Inflammation and Disease

So I finished my first lesson of 28 in my Whole Person Health Coaching program.  The first lesson was on inflammation and disease taught by Dr. Barry Sears.  I had heard of the Zone Diet but every other person in the world seems to have the miracle diet so I never paid much attention to that particular diet as a way to loose weight. I mean after all isn't it always just about calories in minus calories out to loose weight?  However, after a weeks worth of reading the handouts, watching the videos, and researching hormonal balance and food, I am now convinced that what Dr. Sears is correct.  We should eat 50g of fat everyday, 100g of protein, and 600 calories of carbohydrates (200-300 of the 600 carbs should come from fruits and vegetables). If we eat this way we will reduce diseases and be a healthier weight. Below is the final write up  I did in order to complete the course and receive Continuing Education Credit hours. Email me if you have any questions.

Please describe how you would apply this information to either a patient/client situation or to your own personal self care:

As a wellness coach I believe it is my job to actively listen to a patient, make educated assessments about their health issues, educate the patient on why gaps in wellness occur, and guide them down a pathway that will lead to improved health. In the beginning of a wellness program I believe it's important to define “Wellness” for the patient, make sure they understand that the current health of Americans could be improved, and outline possible health risks without changes in lifestyle.

I will define wellness for the patient as more than the absence of disease and discomfort. True wellness means all the bodily systems are functioning properly, you feel good emotionally, physically, and you have clarity of thought.

I will then provide some data to illustrate that Americans may not be as healthy as one would think we are, given our tremendous healthcare system.

• Cardiovascular disease is still the major killer of middle-aged men and by far the leading cause of death for Americans overall. For about half of those who die from heart disease, the very first Symptom is sudden death.(1)
• About 250,000 sudden cardiac deaths occur every year.(2)
• U.S. Cancer deaths will jump 45% in the next two decades from 1.6 million in 2010 to 2.3 million by 2030.(3)
• 68 percent of Americans are overweight and 33.8 percent are obese. Additionally around 17 percent of children and adolescents aged 2-19 were considered obese.(4)
• America's Diabetes epidemic has grown by 33 percent in the last decade.(5)

After I provide a few examples of the American health crisis I will make sure the patient understands what is most important - all of the conditions listed above, plus others, can be improved and even reversed with better nutrition. Heart disease, Cancer, Alzheimer's, Obesity, Diabetes, Asthma, Allergies, and all medical termed “itis” conditions are caused by or impacted by what is termed “Silent Inflammation”.

I will define for the patient what inflammation is,the process of how it happens, and differentiate between classical and silent inflammation. Inflammation is a biological response, at a cellular level, happening in the body that involves pro-inflammatory and anti-inflammatory hormones. When the body detects a foreign presence the cells leak Histamines causing the capillaries to leak plasma so the micro-phage cells can get to the site of the problem and destroy the cells in question. Cellular destruction is great part our immune system that helps to fight off bacteria and viruses but some times our body's great immune system turns on itself causing good cells to be destroyed and causing the acceleration of the aging process and disease. Silent Inflammation is a chronic inflammatory state happening in the body that operates below the threshold of pain so it can go on for years or decades virtually unnoticed until a disease state is presented. I will emphasize virtually unnoticed because if the patient is in tune with their body they might have noticed there were warning signs that things were not all that well. At this point I will question them to think about any warning signs they may not have thought much about until now. For example, frequent heart burn, digestive and bowel problems, frequent illnesses or infections and lack of energy just to name a few. Silent Inflammation is dangerous because it's chronic and goes unnoticed. Classical Inflammation, like an ankle sprain, is painful but Silent Inflammation kills.

I will inform the patient about the 3 blood tests that can be utilized to determine if Silent Inflammation is happening in the body and encourage the patient to discuss these with their physician when the go for their next checkup. .

• AA/EPA ratio in the body - Aracadonic Acid and Eicosapentaenoic Acid are pro-inflammatory and Anti-inflammatory hormones so if the levels are high inflammation is occurring. A good number is less than 3.
• Insulin level – The higher the Insulin level the more pro-inflammatory fat your body is storing. A good number would be less than 10 uU/mL
• Triglycerides/HDL – Are you carrying more “bad fat” that is causing more inflammation? A good number would be 2 or less.

At this point if the patient has been in pain or prescribed an anti-inflammatory by their doctor they will most likely ask the question about using anti-inflammatory drugs. I will explain that while there are over-the-counter and prescription drugs that can reduce Silent Inflammation, Aspirin, NSAID's, and Cox 2 inhibitors, these drugs work well to suppress the Pro-inflammatory Eicosanoids but the problem with these drugs is that they suppress not only the pro-inflammatory hormones but also the anti-inflammatory hormones. Long term use can result in a poor immune system, bone marrow suppression, Osteoporosis, heart attack, heart failure and even death. So I would not recommend long term use of any anti-inflammation drugs. They may be OK to start off with but diet is the best long term way to manage inflammation related disease.

It will be important for the patient to know what happens, in the body, to the food we eat and what causes silent inflammation. This way if the patients hormone levels are considered good right now they can keep them that way over time or if needed improve them. I will explain there are three hormones in the body that change every time we eat and they are Insulin, Glucagon, and Eicosanoids. Insulin is stimulated be eating Carbohydrates and causes the body to hold onto glucose and store it in the body. Glucagon is stimulated by protein and it causes the body to release stored energy. Eicosanoids are signaling hormones that say if more Insulin is needed or if the body should release Glucagon, and even if pro-inflammatory or anti-inflammatory reactions need to occur. I will emphasize the key to controlling silent inflammation is controlling insulin. And also emphasize that the causes of silent inflammation all stem from the western diet where we have made food cheap and processed in the last 100 years. We do not eat like Americans did 100 years ago. (Since 1985 the average American has increased their calorie consumption by 300 calories each and 93 percent of the added calories are in the form of sugar, omega 6 fats, and refined grains.(6))

I will explain to the patient that the causes of silent inflammation are three-fold,

1. Increased Consumption of refined carbohydrates - which increases Insulin levels in the blood (This alone is not enough to cause Silent Inflammation)
2. Increase vegetable oil consumption – Corn Oil, Soybean, sunflower, safflower (These Omega 6 oils combine with the Insulin to convert the Carbohydrates to Aracadonic Acid which is a pro-inflammatory fatty acid)
3. Decreased Omega 3 consumption through fish oil - Omega 3 oil blocks Insulin from glucose storage, has strong Anti-inflammatory properties, and not to mention makes you smarter

I will encourage the patient to eat in the “Zone”, a low glycemic diet and explain that to eat in the Zone is to eat so the body keeps a consistent balance of Insulin and Glucagon. I will emphasize the “Zone” is a medical state of being in balance hormonally not a fad diet designed to loose weight . I will spend a lot of time with the patient explaining the Zone Diet created by Dr. Barry Sears and show how it incorporates reduced refined carbohydrates, Omega 6 fatty acid reduction, and Omega 3 supplements. When a patient is eating in the Zone they will receive enough carbohydrates, protein, and fats at each meal to avoid spikes and valleys in the Eicosanoid hormones.

I will draw out the Zone diet pyramid and compare it to the USDA recommended pyramid highlighting the Zone pyramid was developed by doctors with science at its foundation without special interest and food industry lobbyists. The Zone food pyramid consists of vegetables on the bottom followed by fruit (these are your carbohydrates), Next comes protein, then oils (primarily Omega 3), and finally grains and sweets. When eating in the Zone one should eat small meals and consume fruit or vegetables and 3 – 4oz of protein at each meal. I will explain to the patient that there are two ways to look at how they can eat in the zone,

1. Divide the plate into 3 equal portions and on 1/3 of the plate put protein the size of your palm and then pile the rest of the plate with non starchy vegetables and fruit.
2. Or think of it as a 1-2-3 program. 50 grams of fat 100 grams of protein, and 600 calories of carbohydrates each day divided over 3 meals and 1 or 2 snacks. At least 200 of the 600 carbohydrate calories should come from not starchy vegetables. The other 400 calories can be used for grains and fruit so people don't feel too limited.

If the patient can make only one change I will recommend they TAKE PURE FISH OIL SUPPLEMENTS up to 7.5g a day! But I strongly recommend following all these guidelines,

• Never go more than 5 hours without a zone meal or snack
• Eat a zone balanced breakfast within one hour of waking up
• Make sure one third of your plate is protein at every meal
• Stop eating refined carbohydrates
• Eat 300 of your 600 carbohydrate calories from vegetables
• Take fish oil supplements

And finally, I will recommend the patient go to their library and check-out “Mastering the Zone” by Dr. Barry Sears and “In Defense of Food” by Michael Pollan so they can get a better understanding of the state of our food industry and how to eat for optimal health.

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¹ Brody, Jane E. Hunt for Heart Disease Tracks a New Suspect. New York: Times 2004

² Brody, Jane E. Hunt for Heart Disease Tracks a New Suspect. New York: Times 2004

³ Steenhuysen, Julie U.S. Cancer diagnosis will Jump 45 Percent by 2030. Chicago: Reuters 2009

4 Steenhuysen, Julie 68 percent of Americans overweight, 33.8 percent obese. Chicago: Reuters 2010

5 Sears Dr. Barry Ph.D. The Anti-Inflammation Zone - Reversing The Silent Epidemic That's Destroying Our Health. Copyright 2005

6 Pollan, Michael In Defense of Food. Copyright 2008