What’s a Healthy Eating Pattern?

November 24, 2008

What’s a Healthy Eating Pattern? 


 Competency # 5 The Way to Eat                       Reference:   Am J Clin Nutr: Nov 2008 Fargnoli et al 1213 


 If you stick with a “healthy diet” you can lower your risk of heart disease.  We know that.  What’s a healthy diet?  The Harvard Nurses’ Study followed 1922 women starting in 1980.  Every four years these nurses were given questionnaires about their eating habits.   62% of these women were overweight, just like average Americans.  They were randomly selected from the 122,000 women in the study, but in part because they had no active disease at the time they started.   Their blood was collected in 1990.  


Now, in 2008, we have the laboratory sophistication to go back to those blood samples and measure the changes in inflammatory markers against their dietary habits. Nine measures were known to be associated independently with mortality risk.  They called these measures AHEI or Alternate Healthy Eating Index.  


The nine measures are as follows: 


1) number of fruit servings per day  

2) number of  veggie servings per day  

3) ratio of white meat to red meat  

4) trans fat intake 

5) ratio of polyunsaturated fat to saturated fat  

6) fiber    

7) nuts and soy  

8) moderate alcohol and 

9) multivitamin use.  


On a 1-9 scale, each of these was given a value.   Some folks were as low as 2.5 points.    Some were as high as 87 points.  Take the top 20% and measure their blood markers of inflammation. Here’s the list of what got better.  The healthy diet folks had a 24% higher adiponectin level.  Adiponectin is secreted by fat tissue.  It makes you more insulin sensitive, is inversely related to weight, and has a marked lowering of heart disease risk.  You want more in your blood.  Resistin was lower some 17%.    Resistin is thought to be another fat secreted hormone that is markedly associated with inflammation.  You want lower.  C-reactive protein was 41% lower.  sE-selectin was 19% lower, ferritin was 24% lower.  The list goes on.  


If you can spell them, much less pronounce them, you would see that there is a clustering of across-the-board beneficial effects on inflammation.  A good diet lowers inflammation. We are getting closer to understanding how our diet messes up our arteries.  Inflammation is the key and the sophistication of your body’s internal chemistry is awesome.  There are many regulatory mechanisms that all work together in a beautiful ballet.  Your fat tissue is the source of those hormones.  It is not a simple, silent calorie storage device.  It is active, secreting hormones that direct much of your metabolism and your inflammation.  The inflammation doesn’t get you in the near term.  But when a heart attack strikes at age 48, you wonder just what went wrong.  “Why didn’t somebody tell me sooner?”  Well, consider yourself informed. 


 WWW: What Will Work for me?  This is the dilemma of an illness with no symptoms.  Inflammation is the furnace burning within.  The good news is that you can change your diet today.  The choice I make right now works within hours.   I suspect being overweight isn’t the problem.  It’s being inflamed.  Brings a whole new meaning to the term “having the hots”.  Remember, Eve had an apple.  What a loving spouse!


Column written by Dr. John E. Whitcomb, MD, Brookfield Longevity, Brookfield, WI.  (262-784-5300)

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