Monday, July 7, 2014

Understanding inflammation: Why you can't fix a diet problem with exercise

Most people are under the impression that they can eat whatever they want and just rely on exercise to undo the damage by creating a calorie deficit.  The problem is that weight gain is a fairly complex problem with many underlying issues, a caloric excess being only one of them.  Two of these issues that have garnered a lot of attention over the last few years are chronic inflammation and insulin resistance.    While 10 years ago one could argue that these two are only associated with one another and one doesn't necessarily cause the other, there is a significant amount of data that shows that they are associated with one another, that one does cause the other, and, ironically enough, they both reinforce one another(1).  In this blog we will look at how modulating inflammation through diet can help improve fat loss.

Before we start off, I feel it's important to point out the purpose of this article.  First off, if you begin to deal with inflammation but you still eat more calories than you burn, you will gain weight.  Calories do matter, period.  However, managing inflammation tends to decrease calories by improving hormonal signaling in the body.  The end result typically leads to a decrease in appetite and better fat burning through better hormonal signaling.

Second, inflammation isn't bad.  Inflammation is a good thing and is necessary to fight infection as well as improve athletic performance by allowing you to adapt to training.  However, high levels of inflammation or inflammation at the wrong time is very detrimental to performance and overall health.  An additional factor to take in to consideration is the current physiological state of the person, which can determine how much of a negative impact their food choices can have.  The purpose of this article is to give a clearer understanding of what paying attention to inflammation can do for you as well as providing context to when it is something that should become a concern.

For years epidemiological research showed an association between inflammation and insulin resistance but up until recently we had no idea how, or in which direction, it worked.  Does inflammation cause insulin resistance or is it the other way around.  Recent research has shown that increased levels of chronic inflammation signal insulin resistance in fat and muscle tissue, potentially to preserve glucose for the immune system.  I covered this very topic in a blog found here.  In addition, as chronic insulin resistance persists and the pancreas begins to create less insulin due to damage, more inflammation is created as the anti-inflammatory effect of insulin on the inflammatory FOXO1 gene decreases(1).  So not only does inflammation cause insulin resistance, over time insulin resistance will reinforce inflammation by creating more inflammation.  Leptin, a hormone that tends to be high in people with insulin resistance, is highly inflammatory.  So how does this relate to diet?

Certain foods can increase inflammation, particularly foods containing gluten, a storage protein found in wheat and other grains(2).  This in and of itself is not a bad thing.  In fact, an otherwise healthy individual with a healthy diet can probably have foods that contain gluten with little to no problem.  Maintaining a healthy gut microbiota promotes an anti-inflammatory effect that potentially counteracts the inflammatory effect from gluten.  A diet that promotes healthy gut flora and this anti-inflammatory effect tends to be highly diverse and contains a large amount of fiber from vegetables and fruit.  However, I don't believe many people pay attention to this and a high vegetable/low grain diet is certainly not the norm, particularly in people who think they are going to eat whatever they want and exercise it away.  Unfortunately, excessive exercise can make the problem worse by contributing to the inflammation and increasing hunger, or at the very least not allowing the immune system to repair the damage caused by the low quality diet.

So what should you take from this?  First, pay attention to the quality of your diet and shift away from focusing on calories in and calories out.  Second, make sure your diet is diverse and you consume a large volume of vegetables.  Third, if you choose to eat foods that are more inflammatory, your need for vegetables likely increases to counteract the inflammation.  Finally, understand that you cannot fix a diet problem with exercise and shift your approach accordingly.