The Positive Side

Winter 2016 

Calming the Flames

How diet can help cool chronic inflammation.

By Pamela Fergusson

Inflammation is a hot topic right now, especially for people living with HIV and other chronic conditions. Simply put, inflammation is our body’s natural response to infection or injury.

There are two types of inflammation: acute and chronic. With acute inflammation (a hangnail, for example), injured or infected cells signal the immune system to respond with a cascade of healing chemicals. The site of the infection or injury may get swollen, warm and sore as the chemical processes of inflammation work to repair the body. Once healing has occurred, the body sends chemicals to “turn off” the inflammation. The other type is chronic inflammation, in which the immune system is turned on permanently. HIV causes chronic inflammation. Antiretroviral therapy (ART) reduces but does not eliminate this inflammation.

The good news is how well—and easily—inflammation can be reduced through diet. An anti-inflammatory diet should reduce chronic inflammation and the risk of illnesses associated with it, such as diabetes, heart disease and possibly some cancers—problems that are more likely to crop up as we age. With the high fibre content of the diet you can also more easily achieve and maintain a healthy weight. And the antioxidants will slow aging of your cells, which might help you look and feel younger, too!

Connect the dots

Here’s how the immune system, HIV and diet link up: The gut is our biggest immune system organ, containing immune cells called GALT (gut-associated lymphoid tissue) cells. Healthy GALT cells help to protect the body from disease. HIV attacks GALT cells, even in people taking ART, allowing germs to pass into the body’s circulatory system and causing inflammation throughout the body. This increases the chance for diabetes, heart disease, liver or kidney disease, and possibly depression. Switching from a diet that relies heavily on red meat and highly processed and refined foods to one that includes more whole grains, fruits and vegetables, and good protein sources is one of the most effective ways to dial down chronic inflammation.

Refocus your diet

An anti-inflammatory diet includes plenty of vegetables and fruit, beans and lentils, nuts, seeds and whole grains. As a person with HIV, it’s important to also ensure that you get sufficient calcium to maintain the strength of your bones, so try to eat calcium-rich foods like cheese, yogurt, sardines (with the bones in) and leafy green vegetables like spinach and kale. Osteoporosis Canada’s website is a great resource.

Try to consume red meat only a few times a month, replacing it with fish, eggs or seafood. Meat portions should be small, about the size of your palm. Consider eating vegetarian one or two days of the week. Vegetarian chili full of fibre-packed beans is a great high-protein choice.

Increase your protein from plant-based foods such as lentils, tofu or tempeh (made from soybeans). If you haven’t tried it, it’s time to lose your tempeh virginity! Tempeh also supplies calcium and iron, and soaks up marinades beautifully.

Try to avoid inflammation-promoting foods, such as sugar, white bread, white pasta and white rice, trans or hydrogenated fats and alcohol.

Know your fatty acids

The nutritional powerhouses of an anti-inflammatory diet are omega-3 fatty acids, antioxidants and fibre. Omega-3 fatty acids are also known as essential fatty acids. Our body cannot make them on its own; therefore, we must consume them in our diet.

Two crucial omega-3s—EPA and DHA—are found primarily in oily fish like wild salmon, anchovies and sardines. While fish are the best sources of omega-3s, alpha-linolenic acid (ALA), another omega-3 fatty acid, is found in plant sources such as nuts and seeds, including flax. Although it’s best to get your nutrients from food sources, you can also consider an omega-3 or flax oil supplement.

Not all omega fatty acids are desirable—omega-6 fatty acids should be limited, as they tend to promote inflammation. Use oils low in omega-6, such as olive, avocado, flax or canola.

Be pro antioxidants

Myriad studies, such as the recently completed 10-year ATTICA study examining the link between diabetes and a healthy lifestyle, have shown that eating a Mediterranean-style diet rich in fruits and vegetables lowers the chance of developing inflammation-related diseases.

Brightly coloured fruits and vegetables tend to be excellent sources of antioxidants, helpful tools for reducing inflammation. Try to include more purple and red berries, dark green veggies and sweet potatoes in your meals.

Increase your fibre intake

Another way to reduce inflammation is by increasing your intake of both soluble and insoluble fibre.

Soluble fibre dissolves in water and forms a gel that slows digestion. This slowing effect may be beneficial to blood sugar levels and insulin sensitivity, helping to control diabetes. It also reduces LDL (or “bad”) cholesterol. Sources of soluble fibre include avocados, beans, nuts and whole grains like oats and millet.

Insoluble fibre is found in whole grains, fruits and vegetables. It prevents constipation by adding bulk to your diet and some studies suggest that it might help reduce your risk of certain cancers.

So take a break from white bread, pasta and rice and try whole grains like quinoa, buckwheat or brown rice.

Keep it hassle-free

If it seems like anti-inflammatory eating takes up too much time and money, keeping your pantry packed with canned beans and whole grains will make it much easier.

Check out our Bounty Bowl recipe for a cheap, quick and healthy meal.

Your freezer was made for more than ice cubes. Buy extra bags of frozen fruit and greens like kale and spinach for your smoothies when they are on sale at the supermarket and freeze them for later use.

Feed your head, too!

Does kale leave you cold? Do whole grains leave you wholly confused? Don’t worry; there are lots of great resources to assist your anti-inflammatory quest. Check out Created by Dietitians of Canada, the site contains many anti-inflammatory recipes. Another good source for recipes that boost the fruit and veggie content of your diet is

Savour the benefits

If you are trying to stay your healthiest and reduce your risk of complications like diabetes or heart disease, an inflammation-fighting diet can be a valuable part of a larger doctor-advised program. Regular dental checkups and good dental hygiene, adequate sleep, exercise and stress reduction are also important aspects of an anti-inflammatory lifestyle. It’s no surprise that smoking is linked to inflammation—yet another reason to quit.

Fighting inflammation through nutrition puts you in control of your health. Get ready to feel the power!

Bounty Bowl

Cook a big pot of your favourite whole grain, such as quinoa, buckwheat or millet. Refrigerated in a sealed container, it can keep for up to five days. Along with canned beans (black, Romano or pinto) or chickpeas, this can form the basis for many meals. Just add sauce, steamed or raw veggies and some tofu, tempeh or oily fish, and you will have a one-bowl inflammation-fighter.

Spinach Salad

A spinach salad with strawberries, blueberries or pomegranate seeds is a great idea. Add some nuts and chia seeds for an added anti-inflammatory boost.

Sauces and Toppings

For a delicious salad dressing or topping for your one-bowl meals, simply mix plain yogurt with chopped herbs. Or use tahini thinned with olive oil and lemon juice.

A sauce made with two tablespoons of almond butter, one tablespoon of low-sodium soy sauce and one teaspoon of ketchup makes a tasty topping for grilled tempeh.

Green Smoothie

Boost your intake of greens along with your energy by making a smoothie. Mix ice cubes, half a cup of coconut water, half a banana, half a cup of frozen mango and three handfuls of fresh spinach in your blender, along with some flax meal. If you need additional protein and calcium, add a couple of spoonfuls of yogurt or some fortified soy milk. You can’t taste the spinach—promise!

Pamela Fergusson is a registered dietitian with a PhD in nutrition. She has worked in Canada, the UK and the U.S. directly with clients and in education and research.