Wednesday, March 26, 2014

A Story About Inflammation: Oils and Your Health

Here at the Sweat and Butter Journal, I write on topics about which I'm asked most commonly by our health coaching clients and workshop attendees, and oils top the list.  Understanding the nature of oils as they pertain to human health requires an understanding of "inflammation", a buzz word that can take on a wide range of meaning.  For our purposes, I will review the dangers of inflammation when it persists in the body as well as how selection of cooking oils/fats can exacerbate it.  

This article is rather dense.  If you are the type who found yourself spacing out in science class, here are the take home points:
  • The primary problem with oil consumption in our nation is that we consume too much omega-6-rich fat and too little omega-3-rich fat.  Both types of fatty acids are important to your health, but neither should be consumed in great abundance.  The idea ratio of omega-6-to-omega-3 is 2:1, but the actual ratio in the typical Western diet is 20:1.  This ratio promotes low-grade, chronic inflammation.
  • Seed and vegetable oils such as canola, safflower, and sunflower are rich in omega-6 fatty acids.  Wild-caught fish, walnuts, seaweed, and grass-fed beef are rich in omega-3 fatty acids.
  • Extra virgin olive oil will easily burn even under low heat, thus becoming oxidized and potentially damaging to your health.  It's best to drizzle olive oil on food that is already cooked.  Keep your olive oil refrigerated in an air-tight container.
  • Cook with unrefined coconut oil, palm oil, or butter or lard produced from grass-fed animals.
  • It's better to eat fish a few times per week than to supplement with high doses of fish oil.  If you don't eat fish, I recommend supplementing with a fermented cod liver oil/butter oil blend.  Keep this oil in the fridge and in an air-tight container.
Let's start with a little cell biology and biochemistry...
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This story begins at the level of the cell.  Each cell in your body is comprised of phospholipids.  The structure of a phospholipid permits a bilayer of these compounds to arrange themselves such that the internal environment of the cell remains tightly regulated.  
If you look closely at this image, you will see the fatty acyl ("acid") tails of the phospholipids labeled at the bottom right corner.  Here is an enlarged schematic of the structure of phospholipids: 
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These fatty acid tails (blue squiggly lines in the image to the left) help the cell membrane to keep certain things in and other things out.  As I mentioned before, the phospholipid bilayer is the gatekeeper.  Because your body tissues are regularly under physical stress, it's important that your cells are compressible and flexible.  A fragile cell will easily break open, which renders it useless. Fatty acid chains stack neatly together allowing phospholipids to sit very closely together in order to fully enclose the cell, but this neat stacking also tends to make the cell membrane rigid.  A rigid cell membrane is fragile, so this is not favorable.  Fortunately low-density lipoprotein (LDL) is constantly delivering cholesterol to the cell membranes of every tissue in your body, wedging it between the otherwise perfectly arranged phospholipids.  Though it may seem counter-intuitive, cholesterol helps promote fluidity in the cell membrane phospholipid bilayer, and this is important for the health of your cells.  

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Phospholipids are clearly important, but the nature of their structure can also lead to problems.  Their fatty acid chains are polyunsaturated fatty acids (PUFAs).  This type off fatty acid is great for use in the phospholipid bilayer because, as I've already mentioned, they can stack neatly beside one another, but this structure is also easily oxidized.   Oxidation is a chemical reaction whereby the multiple double bonds of PUFAs are broken and rearranged when exposed to oxygen, and these rearranged bonds are at an increased risk of forming free radicals.  
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Free radicals aren't necessarily a big problem in small doses, because our cell membranes are equipped with special enzymes and antioxidants such as Vitamin E to repair damaged ("rearranged") fatty acid chains.  If they aren't repaired, free radicals will greedily steal electrons from nearby structures - i.e. DNA, organelles, other phospholipids, proteins, etc. - in order to stabilize themselves, but this theft is damaging.

OK.  Now, you're probably thinking, how do cooking oils fit into this picture?  Moving on.

Not All Cooking Oils Are Made the Same
The next chapter in this story will be a little more useful in the kitchen.  Every cooking oil that you see in the grocery store has a slightly different fatty acid profile.  The two major types of fatty acids that we must cover are omega-3 and omega-6 PUFAs. 

All of the omega-3s are derived from alpha-linoleic acid (ALA), whereas the omega-6s are derived from linoleic acid.  Several enzymes are required to convert these precursors to the the various omega-3s, such as EPA and DHA, and omega-6s.  The details of these conversions from precursors to useful fatty acids are found in the image below:
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(Isn't it interestingthat the same enzymes are used in both pathways?!  This means that whichever 
pathway is supplied with more precursors will procede preferentially over the other.  Neat.)

Omega-3s are generally said to be "anti-inflammatory" and omega-6s are generally regarded as "pro-inflammatory".  The reason for this takes us back into the biology of the cell membrane.  As you can see in the image above, EPA and DHA are intermediates in the omega-3 synthesis pathway.  Both of these compounds are readily converted into anti-inflammatory substances.  On the other side of the image, arachidonic acid (AA) is an intermediate in the omega-6 synthesis pathway.  AA is readily converted into pro-inflammatory compounds.  The balance between EPA/DHA versus AA production is the fundamental root of inflammation in the body.  If you are producing AA at a higher rate than EPA/DHA, you are inflamed.  But what does it mean to be inflamed?  We'll get to that a little bit later.  For now, just understand that it's no bueno.  

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Until we can talk about inflammation, there are still a few important things to discuss about cooking oils.  Depending on its source, an oil will contain different proportions of PUFAs.  When you eat omega-6 PUFAs, they are incorporated into the phospholipids that comprise the cell membranes.  As you may have already guessed, if you are consuming more omega-6 PUFAs in your diet, you'll be producing more pro-inflammatory compounds via a higher proportion of AA versus EPA/DHA, as your omega-6-rich diet will provide a steady supply of precursors to feed the omega-6 synthesis pathway shown in the image above.  When the cell membrane is injured due to free radical damage or trauma, AA is produced and converted into the pro-inflammatory compounds mentioned before, namely LTC4PGI2PGE2, and PGF2.  
Below you'll find a list of common cooking substances and their relative proportions of anti-inflammatory omega-3s and omega-6s.  A low-inflammatory diet will have a relatively low proportion of omega-6s. Unfortunately, vegetable oils have been produced cheaply and abundantly since the 1960s, which marked the beginning of the demonization of saturated fats.  These oils - canola oil, safflower oil, sunflower oil, soybean oil, and corn oil, as seen in the chart below - are rich in linoleic acid (blue).  If you read the labels of most processed foods, you'll see that one or more of these oils have been slipped into the product.  Likewise, restaurants use these oils in the majority of their meals because they are so cheap.  This has meant bad news for consumers of the Western diet.  As I mentioned before, both omega-6s and omega-3s are important for the construction of healthy cell membranes, but the ideal relative proportion is 2:1, omega-6-to-omega3.  For the reasons noted, the typical Western dieter is likely consuming a ratio closer to 14:1 or 20:1! This means a greater opportunity for the production of AA and thus pro-inflammatory compounds. 

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I recommend that you minimize use of omega-6-rich oils at the top of the list in favor of butter, ghee, lard, palm oil, and coconut oil

Before we shift the discussion to the dangers of inflammation, I want to make a few comments about extra virgin olive oil (EVOO).  This oil has been touted as a superfood for years, as it is consumed in high quantities by healthy populations that live in the vicinity of the Mediterranean Sea.  On the chart above, you'll see that olive oil is comparable to safflower oil in fatty acid composition, but extra virgin olive oil tends to be lower in omega-6s than more refined varieties.  Having said this, the omega-6 content of EVOO is still higher than the healthier options I mentioned before such as butter or coconut oil, so use it sparingly. Furthermore, EVOO burns easily even at low temperatures, which expedites the oxidation process.  As you'll recall from our discussion at the beginning of this article, oxidation is our enemy because it leads to free radical production in the phospholipids of our cell membranes. This free radical formation can trigger the conversion of phospholipid fatty acid tails to AA, which, as you know, easily converts to pro-inflammatory compounds.

The Final Chapter: Inflammation
It's time to come full circle.  We know that a diet rich in omega-6s may lead to inflammation, but what exactly is inflammation?

When we hear the word inflammation, we normally think of sore joints .  After running a marathon, your knees or hips may be sore and inflamed for weeks.  This is an example of acute inflammation, which occurs in response to injury.  It's easy to know that your knees are inflamed because they hurt and this may limit your mobility.  On the other hand, chronic inflammation is probably far less noticeable, which is why it's routinely referred to as "low-grade" inflammation.  This is dangerous because, unlike in response to acute inflammation, we don't always address chronic inflammation since it can often burn in the background without producing any dramatic symptoms.  After all, if you aren't experiencing any severe pain at the moment, how will you know you need to change your ways?  A little stress once in a while can set into motion cellular mechanisms that will make you stronger through a process called "hormesis", but a relentless bombardment of stressors can be destructive.  Chronic inflammation can persist for years, and serious disease processes are normally well under way before you change your ways through lifestyle modification. 

The pro-inflammatory compounds produced from AA in response to free radicals or other damaging trauma to a cell membrane set into motion physiologic mechanisms that help to repair the damage.  Evolution at its finest!  Prostaglandins and prostacyclins work to dilate blood vessels, allowing blood carrying immune cells to rush to the site of injury.  Leukotrienes raise a red flag to mark the site of injury in order to direct the immune cells that are brought to the site by the increase in blood flow.  These immune cells, namely neutrophils, go to work on the damaged tissue at the site of injury.  If they hang around for along enough, they also start to eat away at healthy tissue, disrupting the physiologic processes that keep us healthy, which is why chronic inflammation has been linked to so many chronic diseases, including cancer, heart disease, diabetes, obesity, and Alzheimer's dementia.  

To mitigate the inflammatory effects of an omega6-rich diet, you must aim to restore your omega-6-to-omega-3 ratio to 2:1.  First of all, reduce your omega-6 consumption by cutting out vegetable oils altogether.  Cooking with butter, lard, palm oil, and coconut oil tastes better and is better for you.  Likewise, you should increase your consumption of anti-inflammatory, omega-3-rich foods like fatty fish, walnuts, and seaweed.  Certain fish are richer in omega-3s than others.  Check out the graphic below.

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Please keep in mind that PUFAs are naturally produced in chloroplasts in the leaves of plants! Fish that feed on algae (or fish that feed on fish that feed on algae) are rich in omega-3s because they feast on wild marine plant-life.  Farmed fish, on the other hand, are fattened up with soy products, which are rich in omega-6s. Take care to purchase wild-caught fish. Likewise, cows that spend their lives grazing on healthy, lush grass as nature intended will provide you with a healthier fatty acid composition when compared to cows that are marbled up at a feedlot.  Vegetarians and vegans argue that they can consume sufficient omega-3s on their diets.  Of course you can obtain a lot of ALA by eating flax seeds and other leafy plants, but our bodies aren't great at converting ALA to EPA and, in particular, DHA.  Our herbivorous critter friends help us out by munching plants rich in ALA, converting it into EPA and DHA, then stashing it away in their meaty flesh to the benefit of predators - us.
Modern feedlot
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One note about fish oil supplementation.  Fish oil is often touted for its anti-inflammatory effects, but all PUFAs - both omega-3s and omega-6s - are at risk of oxidation and thus free radical formation, so consuming large quantities of even "healthy" omega-3-laden fish oil predisposes you to harm. Of all the fats you consume in a day, it's best to keep your PUFA consumption to around 1-3% of your daily caloric intake.  If you absolutely won't eat fish, taking just 1000mg (1g) of fish oil daily is sufficient to reap the benefits (although the clinical evidence on the beneficence of fish oil supplementation is a mixed bag).  It's thought that Vitamin E will prevent the oxidation of this high-dose PUFA supplementation, though this is also debatable.  Better yet, I recommend fermented cod liver oil/butter oil in capsule or liquid form.  This formulation provides ample Vitamin D, Vitamin K, Vitamin E, and Vitamin A in addition to sufficient omega-3s.  Keep your fish oil refrigerated in an air-tight container, as oxygen exposure increases the likelihood of oxidation. 

I hope this article helps you to understand the importance of selecting healthy, nourishing oils and fats for use in the kitchen.  This guide is incomplete in a lot of ways, but I didn't want to burden you with too many details.  I'll leave that to the guys getting their hands dirty in the lab. I'm only the messenger, and, as the messenger, I would be happy to answer any questions you have about the information presented here or to start a discussion if you want to delve even deeper.  

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD.  He can be reached at  You can also connect with him on Google+. 

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Wednesday, March 5, 2014

Recess For Your Brain're stressed and overworked.  This is a common feeling for most people, and we all have our go-to resources to de-stress.  Let's take a step back to examine how we may constantly perpetuate an endless cycle of stress without even knowing it.  By tweaking our daily routines we can see how bombarded we really are by our surroundings.  Once we've considered the reasons for which it's so difficult to find calm in the world, I'll provide a few relaxation methods that you can put into practice starting right now.  Let me take your brain to recess...

We are currently over-stimulated by an unrelenting stream of distraction to the point where we have been conditioned to crave it.  We are addicted to self-induced stress, like constantly checking our phones, emails, and social media.  Often times, this method allows us to disappear for a moment and take ourselves away from an uncomfortable silence or re-center ourselves during a tedious task.  This perpetual obsession with smart phones is likely contributing to a low-grade anxiety that many of us experience without even realizing it.  
Imagine this scenario:  You decide to leave your phone in the car on your way into your favorite bar for a quick bite to eat.  Anticipating some solo time, crossing the street seems strangely liberating because you are completely alert and aware of your surroundings now that your nose is no longer pasted to a small screen.  Unfortunately, within a matter of minutes, you are already searching your pockets for the phone that you had just moments before decided to leave in the car.   You sit down at the bar and remember the Sweat and Butter workshop you attended about eating for energy, so you order a side salad with olive oil and vinegar to accompany your steak and sautéed veggies for dinner.  Finally, you start to settle in for a mindful meal.  Things are starting off pretty pretty well, this evening!  Then you realize that the room in which you had been seeking peace of mind is filled with jams from the nineties, an incessant flashing jukebox, five TVs broadcasting a silent report on the latest sports scores, and the low hum of multiple conversations.  This is life as we know it.

Is it possible to find truly relaxing space anymore?  Think about grab a banana as you rush out the door in the morning.  You shovel your lunch into your mouth in between checking emails and finishing paperwork.  Then, you plop down on the couch after a long day and mindlessly eat your takeout in front of a glass screen that recreates a world in front of you in which you are not forced to interact.  Because life keeps you constantly on the go, you are forced to find solace in "relaxing" activities, many of which aren't relaxing in the slightest. Crappy TV isn't rejuvenating; it just adds to the stress.    

Have you ever seen such plush terrycloth in your life?!
There needs to be a disconnect, but sometimes this can seem like a chore.  "I want peace and if this isn't working then nothing will!" The reality is that creating and maintaing healthy, stress management strategies takes time, practice and patience.  
For those of you who have tried to implement relaxation tactics, you may find yourself confused by guidance you have received in the past.  If a yoga guru tells you: “Chill out! Just meditate, man!”, it's natural to have an insatiable urge to throat-punch them with your hand bone.  This is likely due to the insecurity that you feel when it seems like you are the only one missing out on the zen.

Magazines depict an unachievable ideal for us.  Simply climb an incredibly high mountain far from any civilization, and then hold a striking yoga pose effortlessly in order to be one with the universe.  Another example would be this cat picture. (above)  This picture says: "Allow your mind to evaporate any thoughts and calmly relax into serenity with the aromatherapy of freshly cut cucumbers."  Ahhhh...smells like fresh bullsh$t to me!

These cliches are everywhere.  It's as though we are expected to have some innate state of enlightenment that we simply need to tap into.  "Yes, of simple!"  If you have ever unsuccessfully attempted meditation, you may know the feeling of trying to connect to that quiet space only to find yourself running through a grocery list in your head before suddenly switching channels to consider the types of nuts that North American squirrels prefer.  This cycle can be maddening and discouraging.

Didju move my bongos, bro?
I realized the importance of space and calm recently when I was on the bus.  Every day I get onto the bus early enough to grab a seat as the rest of the stops start to pack in like sardines.  Most of the time I'm sleepy enough to enjoy the rumble of the engine and the warmth of the cabin, protected from the winter cold.  I never feel the need for a book,  because my brain isn't ready just yet.  Nor am I compelled to put on headphones since the bus is quiet with everyone mentally preparing for their day.  On this particular morning, I found myself unusually jarred by something new on the bus.  One of the stops now has an automatic ad over the speakers that announces the unbeatable prices that Megabus offers.  The voice narration of the ad jarred me.  I became irritated because it was ripping me out of my quiet moment. I quickly realized that this was my only quiet space, that time on the bus was sacred!  The ad made me realize that I needed to schedule more down time for my brain on a daily basis, because each and every moment seems to be saturated with information to process. 

I have since started incorporating three simple things into my daily routine: 

1. 5-5-5 breathing.  Breathe in for 5 seconds, hold it for 5 seconds, breathe out for 5 seconds, then repeat this four more times.  Better yet, make your goal to do this 5 times a day.  Focus on every breath.  This is easy to do, and once you find your groove you can use this as a reset switch to sooth your information-overloaded brain. 

2. Go for a walk.  You know all of those strange thoughts that streamline into our consciousness somewhat randomly throughout the day?  No matter how insignificant they may seem they must be coming from somewhere.  Get up and move around once in a while. Aside from the physical benefits of breaking up a long day in front of a computer screen with regular bouts of movement, the change of scenery will benefit your psychological health.

3. Practice mindfulness.  Try to be present at every moment, even if you're alone.  Put the phone away and enjoy your meal at the table.  Eat and converse with your family instead of gluing yourself to yet another screen: the TV.  Enjoy your food.  Look at the colors.  Think of how it nourishes you.  Allow your mind to wander in order to release any clogged areas of the mind.  This quiet space will allow your thoughts to run free.  It’s like recess for the brain

It can be an overwhelming task to find peace in your busy world.  Finding that calm, quiet space of mind takes patience and practice. These three steps will help you crowd out old habits and make you more aware of where your serenity actually lies. 

Stephanie Telep is a co-owner and health coach at Sweat and Butter.  She received her training at the Institute for Integrative Nutrition and holds a bachelor’s degree in Psychology from Duquesne University.  She hopes to help others make necessary changes in their lives while fostering a positive and healthy attitude.  She can be reached at 

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