dietary pattern is characterized by a high

intake of saturated fatty acids, trans fatty acids, and

processed foods; and low intakes of mono- and poly-

unsaturated fatty acids, dietary fiber, and micronutrients.

The foods most commonly consumed in the Western

dietary pattern are grain-fed beef, processed meat (eg, deli

meats or hotdogs), refined-grain products, eggs, French

fries, high-fat dairy products, and sweets and other

desserts.19,20

In contrast with the Paleolithic diet, which contained

no refined sugar, in 2000 the consumption of all refined

sugars in the US was 69.1 kg, up from 55.5 kg in 1970.21 In

addition, the typical Western diet has been estimated to

contain 16 to 30 times more omega-6 fat than omega-3

fat15,22 and has a potassium-to-sodium ratio of

1:1.25–3.75.17 The potassium, found primarily in plant

foods, is mostly in the form of potassium bicarbonate

(KHCO3), while sodium in the Western diet is in the form

of sodium chloride (NaCl) from processed foods.

Therefore, the imbalance of potassium to sodium in the

Western diet is also accompanied by elevated dietary chlo-

ride consumption and decreased dietary bicarbonate con-

sumption.17 Additionally, in the year 2000, cereal grains,

such as wheat and rye, were consumed at a rate of 200

pounds per person per year in the United States.21

Summarizing the major differences between ances-

tral diets and the Western diet, Simopoulos writes,

“Today industrialized societies are characterized by (1) an

increase in energy intake and decrease in energy expendi-

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C

OMMENTARY

by John Neustadt, ND

THE WESTERN DIETARY PATTERN

FOOD AND INFLAMMATION

TABLE 1 NUTRIENT CONTENT OF PALEOLITHIC AND

WESTERN DIETS15-18, 21

TABLE 2 SOME INFLAMMATORY MEDIATORS

CONCLUSION

TABLE 3 DIETARY PATTERN OR COMPONENTS AND

TABLE 4

HEALTHY DIET AND LIFESTYLE RECOMMENDATIONS^16