Turn down the heat: Helping inflammatory disease through the diet
Dr Jessica Black,
Naturopathic doctor and author of The Anti-Inflammatory Diet and Recipe Book
According to UK charity Arthritis Care, nine million people in the UK suffer with arthritis. There are, in fact, more than 200 varieties of this painful joint disease, but the most familiar are osteoarthritis and rheumatoid arthritis. The former is caused by the breakdown of cartilage over time, and development of bony spurs; the latter is a systemic disease caused by an autoimmune reaction. Both varieties result in pain and inflammation in the affected joints.
Inflammation is controlled by the body’s immune response to infection, injury, foreign substances, blood pH balance, and other immune system triggers. Free radical damage is also associated with inflammation.
Diet plays an important part in reducing inflammation and relieving the symptoms of conditions such as arthritis. Perhaps the best-known dietary advice for arthritis sufferers is to consume essential fatty acids (EFAs), which play a key role in decreasing inflammation. This means upping omega-3 with, for example, flax and hemp seeds, walnuts and sardines, and omega-6 with sesame, sunflower and pumpkin seeds. A moderate amount of lean protein should also be included in the diet, coming from fatty fish such as salmon, mackerel, sardines and halibut, and monounsaturated fats such as olive oil should replace animal fats.
In contrast, some foods exacerbate inflammatory conditions. For example, saturated fats and hydrogenated oils, refined carbohydrates and highly processed foods should all be avoided by arthritis sufferers, because they all have the potential effect of triggering inflammatory response. Inflammation can impair the body’s natural ability to regulate blood sugar – and this is made worse by eating refined carbohydrates. Animal fats, meanwhile, are high in arachidonic acid, which has been linked to inflammation, and gluten, which is found in wheat and many other grains, is also known to cause inflammation.
Antioxidants are an important element of the diet, particularly for those with arthritis; nuts, seeds and fibre in the form of fresh fruits, veg and wholegrains should always be consumed in favour of processed foods as they contain various helpful nutrients. Beta-carotene, vitamin C and vitamin E are all associated with lower levels of C-reactive protein and interleukin-6, which are two major inflammatory markers within the body, and vitamin A has also been shown to be effective in the treatment of arthritis. Folic acid is important for those with rheumatoid arthritis taking methotrexate (it reduces the incidence of liver-function-test abnormalities and gastrointestinal intolerance).
Proper digestion is very important for arthritis sufferers because it ensures adequate absorption of the nutrients that are needed for metabolism, tissue repair and enzyme function. Taking two teaspoons of apple cider vinegar prior to meals may, by increasing the acidity in the stomach, aid digestion as it helps control blood sugar, decreases inflammation and induces satiety. Some spices may also be good remedies for inflammation. Cinnamon has been shown to help balance blood glucose, while curcumin from turmeric has anti-inflammatory and antioxidant properties. Ginger has been used for centuries to treat stomach conditions, nausea and inflammation.
Quick Quinoa Salad with Cooling Mint and Cucumber
This simple salad is packed full of nutrients that help to reduce inflammation, improve bone health and support the body’s digestive system. Quinoa is not technically a grain, but a seed high in fibre and is an excellent source of magnesium, which helps to balance blood sugar and triglycerides. Parsley is high in both vitamin C and vitamin K (vitamin K being essential for the normal formation of a protein in bones called osteocalcin. This protein binds to calcium and helps to hold the calcium in the bones). Parsley also aids digestion, along with the mint and lemon juice in this recipe. Garlic can assist in balancing the inflammatory response in the body, while the recipe’s olive and olive oil content provides important monounsaturated fats. Cucumbers are high in vitamin C and contain silicon, which is essential for calcium absorption. Serves 4
• 170g quinoa
• 480ml water
• 1 bunch parsley, finely chopped
• 20-25 pitted Kalamata olives, cut into thirds
• 1 cucumber, peeled, quartered and sliced
• 2 large cloves garlic, crushed
• 2 tbsp fresh mint, finely chopped
• 160ml lemon juice, freshly squeezed
• 5 tbsp olive oil
• 6-8 green lettuce leaves
Bring the quinoa and water to the boil in a saucepan for 3 minutes. Reduce heat to low, cover, and simmer until all water has been absorbed by the quinoa. Then set aside to cool. Add all the other ingredients together in a large bowl and set aside until the quinoa is cool enough to mix. Add the quinoa to the rest of the ingredients, combine and then leave to cool further before serving on large green lettuce leaves.
Sunflower Seed Crusted Halibut and Steamed Vegetables with a Ginger Coriander Sauce over Wild Rice
This fresh, healthy, tasty main course offers a whole range of anti-inflammatory benefits. Halibut contains good levels of omega-3 fatty acids for a white fish, wild rice is a wholegrain high in fibre,28 and the sunflower seeds and almonds contain unsaturated fats. Garlic and ginger both offer powerful antiinflammatory properties, while the quercetin in the onions inhibits the enzymes that trigger inflammation. This dish is packed full of antioxidants too. Beetroot and lime are both high in vitamin C, while beans are high in vitamin K, edamame (green soybeans in the pod) are a great source of fibre, protein and vitamin K, and broccoli is a vitamin powerhouse offering fibre, calcium, vitamins A, C and E, and folic acid. In theory, as well as having antioxidant capabilities, coriander leaves help to regulate blood sugar levels – although you’d probably need to eat a much larger amount than used in this recipe to reap the benefits! Serves 4
FOR THE MAIN DISH
• 400g wild rice
• 950ml water
• 900g halibut, sliced into 4 equally sized fillets
• 85g ground almonds
• 170g ground sunflower seeds
• 1 tbsp garlic powder
• 2 medium eggs
• 200g yellow beans
• 1 large red beetroot, cut into long 1cm pieces
• 2 broccoli florets, chopped
• 250g edamame, shelled
• Coriander and lime wedges for garnish
FOR THE SAUCE
• 1 medium red onion, chopped
• 2 large cloves garlic, minced
• 1 tbsp fresh ginger, finely grated
• 4 tbsp olive oil
• 2 tbsp soy sauce
• 3 tbsp lime juice
• 120ml water
• Small bunch of coriander leaves
Bring the water and wild rice to a boil in a large saucepan and allow to boil for 4 minutes. Reduce the heat to low, then cover and simmer until all the water is absorbed.
In the meantime, prepare the sauce. Heat the olive oil over a medium heat, adding the garlic, onions and ginger, and sautéing until the onions are translucent, stirring often. Blend all the sauce ingredients in a blender or food processor, making sure the coriander leaves are still visible. Set aside.
Combine the ground almonds, sunflower seeds and garlic powder on a plate. Crack the eggs into a bowl, beat lightly with a fork and then dip the halibut fillets into the egg before pressing into the seed mixture. Coat the halibut completely, then place onto a lightly oiled baking sheet and bake in an oven preheated to 180°C/350°F/Gas 4 for 25-30 minutes, or until the halibut flakes easily with a fork.
While the halibut is baking, steam all the vegetables, except the edamame, until they are just cooked (the less cooked they are, the more vitamin C will be retained). Add the edamame and steam for another 2 minutes, and use this time to gently warm the ginger sauce on a low heat. Serve the baked halibut over the wild rice and drizzle with the ginger sauce. Serve the steamed vegetables on the side and drizzle with ginger sauce if desired. Garnish the dish with fresh coriander leaves and lime wedges.