As science delves deeper into the connection between certain plant-based foods and prevention of chronic diseases, many people are taking an interest in the latest food darlings: those that prevent cellular inflammation.
Anti-inflammatory diets have long been recommended for heart disease, weight loss, depression, acne, anti-aging, arthritis, Crohn's disease, and multiple sclerosis by doctors such as Barry Sears (creator of the Zone Diet), Nicholas Perricone (a weight-loss and youthfulness guru), and Andrew Weil (widely known for his healthy eating credo and cookbooks).
But nutritionists are seeing more and more patients interested in these diets, in response to a growing buzz about anti-inflammatory foods fueled in part by new books such as The Inflammation Syndrome (Wiley, 2010), Anti-Inflammatory Foods for Health (Fair Winds, 2008), and The Anti-Inflammation Diet (2010). In his best-seller Anticancer: A New Way of Life, (2008) cancer survivor and physician David Servan-Schrieber explores foods that he believes prevent or curb cancer growth through their anti-inflammatory properties.
"When cancer patients ask me about it, I tell them is that this diet is not just related to cancer but a number of chronic diseases, so you're really looking at a broad picture of disease prevention," says Katrina Claghorn, advanced practice clinical dietitian specialist at Abrahmson Cancer Center at the University of Pennsylvania.
The foundation of the anti-inflammatory diet is berries, leafy greens, and brightly colored vegetables that are packed with flavonoids and carotenoids with both antioxidant and anti-inflammatory effects, and foods rich in omega-3 fatty acids such as mackerel, salmon, sardines, anchovies, walnuts, flax, and soybeans.
Other good fats with anti-inflammatory properties include olives and olive oil, pumpkin seeds and pumpkin seed oil, sunflower seeds, almonds, and sesame seeds.
To amp up flavor, garlic, onion, ginger, rosemary, cumin, black pepper, and turmeric are recommended in unlimited amounts. Green tea is also rich in anti-inflammatory compounds and has been associated with disease prevention. Red wine and 70 percent dark chocolate can be consumed occasionally for additional health benefits.
If this way of eating sounds like common sense, it's because it comes straight from traditional Mediterranean and Asian kitchens (where, by the way, obesity, certain cancers, diabetes and heart disease rates are much lower than in the United States). It's also rich in antioxidants and fiber and low in saturated fat and refined carbohydrates.
"If you look at these recommended foods, they don't just contain one property - they usually have a host of beneficial properties," says Debra DeMille, a local nutrition counselor. "The important thing is to eat whole foods so you get all of the good compounds."
On the flip side - and for every positive dietary recommendation, there's always a flip side - certain foods are known to cause inflammation, and experts recommend avoiding them. These include high-fat meats and non-organic dairy, sugar, fast foods, white flour, trans fats, corn syrup, and junk foods.
There are limits, of course, to the impact of anti-inflammatory foods. Experts stress that there's no single food that can improve health. A steady intake of berries won't help much if the person in question is a smoker and continues to consume Devil Dogs regularly. A true disease-prevention lifestyle incorporates exercise, adequate sleep, mind-body practices such as meditation or yoga, and avoiding exposure to toxic chemicals. And no diet can replace conventional treatments if a person is already sick.
DeMille offers an "Eat Your Herbs" class exploring the anti-inflammatory and cancer-fighting properties of herbs, allium plants, and spices to cancer survivors at the Joan Karnell Cancer Center at Pennsylvania Hospital.
The idea is to help the survivors prevent secondary cancers and promote general health and well-being by introducing more whole foods (and phytochemicals, by extension) into their diets.
"We don't have dose-specific information for these foods," says DeMille. "It can never hurt, though, to be eating them as much as possible and make your body chemistry an uncomfortable place for cancer cells."
The trick is making the anti-inflammatory foods pleasurable and learning to love ingredients that can sometimes sound too virtuous to be tempting. Nobody needs encouragement to down a glass of red wine or a square of chocolate, but it can be more challenging to incorporate Swiss chard into the daily menu.
"Some people think of garlic as socially limiting," says DeMille. "You can use green onion, leeks, or shallots instead if you like, but they're so good for you and so delicious that I encourage you to put them in everything but your breakfast cereal."
The good news is that anti-inflammatory meals can be as simple as sardines (fresh sardines can be found at Whole Foods, fish markets, or DiBruno Bros.) brushed with olive oil and broiled; poached salmon; or a seed and nut-laden granola. Or they can be more complex preparations that layer nutrients, such as black bean cakes with chunks of garlic, feathery wisps of cilantro, and a spicy pumpkin seed salsa; curried quinoa with coconut milk and kale; or a fresh berry tart with no-dairy, no-sugar filling and a pecan and walnut crust (see accompanying recipes).
There are other ways to incorporate anti-inflammatory ingredients on a daily basis. DeMille recommends adding turmeric or curry powder to eggs, rice, or soups. She adds grated ginger to marinades, salad dressings, and pasta dishes. She also suggests growing your own herbs, or freezing or drying excess packaged herbs to have on hand. Berries and flaxseed can be tossed into cereals, salads, and smoothies. Nuts and seeds can be eaten as a snack, while oils can be drizzled over raw vegetables and grilled fish and used for sauteing.
Overall, dietitians say, the emphasis should be on incorporating what tastes good. "There's a tendency to go to extremes. I try to encourage people to eat well and enjoy food," Claghorn says. "When I see the number of diets that have marched through my office over the years I'm reminded that the important thing is that we not forget the pleasure of food."
No-Bake Nut and Berry Tart
Makes 8 to 10 servings
For the crust:
1 cup raw pecans
1 cup raw walnuts
1 tablespoon flaxseed (optional)
1/2 cup dried apricots, soaked in water for an hour
1 teaspoon finely grated lemon zest
Pinch of ground cinnamon
1/4 teaspoon coarse salt
For the filling:
1 cup unsalted cashews
1 cup water
2 tablespoons honey
1/2 teaspoon coarse salt
1 tablespoon almond extract
1 tablespoon lemon juice
1 tablespoon arrowroot powder
3 cups any combination of berries
1 1/2 tablespoons natural, all-fruit seedless berry preserves
1. Process pecans, walnuts, and flaxseed (if using) in a food processor until finely chopped. Drain apricots and add them to nuts with lemon zest, cinnamon, and salt. Process until mixture becomes sticky and comes together. Press into a 9-inch tart pan. Wrap with plastic wrap and freeze for 30 minutes.
2. Meanwhile, make cashew cream: Combine cashews, water, honey, salt, and almond extract in a blender jar and blend until smooth. Transfer cashew cream to a saucepan and bring to a boil. Whisk for 1 minute, then lower the heat. In a small bowl, combine lemon juice and arrowroot powder until a paste forms. Increase heat on the cashew mixture and stir in the arrowroot paste, whisking for 1 minute, or until thickened. Remove from heat.
3. Spread cashew cream over crust. If using strawberries, hull and halve them. Warm preserves for a few seconds in the microwave and stir. Toss berries with preserves. Layer berries on top of filling. Serve immediately.
- From Elisa Ludwig
Per serving (based on 10): 335 calories, 6 grams protein, 32 grams carbohydrates, 19 grams sugar, 22 grams fat, trace cholesterol, 185 milligrams sodium, 6 grams dietary fiber.
Black Bean Cakes With Pumpkin Seed Salsa
Makes 8 servings
For the cakes:
2 cups dried black beans, picked over and rinsed, soaked overnight and drained
1/2 teaspoon cumin
1 quart water or broth
8 medium cloves garlic, minced
1/2 cup fresh cilantro, chopped
1/2 teaspoon salt
1-2 tablespoons extra virgin olive oil
For the salsa:
1 cup hulled pumpkin seeds
2 plum tomatoes, cored
1 small jalapeño
1/4 cup chopped red onion
1 tablespoon lime juice
1/2 teaspoon ground cumin
1/2 teaspoon pepper
1 teaspoon coarse salt
1. Combine black beans, cumin, and water or broth in a large saucepan over high heat. Bring to a boil. Reduce heat to low, partially cover, and simmer until beans are tender (60-70 minutes). Drain well.
2. In a large bowl, mash beans and garlic together well. Stir in cilantro and salt. Form mixture into 8 cakes. Transfer to a plate and refrigerate for 1 hour.
3. Meanwhile, make salsa. In a dry skillet over medium-high heat, toast pumpkin seeds until they are golden brown and plump. Remove from heat. Add tomatoes, tomatillos, and jalapeño to pan and char over heat, turning until all sides are deeply browned. Remove and allow to cool. Cut tomatoes and tomatillos into big chunks. Seed, stem and mince jalapeño. Combine all ingredients except the onion in the bowl of a food processor and pulse until chunky. Stir in onion, and adjust seasoning to taste.
4. In a large, nonstick frying pan, heat olive oil over medium heat. Add cakes and cook, turning over once until warmed and the outside is slightly crisp, about 5-7 minutes. Serve with salsa.
Per serving: 287 calories, 15 grams protein, 35 grams carbohydrates, 3 grams sugar, 12 grams fat, no cholesterol, 448 milligrams sodium, 8 grams dietary fiber.
Curried Quinoa Greens With Coconut Dressing
Makes 6 to 8 servings
2/3 cup quinoa
2 1/2 cups water or broth
3 cups young kale, stems removed and chopped into bite-size pieces
1 teaspoon curry powder
Pinch of salt
3 tablespoons unsweetened light coconut milk
2 teaspoons fresh-squeezed lime juice
1/4 teaspoon curry powder
1/4 teaspoon agave nectar
1/3 cup unsalted dry-roasted peanuts
1. In a dry, 4-quart nonstick saute pan over medium heat, toast quinoa for 5 or 6 minutes until fragrant, gently turning grains over from time to time. Add water or broth, kale, 1 teaspoon curry powder, and salt; cover and raise the temperature to high to bring mixture to a boil. Lower heat and simmer until quinoa and kale are tender, quinoa "tails" have popped, and liquid is absorbed, about 15 minutes. Remove pan from heat and transfer mixture to a large bowl.
2. In a small bowl, place coconut milk, lime juice, 1/4 teaspoon curry powder, and agave nectar and whisk together briskly. Pour coconut-milk mixture over quinoa and toss to combine well. Add peanuts just before serving.
Per serving (based on 8): 103 calories, 4 grams protein, 14 grams carbohydrates, 1 gram sugar, 4 grams fat, no cholesterol, 14 milligrams sodium, 2 grams dietary fiber.
Makes 4 servings
4 cups baby spinach, well washed and dried
1 cup water
2-3 cloves roasted garlic or 1 clove raw garlic
1-2 teaspoons freshly squeezed lemon juice
Pinch of salt
1 ripe avocado, halved and pitted
2 tablespoons crushed hazelnuts or lightly toasted pine nuts
1. In a blender, place spinach, water, garlic, lemon juice, and salt. Pack spinach leaves down and then blend until smooth, scraping down the sides as necessary.
2. Spoon avocado out of its skin and into the blender and process until smooth. Taste and add additional salt, garlic or lemon juice if necessary. Divide into 4 equal portions and garnish with nuts.
Per serving: 77 calories, 2 grams protein, 3 grams carbohydrates, trace sugar, 7 grams fat, no cholesterol, 40 milligrams sodium, 5 grams dietary fiber.
Grilled Fresh Sardines
Makes 4 servings
1 pound sardines
1. Cut the heads off the sardines if you wish and then rinse sardines under cold water. Brush with olive oil and sprinkle lightly with salt.
2. Place them on a grill or under a hot broiler. Cook them about 2 minutes per side until the flesh is just firm and the skin lightly browned.
3. Serve immediately with lemon.
Per serving: 163 calories, 19 grams protein, trace carbohydrates, trace sugar, 9 grams fat, no cholesterol, 145 milligrams sodium, trace dietary fiber.
For more information on cooking classes at Joan Karnell Cancer Center, visit pennmedicine.org/karnell