Whole food is healthy. Processing removes fibre and unsaturated oils which have an anti-inflammatory effect. This leaves high calorie inflammatory food. The easiest guide is ‘The less processed the food the healthier it is’
Inflammatory vs Anti-inflammatory food
Inflammatory diets have caused obesity, heart disease, diabetes, cancer and every other disease to get worse. This happens because chronic inflammation is the common pathway for all illnesses, and eating more inflammatory food makes our inflammation worse. Choosing anti-inflammatory food decreases inflammation and helps us to heal.
The easiest guide is the more processed it is the more inflammatory it is. When we process a food we remove the anti-inflammatory parts and keep the part that causes inflammation. Sounds crazy I know but we didn’t realize what we were doing. Now we have made lots of “Modern” foods that are highly processed and highly inflammatory. These cause obesity and make all diseases worse.
Whole Sugar to Processed Sugar
White sugar is a creation of man. Sugar is found in all fruits and vegetables and is very good for us while it is part of a whole fruit or vegetable. We make it bad when we separate the sugar (Process) from its original food and add it to another. This is artificial. In its original form it is can be an anti-inflammatory food, in its processed form it is very inflammatory.
WHO has this definition of free or processed sugar and guideline for consumption.
“Increasing or decreasing free sugars is associated with parallel changes in body weight, and the relationship is present regardless of the level of intake of free sugars. In other words the more free or added sugar you have the more weight you will gain. The excess body weight associated with free sugars intake results from excess energy intake.”
Why do we process sugar?
- Processed sugar is added to foods to make them sweeter, more palatable and more attractive to eat.
- When we increase the concentration of sugar it has preservative properties which reduces waste.
So we process sugar to make money by adding it to other foods so that we can sell more of those foods.
Sugar causes inflammation (ref). It needs to be avoided. Americans add sugar to everything. Get used to eating less sweet food.
Whole Grain to Processed Grain (White Flour)
Grains are not well understood by most people. They are a good example of taking a basic food and removing the anti-inflammatory components (Bran and Germ) to create the second most inflammatory food we have. We consume very large volumes of bread. Wholegrain bread is like taking an organic anti-inflammatory medicine but white bread is feeding on an inflammatory poison.
Why did this happen?
With the invention of roller mills we were able to remove the bran and the germ. This removes the oils and extends the shelf life. The resulting white flour makes lighter fluffier breads and pastries. It is unfortunate that they are so inflammatory. The longer shelf life means less waste and this was very important during the poverty of the great depression. White bread remains the bread of choice for those who cannot afford whole grains.
Whole Meat to Processed Meat
When we started collecting data for nutrition studies red meat and processed meat were one category. When it became apparent that meat was a concern we started to separate red meat from white meat and unprocessed red meat from processed meat. In the excitement to become healthy we generated a lot of advice that we now know is wrong. The evidence continues to grow and it now appears that processing is the problem.
Rohrmann and Linseisen have published a very good summary of this which you can read here.
Basically Rohrmann and Linseisen recognise the important components of meat which include protein, iron, zinc, a variety of vitamens, cholesterol and saturated fat. It was thought that cholesterol and saturated fat were a cause for concern. Indeed, in isolation and in excess they may be unhealthy, but as a whole food evidence shows cholesterol can be healthy. Processing is the problem. Fresh whole steak is healthy.
They also raise a concern over the volume of whole red meat and processed red meat that is being consumed. They say that this is not clear because people who eat less meat (Whole or processed) tend to be leading a much healthier lifestyle and it may be all these other things that are producing the benefit and not the quantity of red meat that they consume. In order to answer this question they feel that other types of studies will be needed such as the Mendelian randomisation approach.
Age and disease
If you are young and healthy you may be able to cope with white bread. Disease comes with systemic inflammation. Age comes with inflammation. So if you have any illness or are getting older your body will not cope well with white bread. Your inflammation will get worse. The good news is that you can reduce your illness, pain and suffering by changing from white bread to wholegrain.
Obesity
Obesity comes with inflammation. Inflammation causes obesity. You can lose some weight. If you change from white bread to wholegrain you can lose weight . Inflammatory markers will also reduce. You will have more energy.
How does this happen?
In an attempt to understand the reason for this Phillip Karl and his team showed that more calories passed through into the faeces and the resting metabolic rate increased. So they didn’t absorb all the calories plus they were burning more energy.
Cholesterol
All discussion about fats in your diet is governed by cholesterol levels or weight control.
Cholesterol can be deposited in artery walls causing narrowing which reduces blood flow and the supply of food. (nutrients) Lack of nutrients causes cells to not work properly, not heal and eventually to die.
Cholesterol is not a problem for everyone.
The initial work exploring the effects of cholesterol by Keys et al in 1965 stated “Your body needs cholesterol. If it doesn’t get enough from your diet the liver will make more. Attention to [dietary cholesterol] alone accomplishes little,” So he didn’t think it was that important.
Maria Fernandez in her article in 2012 reviewed the evidence for dietary cholesterol. Only 25% of the population will raise their LDL Cholesterol levels if fed high cholesterol diets, but even these will also increase HDL Cholesterol levels so maintaining the LDL/HDL cholesterol ratio which is a key marker of CHD risk. Risk is then neutral. She felt that the evidence for a recommendation to limit cholesterol intake did not exist and that the upper limit should be reviewed.
The US is one of the few countries that maintained an upper limit for dietary cholesterol finally removing it in 2015. This added to the confusion in the general population. Australia Canada, New Zealand, India and most European countries do not have an upper limit for cholesterol.
In 2020 Dehghan et al published their study Association of egg intake with blood lipids, cardiovascular disease, and mortality in 177,000 people in 50 countries. They compared a diet of 7 eggs or more per week to a diet of 1 or less per week.
Their conclusion was “In 3 large international prospective studies including ∼177,000 individuals, 12,701 deaths, and 13,658 CVD events from 50 countries in 6 continents, we did not find significant associations between egg intake and blood lipids, mortality, or major CVD events.”
In summary
Cholesterol is very important but unfortunately changes to cholesterol in your diet probably won’t help. However there remains very good evidence that an anti-inflammatory diet will help. Weight loss remains an extremely important risk reduction strategy and the discussion around saturated and polyunsaturated fats is important for weight loss and insulin sensitivity. However it is not yet clear whether insulin sensitivity is more sensitive to carbohydrate intake or inflammatory foods.
Fats
Fats are divided into saturated, monounsaturated, and polyunsaturated. Saturated can be further divided into short, medium and long chain fatty acids.
Saturated fats
No double bonds. Saturated fat only appears to be a problem if you have a high carbohydrate intake. Diets low in carbs are protected from saturated fats. High carb diet. (>40%)
Carbohydrate is far more important than fat. If you choose a high carbohydrate diet then check your cholesterol. If your cholesterol level is high you can replace saturated fats (cream, milk, fatty meat) with monounsaturated fats (olive oil, nuts, and avocados. )
Monounsaturated Fats
One double bond. 42% of the fat in Lean red meat is saturated. 44.6% is monounsaturated and 16.95% is polyunsaturated. This helps to explain why red meat is not a cardiac risk.
Polyunsaturated fats
Two or more double bonds. These are the omega-3 and omega-6 fatty acids found mainly in nuts, seeds and fish. These lower cardiac risk.
| Total Fat | Saturated | Monosaturated | Polyunsaturated | Protein | |
| lean red meat (ref) | 2.7g/100g | 1.149g/100g | 1.205g/100g | 0.448g/100g | 23.2g/100g |
| salmon (ref) | 6.34g/100g | 3.320g/100g | 5.390g/100g | 2.655g/100g | 19.8g/100g |
| Avocado (ref) | 22.7g/100g | 3.33g/100g | 15.0g/100g | 4.0g/100g | 1.78g/100g |
Trans Fatty Acids
When vegetable oils are hydrogenated they become more stable and have a longer working life (Trans Fatty Acids). This made them popular for frying fast foods and baked goods. Unfortunately they are very inflammatory and are regarded as the very worst of the fats. The FDA has banned the use of Trans Fatty Acids.
Thermic Effect
We use energy (Thermic effect) when we break food down and store it (digestion). Some foods are harder to digest than others and we have to burn more energy. Cream is easy to digest (2.5%). We don’t use much energy to break it down and store it. Olive oil is harder to digest so burns more energy (5.1%). This explains why trials have shown a small weight loss just by changing from saturated fats to monounsaturated fats.
Higher-carbohydrate meals, particularly those with a higher fibre content, increase the thermic effect of food compared to higher fat meals, and in particular those high in saturated fats. Higher protein meals have a higher thermic effect of food than lower protein meals. (ref) Fibre and protein are harder to digest and burn more energy.
Minimally refined grains increase the thermic effect of food, compared to refined grains. Less processed is better.
Whole Foods, not components
We have had the opportunity to take food apart and examine the components. Sometimes we have made guesses about whole foods based on the measured components. These guesses have guided research. The avalanche of information has been overwhelming and generated a lot of confusion especially when research uncovers the true value of whole foods. For example butter was vilified because one of the components is cholesterol. Research has now demonstrated that butter as a whole food is not a cardiac risk. (ref). Processing removes parts of whole foods and often makes them less healthy. Less processed is best.
Whole food, nothing added
Many things can be added to make food last longer (Salt, Sugar, Preservatives). Additives can make food smoother, creamier, more moist. Sugar is the most dangerous additive because of the scale in which it has been added and how it changes the taste of food such that we crave its sweetness. Sugar consumption is directly proportional to obesity in developed countries. It also makes the inflammation in every disease process worse.