Inflammation, Diet & Diabetes

0:03 [Music]0:12 hello and thank you for joining us today my name is Jennifer bino and it's a pleasure to mix my personal life and my0:19 professional life a little bit today I'm honored to support my team here at diabetes Canada who are bringing this0:25 amazing event to you um in addition on a personal note I've lived with type 1 diabetes for over 35 years I was0:32 diagnosed as a teenager and once having jumped that hurdle of learning all about diabetes and diabetes Management in the0:39 late 1980s I became very quickly fascinated with the role of nutrition it0:45 truly is a Cornerstone of diabetes management because of my diagnosis and emerging fascination with Nutrition0:51 management I went on to study nutrition and become a registered dietitian and worked in diabetes education early on in0:57 my career after so many years personally and professionally some might say I'm a bit of an expert as a person with1:04 diabetes and maybe as a dietitian as well but I'm always learning and today is no exception it's my pleasure to1:12 introduce today's keynote speaker Desiree neelen who will be making walking us through inflammation diet and1:18 diabetes Desiree is a registered dietician with a focus on plant-based nutrition and digestive health she's the1:25 author of two Canadian best-selling plant-based cookbooks eat more plants and good for gut as well as the host of1:31 an evidence-informed Wellness podcast the all sorts podcast she lives in Vancouver where she owns a private1:38 practice with a non-diet weight neutral approach to nutrition and health Desiree1:43 is a mom of Two and a sometimes neglectful Gardener over to you1:49 Desiree hello everyone as Jennifer mentioned my name is desire neelsen I am1:55 a registered dietitian coming at you from my kitchen here in East Vancouver2:01 and I am so excited to share this presentation with you all because I got2:06 my start as a dietician working in chronic inflammatory disease and so2:13 chronic inflammation and the role the diet and lifestyle have to play have always been a big clinical interest of2:19 mine but also a part of my practice so today we're going to shift that lens to diabetes and take a look at how chronic2:27 inflammation has a role in both type 1 and type two diabetes but also how diet2:33 plays into that so that's me I'm Desiree like I said I've been a dietitian for2:39 over 15 years now always here on the West Coast I have had a private practice2:45 for over a decade now where we focus on chronic inflammatory and digestive concerns and of course plant-based2:51 eating because I'm a plant-based person I have a couple of cookbooks which I'm2:56 there we go covering up right now eat more plants which which came out in 2019 and good for your gut which came out in3:02 2021 and then I even have a new book called plant magic coming out in April3:08 of next year one of the reasons why the cookbooks are so important to me is that I realized very early on as a dietician3:15 is that I can provide nutritional information and education but you still have to go home and figure out what to3:21 make for dinner for yourself and your family and so if I can create delicious3:27 easy to prepare recipes with nutrition in mind then you can exhale just follow3:32 the recipe and know that you're feeding yourself and your family something really nutrient dense I also have the3:38 following disclosures so as a dietitian in private practice who does social media I have worked with multiple food3:46 and supplement companies as a spokesperson or as a collaborator on social media on an ongoing basis I'm3:53 also the author of books on nutrition and inflammation and I have received a speaker fee from diabetes Canada for4:00 this learning activity so here's what we're going to talk about today beyond the high4:06 anti-inflammatory I have to say you know part of me has gotten away from talking about anti-inflammatory Nutrition a4:12 little bit on my social media feeds because it's become such a buzzword and so filled with pseudoscience and4:19 misinformation that I want to ensure that I'm not helping to perpetuate any of these myths so today is going to be a4:25 lot about myth busting what is inflammation how is it connected to diabet abetes what's the actual science4:31 behind nutrition's connection to inflammation plus of course a lot of wacky internet myths to ignore and some4:38 very simple practical ways to make change we're not just going to talk theory today this is news you can use4:45 things that you can take home in your life today to help start to make changes4:50 and then we'll talk about the opportunity for Q&A so what's this inflammation thing4:55 we're talking about the first thing you need to know is that inflam infation is not always a bad thing when we talk5:03 specifically about anti-inflammatory nutrition we immediately think that inflammation is5:09 somehow awful and never a good thing and we want to eradicate it whenever possible the first thing you need to5:15 know is that it is impossible to eliminate inflammation and that's a very good thing because inflammation is a5:22 normal response of your immune system when there is damage in the body the5:28 immune system turn turns on inflammation but there's acute inflammation and chronic inflammation and you can kind of5:34 think of acute inflammation like your body's paramedics great example is that if you're cooking in the kitchen and you5:41 accidentally cut yourself with a knife that redness that heat that swelling you5:46 feel and you see is inflammation that is acute inflammation rushing to the area5:52 to engulf any bacteria that might have been on your skin surface or on the knife to help to send6:00 all of the you know little chemicals and Messengers that your body needs to start to like sew up and mop up that cut6:06 inflammation is a great thing when the threat is present it turns on and when the threat is not present it turns off6:14 that's when it's acute that's when it's helpful chronic inflammation is a little different it's actually a very different6:20 pathway and chronic inflammation is more like the bull in the china shop so it6:25 goes around and makes a lot of noise it breaks a lot of stuff and it ends up causing more6:31 damage than help that's what we want to try and moderate that's what we want to6:37 try and focus our diet and lifestyle activities to help to calm chronic6:43 inflammation and we'll talk about why this is important in a minute so what causes chronic inflammation if I talked6:50 about inflammation as being a response to damage it doesn't just happen out of6:55 nowhere the immune system is efficient it's not going to turn on if you don't7:00 need it right so there's got to be some sort of damage that the body is attempting to respond to with7:07 inflammation and this can be increased body fat particularly around the7:13 midsection stress we greatly underestimate the effect of stress in7:18 our lives and the damaging effect that it can have on our long-term Health our7:24 gut bacteria also play a role we'll talk a lot more about that in this presentation gut barrier dysfunction7:30 which you might have seen on the internet as quote unquote leaky gut which sounds like a madeup internet thing it's actually legit and we'll talk7:37 a little bit more about what it is and how it impacts inflammation later certain disease States like diabetes can7:45 influence inflammatory States as well as dietary pressures what you are or are not eating and then inactivity so as you7:53 can see as much as I am a dietitian and I would love to say if you eat a certain7:58 way it will be 100% taken care of by nutrition that's not the case most of the chronic diseases we experience most8:05 of the chronic conditions including inflammation that we experience are8:11 multifactorial we have to take a holistic view we have to think about our stress we have to think about our sleep8:17 we have to think about how we move or don't move our bodies as well as what we're8:23 eating so what is the connection between diabetes and8:28 inflammation and does inflammation even play a role in diabetes we actually see this in the literature both in type two8:35 and in type 1 diabetes so we know that the presence of chronic inflammation8:40 plays a role in the onset and progression of type two diabetes and we8:46 also observe in type 2 diabetes a chronic lowgrade inflammation in both8:53 the fat and muscle cells as well as in the liver and the pancreas and we know8:58 that having this oxidative stress and inflammation in diabetes contributes to9:04 Future risk factors such as heart disease as well as impaired wound healing and nerve damage but what about9:10 type one we actually know that inflammatory cells are involved in the original destruction of pancreatic beta9:17 cells and that the autoimmune process remember when I talked about the immune system being efficient and it's not9:23 going to turn on or attack if it doesn't need to well in autoimmunity there is9:29 there is a little bit of a breakdown of appropriate immune response and so we see this autoimmune process in diabetes9:37 contributing to chronic inflammation in addition lifestyle derived inflammation9:42 so if you have type 1 diabetes and through all of those factors we talked about before dietary pressures9:48 inactivity stress lack of sleep that can increase insulin resistance which can9:55 make your insulin therapy more challenging10:00 so we have to talk about blood sugars and inflammation and we're going to cover this a little bit in the myths10:06 section but I want to get into it in a foundational way here because there is so much misinformation about the role10:13 that blood sugars play in chronic inflammation so we have to State off the10:19 top that yes chronic hyperglycemia so chronic high blood sugars is an10:26 inflammatory state which is just one more reason why getting our blood sugars10:32 under control and hitting our targets with diabetes is so so important and10:38 when it comes to what plays into rise of blood sugars right if we didn't eat our blood sugars wouldn't rise that wouldn't10:44 be a very good idea so the foods we eat do impact our blood sugars we know this10:50 when we have diabetes and that means being mindful of the glycemic load of10:57 foods versus glycemic in index and we're going to talk about that distinction later on in the in the what to eat11:03 section but being mindful of glycemic load is a good idea however and this is a big however11:11 it's very incorrect to label higher glycemic index Foods as inflammatory and11:18 I see this I see influencers on social media talking11:23 about how oats are not a healthful food which could not be further from the truth11:29 and further from Decades of science we need to ensure that we don't11:35 connect any rise of blood sugar with inflammation yes we want to be mindful11:42 of glycemic load but just because your blood sugars rise at all doesn't mean11:48 you're stoking the fires of chronic inflammation and just like how we eat11:56 and our diabetes can influence inflammation influ chronic INF12:01 inflammation can influence our diabetes and how we respond to the foods we eat12:08 and our blood sugars because we know that chronic inflammation affects how12:13 the body regulates blood sugar response so when there is a lot of chronic inflammation in the body it actually12:21 decreases the insulin sensitivity in our cells which means we're going to be more12:27 insulin resistant we're going to have a harder time managing our blood sugars12:33 what's more it also impairs the release of insulin in the pancreas so not only12:40 are we having difficulty getting the insulin out of the pancreas and into the bloodstream but then our tissues and our12:47 cells are less responsive and I know that this can seem now like a catch 2212:53 because if you have diabetes and your blood sugars are higher that's stoking chronic inflammation but if you have13:00 chronic inflammation that's making it harder to control your blood sugars is this a zero sum game it's not just13:07 because we see that this is true we need to know two things one that controlling13:12 our blood sugars is not as cut and dried as the internet would like you to believe this is really important because13:19 I think we see this very biased unscientific information that can cause13:24 us to blame ourselves when we're having difficulty getting our sugars under control but know that there's so much13:30 going on clinically that makes that challenging but the second thing that's really important is knowing that hey if13:38 we know what contributes to chronic inflammation and we know that lowering chronic inflammation would be really13:45 good for our diabetes and really good for balancing our blood sugars then hopefully that motivates us to make some13:51 changes because we know that as we move towards these changes that's only going to be a benefit for our13:57 body so so let's talk diabetes and let's take a little detour into our ascending14:04 colon where trillions of bacteria live this is an incredible thing you know we14:10 we were you know so so taught to be scared of germs and bacteria but you and14:16 bacteria are co-collaborators in your life and in your health and the trillions of14:22 bacteria living in your digestive tract transform the undigested fibers from14:27 plant Foods fruits and vegetables and legumes into helpful compounds called short chain fatty acids they're exactly14:36 like they sound they're tiny little fats and they have a whole bunch of benefits14:41 bacteria also contribute to the health of your digestive barrier so when we talked about that leaky gut and how14:47 leaky gut can influence chronic inflammation one of the things you have to realize is that your digestive tract14:54 even though you think it's inside of you because you don't see it is actually from from entrance on through exit15:00 continuous with the outside world so to your body your gut is the outside world15:07 and so that barrier between you and the outside world AKA your gut is as15:12 critical for keeping you well and keeping your immune system calm as your skin is think about it when you cut15:19 yourself in the kitchen inflammation comes to play because that Skin Barrier15:25 is compromised when the digestive barrier is compromised that can also15:31 increase chronic inflammation so having good gut bacteria to help protect the15:37 gut and keep that barrier strong is super super important what's more we see15:43 that both in type one diabetes and type two diabetes we do see in the literature15:49 patterns uh that are different from people without diabetes and they tend to be enriched in types of bacteria that15:57 sort of stoke the fires of inflammation a little bit more than we would like to see and one of the reasons for that is16:04 that some of these bacteria have molecules on their Co on the outer coat of their cell so bacteria sort of have a16:11 skin just like we do and these molecules called LPS or16:17 lipopolysaccharides are associated with inflammation and insulin resistance in16:22 type two diabetes and they may contribute to Type 1 diabetes as well and we also see in the research those16:28 short chain fatty acids when we have lower levels of them because we don't have enough of the good bacteria that16:35 make them when we have low levels of short chain fatty acids we tends to be associated with poor health16:43 outcomes so now that we know what inflammation is and what contributes to16:49 it let's zero in on the thing that I know best which is nutrition the science16:54 of how nutrition impacts inflammation and we're going to start with some hard truths here because what we think17:01 anti-inflammatory nutrition is is very different from what it actually is if17:06 you start scrolling on Facebook or Instagram or Tik Tok and you look up you17:12 know influencers talking about inflammation you're going to see all sorts of things like gluten is17:19 inflammatory or fruit is high in sugar and it's inflammatory and they are 100% wrong so17:26 let's get into it what is anti-inflam if it's not that what is anti-inflammatory17:32 nutrition the one thing that you need to realize is that no one food or one meal17:39 will cause or correct chronic inflammation when we have diabetes17:45 therapeutic nutrition is going to cover two bases first to help improve blood17:52 sugars and get them into targets and then the second is the positive like17:57 your body body isn't made and your health isn't made by what you do not eat you have biological requirements for you18:04 know nutrients like iron to to build red blood cells and be vitamins to help you18:11 harness the energy from food part in addition to keeping blood sugars under18:16 control another piece of therapeutic nutrition is helping to provide the nutrients you need for your overall18:24 health and nutrients that can help to lessen inflammation and so we are always18:29 talking about pattern over plate it's something I'm fond of saying which means18:35 it's not about one food it's not about one meal it's about the overall pattern18:40 day in day out weeks after months after years and that pattern is rich in whole18:47 plant Foods this is not about dietary labels this isn't about being a18:53 carnivore or an vegan this is about however works best for you you eating a19:00 high plant food diet which is lower in hyper processed so the ultra processed19:06 foods like the snack foods those kind of things I'm not talking about a can of beans but we're talking about more the19:12 snacks and the fast foods and then lower in animal Foods however makes sense for19:17 your life and there is also no one anti-inflammatory diet so if you're like19:23 oh give me a list of like what is exactly the Foods on an anti-inflammatory diet19:28 we actually don't have data to say this is it eat this and only this what we do19:36 have is other dietary patterns like the Mediterranean diet that have been also19:41 studied for their positive impa impact on inflammation um and we do have a19:46 little bit of data from my world of Digestive Disease but nothing that's gold standard yet and so again pattern19:53 over plate we know that an anti-inflammatory diet is about about being nutrient dense versus energy dense20:02 so we don't need food with lots of calories but not a lot of nutrition we20:07 need whole plant foods that are rich in nutrients without a ton of energy and20:13 it's totally in line with basic healthy eating guidelines so this is not information that's going to look new20:19 this is lots of fruits lots of vegetables whole grains nuts seeds20:25 legumes we want to choose other things moderation so this isn't a bam this20:31 isn't elimination this is fewer hyper processed foods less red meat less high20:38 fat Dairy generally speaking this is something we can all sort of get behind no matter how we like to20:46 eat so let's get into the nitty-gritty now that I've said you're like yes yes yes I know I know pattern over plate20:53 let's just like eat all the nice things what's the science actually say let's get into specific20:59 I always start with fats because fats are almost never a part of this21:05 inflammation question unless we're talking about Omega-3s and Omega sixes21:10 most of our energy goes there it should go somewhere different if you look on the internet what we're going to think21:16 causes inflammation is seed oils we're going to talk about why that's not true later on in the presentation what21:22 actually contributes to inflammation is too much fat in general particularly21:29 saturated fats which come from red meat tropical oils like coconut and palm and21:36 high-fat Dairy when it comes to sugars again people say sugar is inflammatory21:42 anything that turns into sugar like grains like fruit is inflammatory no no no what actually21:49 causes inflammation is a again a pattern this isn't your you know birthday cake21:56 in a week of generally nutrient-dense eating this is a pattern of hyper processed carbs so when most of the22:03 foods you consume are conveniences are really carb rich or22:10 fast foods and excess added sugars that's a pattern that's going to22:15 contribute more to inflammation it's not about one food something else that we22:20 generally don't talk about with respect to inflammation is fiber and we know that low fiber diets are associated with22:28 increased inflammation and most of us in North America are consuming what would22:34 be described as a low fiber diet the average intake of fiber in North America is about 15 grams a day whereas the22:41 evidence suggests that we should be consuming between 25 and 38 grams a day if we're under 50 years of age we need22:49 our diet to be high in fiber as well as high and fermentable carbohydrates to22:54 feed the beneficial bacteria we talked about why bacteria are important this is why one of the reasons why fiber and23:02 whole plant foods are so important is because when we feed beneficial bacteria23:07 those beneficial bacteria keep our digestive tract strong they make those short chain fatty acids and all of this23:13 starts to make a little bit more sense and then finally phytochemicals so when23:19 we eat whole plant Foods fruits vegetables nuts seeds legumes um whole grains there we go I23:26 got them all they all contain naturally occurring compounds that have antioxidant and23:34 anti-inflammatory actions and this isn't about extracting something and putting it in a pill because generally those23:40 things don't work very well but when we are consuming again a pattern of foods23:45 that are high in these phytochemicals all those little positive influences add23:51 up to help us lessen inflammation so this is probably the23:57 time where we should talk about added sugars versus natural sugars because I know there's a lot of confusion here it24:03 is very important for you to know that even in diabetes there is no guideline24:10 or recommendation for limiting the naturally occurring sugars in fruits and vegetables none none24:18 whatsoever however there are very solid guidelines and very solid evidence for24:24 reducing added sugars what's an added sugar it's not what you might expect24:29 this includes things like fruit juice concentrates honey maple syrup coconut24:34 sugar I see as a dietitian but also as a recipe developer I see online so often24:39 oh here eat my healthy cookies they're not made with refined sugar but instead24:45 they have two cups of coconut sugar well two cups of coconut sugar versus two cups of cane sugar it's the same thing24:51 right as a dietitian I want to see you consume fewer added sugars in total and24:57 diabetes Canada recommends no more than 10% of calories from added sugars over the course of your day and another25:04 recommendation that I love because I don't typically um promote calorie counting in my own practice is a a hard25:12 sort of like teaspoon or gram limit on sugars so the American Heart Association25:18 recommends no more than nine teaspoons daily or if you're looking at nutrition fax panels 36 grams of sugars for larger25:27 more active bodies which we typically describe as men and then six teaspoons daily or 24 grams of added sugars for25:34 smaller less active bodies or women and as I sort of alluded to before25:40 how we eat is not just about providing nutrients for our bodies how we eat also25:47 impacts the bacteria living in your gut and there's this saying you are what you eat right so you are what you eat you25:54 digest you absorb it into your bloodstream but we only digest and absorb between 80 to 95% of all the food26:02 and drinks we consume what happens to that 5 to 20% it26:08 travels through your digestive tract and anything that travels through your digestive tract gets exposed to your gut26:15 bacteria and anything your gut bacteria get exposed to they can be transformed by it they're either going to eat it or26:22 not eat it and that will determine which kind of bacteria want to call you home26:27 we talked about how those bacteria are so important for the health of your digestive barrier but also how your26:32 nervous system and immune system remember immune system is inflammation26:37 how both of those systems function and so when we talked about fat and we talked about how most people are26:44 concerned with Omega-3s and Omega sixes and we're going to clarify that later but why we should be more concerned with26:51 saturated fat which nobody talks about with respect to inflammation here's one26:56 of the reasons why this can be an issue High saturated fat diets can increase LPS in27:04 circulation remember how we talked about that LPS those lipopolysaccharides that can be on the outer skin of bacteria and27:12 how those can Stoke inflammation consuming high saturat so27:17 lots of high fat Dairy lots of red meat lots of hyper processed foods high in27:22 saturated fat they can increase the amount of the LPS that gets into your27:29 bloodstream and when that happens the body recognizes that as foreign and it27:35 attacks it with inflammation so the thing that you need to know because there's a lot of science here and I like27:42 to share the science because I think when we understand the why we're more27:47 motivated for the what I could say just eat your fruits and vegetables I mean is that new when was the last time you27:52 heard a dietitian tell you to eat your fruits and vegetables right but when you see oh the fruits and vegetables contain27:58 fiber they also contain fermentable carbohydrates those feed the bacteria28:04 those keep my digestive system strong and keep inflammation at Bay in the28:10 immune system then you start to see how this all comes together so what do you actually need to remember here you want28:17 to eat the food that feeds the kind of bacteria you want more of in your gut and good bugs like plants high fiber28:25 high and fermentable carbohydrates the stuff that makes you gassy it's true a little bit of gas is totally normal and28:32 a very good thing so yes I want to close this by28:39 saying yes Canadians generally do eat too many added sugars but no sugar is28:44 not toxic or inflammatory like I said before a teaspoon of sugar in your salad28:50 dressing to make your salad super delicious so you want to eat more salad28:55 that's a very good thing it does doesn't work like a magic eraser to take away all the health29:02 benefits so let's get into myths now like the no carb diet that's me29:09 walking away and this very unpopular fact but29:14 this is fact based in decades of science our blood sugars are supposed to rise it29:23 was how we were biologically designed and so we get into a little bit of29:30 tricky territory when we have diabetes because yes our blood sugars are meant to rise but if our blood sugars rise too29:37 much if we are insulin resistant if we are chronically high blood sugar that's29:45 also an inflammatory state that increases our risk of side effects things like cardiovascular disease or29:51 nerve damage later on so what's the sweet spot for us and how do we determine the foods we need to stay in29:58 that sweet spot one of the tools that has been given to us in the research is30:05 glycemic index and glycemic load and I've seen this being co-opted on the30:13 internet to provide a lot of misleading30:18 advice and incorrect advice and so let's get into it what is the GI or glycemic30:24 index it measures the blood sugar rise over time for a given food and so the GI30:32 of a food is always for a reference amount so it's the same weight of30:37 food and then you go over time right so like one hour or two hours and a high GI30:44 food is going to cause blood sugars to rise up really fast and then to crash in30:51 theory and that's the important Point here and low GI carbs are going to give30:56 you a little sustained bump so it makes sense okay low GI we probably want and high GI we31:04 probably don't want right except the problem with high GI versus31:11 what is known as glycemic load which measures the actual glycemic31:17 impact of a food is that there are foods that are high GI that don't actually raise your blood31:24 sugars a lot things like carrots or watermelon and the reason for31:31 that is that the glycemic load measures the potential of the food to raise your31:37 blood sugars like the glycemic index against how many carbohydrates are31:44 actually in that serving so yes if you ate like a whole like a couple of pounds31:52 of carrots or watermelon that's going to be a high GI and a lot of carbo hydrate31:58 and that would actually increase your blood sugars quite a bit but most of us eat just a little bit and that little32:05 bit doesn't actually have a lot of carbohydrate so it doesn't actually raise our blood sugars that much and low32:12 gii SL low glycemic low nutrition is evidence-based in diabetes however we32:19 also need to consider the total dietary effect because we generally don't eat32:25 Foods in isolation except for maybe a random apple or a small handful of32:32 carrots the other thing we need to think about is the hacks you see on the32:37 internet are probably not what you want to follow in addition to people who are32:43 talking about blood sugars Rising as always being a bad thing remember your32:48 blood sugars Were Meant to rise alongside It is Well blood sugars are32:54 spiking spiking causes diabetes it doesn't and here's a hack to make sure33:00 that doesn't happen right they invent a problem they freak you out about it and33:06 then they give you a solution that is theirs and uniquely theirs and one of the hacks that's going around is33:11 drinking apple cider vinegar AKA ACV and33:16 it's become a popular internet hack the idea that you drink uh some apple cider vinegar before a meal to lower your33:23 blood sugars in reality after acid is there's always there's always a kernel of Truth33:30 here acid is one of four factors that helps to lower the glycemic impact of a33:35 meal the factors are acid but also protein fiber and fat so when we build a33:44 meal we add some protein maybe a little bit of chicken maybe a little bit of33:50 lentils we have fiber from whole grains or vegetables we add a little bit of fat33:57 fat maybe it's a little bit of cooking oil or some avocado or some nuts and34:02 then yeah absolutely we can add some acid some fruits have high acidity but we can also add lemon juice or a little34:09 bit of vinegar sounds like a really delicious salad to me doesn't it you we34:14 in the process of making a balanced meal cons consider all four factors and you34:20 never have to choke down an actual shot of apple cider vinegar which in all34:26 honesty is also associated with some very real dangers not only is it really bad for your tooth enamel but it can34:32 also burn your esophagus and what the influencers don't tell you as they are sharing all of the success stories of34:40 their hacks they don't tell you about the people who have been harmed by it and that's a very real concern when34:46 you're consuming information on the internet so you need to know not only do you not need to choke down something34:52 that doesn't taste that delicious it's also not very safe for you34:57 the other one that's quite pervasive in this Camp of blood sugars rise is always bad are grains causing inflammation so35:06 one the blood sugars we talk about but two there's a lot of misinformation35:11 about things like gluten which is found in wheat barley and Rye or lectins which is found which are found in many plant35:18 Foods it is incorrect categorically35:23 unscientific and non-evidence-based that gluten causes inflammation in anyone except for35:30 those with celiac disease which is an autoimmune disease that has a gluten35:37 trigger and when we look at grains grains are not all the same thing there35:44 are hyper processed refined grain products which absolutely have a high35:49 glycemic index and a high glycemic load and we have grains in their most natural35:56 state which is whole we're talking about the quinoa the Millet the whole wheat36:01 bread the whole wheat pasta whole grains have a very different impact on our36:07 blood sugars than hyper processed and refined grains so we need to know that36:14 whole grains are absolutely associated in decades of research with a lower risk36:20 of chronic disease and decreased inflammation because high fiber foods like whole grains feed the microbiome36:28 high fiber whole grains help moderate you know that nice little sustained bump in blood sugar high fiber grains help36:36 produce that and high fiber hole grains are generally more nutrient-dense they are also much richer in protein than we36:42 realize another factor that moderates blood sugars they contain tons of B36:47 vitamins and minerals like iron and zinc again to help support our metabolism so36:53 that it responds appropriately to the foods we eat36:58 and nope I told you I was coming back to this one seed oils do not cause inflammation 15 years ago when I got my37:06 start as a dietitian we were on about this seed oil thing and I have to admit that myself based on the evidence at the37:13 time was convinced that consuming more omega-6 fatty acids which we find not37:20 just in seed oils but in meat as well as whole grains and almost all nuts and37:25 seeds were potentially pro-inflammatory 15 years later we have so much more37:32 evidence to confirm not only are omega-6 fats and the foods that they contain37:39 them like seed oils not only are they not inflammatory we have data to show that37:46 omega-6 Rich oils like sunflower seed oil and canola oil are actually37:51 anti-inflammatory particularly when we replace hyper processed refined High GI37:59 carbohydrate Foods or saturated fats with omega-6 oils and this is really38:06 important because there is an enormous amount of Wellness elitism that constantly finds fault with38:14 foods that are affordable and available to all like sunflower and canola oils if38:21 you can't afford avocado oil or you can't afford olive oil these Foods foods38:27 are absolutely affordable and will not contribute to inflammation so we can all38:33 exhale breathe a s of relief and know that we're doing a good thing for our bodies so let's talk about now that38:40 we've sort of like gone through the theory we've seen the science we've talked about some myths what can you38:46 actually do in your diet today and in an ongoing basis to help lessen chronic38:52 inflammation let's get into it the first thing you need to know is that there are very few rules in nutrition good38:59 nutrition is 100% individualized so even everything that I39:04 say here although it is evidence-based may or may not be right for you a classic example I encourage people to39:12 consume a lot of nuts and seeds because they're very nutritious but what if you have a peanut allergy that's the39:18 individualization peanuts are not right for you because you have an allergy but perhaps you can consume almonds or39:24 perhaps you can consume pumpkin seeds or sunflower seeds it's really important to get individualized advice whenever we39:31 can because that's what going to be what's best suited for you now having said that there are a couple of global39:39 rules that are always correct always always always things like drink water39:44 for example and the first and most important rule which I've already mentioned a couple times in this39:49 presentation is pattern over plate and this is the kind of plate to39:55 make your pattern most often again it's about most of the time not about hard40:01 rigid rules that we have to adhere to 247 365 and this again seems like such a40:08 dietition thing that it must not be effective or powerful but it's deeply40:15 evidence-based this is what we call the plate method no counting calories no counting grams of anything if you can40:23 adhere to the plate method most often it is the most profound way to help you40:29 balance your blood sugars and ensure that your meals are nutritionally balanced half your plate fruits and40:36 vegetables a quarter of your plate proteins and a quarter of your plate whole grains and starchy vegetables and40:43 then a little dot there because you want to have a little bit of fat in there to help moderate blood sugars and improve40:48 flavor of the meal and improve fat soluble nutrient absorption when you do this it's not40:55 about never eating a high gii food it's not about any other rules in nutrition41:02 Good Foods bad foods it's about creating a better energy balance more nutrient dense versus41:09 energy dense getting that protein fiber and fat in there for blood sugar balance41:14 and providing adequate nutrition the second rule of nutrition41:20 just eat more plants we get into this well I eat this way and I eat that way and this is me41:27 and that's you no matter how you eat really you don't got to put a label on it wherever you are on the spectrum of41:36 plant-based eating just shift towards more plants it is so profound in terms41:44 of increasing nutrient density increasing fiber increasing fermentable41:50 carbohydrates and it's important to not get this one twisted because one of the41:55 biggest challenges after 15 years of counseling people in nutrition is that one of the biggest42:03 challenges we face in making personal nutrition choices is something called42:09 nutritionism and this is the idea that we get caught up in the minutia of this42:15 nutrient or that nutrient or this good food or this bad food and we lose the42:20 forest for the trees we abandon these kind of boring42:25 traditional but evidence-based habits and strategies like the plate method or like eating42:32 more plants for the shiny hack right so instead of saying oh I'm going to use42:37 the plate method I'm going to consume my oats with some frozen berries which are42:44 high in fiber that's increasing my fruit and vegetable I'm going to add some42:49 healthy fat in the form of peanut butter or maybe some ground flax that will also42:55 increase fiber to balance my blood sugars instead we look on the internet and someone says oh I don't like oats43:02 because they're carbs and they make your blood sugar Spike no that's not the case stick to the tried and true and don't43:09 get caught up in that minutia the other thing that I see in private practice is43:15 that we tend to you know we can have these conversation what is the rule eat43:21 more whole plant Foods fruits vegetables nuts seeds whole grain43:27 and then I get questions saying okay so tell me about the breakfast cereal that I should eat43:32 which one has the most fiber tell me which cracker is healthier tell me which granola bar is healthier um tell me43:39 which like packaged side dish is healthier and do you see what's happening here absolutely these foods43:47 can play a role in our life they're convenient and they can be nutritious and I'm not saying we don't eat them but43:53 we forget about the oh I could just eat an apple right now with a little bit of peanut butter but I look for the you44:01 know the granola bar instead or well I could just you know buy this salad kit44:09 and like have these ready-made vegetables and have a nice salad on the side instead you're like okay so what44:15 sort of like Side Package side dish should I buy fruits vegetables nuts seeds whole44:23 grains in their whole form as much as possible these are not they don't have44:28 any fancy marketing on the package to continue to remind you how good for you they are and we tend to get really44:36 caught up in marketing and a shiny package that says high in fiber or high in protein but we forget that the whole44:42 foods are where it's at and that's the foundation of a nutritious44:48 diet so let's talk about fiber a little more because fiber is considered a protective factor in type two diabetes44:54 and there are also many different fibers with plant foods which again if you're like okay so what fiber supplement45:00 should I take or which fiber enriched cracker should I consume we want to get45:06 our fiber ideally from a variety of whole plant Foods because there are so many different fibers with so many45:12 different activities some sweep the gut clear keep you moving some help bind45:19 stuff like cholesterol to help you remove it from the body and flush it out some feed your gut bacteria some keep45:25 you full and satisfi if IED and your blood sugar is more stable so if we're just trying to get that from a single45:31 isolated supplement we're going to lose all of the other benefits of a variety45:36 of fiber so we want to think of Whole Foods first and foremost and then a45:42 variety of Whole Foods and what does a high-fiber day actually look like it's a lot simpler45:49 than you think so I wanted to give this option you know like a very simple breakfast two pieces of spread of GRA45:55 bread with peanut butter and sliced Apple that doesn't look like an unusual breakfast right pretty normal you know a46:01 higher fiber bread is going to get you there or a lunch a nice sweet potato with lentil and spinach salad again as a46:08 snack instead of like a granola bar thing just grab a little handful of almonds super high protein fiber46:16 vitamins really nutrient dense it's going to keep your blood sugars balanced and then like an easy chicken curry with46:22 some brown rice and some frozen broccoli because again when it comes to I talked a little bit about46:28 affordability Frozen fruits and vegetables are incredible and we live in a Northern country where not everything46:34 is in season all year round Frozen is a very great nutritious option that is46:39 often more affordable than fresh and I want you to embrace that the other thing to embrace and really helps with respect46:47 to variety is eat in season because when things are in season they are more46:53 abundant and the price is lower so you know we don't eat strawberries in46:58 January because they're too expensive for example and like in the cooler months that's when we're looking at root47:03 vegetables like rutabagas and sweet potatoes and celery root like all these47:09 things are Granny's used to prepare we need to get back into them they're incredibly nutrient dense they're very47:15 affordable they're locally grown like it's a win-win all around the other thing we want to talk47:22 about in terms of making choices we want to watch sat ated fat we want to watch47:28 excess added sugars and salt so we talked about this already so this is really about um eating less fried food47:36 less butter less cheese fewer high-fat red meats and keeping sugar sweetened47:42 beverages uh wa like to a minimum if at all watching your baked goods watching47:49 packet Pat pack package snacks sometimes you just get tongue tied after half an47:54 hour and keeping your dessert erts moderate this isn't about saying no forever remember pattern over48:02 plate and then of course extra credit I mentioned this once before and I'll reiterate it now food doesn't work like48:09 a magic eraser no one food will lower inflammation without addressing the whole dietary pattern but we do have48:17 some data on some particularly interesting foods that have anti-inflammatory activi so if you want48:23 to include them as part of your whole plant food dietary pattern it definitely48:30 couldn't hurt the first category is flavonoid rich foods flavonoids are a48:35 type of phytochemical that we have quite a bit of research to support their anti-oxidant and anti-inflammatory48:42 nature these are things like berries coffee yes coffee maybe without seven48:48 pounds of sugar and cream in it but the coffee itself is not a harmful beverage48:54 it's a bean extract it's a plant food cocoa green tea onions apples all of49:00 those foods are rich in flavonoids spices and aromatics things like turmeric ginger garlic dried parsley are49:09 particularly high in phyto chemicals but honestly get your spice drawer open and49:16 stop measuring in sprinkles start measuring in spoons everything from cumin to Cinnamon to chili powder all49:24 spices and herbs are really beneficial they also make healthy food taste49:30 incredible so be heavy-handed with your spices and herbs and then yes finally we49:36 talk about omega-3 we sort of talked about the Omega 6 piece of it and how we don't need to worry about49:43 omega-6's because we know that seed oils do contribute to anti-inflammatory diet49:48 patterns but let's talk about Omega-3s quickly omega-3 fatty acids are an49:54 essential fatty acids when we say essential that means we need to consume them our body doesn't make them and50:01 there aren't a lot of foods that are high in omega-3 fats so essentially cold water oily fish like salmon mackerel50:08 sardines and seeds such as hemp flax and chia and so in the research now we see50:17 that as long as you get enough omega-3 fatty acids that appears to be much more50:22 important than avoiding omega-6 fats for maintain Ming that inflammatory50:27 balance which is why I created something called the daily three and I love this50:33 it's just a really simple positive nutrition strategy to help you get more50:38 nutrition into your day my daily three are Omega-3 Rich seeds green leafy50:44 vegetables and beans and lentils we already talked about why the omega-3 Rich seeds are important try to50:50 get two to three tablespoons a day flax is the most cost effective of the bunch50:56 if you buy whole flax it's literally pennies of serving and then you can grind it yourself in an old coffee51:04 grinder and it's a wonderful way to uh get Omega-3s and some helpful fiber and51:09 minerals into your life green leafy vegetables literally if it is green and51:15 leafy everything from bok choy to arugula to broccoli to dandelion greens51:21 try and work your way up to two cups daily if you can Frozen spinach is the absolute win here by frozen spinach51:28 without any seasonings or sauces if you've ever seen how much51:34 spinach wilts down into nothing frozen spinach is the hack a hack you can51:39 actually use because it's already sort of like preconcentrated and really really affordable then I would say you51:45 don't need two cups but a half a cup of frozen spinach maybe a cup if you're feeling saucy is an incredible51:51 nutrient-dense addition to meals and then beans and lentils you know many cultures depending on your background51:57 already have like a really hearty Reliance on beans and lentils others don't consume them at all and I would52:05 like to encourage you to consume them you want to start slow though if you're new to beans and lentils eat just a52:10 quarter cup a day because they're very strong fibers and fermentable52:16 carbohydrates so you want to ensure that you let your digestive system adjust and52:21 then you only increase your dose as your body uh gets used to them so here we go what do you need to52:29 know what's the news you can use chronic inflammation is a key feature in diabetes and it can make blood sugar52:35 regulation difficult but how we eat can influence inflammation through blood sugar balance and immun supportive52:41 nutrients and feeding our good gut bacteria use the plate method and the52:46 daily three as your simple and evidence-based hacks for better52:52 nutrition and eat more whole nutrient dense plant Foods rely on inexpensive52:58 Stables like dried beans rely on frozen vegetables all of these things are53:03 incredibly nutritious and make it easier to eat well and if you saw all that and53:09 you've got questions well I've got answers for you on November 18th for the live Q&A so I hope you will join me53:16 thank you so much for taking this time out of your day to get nerdy about nutrition with me I hope you've learned53:22 something new and interesting and helpful and I look forward to seeing you at the live53:32 [Music] Q&A