Weight loss trends come and go as quickly as the DoorDash delivery guy, but there is one exceptional diet that doesnt seem to be going anywhere, and thats intermittent fasting. Its benefits go far beyond the simple weight loss other diets promise, and current research has just scratched the surface, leaving much more to learn. Intermittent fasting has been linked to better immunity and lower disease rates because foregoing food for a short period has been shown to help the body's immune system fight off infections. Studies also show it may help stop the clock on aging, fend off obesity, and lead to longer lifespans.

The most popular type of intermittent fasting is time-restricted eating, or only eating within an 8-to-10 hour window each day. Another well-publicized alternative method is known as alternate-day fasting, which involves fasting for longer windows of time, such as 24 hours or even 36 hours, followed by periods of unrestricted eating.

It appears to work for weight loss and disease prevention, according to some scientific studies. But is alternate-day fasting practical and effective for the long term compared to typical calorie-restricted diets?

We consulted the research and nutrition experts for a holistic answer. Here, youll find an explanation of what clinical trials have shown, plus practical advice from Skylar Griggs, MS, RD, LDN, a registered dietitian and owner of Newbury Street Nutrition as well as lead dietitian for the preventive cardiology division at Childrens Hospital Boston; and Jill Edwards, MS, CEP, Director of Education for the T. Colin Campbell Center for Nutrition Studies.

The alternate-day method of intermittent fasting allows for unrestricted eating one day, or feasting, followed by a full day of fasting. On fasting days, advocates for this style of intermittent fasting suggest consuming only 25 percent ofyour normal caloric intake, rather than foregoing food altogether. So if your normal food intake amounts to 2,000 calories a day, you would eat 500 calories on fasting days, according to this plan.

Comparing alternate-day fasting with calorie-restricting diets, studies havesuggestedthat they work equally wellfor weight losssince at the end of the week you've had approximately the samenumberof calories on each.People on analternate-day fasting dieteat about one-third fewer calories overall for the week,which is comparable to a calorie-restricted diet.

On an alternate-dayfastingdiet,you would eat about 9,500 calories over the course of a week,or about 1,000 less than if youate 1,500 calories per day on a calorie-restricteddiet. This is significantly less than the standard 2,000 calorie-a-dayintake which amountsto 14,000 caloriesover the course of a week and would result in losing between 1 and 2 pounds a week (since a pound is equal to 3,500 calories).

Proponents of this diet method tout the freedom it allows on feasting days: Diet only half the time! proclaims the subtitle on one popular book on the subject. Delay, dont deny, declares another.Covers of these books feature images of processed and animal foods, like donuts and burgers.

There are no widely accepted guidelines on what to eat on feasting days, and this is certainly a big part of the appeal for many who try it: The reward for fasting is feasting! Still, if weight loss is a goal, it stands to reason that choosing plant-based whole foods like nutritious fruits and vegetables, whole grains and legumes, nuts, and seeds would be much more beneficial than processed junk, and lead to better health as well.

Many people will begin their feasting day by eating soon after waking up,then continuing to eat as they wish through bedtime.Others might fast from after dinner one day say, from 7 p.m. on Sunday and then break their fast for a 7 p.m. with dinner the following day, in this example, Monday evening. They wouldthen have afeasting day on Tuesday, through 7 p.m., and then fast on Wednesday.

People can plan their alternate-day fasting schedule in advance and decide which days of the week they choose as fasting or feasting days. A fasting day might include nothing more than a light lunch and an early modest dinner, so its better to plan to feast on days that include social engagements.

If this sounds like something you would like to try, there is science behind why and how it works. (If not, you're not the only one who finds the schedule unappealing, studies show.)

Research has shownthat animals placed ona variety of fasting regimens, including alternate-day fasting, experienceextraordinary health benefits, including longer life spans, and slowed or reversed signs of aging. They also benefit from a reduced incidence of disease and other negative health outcomes, including diabetes, cancer, high cholesterol, cardiovascular disease, neurodegenerative diseases, and obesity.

While human research is still emerging, a 2017 randomized controlled trial study on obese adults was less optimistic than the animal studies, showing the subjects who tried alternate-day fasting had the same amount ofweight loss as thegroup assigned to a traditional calorie-restricted diet. One note: The people in the alternate-day fasting group did not adhere to the prescribed calorie count, eating more than the recommendedamount on fasting days, and alsoless than they were supposed to eat on feasting days. The dropout rate was also higher in the alternate-day fasting group (38 percent)thanthe calorie-restricted group (29 percent), indicating it's harder to sustain this type of dieting.

A more recent randomized controlled trial study on alternate-day fasting in healthy humansshowed more positive results. The 2019 report showed a number of beneficial outcomes for the alternate-day fasting group compared to the control group.

The benefits of alternate-day fasting included:Body fat loss (particularly around the belly); improved cardiovascular health; reduced levels of an age-associated inflammatory marker; and lower levels of LDL (or so-called "bad") cholesterol.

So, with promising initial findings, why isnt everyone fasting? One perspective is quite simply that its hard to go without food for large chunks of time. Unlike a lab animal, most humans arentfedrestricted rations on a controlled schedule. We also dont live in a carefully monitored biodome, and people on a Western diet are used to eatingthree meals a day plus snacks. There's little support or precedence for eating differently.

But for people trying to lose weight, more traditional calorie-restricted diets pose their own challenges. Our bodies havent caught up to the evolution of our food systems were still hard-wired to prefer calorie-dense foods such as sweetsand high-fat foods, which would have been a rare and valuable find for our foraging ancestors but are now readily available at every drive-through, food court, vending machine and grocery store.

This biologically-ingrained urge to indulge is what drives many dieters to try alternate-day fasting, since it allowsthem to eat with abandon several days a week. This kind of freedom surely comes as a relief for anyone who is tired of constantly counting carbs or calories.

Plus, thepotential benefits ofslowing the aging process, improving cardiovascular health, and slashing LDL cholesterol while helping the immune system fight off potential infections likely attract a few takers too.

Skylar Griggs, MS, RD, has counseled thousands of clients on their nutrition and weight loss goals over the course of her career, but she has not recommended alternate-day or any style of fasting to any of them, for a few reasons.

First, the majority of the studies conducted on alternate-day fasting so far have been on animals. And for those studies done on humans, weight loss has not appeared to be significantly different than for people following standard calorie-restricted diets.Weight loss and weight management are the primary reasons people come to me, she said, And the research on weight loss is fairly limited. Second, people show poor long-term adherence to extreme diets, Griggs has found, and she putsalternate-day fasting in this category.

Any diet that is extreme and not approachable is hard to follow, said Griggs. Any diet you cant do 80/20 [80 percent healthy, 20 percentwiggle room] is not sustainable. When the plan is a bit malleable when it can bend a little bit people are more likely to stay with it.

Alternating between feast and famine days could also have negative effects on the metabolism, Griggs says,ultimatelyinhibiting weight loss and causing other health issues.

I think any time you restrict yourself down to 500 calories, youre just creating a disaster," she warns. "The body is so hungry, its likely to cause a decrease in metabolism and your body to go into starvation mode, Griggs said. Youll be more likely to overdo it the next day, and then with binge-type days, over time, triglycerides and blood pressure can become elevated.

The black-and-white thinking that alternate-day fasting encourages can be worrisome for people prone to eating disorders, says Griggs, who served as the lead outpatient dietician for Renfrew Center of New Jersey, an outpatient center for women with eating disorders,It follows a pretty typical eating disorder pattern: Restrict. Binge. Restrict again."

Overall, Griggs advised that people seeking to lose weight should stick to a more traditional plan and avoid going more than 4-5 hours without food during the day to keep the metabolism chugging along and avoid late-night eatingsince that'swhen people are most likely to overeat.

I think a lot of people are looking for the shiny new thing they think is going to be the answer," Griggs said. "But the things that are good for your healthare not usually super sexy. Instead, she advises: Eat fruits. Eat vegetables. Increase your fiber intake. Include healthy fats. Eat consistently during the day. These are not going to be on the cover of a magazine, but theyre definitely good for your health.

For those still bent on giving alternate-day fasting a try, Griggs has this advice: Whatever [diet] you decide to do, getting a dietician looped in is super important. Get the support of someone who is based in science and has gone through a lot of school, training, accredited programs, and hospital internships. Dont just go to, say, your gym for advice.

Alternate-day fasting style is not the number-one choice of another respected expert,Jill Edwards, MS, CEP of the T. Colin Campbell Center for Nutrition. For Edwards, the main objection is primarily for practical reasons.

Research has shown that it is not at all sustainable. Life happens. You have a luncheon, your kids have a birthday party. If youre only eating 500 calories a day, it makes it hard to sit down for dinner with your family, Edwards said. She has a personal friend who'd tried the diet style.

Id ask her to get lunch, and shed say, I cant, this is not my eating day, Edwards said. I think she lasted two weeks. The same friend then switched over to the time-restricted version of intermittent fasting, which requires eating every day within an 8- or 10-, or even 12-hour window. She had great success with this approach, which is the same type of intermittent fasting that Edwards herself practices and advocates.

More people would be medically eligible to practice this eating pattern as opposed to alternate-day fasting, Edwards notes, because of the comparatively shorter periods of fasting. With time-restricted eating, you get all the benefits of intermittent fasting, but its much more manageable. Youre eating according to your bodys internal clock,your circadian rhythms, and keeping the same cycle every day, she said.

Your body utilizes more fat stores in the morning as its way of planning to get through the day without the need to eat through the night. And then on the other end of that, you automatically cut out late-night eating, which is what sabotages your circadian rhythms, and according to research, leads to weight gain.

In other words, because people practicing the time-restricted version of intermittent fasting will eat, say, only between 11 a.m. and 7 p.m., they strategically use the bodys tendency to burn fat stores in the morning, and also shut down snacking at night, which is the time people generally go off the rails with their calorie intake and make poor food choices.

There is a magic number. We should not consume any calories not one piece of fruit or a cracker after 7 p.m. That way you have less gastrointestinal distress, higher sleep quality, and better weight management, Edwards said (though she personally makes exceptions on the weekends).

For people who want to make a go of the alternate-day fasting diet anyway, Edwards advised that they choose their feast day foods with care. You want to make the most of the calories and choose nutrient-dense foods on the days youre eating a lot. Dont stuff your face with calorically dense food that isnt nutrient-dense, she said.

As far as whether the health benefits of fasting would be compromised if one binged on junk food during their feast day, Edwards said the jury was out. Its hard to say because fasting is very powerful. But to me, its like smoking a cigarette and having an orange afterward. The orange is going to help scavenge some of the free radicals, but not all of them. So my thing is, dont smoke the cigarette, she said.

For the fasting-curious, Edwards pointed to the TrueNorth Health Center, a facility that specializes in medically supervised water fasting, as a resource for many well-documented case studies of the powerful effects of fasting on health. And, like Griggs, Edwards advised anyone considering trying alternate-day fasting to consult a medical professional first.

While experts dont all agree on whether any type of intermittent fasting is to be advised, recent studies and the two above-featured nutrition experts all align on at least five points when it comes to alternate-day fasting.

Check with your dietician or medical expert before you embark on any new diet. If you decide to try alternate-day fasting (and youre medically cleared to do so), choosing foods that are mostly plant-based and healthy on feast days, rather than processed foods high in unhealthy saturated fat and added sugar, is likely to enhance your results.

See the rest here:
Should You Try Alternate-Day Fasting? Here's What the Experts Say - The Beet

Martin Clunes, 60, explained he managed to lose over three stone thanks to the 5:2 diet.

"Its great and its supposed to be good for cholesterol, too."

He continued: "Now I do 6:1 and that seems to work fine.

"I eat anything I want on the other days.

"Its easy and seems to keep the weight off me."

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The actor also attributed his weight loss to the regular exercise he practices on his farm.

"I have a couple of big horses and ride them.

"Im very healthy.

"This is a difficult age, obviously, but Im doing fine Im not on any medication.

However, for two non-consecutive days, slimmers should eat just 25 percent of their usual calorie intake.

That would be 500 calories for women and 600 for men.

There are no restrictions on foods but it is expected that women and men lose around one pound a week.

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Martin Clunes weight loss: Actor lost 3 stone with simple and 'easy' diet - 'it's great' - Express

MILWAUKEE (PRWEB) December 17, 2021

In an AAEA session taking place at the 2022 ASSA Annual Meeting [Food Prices and the Affordability of Healthy Diets: New Data and Methods to Inform Agriculture, Food Systems, Safety Nets and Nutrition Programs, AAEA members provide new data on whether people can afford to eat healthy foods around the world. Research presented in this session begins with work underlying the United Nations estimate that about 3 billion people cannot afford a healthy diet worldwide, and adds new insights on impacts of COVID, long-term trends and historical perspectives on retail markets and food access in the U.S. and globally.

Yan Bai, Tufts UniversityAnna Herforth, IndependentNada Hamadeh, World Bank Development Data Group

Jessica Wallingford, Tufts UniversityAishwarya Venkat, Tufts UniversityWilliam Masters, Tufts University

Michail Moatsos, Utrecht University

Robert C. Allen, New York University

If you are interested in viewing this virtual session with a free Media & Press Registration on Friday, January 7 from 3:45 pm 5:45 pm Easter, please contact Allison Ware in the AAEA Business Office.

ABOUT AAEA: Established in 1910, the Agricultural & Applied Economics Association (AAEA) is the leading professional association for agricultural and applied economists, with 2,500 members in more than 60 countries. Members of the AAEA work in academic or government institutions as well as in industry and not-for-profit organizations, and engage in a variety of research, teaching, and outreach activities in the areas of agriculture, the environment, food, health, and international development. The AAEA publishes two journals, the American Journal of Agricultural Economics and Applied Economic Perspectives & Policy, as well as the online magazine Choices and the online open access publication series Applied Economics Teaching Resources. To learn more, visit http://www.aaea.org.

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Food Prices and the Affordability of Healthy Diets: New Data and Methods to Inform Agriculture, Food Systems, Safety Nets and Nutrition Programs - PR...

Express News Service

Food has acquireda new religionPeganism. The current buzzword in the wellness circuit is the pegan plan, which includes 75 percent vegetables and 25 percent high-quality meat. And it is for the inveterate weightwatchers. Most of us are familiar with either of the two surrogates of the pegan planpaleo and vegan. Presented to the world by the US-based Cleveland Clinic doctor and bestselling author Dr Mark Hyman in 2015, the pegan diet supports a novel practice of nourishment by integrating the cores of the paleo diet with veganism. Astonishingly at the start, paleo and vegan diets seem to be an erratic combo in nature as the former is meat-based and the latter excludes any kind of animal product. Pegan inherits the best of both worldsplant-rich, whole foods, healthy fats with minimum processed foods, and reduced sugar and starch intake.

Understanding the PlanDr Hyman advocates nutritious plant foods low in sugar and starch and those which promote HDL (high-density lipid) or good fat like nuts and seeds, olive oil and avocados. Nutritionist Ritu Gupta, the founder of Nutrique, a New Delhi-based weight and health management portal, explains, The pegan diet focuses strongly on whole foods that are plant-basedand discourages eating conventionally farmed meats or eggs.

Instead,it places emphasis on grass-fed, pasture-raised sources of poultry, and whole eggs. It does help reduce inflammation and maintain blood sugar levels naturally for a healthier you. Anisha Arora Chopra, a 37-year-old dentist from Raipur, who found it difficult to followit in the initial stages, testifies the beneficial effects of this regimen. After a month into the pegan diet, it felt amazing. I saw many changes, some of which were that I lost six kilos in two months. My anxiety attacks stopped occurring and I slept better, she states. Chopra says that her blood sugarlevels are in better control without any medicines,she can focus better on work and personal life, and is an overall happier person now.

The Nutritional GapThere is no definition of an ideal diet. Every eating habit we have comes with its own set of advantages and disadvantages. Nutraceutical Formulation expert and the founder of supplement brand PRO2FIT, Saurabh Shah answers: Essentially, every diet choice we make needs to be supplemented well to avoid lack of nutrient deficiency. Vegans usually find it difficult to meet their daily protein, calcium, Vitamin B12 needs. It becomes necessary to complement it with the right kind of supplements so that the deficiency of these is met to avoid complications.

Starch is an essential part of our diet as they provide energy to the body. Avoiding any particular macro-nutrient from the diet is not advisable. Everything, when eatenin proportion, serves its purpose in the body and the same applies to starch and carbs. Carbs (starch, fibre, sugar) are a good source of energy, iron, Vitamin B, provided it is not processed, advises Shah.

Chefs TakeUnlike vegan, its not featured in restaurant menus yet but awareness among chefs is created by requests for preparations with specific ingredients. Ganesh Chandrakant Teli, the Executive Chef at The Leela Palace Jaipur, who innovated sweet potato burritos and shrimp with zucchini noodles on a guests request, says, It can be compared to the very popular Mediterranean dietfresh and organic ingredients, heart-friendly, obesity-controlled and aids inkeeping disorders at bay.

The pegan diet is trending as it allows vegans to have animal products in moderation.It broadens their dietary choices, and lowers the chance of developing deficiencies. This is something Indians have been following since long, concludes Dietician Rajat Jain, founder of Health Wealth Diet Clinic.

Pegan meal bowlRecipe by Balvinder Pal Singh Lubana, Executive Chef Marriott, Hyderabad

Ingredients French beans 50 gm Button mushroom 50 gm Broccoli 25 gm Cherry Tomatoes 6 pieces Bok Choy 50 gm Zucchini 3 pieces Brussels sprouts 4 gm Hald an Avocado Coconut oil (unrefined) 1 tsp Poached Eggs 2 Boiled chickpeas 1 cup Chopped garlic cloves 4 Chopped onions 1 Himalayan pink salt to taste A spring of basil

Method Wash and clean allvegetables thoroughly before processing In a deep pan, add water to boil chickpeas Cut the mushrooms into or . They need to be even-sized. Cut broccoli into florets. Peel the asparagus. Cut the French beans into batons, and zucchini into batons. Add salt, garlic to the mushrooms, and set aside. In a pan, add broccoli and a little water, salt and steam the broccoli. Repeat with the beans and zucchini. In a sauce pan, add the garlic, 1 tsp coconut oil and roast till the raw smell goes away Add the mushroom and saut till mushrooms are done. Remove and saut the bokchoy. Add 1 tsp oil, and add the rest of the garlic and the cooled chickpea and saut In a deep pot, bring water to a boil, add a little salt and vinegar, swirl the water with a perforated spoon and slowly add whole egg so it coagulates. Take out once the exterior is firmand transfer intocold water.

To assemble In a wide bowl, add the bokchoy, 1-2 tsp sauted chickpeas, 1 tsp mushrooms, the vegetables, and poached egg. Garnish with chopped basil, sliced avocado, and cherry tomatoes. Serve immediately

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Embrace the best of meat and veggies with a 'pegan' diet plan - The New Indian Express

When she moved back to Lagos in 2010 after living and working abroad, Affiong Osuchukwu noticed that a lot of the Nigerian food she cherished had become meat-centric. Although the essence of the dishes hadnt changed, they seemed, to her, to be meatier.

I never recalled a pot of soup as having as much meat and fish as I see today, she said. My running joke is Where is the soup in the soup? Because all I see is animal parts. The soup is not there.

Ms. Osuchukwu runs Plant Food Federation, a website focused on plant-based approaches to Nigerian cuisine, and she is one of many cooks in West Africa and the diaspora navigating the experience of being vegan in a culture that holds certain ideas about food close. She is also part of a growing number of people trying to confront a misconception that it is difficult and even limiting to eat a meatless diet using West African ingredients.

On the contrary, Ms. Osuchukwu, who is originally from Calabar, in southern Nigeria, said that there are many ingredients available across the country that can be used to adapt traditional dishes for a plant-based diet, like sliced ugba, a fermented oil bean seed, which steps in for dried and smoked fish in native rice and in abacha, a salad of shredded cassava, red palm oil and fresh herbs.

People always ask me know how I handle being vegan or plant-based in Nigeria because they believe we dont have food diversity here, she said, and I always look at them like, No, actually, we have more food diversity locally, right here, than in many different parts of the world.

West Africans are passionate about adaptations to their dishes. New approaches are questioned, and traditional ways of making beloved recipes are championed. But plant-based ingredients are not just replacing meat in these recipes; they are revealing new paths to familiar flavors.

Removing animal products from recipes like moin moin, steamed bean cakes that may be packed with meat, fish or eggs (sometimes all three), and often served at holiday celebrations; gizdodo, a chicken gizzard and plantain dish; and kontomire stew, a melon seed soup made with cocoyam leaves, hasnt created the kind of culinary gap one might imagine.

Moin moin, for example, does not need the additions of animal products that have become ubiquitous across Lagos. (The Nigerian Cookbook by H.O. Anthonio and M. Isoun, published in 1982, features a plant-based recipe.) Mushrooms can step into many dishes, hitting all of the same notes you would find in a meat-based recipe. Lemongrass, coconut, cassava and seasonal fruit are indigenous ingredients across many parts of West Africa, and they shine in a lemongrass tapioca.

Afia Amoako, who posts on Instagram and TikTok as @thecanadianafrican, said something that resonated with the recipe developer in me: There is no standard recipe for many traditional dishes. There are only standard methods, ways of building and layering flavor, techniques that produce a familiar outcome.

We all know how incredibly protective of their food West African people are, but we sometimes forget that everyone does it differently in their own household, she said.

When Ms. Amoako, a Ghanaian doctoral student living in Toronto, became a vegan about six years ago, her family and friends wondered how this would change her relationship to the food she grew up eating food her parents ate daily.

She says it has helped her connect to a more traditional way of eating.

My mom has been so gracious about helping me veganize a lot of my dishes, Ms. Amoako said. Shell say, OK, lets pull out what we did in the village because that aligns with how youre eating.

Her social media platforms have become robust forums for discussing what it means for everyday Ghanaian dishes to be adapted to suit a plant-based diet.

My work on my platforms is a reminder to fellow Ghanaians that being vegan doesnt mean losing or giving up your culture, Ms. Amoako said.

In fact, she sees a harmony between exploring the continents history and adapting her cuisine.

The ways that we did it before, she said, there was sustainability built into it.

Fatmata Binta, a Fulani chef based in Ghana, has also found that harmony.

She examines the plant-based foundations of Fulani cuisine through her dinner series, Fulani Kitchen, which was inspired by her visits to Fulani settlements throughout Ghana.

She says that most people assume that the cuisine is meat-centric, because of the Fulani peoples connection to cattle. But, she says, cattle is business for Fulani people the meat is mostly sold at markets and is a central source of income for the community.

Though Ms. Binta is not vegan, she notes that plant-based eating aligns with a more traditional way of life.

Our nomadic lifestyle requires that we travel mostly with nonperishable and preserved foods, she said. Grains, legumes, potatoes and sun-dried ingredients make up most of our diet.

During the pandemic, unable to travel easily, she began finding ingredients at Nima Market in Ghana, where Fulani and Hausa traders would sell ingredients, and foraging locally in and around Aburi. I discovered so many local ingredients by foraging, and Im able to work with the ingredients when they are at their best, she said. Its so inspiring and therapeutic.

For some West African chefs in the diaspora, engaging with vegetarian interpretations of their cuisines has prompted other kinds of self-reflection.

Salimatu Amabebe, who uses the pronouns he and they, is the director of Black Feast, a Bay Area dinner series that incorporates the work of Black artists and musicians, and centers the Black experience through a plant-based lens. He also seeks to merge two culinary identities: as a youth in the United States where his Nigerian fathers cooking was central to daily life, and as a professional cook. The dinners are set up on a sliding scale fee, ensuring that they are financially accessible. For Mr. Amabebe, it was a move toward inclusivity something he said he didnt feel within the broader vegan community.

Mr. Amabebe ate a vegan diet for 13 years, but said that identifying as a vegan felt disingenuous. The term vegan, he said, is used to market food to people.

I have a lot of discomfort in using Western food terms to describe Nigerian cuisine, even when the dishes are traditionally that way, he said, adding, The West African food I know is very much about sharing with family and community, rather than mass marketing.

Putting vegan and Nigerian cuisine together feels a little bit like Im like doing something conscious, he said. I would love to find words or phrases that feel true, or easier on my soul.

In fact, all of the people I spoke to said that the word vegan didnt easily apply to West African foodways, and the way they are discussed.

Ms. Osuchukwu often relies on terms like plant-based, plant-based vegan or sometimes even vegetarian. She says she will tell people that shes a vegetarian because they understand vegetarian.

She added: I dont actually like using the word vegan to be honest, regardless of where I am. I feel that plant-based is a better descriptor of our food.

No matter the terms they use to describe their diets, these four West Africans are telling a story with many chapters, and figuring out their place in the world.

I am rooting my diet in the history of cooking in my family, Ms. Amoako said. I am just living how my grandparents and my parents did.

For Mr. Amabebe, it is more about his own journey. Having a background of working in kitchens run by white chefs, where theres a specific style of consistency around fine dining, the process of cooking Nigerian food brings me back home, said Mr. Amabebe, who finds that Nigerian home cooking truly lets the cooks style and ingredients shine.

The food changes you. You cant help but change your mind about how you do things. Those ingredients are talking to you.

Recipes: Moin Moin (Steamed Bean Cakes) | Roasted Mushrooms in Ata Din Din | Coconut-Lemongrass Tapioca With Caramelized Citrus

See more here:
Connecting With West Africas Plant-Based Past - The New York Times

Introduction

In recent decades, the prevalence of mental health disorders has been increasing and is a major public health problem. The current worldwide prevalence of depression is estimated at 350 million.1,2 According to the World Health Organization, more than a quarter of European adults have experienced psychological disorders. Data from the Global Burden of Disease Study highlights the significant contribution of mental health and depression to the global burden of non-communicable diseases, including years of disability.3 Therefore, it is important to determine new preventive measures or strategies to reduce the development of the disease. Multi-factor processes, most likely to involve biological, social, genetic, and environmental factors, contribute to the individuals mental health and well-being.4,5 There is increasing attention to the possible contribution of modifiable lifestyle behaviors (such as habitual dietary intake) to the development of common mental health disorders. In addition, the emerging field of nutritional psychiatry no longer focuses on specific nutrients or foods but turns its attention to the relationship between eating patterns and mental health.6,7

Healthy eating patterns, such as the Norwegian and Mediterranean diets, which are characterized by a high intake of fruits, vegetables, whole grains, fish, and lean meat, are associated with a lower likelihood of depression.810 On the contrary, it is reported that people with unhealthy or Western-style diets have an increased risk of depression, which is typically characterized by a large consumption of energy-dense, high-fat and high-sugar products, processed and red meat, refined grains, and alcohol. However, meta-analysis and systematic reviews have not yet provided confirmation, partly because of the limited number of studies. Eating patterns and diet quality are also related to well-being, anxiety, and stress, which suggests that the biological mechanisms that underpin the health-related diet go beyond depressive symptoms. Inflammation has been proposed as the basis of the mechanism linking diet to mental health.11,12 There is increasing evidence that depression is related to increased concentrations of pro-inflammatory cytokines. Although high heterogeneity was observed in earlier meta-analyses, a recent meta-analysis (MDD) of cytokines and chemokines in major depression confirmed that concentrations of tumor necrosis factor A (TNF-A) and interleukin-6 (IL-6), as well as other cytokines and chemokines, were significantly elevated in MDD patients. At present, relevant studies have reported that there is an association between the inflammatory potential of habitual diet and mental health, but the specific mechanism has not yet reached a consistent conclusion.1315 Lucas et al reported Eating patterns related to circulating levels of C-reactive protein (CRP), IL-6, and TNF- receptor 2 were determined, and their relationship with depression risk was examined among participants in the Nurses Health Study.1618 They reported a 3040% increase in the risk of depression, depending on the definition, comparing the highest and lowest quintiles (that is, the most pro-inflammatory versus the most anti-inflammatory).19 In recent years, the Dietary Inflammatory Index (DII) has been developed to characterize an individuals continuous diet from maximum anti-inflammatory to pro-inflammatory. So far, DII has been associated with CRP, IL-6, and TNF-a. To date, only three studies have examined the relationship between DII and depression; all have reported that those with the most pro-inflammatory diets have an increased risk of depression.20

One candidate mechanism for motivation-related disorders in major depression is inflammation. Now, a large amount of literature shows that compared with the control group, some patients with depression have increased expression of inflammatory proteins and genes in peripheral tissues and cerebrospinal fluid (CSF), and increased peripheral blood acute phase proteins, chemokines, and adhesion molecules. A meta-analysis of these documents has determined that the most reliable inflammatory biomarkers for depression are the increase in peripheral blood inflammatory cytokines tumor necrosis factor (TNF) and interleukin (IL)-6 and the increase in acute phase protein C-reactive protein. Finally, compared with the general population, in the list of common symptoms, non-depressed individuals with primary immune diseases showed a significantly higher incidence of anhedonia symptoms.2123

Patients with depression show a wide range of clinical manifestations, including cognitive and autonomic symptoms. Importantly, these symptoms may differ in their biological causes, and deconstructing depression into specific symptoms may provide valuable insights into underlying neurobiology. A study has conducted a narrative review of the existing literature (21 studies) to clarify whether the link between depression and inflammation has specific symptoms. Overall, there is evidence that there is an association between neurovegetative symptoms of depression and inflammation, independent of cognitive symptoms. This is not the case with cognitive symptoms and inflammation. There is also some evidence that there are gender differences in the direction of the relationship between depression and inflammation.24 At the same time, a meta-analysis of 22 studies showed that CRP and IL-6 inflammatory cytokine levels are significantly positively correlated with the risk of concurrent depression. At the same time, inflammation (measured by CRP or IL-6) can predict future depression. This suggests that there may be a two-way relationship between depression and pro-inflammatory states.25 Another review identified the cross-sectional and longitudinal associations of two inflammatory markers, C-reactive protein (CRP) and interleukin 6 (IL-6), and depression in the elderly. The results show that there is a cross-sectional and longitudinal relationship between CRP and IL-6 and depression in the elderly. In longitudinal studies, inflammation causes depression, rather than inflammation.26

Elevated biomarkers of systemic inflammation have been reported in individuals with cognitive decline; however, most of the literature involves cross-sectional analyses with mixed results. A study investigating the etiology of this association conducted a meta-analysis of prospective studies examining the association between baseline interleukin-6 (IL-6), an established marker of peripheral inflammation, and the risk of cognitive decline at follow-up in adults without dementia. At the same time, mindfulness-based intervention (MBI) has a positive impact on the mental health of different populations. One study examined the effects of MBI on a psychiatric biomarker used to summarize the effects of low-grade inflammation. The results showed that MBI showed a low but significant effect on health outcomes associated with low-grade inflammatory biomarkers.22

The Dietary Approach to Stopping Hypertension (DASH) is based on seven components, with the four highest intakes considered ideal (vegetables, fruits, whole grains, and legumes) and three components, with avoidance or minimum intakes, considered ideal (conversion and red meat, sweet drinks, and sodium). The minimum value of each section is 1, the maximum value is 5, and the middle value is graded proportionately.27,28 The scores for all components are added up to a DASH total score ranging from 5 to 40, with higher scores indicating a healthier diet.29

There is increasing evidence that there is a link between depression and high blood pressure. Unhealthy lifestyle habits, such as high-energy intake and poor diet, smoking and drinking, and lack of physical exercise, are all risk factors for depression and high blood pressure. In addition, depression and hypertension are related to the imbalance of redox activity signaling and increased immune-inflammatory response.30,31 These diseases may lead to excessive activation of the hypothalamic-pituitary-adrenal axis, leading to increased secretion of corticotropin-releasing factor, corticotropin, and cortisol. These known risk factors are increased blood pressure and depressive symptoms. Oxidative stress and mild inflammation may also cause autonomic nervous system dysfunction, including increased sympathetic nerve activity and decreased parasympathetic nerve activity, and promote high blood pressure and depression.32 In addition, due to the role of endothelial cells in the production of brain-derived neurotrophic factors, endothelial dysfunction is considered a risk factor for depression. Endothelial dysfunction is also a risk factor for high blood pressure because it may lead to an increase in blood pressure and the vascular endothelium may acquire pro-inflammatory properties.33

The Diet to Stop High Blood Pressure (DASH) diet plan, which includes following a diet rich in fruits, vegetables, and low-fat dairy products, as well as low in SFA and red meat, is effective in reducing inflammatory markers and cardiovascular risk factors, including blood pressure And blood lipids. In addition, it has been reported that there is a negative correlation between adherence to a DASH diet and diabetes or CVD. Since hypertension and depression have many common risk factors, and because of the potential benefits of the DASH diet for diabetes, CVD, and low-grade inflammation, it is determined that the dietary treatment of hypertension may be related to the risk of depression.34,35

Adhering to the DASH diet can not only reduce the risk of CRC and CRA in men and women but also reduce the risk of renal function decline and all-cause mortality.36 There is evidence that the protective properties of the DASH diet may be partly due to its inverse relationship with visceral obesity.37 Some studies have provided evidence that the Dietary Approaches to Stop Hypertension (DASH) diet is associated with reduced levels of oxidative stress and inflammation, and may provide effective means for chronic disease prevention.38 Compared with the conventional diet, adherence to the DASH diet can effectively improve the circulating serum inflammatory biomarkers in adults and promote the formation of a systemic anti-inflammatory environment, at the same time, it can also reduce the risk of aggregate metabolism in elderly women. Consequently, it may be a valuable strategy to inhibit the inflammatory process.39,40 DASH diet can significantly increase GSH and reduce MDA levels. In addition, there is a trend to improve TAC, NO, and f2-is prostaglandins by sticking to the DASH diet.41 Intake of the DASH diet for 8 weeks in NAFLD patients has significant effects on body weight, BMI, ALT, ALP, triglycerides, insulin metabolism markers, inflammation markers, glutathione, and malondialdehyde.42 Whilst, DASH diet in pregnant women with GDM has a beneficial effect on FPG, serum insulin levels, HOMA-IR score, plasma TAC, and total GSH levels.43

The Alternative Healthy Eating Index 2010 (AHEI-2010) is based on 11 ingredients, of which six are considered ideal for maximum intake (vegetables, fruits, whole grains, nuts and legumes, long-chain omega-3 fats (DHA and EPA), and polyunsaturated fatty acids) and one is considered ideal for moderate intake (alcohol). Four ingredients to avoid or minimize are considered ideal (sugar-sweetened beverages and fruit juices, red and processed meats, trans fats, and sodium). The minimum value of each section is 0, the maximum value is 10, and the middle value is graded proportionately. The scores for all the components are added to produce an aHEI-2010 overall score, which ranges from 0 to 110, with a higher score indicating a healthier diet.44,45

Prospective studies have shown that, as measured by the Alternative Healthy Eating Index (AHEI), adherence to a healthy eating pattern is associated with a lower risk of recurrence of depressive symptoms in women, but not in men. This favorable association is attributed to the components of AHEI, including vegetables, fruits, and the ratio of PUFA/SFA. In addition, it is reported that according to the Healthy Eating Index (HEI)-2005 measurement, African Americans and white adults living in Baltimore have a higher quality of their diet and fewer symptoms of depression.46,47 Similar findings have been reported in the National Health and Nutrition Examination Survey, where a higher HEI is associated with a lower risk of depression in adults. The results of the meta-analysis of observational studies also revealed a significant negative correlation between healthy eating patterns (determined by factor analysis) and depression risk.48,49

Several possible mechanisms may explain the negative correlation between AHEI-2010 and depression. This association is caused by the cumulative effect of all the components of AHEI-2010, not by individual nutrients or food groups. The high content of folic acid, B vitamins, and antioxidants in a healthy diet may reduce the damage of oxidative stress to neurons. Due to the relationship between high levels of inflammatory biomarkers and depressive symptoms, the anti-inflammatory properties of the foods contained in AHEI have been shown to reduce the concentration of monoamines. In addition, the high levels of PUFA and n-3 fatty acids present in oily fish and other components of AHEI are other possible mechanisms.5052

The Relative Mediterranean Diet Score (rMED) described by Buckland et al estimates compliance with MD and is based on 9 ideal or bad dietary components. In terms of health, the ideal ingredients include grains, vegetables (excluding potatoes), beans, fruits and nuts, fresh fish, olive oil, and moderate alcohol consumption. In turn, undesirable ingredients include meat and dairy products. Each ingredient (except alcohol) is expressed in grams per 1000 kcal per day and is divided into gender-specific tertiles. Values between 0 and 2 are assigned to each tertile of the ideal component.53,54 For unwanted ingredients, the scores are reversed. For alcohol consumption, if the alcohol consumption is in the range of 525 g/day for women and 1050 g/day for men, 2 points are allocated; otherwise, it is recorded as 0 points. rMED is the sum of all 9 components. The total score ranges from 0 points (non-compliance) to 18 points (complete compliance).55

MD is characterized by high consumption of olive oil, whole grains, and plant food, low in saturated fat and sugar intake, and moderate consumption of fish, dairy products, and red wine, is considered to be one of the best models of a healthy diet because it has several cardiovascular diseases, cancer, diabetes, metabolic syndrome, inflammation and oxidative stress, and the beneficial effects of overall mortality rates. In particular, recent evidence suggests that inflammation and oxidative stress may constitute potential pathways for a potential link between diet and depression. This is supported by several studies that report a significant association between the inflammatory potential of diet and depression or depressive symptoms.56,57

Many possible approaches have been proposed to explain the link between diet and depression, including inflammation, oxidative stress, and regulation of neurotransmitter synthesis. Epidemiological studies report a negative correlation between MD compliance and inflammation and oxidative stress marker levels. Specifically, inflammation is the result of an imbalance between pro-inflammatory and anti-inflammatory mediators. In the brain, pro-inflammatory cytokines, such as IL-6 and TNF-, affect almost all pathways involved in the pathophysiology of depression, such as changes in neurotransmitter expression, neuroendocrine function, and synaptic plasticity.58,59

Certain Mediterranean diet components may affect preclinical vascular changes through potential new mechanisms. These changes may be related to cardiovascular risk by reducing endothelial oxidative stress, reducing inflammation, and enhancing endothelial function.60 Furthermore, greater adherence to the Mediterranean diet, especially its fish composition is related to lower CRP blood concentration.61 MedDiet has similar effects on inflammation in men and women. In addition, the variability of MedDiets anti-inflammatory effects may be partly due to the individuals overall inflammatory state; however, this observation seems to be more specific to men.62 In addition, the understanding of how nutrition affects the prevention and/or treatment of neurodegenerative diseases has also been greatly developed in recent years. The protective effect of the Mediterranean diet (MD) in preventing neurodegenerative diseases has been reported in many studies. The distinctive feature of the Mediterranean diet is the moderate intake of red wine and extra virgin olive oil, both of which are rich in polyphenolic compounds, such as resveratrol, oleuropein, hydroxytyrosol, and its derivatives. In vitro studies have shown They have neuroprotective properties, including anti-inflammatory effects on microglia.63

DII is an inflammatory index developed and verified by a researcher at the University of South Carolina in Columbia to evaluate the inflammatory potential of an individuals diet to understand the inflammatory impact of diet on human health. The purpose of creating the inflammation index is to provide a tool to classify an individuals diet from the most anti-inflammatory to the most pro-inflammatory continuity. The original DII was derived from the results of articles evaluating the effects of specific foods and ingredients on specific inflammatory markers published from 1950 to 2007. Each food and ingredient was assigned a score and multiplied by the actual food intake parameters of the individual to produce a The overall score summarizes a persons diet from the maximum anti-inflammatory to the maximum pro-inflammatory degree. Specific markers are IL-1, IL-4, IL-6, IL-10, TNF- and CRP. In 2014, South Carolina researchers improved the original DII scoring for peer-reviewed journals updated from 2007 to 2010; the improved scoring system has been applied to 45 food parameters, including whole foods, nutrition, and other biologically active compounds, from all over the world Eleven food consumption data sets were determined, and the entire diet was considered, not just individual nutrition or food, and a comprehensive database was established to represent various diets of different populations in different regions of the world, which can be applied globally. The DII includes micronutrients, micronutrients, and other common dietary components, such as flavonoids and caffeine. It is a new tool for evaluating the potential of dietary inflammation and can be applied to any population that has collected dietary data. DII can be obtained through 24-hour diet recall interviews or food record data. Food parameters can increase or decrease inflammatory potential through pro-inflammatory and anti-inflammatory markers; according to the influence of food parameters on inflammation, significantly increase IL-1, IL-6, TNF- or CRP, or decrease IL-4 or IL-10 Give +1, it is a pro-inflammatory effect; significantly reduce IL-1, IL-6, TNF- or CRP, or increase the -1 given by IL-4 or IL-10, which is an anti-inflammatory effect; if food If the parameter does not produce any significant changes in inflammation markers, 0 is assigned.6466

The steps to establish a personal DII are as follows. The calculation of DII is based on dietary intake data and then linked to a representative database, which provides a reliable mean and standard deviation for 45 food parameters, and calculates the Z score of each persons food parameter, to balance the right bias Influence, the Z value is converted to the central percentile. The calculation of food-specific inflammation score is first weighted according to the research design and research type. These weighted valuesare used to calculate the pro-inflammatory component of each food parameter: a. Divide the number of weighted pro-inflammatory articles by the total number of weighted articles, b. Subtract the anti-inflammatory score from the pro-inflammatory score, and choose 236 as the critical point, that is, the median of the total number of weighted articles of all food parameters, to represent an optimal and robust literature library, all with weighted articles 236 Food parameters are assigned to the full value of the score. Adjust the foods and ingredients with weighted foods <236 as follows: divide the weighted foods by 236; then multiply the scores by the food parameter-specific original inflammatory effect score to obtain the food parameter-specific overall inflammatory effect score. Multiply the central percentile value of each food parameter by its respective overall food parameter specific inflammatory effect score to obtain the food parameter specific DII score. Add up all food parameter-specific DII scores to obtain personal DII scores.67

Chronic low-grade inflammation has complex and multifocal endogenous and exogenous causes, and diet has always been considered an important factor in regulating inflammation. A healthy diet (such as a Mediterranean diet, rich in fruits and vegetables) is usually associated with lower levels of inflammation, and a Western diet (such as high fat and simple carbohydrates) is associated with higher levels of inflammatory markers, which can cause inflammation in the immune system.68,69 Belongs to the inflammatory diet. Studies have shown that the Western diet can change the intestinal microbial ecosystem and promote the occurrence and development of chronic inflammation. A study on cardiovascular risk showed that complement components C3, CPR, IL-6, TNF-, WBC, and neutrophil/lymphocyte ratio (NLR) are all increased in people with higher DII scores, and NLR is a sign of systemic inflammation. A meta-analysis on the relationship between DII and the risk of prostate cancer showed that a pro-inflammatory diet can lead to increased cell proliferation, inflammation, and oxidative stress, leading to prostate cancer. The possible mechanism is the promotion of foods such as butter, meat, and candy. An inflammatory diet increases systemic inflammation and causes insulin resistance, leading to an increase in insulin levels. Insulin levels play a role in the occurrence of prostate cancer by stimulating cell proliferation and apoptosis.70,71 A study in the United States showed that adherence to a pro-inflammatory diet including cholesterol and saturated fat has independent positive correlations with inflammation markers of white blood cells, IL-6, and homocysteine, and intake of high sugar, saturated fat, and other pro-inflammatory foods It promotes inflammation, which may increase the risk of various chronic diseases. On the other hand, the intake of the Mediterranean diet (including whole grains, fish, fruits and green vegetables, olive oil, etc.) is associated with lower levels of inflammation and is an anti-inflammatory diet. Adherence to the Mediterranean diet is associated with lower CRP, platelets, and WBC has anti-inflammatory effects and has a protective effect on cardiovascular diseases.72,73

Mental health disorders are more common in women than in men. According to reports, there are gender differences in depression and anxiety, including the age of onset and duration of symptoms, social adaptation, and long-term outcome. Current work shows that there are associations between the potential for dietary inflammation and depressive symptoms, anxiety, and mental health, and these associations are particularly evident in female participants. Although some earlier studies have also reported associations between female depression risk, these are female-only cohorts, and the dietary inflammation potential is determined by two different methods (dietary inflammation pattern and DII). The examination of the Nurses Health Research showed that by definition, comparing the highest and lowest quintiles of dietary inflammation patterns (that is, the most pro-inflammatory versus the most anti-inflammatory), the risk of depression increased by 3040%.74,75 The Australian Longitudinal Study of Womens Health (n = 6438) conducted a 12-year follow-up of middle-aged women and found that people with diet in the top quartile of DII had a 20% lower risk of depression than those in the lowest quartile of DII. To date, only two other studies have investigated the relationship between DII scores and the risk of depression in both sexes.76 In a Spanish cohort study of college graduates (n=15,093), male and female participants reported similar increases in depression risk (OR 1.53 and 1.46, respectively). Consistent with our findings are the latest data from the Whitehall II study, which also revealed a sex-specific association between DII and recurrence of depressive symptoms.77 In a longitudinal analysis of middle-aged men and women (average follow-up age of 60 years), women with the highest DII scores (ie, most pro-inflammatory diets) were almost 3 times more likely to develop recurrent depressive symptoms, even after adjustment After a wide range of confounding factors. No association was observed among male study participants. Compared with the Mitchelstown and Whitehall II cohorts (average age of about 60 years), the Spanish cohort (average age of one-fifth of the DII is 3640 years) may at least partly explain this difference in reporting specific gender relations Time. Further research is necessary to unravel the relationship between gender diet and depression.78,79

Several studies have assessed the relationship between diet and the inflammatory potential of overweight or obesity. Higher DII scores indicate a diet that is more conducive to inflammation and are associated with higher BMI, waist circumference, waist-to-height ratio, and increased risk of cardiovascular disease and cancer. A cross-sectional study of the University of Minas Gerais cohort also showed that the prevalence of obesity increased with the DII score. In addition, a longitudinal study of a Mediterranean cohort also showed that higher DII scores were associated with increased annual mean weight change and incidence of overweight and obesity at 10 years of follow-up. Our findings are consistent with these previous studies that higher DII scores are associated with an increased risk of obesity, while lower DII scores are associated with a lower risk of obesity.8082

A large cross-sectional study showed that in individuals with high cardiovascular risk, there is a direct correlation between DII and BMI and abdominal obesity. A recent meta-analysis of 12 prospective studies reported that subjects with the highest DII quartile had higher BMI levels. A meta-analysis of another observational study showed that there is a significant positive correlation between DII and obesity and BMI. On the other hand, some previous studies have shown that DII is negatively correlated with obesity, or has nothing to do with body weight, BMI, fat mass, and abdominal obesity.83 These controversies may be partly due to differences in the study population, metabolic disorders, BMI cut-off values, age, gender, and socioeconomic status, dietary supplements, and the number of foods and nutrients included in the DII calculation. It may also be related to reported deviations that are known to vary with weight status.81,84

DII provides a quantitative assessment of the potential for dietary inflammation. Current research results show that, compared with obese individuals, a normal-weight diet is more pro-inflammatory and manifests as a higher DII score. However, E-DII did not differ significantly among the three study groups. As mentioned earlier, this may be due to differences in total energy intake using FFQ, which are taken into account when scoring E-DII or energy-related reporting deviations.85,86 A follow-up cohort study showed that there is a direct link between DII and annual weight gain and overweight and obesity in normal-weight individuals. There seems to be a two-way relationship between obesity and inflammation. Body fat mass induces inflammation, which can lead to obesity and weight gain. In addition, a positive correlation was observed between the DII score and circulating leptin (as a pro-inflammatory fat-derived peptide), which underscores the potential role of dietary inflammatory features on adipose tissue inflammation. Chronic inflammation is one of the key mechanisms explaining obesity-related complications.87,88

In the field of obesity, BMI is the most common and convenient obesity classification index. The significance of using BMI is far-reaching because it can give an accurate cut-off point to define the number of people with different weights, and then tell us the prevalence of obesity. Obesity is defined as the excessive accumulation of body fat, and this excess fat is usually considered an indicator of poor health, which in turn constitutes a series of risk factors for diseases, including diabetes, ischemic heart disease, hyperlipidemia, Sleep apnea, arthritis, and others.89

Adipose tissue is not only a storage organ for triglycerides, but also studies have shown the role of white adipose tissue as a producer of certain biologically active substances called adipokines.90

In mammals, white adipose tissue (WAT) stores and releases lipids, while brown adipose tissue (BAT) oxidizes lipids to promote thermogenesis. In obese individuals, WAT undergoes profound changes; it enlarges, becomes dysfunctional, and develops into a state of low-grade inflammation.91 Adipose tissue is the source of pro-inflammatory activity, so it is called obesity-related inflammatory activity.92 Withal, adipose tissue itself is an endocrine organ that can secrete a variety of body fluid mediators, such as adipokines, which can induce or reduce inflammation and oxidative stress.93 Some studies have provided evidence that rodent models have demonstrated that fat inflammation pathways play an important role in diet and obesity-related metabolic disorders, and mRNA microarrays and secretion profiles of human adipose tissue and fat cells have identified similar inflammatory pathways in the obesity Inflammation pathway activated by endotoxin.94

Studies have shown that there is a correlation between dietary inflammatory index and age, and aging is also closely related to elevated systemic inflammation markers. It is important to pay attention to how to measure these indicators in the context of dietary intervention. The levels of acute-phase response factor c-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor (TNF) in the blood of the elderly tend to increase during the aging process. In the National Health and Nutrition Examination Survey (NHANES III), chronically elevated protein in the acute phase is a risk indicator of high mortality. The mortality rate of patients with elevated serum CRP over the age of 60 is 2.7 times higher than that of patients below this threshold (0.30 mg/dl).95,96

Chronic inflammation is a persistent, low-level non-specific body inflammation state. Studies have shown that chronic inflammation is related to cancer, diabetes, and cardiovascular diseases.97 In addition, studies have shown that the occurrence of old age frailty is accompanied by changes in an inflammatory state. Inflammatory factors induce cell senescence through oxidative stress, cell apoptosis, cell cycle arrest, and other pathways, causing tissue, organ, and system damage, which greatly increases the risk of debilitating or age-related chronic diseases.98 A large number of studies have proved that diet plays an important regulatory role in chronic inflammation. Different dietary patterns and dietary ingredients will produce different inflammatory effects. Aging is also a contributing factor to inflammation caused by diet. The underlying mechanism remains to be studied, but it can be simply assumed that old age is related to a more unhealthy and unbalanced diet, which may lead to higher DII scores in the elderly population. Human aging is accompanied by changes that may impair food acquisition, digestion, and metabolism. Many conditions, such as disability, acute and chronic diseases, may affect the nutritional status of elderly patients. There is convincing evidence that diet changes with age, which may promote inflammation, which may help increase or maintain obesity, especially abdominal obesity, in most people who are overweight or obese.99101

Inflammation is a key component of the innate immune systems ability to clear infections and repair injured tissues. Inflammation is caused by the release of pro-inflammatory cytokines from innate immune cells. In addition to the effects on the periphery, cytokines can also communicate with the brain and cause a series of emotional, cognitive, and behavioral changes collectively referred to as disease behavior.102,103 Of particular relevance to this review is that peripheral inflammation has been shown to induce depression-like behaviors in animal models, including decreased exploratory, novelty, and social behavior, decreased food intake; and sleep disorders. These disease behaviors are considered an adaptive response designed to reduce the spread of infection and promote healing. However, long-term inflammatory signaling, such as when the inflammatory response is maintained by continuous psychosocial stress, may have adverse effects, including the risk of depression and other mental illnesses.104

Research conducted in the past few decades has clarified the mechanism by which peripheral inflammation can enter the brain to affect neural processes related to depression, including neuroplasticity, neurotransmitter systems, and neuroendocrine functions. For example, inflammatory cytokines can alter neuroplasticity by reducing the expression of the brain-derived neuroprotective hormone BDNF. Inflammation can also cause changes in the dopaminergic system, which is related to depression. A single injection of high doses of LPS (5 mg/kg) can cause the degeneration of the dopaminergic system in the brain, especially in the substantia nigra and striatum.105107 In addition, the use of IFN- for chronic treatment in non-human primates leads to a decrease in the synthesis and availability of dopamine in the striatum, which is related to a reduction in sucrose consumption that depends on effort. A large number of experimental studies conducted in rodents have shown that the release of dopamine and the reduction of dopamine receptor binding are closely related to the defects of reward motivation behavior in depression.108

In addition to the effect on dopamine, inflammation can also affect the serotonin system through changes in tryptophan metabolism. Under normal, healthy conditions, approximately 5% of tryptophan is metabolized to serotonin, and 95% of tryptophan is metabolized through the kynurenine pathway. The metabolism of tryptophan through the kynurenine pathway can be converted into neurotoxic 3-hydroxykynurenine (OHK) and quinolinic acid (QUIN) or neuroprotective kynurenine.109,110 The way tryptophan is metabolized depends on the presence of indoleamine-2,3-dioxygenase (IDO). In preclinical models, the use of LPS to activate inflammation increases the activity of IDO, thereby assigning more tryptophan metabolism to the kynurenine pathway instead of serotonin synthesis, ultimately leading to serotonin deficiency. In preclinical models, LPS-induced depressive behavior is mediated by IDO activation. It is worth noting that inflammation and IDO both affect glutamate metabolism, which may also play a role in depression.111

In addition, inflammation has a powerful effect on the neuroendocrine system. Inflammatory cytokines may indirectly up-regulate glucocorticoids in the body by interfering with the functional ability of glucocorticoid receptors, leading to the continuous synthesis of corticotropin-releasing hormone (CRH) and the continuous activation of the HPA axis, which have long been associated with the pathogenesis of depression-related. This process can be self-sustaining because long-term elevated glucocorticoids can stimulate the production of neuroinflammation by activating microglia (resident immune cells in the brain).112

Diet affects inflammation, but there are currently few studies on how diet affects inflammation markers. One theory is that a pro-inflammatory diet can increase the levels of inflammatory cytokines by affecting oxidative stress and immune mechanisms. Related studies have shown that macrophages will produce free radicals and release them into tissues after ingesting a pro-inflammatory diet. Free radicals promote cell oxidative stress. Excess free radicals are usually associated with increased inflammation, that is, pro-inflammatory diets can cause inflammation in the blood. The release of sex factors is enhanced, causing inflammation. Research by Barrera et al showed that Western diet can cause postprandial hyperglycemia and hyperlipidemia, and through non-enzymatic glycosylation and glucose-induced NADH: NAD ratio imbalance mechanism to generate reactive oxygen species to increase inflammation and oxidative stress and mediate Expression of inflammatory factors CRP, IL-6, IL-1. Increasingly, the diet is the main medium for the function of the microbiota of the gastrointestinal tract.113,114 A German study showed that in mice fed a pro-inflammatory diet, the integrity of the intestinal immune cell barrier can be disturbed or lost, that is, through different mechanisms to cause intestinal cytotoxic effects, inhibit adenosine monophosphate-activated protein kinase, and Causes the production of mitochondrial reactive oxygen species, activates the mouse NLRP3 inflammasome, and mediates the release of IL-1, that is, diet can directly and indirectly (through the intestinal microbiota) provide a rich source of biologically active substances, and produce local and systemic effects on immune function. Influence and mediate the development of inflammatory response. At the same time, the anti-inflammatory diet, the Mediterranean diet, can reduce the release of pro-inflammatory factors by reducing the proportion of Gram-negative bacteria in the intestine, improving the intestinal barrier function, and reducing endotoxins, thereby reducing metabolic endotoxemia, inflammation, and The subsequent occurrence of metabolic diseases.115,116

The DII/E-DII is a summary measure for assessing the inflammatory potential of the diet. The construct validity of the DII and E-DII has been determined against inflammatory biomarkers in several different populations. Overall, these validated results support the notion that diet plays an essential role in modifying inflammation. Diets can be either pro-inflammatory or antiinflammatory, depending on the hormonal responses they generate.117 A pro-inflammatory diet may increase the chronic, persistent activation of the immune system, which leads to low-grade inflammation. Activation of immune cells, especially polymorphonuclear leukocytes, leads to overproduction of reactive oxygen species (ROS) resulting in oxidative stress. It is not well understood how oxidative stress leads to the development of depression. However, the most likely hypothesis is that the brain neuronal cells are vulnerable to oxidative stress due to their requirement of higher oxygen consumption and consequent generation of ROS, as well as a relatively weak antioxidant defense. ROS activates inflammasomes such as NLRP3 (NOD-, LRR and pyrin domain-containing protein 3), a cytoplasmic protein complex that modulates innate immune function by activating caspase-1, which increases pro-inflammatory cytokines such as IL1b.118,119 ROS also can regulate inflammatory processes by activation of transcription factors, including nuclear factor-kappa B (NF-kb) and activator protein-1 (AP-1) that lead to increased expression of proinflammatory cytokines. Conversely, these cytokines either: 1) stimulate indoleamine 2,3-dioxygenase (IDO) to convert tryptophan to kynurenine which is transformed into the neurotoxic quinolinic acid; or 2) exert an effect on the hypothalamic-pituitary-adrenal (HPA) axis which is linked to a reduction in hippocampal volumes, impaired neuronal plasticity, and decreased neurochemical functioning, resulting in DepS.120,121

Another potential mechanism through which diet may influence DepS includes the brain-gut-microbiota axis, a bilateral communication network between the intestine and brain. The intestinal microbiota and diet play an essential role in these gut-brain interactions and be involved in the pathogenesis of psychiatric disorders, including depression. Depression is associated with an altered gut microbiota composition, richness, and diversity.122,123 First, the neurotransmitter serotonin may have antidepressant and anxiolytic effects. Tryptophan, the main precursor of serotonin, is predominantly produced (>90%) by the gut microbiota. It is evident that the consumption of probiotics, specifically, Lactobacillus spp. and Bifidobacterium spp., affect mood by influencing serotonin levels. Second, in some preclinical studies in mice, consumption of a typical Western diet (high in animal protein and fat, low in fiber) led to a marked decrease in the numbers of total bacteria and a proportional reduction of beneficial Bifidobacterium or Eubacterium species leading to diet-induced dysbiosis. This phenomenon results in increased permeability of the intestinal mucosa, also known as leaky gut, which may increase the immune response and chronic neuroinflammation. This, in turn, stimulates pro-inflammatory cytokine production, which occurs when bacterial components such as lipopolysaccharides from the bacterial cell wall binding to circulating macrophages or monocytes.124126

A growing body of evidence supports the potential use of dietary interventions as adjunctive treatments for mental disorders. This review identified many ways that diet may affect mental health. These include pathways that regulate inflammation, oxidative stress, mitochondrial dysfunction, gut microbiota, tryptophan-kynurenine metabolism, HPA axis, neurogenesis and BDNF, epigenetics, and obesity (Figure 1). However, we do acknowledge that there are many other potential mechanisms involved in the pathophysiology of depression. These mechanisms are not mentioned in this article, but all of them can further reduce the risk of depression through dietary interventions, such as dietary effects on leptin, adiponectin, and mitochondrial biosynthesis. Research highlights the potential of restricting pro-inflammatory diets and/or supporting anti-inflammatory diets in reducing the risk of depression. However, more prospective longitudinal studies and improved methods are needed to confirm the current findings.

Figure 1 The possible main mechanism of dietary inflammatory index and depression.

Community Cohort Study on Specialized Nervous System Diseases (No.2017YFC0907701).

The authors report no conflicts of interest in this work.

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Dietary Inflammation Index and Mental System Diseases | JIR - Dove Medical Press

Inflammation is part of our immune system that helps fight off an infection, a virus, bad bacteria or heal an injury. However, inflammation can be harmful and chronic inflammation has been linked to heart disease, cancer, asthma, diabetes and Alzheimer's disease. WebMD states, "But in some diseases, like arthritis, your body's defense system your immune system triggers inflammation when there are no invaders to fight off. In these autoimmune diseases, your immune system acts as if regular tissues are infected or somehow unusual, causing damage." Eat This, Not That! Health talked to experts who explained why inflammation can be concerning and how to reserve it. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Vernon Williams, MD, sports neurologist and founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA explains, "The role of inflammation in a number of other common disorders is now recognized. Rather than acute inflammation resulting in swelling, redness and pain, these diseases are associated with long-standing, chronic, low-grade inflammation. There is increasing concern that inflammation-particularly chronic, low-grade inflammation-may predispose people to dramatic and long term consequences after specific triggers of an inflammatory episode. Some people are more likely to develop progressive and long-standing pain and dysfunction (and possibly other chronic medical conditions with inflammatory components) after a "trigger" (such as a fall or motor vehicle accident)."

Dr. Williams says, "Part of the concern is that dietary and nutritional status creates this predisposition. For a number of reasons, our current diets fail to provide us with balanced amounts of pro-inflammatory and anti-inflammatory building blocks such that we have a tremendous overabundance of pro-inflammatory substances in our diet and a paucity of anti-inflammatory substances. Paying attention to principles of an anti-inflammatory diet and nutrition can significantly reduce inflammation without the need to use anti-inflammatory medications (which have the risk of potentially serious side effects). This involves avoiding substances that can promote inflammation. Allergens (food, chemical and environmental) cause and promote inflammation. The Omega-6 family of fatty acids (including corn, peanut and safflower oils), trans-fatty acids from partially hydrogenated vegetable oils also cause inflammation. On the other hand, there are dietary options such as Omega-3 and Omega-9 fatty acids, and antioxidants (Vitamin C, Vitamin E, beta-carotene, CoQ) that reduce and fight inflammation."

"From a practical standpoint, adjustments in food and supplement intake such as cooking with extra virgin olive oil, eating more wild caught cold water fish, reducing carbs, and eating larger varieties of fresh, whole, colorful foods help achieve a more advantageous ratio of pro-inflammatory and anti-inflammatory substances in the diet," Dr. Williams states. "This more balanced ratio prevents and reduces the predisposition to dramatic inflammatory responses after a "trigger" event and reduces ongoing inflammation that is at work in pain and other chronic inflammatory conditions."

Dr. Orrin Troum, MD, rheumatologist at Providence Saint John's Health Center in Santa Monica, CA explains, "There are published nutrition and dietary recommendations for patients with rheumatoid arthritis which causes inflammation. Active RA may be associated with poor nutritional intake and anorexia. Trying to overcome these deficiencies are an important part of the management of the disease. Diets rich in fish oil or where additional eicosatetraenoic acid or docosahexaenoic acid are added to the diet results in decreased cytokines and arachidonic acid metabolites and subsequent decreased symptoms. Other proposed dietary manipulations have been tried in RA therapy, but remain unproven. Overweight patients should be encouraged to lose weight to prevent excess stress on the weight bearing joints."

According to Dr. Williams, "Inflammation frequently plays a large role in the continuation of pain. As the baby boomer generation ages, we neurologists and other pain specialists are seeing more patients with inflammatory conditions (arthritis, for instance) that affect older populations and as such, more patients who are suffering the chronically painful effects. The typical course of treatment for the pain associated with these conditions is often confined to non-steroidal anti-inflammatory medications (NSAIDs, such as ibuprofen and Naprosyn), steroids and other medications that can have severe side effects and risks, especially with prolonged use. But new treatments have emerged that can help control pain without the risks and side effects often associated with other treatment courses.

One powerful tool that has been used in medicine for thousands of years is electricity. While medications to control pain often work to block the pain response in the inflammation cycle, electrical signal therapy (EST) works differently."

Dr. Williams says, "Neuromodulation treatments are those that target the nervous system or brain at specific locations in the body and are part of a growing variety of methods that treat a number of conditions including CRPS, Migraine, Neuropathic Pain and many others. This class of treatments delivers electrical stimulation in an effort to relieve pain and restore function.

Radiofrequency During this safe and effective procedure, an electrical current is produced by a radio wave, which heats an affected area of nerve tissue. This is designed to minimize the pain signals from that specific area. There are a number of conditions that this type of therapy can be successfully used to treat including spine pain from arthritis and more. The degree of pain relief can be different for each individual but for the appropriate diagnosis, the majority of patients treated with a radiofrequency procedure experience relief.

Pulsed Radiofrequency (PRF) A variation of continuous radiofrequency treatment for pain, this procedure can offer the added benefits of pain control without the destruction of surrounding tissue in the treatment area. The benefits of this are especially noted in more complicated cases of neuropathic pain. In contrast to traditional radiofrequency, PRF is delivered in short "bursts" to help reduce risk of tissue damage and to confine the effect to the specific nerve being treated.

Electrostimulation with Nerve Blocks Traditional nerve blocks are procedures designed to interrupt nerve pulses (which send pain signals to the brain) by injecting nerves with a local anesthetic agent. Emerging studies are showing that a brief series of combined electrostimulation and nerve blocks can significantly improve pain associated with nerve damage, outperforming the benefits of medications commonly used for these kinds of problems." And to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

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How to Reverse Inflammation, Experts Say Eat This Not That - Eat This, Not That