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SCIENCE 4LIFESTYLE 4GENETICS 4NUTRITION

Help prevent, control and reduce chronic inflammation
LEARN TO BREATHE
MINDFULLY

EAT THE RAINBOW AND
BOOST YOUR GUT HEALTH

SECOND
EDITION

Digital
Edition

HOW BETTER SLEEP CAN
TRANSFORM YOUR LIFE

THE SIGNS
AND SYMPTOMS



Learn to beat INFLAMMATION Inflammation is necessary for the body to heal and defend itself against illness. The inflammatory response, however, can occasionally go too far, activating when there is no threat and leading to pain and discomfort instead. In Learn to Beat Inflammation, you’ll learn about the science behind the body’s inflammatory response and how making small changes to your lifestyle, such as taking care of your gut health and reducing stress, can help you prevent, control, and reduce chronic inflammation.
20 58 Lifestyle 26 Bodies on fire Different ways to self-soothe and reduce stress levels 28 Learning to relax Different ways to self-soothe and reduce stress levels 32 Easy breathing Inflammation 08 Understanding Inflammation Discover inflammation and what it does for our bodies 14 Too much of a good thing Learn what happens when inflammation lingers 16 What causes inflammation? From diet and gut health to environmental factors 20 Signs and symptoms Uncover the symptoms of chronic inflammation 16 4 Our guide to breathing mindfully for less stress 34 Exercise is good for you The benefits of moving your body to reduce inflammation 36 Time for yoga Build strength, gain flexibility and improve your wellbeing 44 Walk off the weight How transform a simple stroll into a workout 48 The benefits of sleep Discover how a lack of sleep contributes to inflammation 50 The A-Z of better sleep Get a good night’s rest with these expert bedtime hacks 54 Breathe and sleep How meditation can improve sleep and reduce inflammation 40 Less pain, more gain! Reap the benefits of gentler exercise to get you moving 54
Recipes 92 Healthy smoothies 94 Shakshuka 96 Superberry breakfast bowl 96 Butternut & kale breakfast strata 97 Flapjack breakfast bars 98 Spice lentil soup 99 Veggie boost grain salad Nutrition 58 Gut health and inflammation Improve your diet for a positive impact on your body 64 Anti-inflammatory foods Strengthen your body’s anti-inflammatory shield 100 Greek-inspired bean burgers 80 Taste your way to better health The herbs and spices that can fight inflammation 82 Inflammatory foods to avoid Discover the food and drink that can increase inflammation 101 Tuna and kimchi jackets 101 Green goddess chicken salad 102 Peri-peri rainbow wrap 103 Sausage stews with butternut squash & cannellini beans 86 How to ferment food Uncover the benefits of fermented food for gut health 88 Fibre & vitamin D The importance of fibre and vitamin D for your body 103 Miso cod with tenderstem broccoli 104 Turmeric roast chicken 105 Chicken & kale stir fry 106 Roast side of salmon with blushing veg 82 108 Sardine & spinach panzanella 109 Beetroot balls in Spanish-style sauce 110 Berry and watermelon sorbet 111 Raw chocolate brownie 112 Frozen berry yoghurt 5
08 Understanding Inflammation Discover inflammation and what it does for our bodies 14 Too much of a good thing Learn what happens when inflammation lingers for too long 16 What causes inflammation? From diet and gut health to environmental factors 20 Signs and symptoms Uncover the symptoms of chronic inflammation 6
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INFLAMMATION 8
UNDERSTANDING INFLAMMATION What is inflammation, when do we need it and what happens when an inflammatory response doesn’t stop? INFLAMMATION Cytokines regulate inflammation in your body by activating cells and telling them where to go, or by creating more cells of the right type that are needed. They might even signal that more cytokines are needed to help in an inflammatory response. It’s all pretty clever and we don’t realise quite how much is happening inside our bodies when faced with illness or injury. The immune system’s response to its trigger can be both inflammatory or anti-inflammatory, depending on what is needed. When your body needs to fight off a viral or bacterial infection, or if you’ve injured yourself, then it will trigger inflammation to help fight the infection or encourage tissue renewal. However, the immune system also knows when it needs to stop inflammation, as too much inflammation over a too-long a period of time can cause problems. You might be able to spot the signs of this process at work, particularly if you’ve injured yourself. If you twist your ankle, you might spot it swell up and bruise around the sore area; if you’ve got a cut, then it will go red as the immune system sends cells to the area to help fight off any bacteria and prevent infection. However, inflammation also happens internally where you can’t see any external symptoms at all. PHOTOS: GETTY IMAGES O ur body is pretty clever. It has a number of built-in systems and processes to cope with everything that is thrown at it. One of these processes is inflammation, which is a natural bodily response to the presence of an unwanted intrusion from a virus, bacteria or other toxic element, or as the result of an injury. Inflammation is part of the immune system. When something happens to you, such as catching a virus or suffering a fall, the immune system responds by sending out its first line of defence. This includes inflammatory cells and cytokines. The inflammatory cells’ job is to attack any bacteria or viruses it finds, and to heal damaged tissue in the case of an injury. Cytokines are incredibly important proteins that act as messengers to signal your immune system to respond in different ways, including the production of more inflammatory cells if needed. There are many types of cytokines, each signalling different responses in the body and communicating between cells – the word derives from the Greek for ‘cell’ (cyto) and ‘movement’ (kinos). For example, chemokines direct immune cells in the right direction towards where they are needed; interferons help the body to resist viral infection. 9
INFLAMMATION An inflammatory response that happens at the point of an injury is called acute inflammation, and is a normal, controlled reaction to a trauma. Sometimes, however, your body triggers inflammatory cells over a long period of time, or when you don’t need them, which can develop into chronic inflammation. We cover more about the differences between acute and chronic inflammation in the next section. When we talk about things like an anti-inflammatory lifestyle or diet, for example, we’re not trying to stop the process of inflammation altogether. We need inflammation to work effectively as part of our body’s immune system response. However, we do want to try Chronic inflammation has been linked to several diseases and conditions, such as high blood pressure Researchers are looking into the impact of inflammation on the development of type 2 diabetes and protect against, or reduce, chronic inflammation and its related symptoms. Chronic inflammation has been linked to a number of serious diseases and conditions, including heart disease, cancer, bowel disorders, high blood pressure, kidney disease, arthritis, vascular dementia and more. Increased risk of inflammation There are many reasons why some people might be at an increased risk of an unhelpful level of inflammation. We’ll explore more of the lifestyle causes of inflammation in a later feature, which are factors that we can exert a measure of control over. Being overweight or obese carries a higher risk of inflammation. We’ve already mentioned the important role that cytokines play in triggering an inflammatory response. However, adipose tissue, aka body fat, can also produce cytokines, including a sub-type called adipokines, which impact on metabolism and inflammation. Some of these adipokines have been shown* to regulate the inflammatory response in 10 cartilage, which suggests a strong link between obesity and osteoarthritis, a form of chronic inflammation. The body can also suffer some internal trauma from carrying excess weight, which can itself trigger inflammatory cells to help try and heal the trauma. If the weight remains or increases, this trauma is ongoing and therefore so is the inflammatory response. Those who have type 1 or type 2 diabetes might also be at an enhanced risk of inflammation, and inflammation itself could be a factor in the development of diabetes. Research has shown that people with type 2 diabetes have higher levels of inflammation and have more cytokines compared to those who don’t have the condition. Being overweight or inactive are risk factors that contribute to type 2 diabetes, but they’re also risk factors for inflammation. Researchers are looking into the impact of inflammation on the development of type 2 diabetes in the first place. However, as the condition begins to develop, the insulin resistance itself can also cause inflammation, which can then contribute to the disease continuing to develop, creating a difficult cycle to break out of. If a person has
UNDERSTANDING INFLAMMATION Inflammation is the body’s natural response to viruses, bacteria and other toxic elements Externals symptoms of inflammation include bruising and swelling diabetes already, following the advice in this book to help reduce or limit inflammation could, therefore, also positively impact on their condition. However, it is important to discuss this with a health professional before making any significant changes to lifestyle or diet. Another risk factor for inflammation could be environmental exposure. Those who work in close contact with certain industrial chemicals or irritants might find that their immune system is constantly having to counteract the effects of these chemicals, triggering an inflammatory response. In fact, introducing any regular toxin to the body will have an impact on inflammation, which means those who drink heavily or smoke will also be at higher risk. Some medications may also promote an inflammatory result as part of their side effects. People with underlying health conditions can be more at risk of chronic inflammation, too. This can include things like an allergy, where the body triggers an immune response to the presence of an irritant, which could result in skin or internal inflammation. It also includes autoimmune disorders, autoinflammatory disorders, digestive disorders, asthma and many other conditions. There can also be genetic factors that increase the risk of chronic inflammation. Even persistent acute inflammations that are not fully recovered from can develop into a more chronic condition. How inflammation affects different parts of the body Inflammation can impact any part of the body and the effects can be quite different depending on where you are experiencing the inflammation. For example, you may suffer an inflammatory condition of the skin. This could be as a result of a specific trigger, so if you come into contact with an irritant, poison or something you are allergic to, your skin may react. This could show as a rash, swelling, blisters or itchy skin. Temperature can also cause inflammation; heat rash is caused when sweat glands become inflamed. Other inflammatory skin conditions include eczema, dermatitis and psoriasis, which can be uncomfortable and more complicated to manage. Some inflammatory lifestyle triggers, such as stress, can also lead to symptoms on the skin. You’ll notice the signs of acute inflammation on the skin, where you have a cut or injury, you might see swelling, redness, bruising and feel soreness. If you’re feeling ill or stressed, you may also notice symptoms of 11
INFLAMMATION Underlying health conditions are at increased risk of inflammation Your organs can suffer from the impact of inflammation, including the heart, lungs and brain inflammation in the mouth, nose, eyes or ears. These areas are more open to infection and attack than other areas, and can often show the signs of inflammation. In your mouth you could develop sores, blisters or inflamed tonsils. Earache is a sign of inflammation of the ear canals; the sensitive area around the eyes can redden and swell. This is commonly caused by bacteria or viruses, but some people find that when they are run down or tired, it’s these areas that can suffer with chronic inflammation too. For example, chronic sinusitis is where the sinuses stay inflamed for three months or more. Your organs can suffer from the impact of inflammation, including the 12 heart, liver, kidney, lungs, brain, intestinal tract and reproductive system. This can lead to such a wide range of symptoms. Asthma is caused by a chronic inflammation of the breathing tubes going in and out of the lungs. The heart can get inflamed, which can lead to serious conditions such as arrhythmia (irregular heartbeat) and heart disease. Chronic inflammation can also contribute to heart attacks and strokes. When the digestive system suffers from inflammation, it can lead to inflammatory bowel disease (IBD), which covers both ulcerative colitis (inflammation of the colon) or Crohn’s disease (any part of the digestive system). Symptoms can include pain, cramps, swelling, fatigue and diarrhoea. The more common irritable bowel syndrome (IBS) may also be connected to
UNDERSTANDING INFLAMMATION inflammation – some studies have suggested that there could be a link between IBS and higher than usual levels of inflammation. Inflammation can also occur in the joints and the bones. Rheumatoid arthritis (RA) is a painful disease that causes inflammation and swelling in the joints – it’s an autoimmune disorder, where the immune system mistakes healthy tissue for a foreign trigger and responds by sending out inflammatory cells. As you can see, inflammation can be at the root of many problems and any part of the body can suffer from excess inflammation. For more serious conditions, there might not be any way to prevent the inflammation, however lifestyle and dietary changes can help to relieve symptoms. Inflammation that has been caused by lifestyle factors (more on this in our feature on the causes on inflammation), can be reduced or relieved through making targeted changes. Benefits of trying to reduce inflammation Throughout this book, we will be exploring ways to limit and reduce inflammation in your body. If you have an underlying condition, check with your medical team first to ensure that any changes you make are okay for you. Also, if you have any ongoing symptoms that you can’t explain, it’s important to talk to a health professional before making any major adjustments to your lifestyle and to rule out any serious reasons for your symptoms. However, if you think that you might be suffering from inflammation caused by lifestyle factors, such as stress, your diet, lack of exercise or not enough sleep, then it’s worth trying out the advice in this book to see if it improves your health and wellbeing. There are benefits of trying to reduce inflammation in your body. In the immediate future, you might notice that your energy levels increase and stay stable throughout the day. This can then help you to feel motivated to exercise, which can help to reduce inflammation further. Your increased energy and activity levels could then have a knock-on effect on your sleep, helping you to rest more fully at night, which also helps to boost your energy levels. Your skin may feel calmer and clearer, and you may notice that your stomach feels more settled and less prone to bloating. Some people even find that they lose weight, if that’s something that is relevant to you, due to the lifestyle changes and the reduction in inflammation. You may feel less stressed, be less likely to suffer from a new mental health condition, or relieve the symptoms of an existing condition. As well as these benefits, you may also be lowering your risk of heart disease, obesity, Alzheimer’s disease, arthritis and more. * ‘Pro-inflammatory cytokines: The link between obesity and osteoarthritis’, September 2018, Wang and He Inflammatory skin conditions include psoriasis, eczema and dermatitis 13
INFLAMMATION OF A T rap your finger in a door and, after screaming and shouting for a while, you will see the finger starting to swell. The swelling is the visible indicator of the body’s response to harm. It’s a dangerous world out there – the body can suffer damage from physical injuries, bacteria, viruses, poisons and toxins. As such, the body has developed many strategies for dealing with injuries. The first to respond are the body’s emergency services, inflammatory cells and cytokines, which produce more inflammatory cells. The aim is to keep the damage local, trapping bacteria or stopping the trauma from injury spreading further. Within the inflamed area, the body sets about repairing damaged tissue and hunting for invading pathogens, targetting them with white blood cells. This is a perfectly normal response and it produces the acute inflammation associated with injury and disease. In medical terms, acute conditions develop suddenly and go just as quickly. In these cases, inflammation is a welcome thing, as it helps the body to heal. 14 However, there is another sort of inflammation – chronic inflammation – that is not nearly so helpful. Chronic medical conditions start slowly and last for a long time, so the same is usually true of chronic inflammation. Chronic inflammation occurs when the body keeps on cranking up the inflammatory response even when there is no longer any injury or danger. One example is rheumatoid arthritis, where joint tissues become inflamed through an unwarranted inflammatory response. Chronic inflammation makes the body think it is under constant attack, so it pumps out white blood cells and other chemicals to deal with the infection. But with no infection to fight, these cells can end up attacking the body itself, causing more inflammation and creating a vicious circle. Stress is a leading cause of chronic inflammation. Nobody can function when under constant stress but unfortunately the stress of modern life has been linked to a host of physical and psychological conditions. It underlies many of the most common modern pathologies, therefore reducing levels of stress is greatly beneficial to health. Inflammation is a natural response to disease and injury but sometimes it lingers long after it should… and then it becomes dangerous
TOO MUCH OF A GOOD THING Conditions and diseases linked to chronic inflammation Health problems associated with chronic inflammation include: 4Fatty liver disease 4Heart disease 4Type I diabetes 4Type II diabetes 4Cancer 4Rheumatoid arthritis 4Endometriosis 4inflammatory bowel diseases 4Asthma 4Obesity 4Alzheimer’s and Parkinson’s disease PHOTOS: GETTY IMAGES Many of these conditions develop from the chronic inflammation that is associated with chronic stress. Looking at ways to reduce stress and inflammation in your life is a key way to improve your health. 15
INFLAMMATION Inflammation can be caused by a number of factors, some preventable and some not, but knowing what you can change puts you in control of your body 16
WHAT CAUSES INFLAMMATION detail, as well as offer tips on how to reduce inflammation for each cause. Lifestyle factors There are some things in the way you live your life that can contribute to inflammation in the body. Many of these are preventable causes, but it’s not always easy to make the necessary changes. Don’t feel you have to alter everything at once; even small swaps or simple solutions can have a huge impact on your level of inflammation. If you don’t sleep well and have poor sleep consistently over a period of time, then this can cause inflammation. Research shows that sleep deprivation has been associated with increases in inflammatory markers in the body. We also know that stress can cause higher levels of inflammation, by which we mean chronic, ongoing stress and not one-off stressful situations that we all experience from time to time. A high level of stress can also impact on your ability to sleep well, doubling the possible causes of inflammation. Weight gain and being overweight can lead to an increased level of inflammation in the body too, which is why it’s important to work towards and maintain a healthy weight for you. This might include taking part in regular exercise – inactivity can be another cause of inflammation. Regular exercise has been shown to improve inflammation from the very first session. Be careful though, as over-exercising flips the switch the other way and can actually cause inflammation. If you do a lot of very high-intensity exercise without adequate time to recover in between, then you could be causing more inflammation than you are reducing it. A balance between some higher-intensity workouts and lower-intensity workouts is best, along with strength work, stretching and recovery days. We know that those who smoke or drink alcohol regularly are at risk of higher levels of inflammation. If possible, try and work towards stopping smoking altogether and limit your alcohol intake. red meats, processed meats, refined white grains, sugary and fatty foods like biscuits, cakes and crisps, full-sugar soft drinks and fried foods. We also know that these kinds of foods can lead to other problems such as weight gain, which in turn can cause higher levels of inflammation. On the flipside, there are foods that can actively help to reduce inflammation, such as oily fish, fruits and vegetables, nuts and seeds, legumes and pulses, and wholegrains. Then there are foods that might be minimally processed that don’t cause high levels of inflammation or actively reduce inflammation. Getting a good balance and diversity across all food groups can help, and this is something that will be explored in more detail in this book. Your diet also impacts on your gut health; an unhealthy gut is more likely to cause inflammation. With a lot of our immune system coming from our gut, it certainly pays to keep this part of our body working efficiently. The typical Western diet these days is, unfortunately, likely to be a cause of increased inflammation levels Diet and gut health What you eat and how you eat it can contribute towards inflammation. If you eat a diet that is very high in ultraprocessed foods, fast foods and sugary drinks, then you’re putting your body under a lot of stress and this can trigger an inflammatory response. The typical Western diet these days is, unfortunately, likely to be a cause of increased inflammation levels. We often rush our food too, eating on the go or in front of the television, which again puts our body under stress. It can be quite hard to undo bad dietary habits – especially when the foods that we enjoy the most might be causing our inflammation. However, we know that the food we choose to eat plays an important role. There are foods that are more likely to cause inflammation, which includes things like Infection One of the most common causes of inflammation, and one of the most noticeable, is the introduction of an infection to the body. Infection is when an outside agent enters the body. There are lots of different types of organism that can cause an infection. We all get viral infections from time to time, which are usually acute infections. This includes things like the common cold, chest infections, coughs, the flu, chicken pox and so on, which are more common in the winter months. All of these infections trigger an immune system response, which includes inflammation, and we usually make a full recovery from these within a few days or weeks. Bacterial infections are caused by bacteria entering our body, which covers things like food poisoning, meningitis, Lyme disease or strep throat. If you have a cut or wound, you need to keep the area clean to prevent it becoming infected from bacteria PHOTOS: GETTY IMAGES B efore you start to learn how to beat inflammation, it’s important to know what can cause it in the first place. For many people, there may be more than one cause and it can be beneficial to take a whole-body approach to have the greatest impact. In this feature, we will look at some of the main known causes, and throughout this book we’ll explore some of these in much more 17
INFLAMMATION Both acute and chronic infections cause inflammation in the body getting in. These bacterial infections need to be treated with antibiotics to not only prevent the bacteria from growing but to also kill off existing bacteria. Again, the body will try and fight the bacteria through an immune system response and inflammation. However, taking antibiotics can also kill off some of our good bacteria, which can imbalance our gut microbiome – in itself a cause of inflammation. Other types of infection include fungal infections like ringworm or thrush, and parasitic infections, like tapeworm, head lice or malaria. Any kind of infection can trigger an inflammatory response from the immune system. Antibiotics can kill off some good bacteria, which can imbalance our gut microbiome – in itself a cause of inflammation Usually, infections are acute and dealt with quickly. However, some people are more prone to chronic infection. This can be due to unhealthy lifestyle factors, like poor nutrition, inactivity, too much alcohol, smoking or high levels of stress. Chronic infection also causes chronic inflammation. Genes Your own genetic makeup could also be a cause of higher levels of inflammation. A 2017 research study at Cardiff University discovered that there is a genetic variation in some people that might cause the immune system to overreact to viruses. The gene, called lfitm3, seems to influence how vulnerable people are to a flu virus and also the extent of the body’s inflammatory response. Another global study in 2016 involved 50 different research centres (published in the journal Nature Genetics) and found that there are hundreds of genes that cause five common – but debilitating – inflammatory diseases. The conditions 18 studied are ankylosing spondylitis, Crohn’s disease and ulcerative colitis (which both come under inflammatory bowel disease), psoriasis and primary sclerosing cholangitis. This may pave the way for new targeted treatments. We can’t control our genetic makeup, so it might be that you are just more prone to higher levels of inflammation than others. However, what you can do, is target the possible lifestyle causes of inflammation and take a look at your diet, for example. If you already have a condition that causes an inflammatory response, you don’t want to add more inflammation on top of that from preventable causes where possible. However, if you do have a genetic inflammatory condition, you should always consult with a medical
WHAT CAUSES INFLAMMATION For some people, inflammation can be caused by their own genetic makeup professional before undertaking any major lifestyle changes. Environmental factors Lifestyle factors, such as lack of sleep can lead to inflammation There are things in the world around us that can also cause inflammation in our body. We can’t always do much about this, but it does pay to be aware. Some of us work in difficult environments as part of our job. You might be exposed regularly to toxins, dust and vapours. As you’re breathing them in all day, this can cause an immune system response from your body, which can trigger chronic inflammation. Even if you don’t work in an extreme environment, just sitting in an office all day with other people exposes you to more pollutants, in addition to viruses and bacteria. If the air quality is low and not circulating enough, you might find yourself getting ill more often. There are also pollutants around the home that we take for granted and don’t often consider. Cleaning products, personal care products, paint… we’re exposed to manufactured chemicals almost every day. And when you’re outside, you might be breathing the fumes from cars and public transport, smoke from chimneys and factories, and so on. You might have a pollen allergy (hayfever), which can mean that even the natural environment is triggering an inflammatory response. Everything in our lives, from the water we drink to the type of lighting we use, can have an impact on our health and wellbeing. Some of these environmental causes of inflammation can be prevented and others can’t. Always try and ensure airflow when you’re indoors, drink fresh or filtered water, use glass bottles not plastic, use PPE when relevant in a toxic work environment, choose your furnishings and cleaning products wisely, and wash your hands regularly to reduce the chance of contracting a virus – the Covid-19 pandemic certainly taught us all a lot about the way viruses spread and prevention. Now that you are aware of the many different causes of inflammation, you can make small changes and start to beat inflammation in your body. 19
INFLAMMATION its and What are the symptoms of chronic inflammation and how is it diagnosed? T he body is designed to remain stable. Human beings have lived everywhere, from the tropics to the Arctic, but wherever we live, the conditions inside the body remain the same: the same temperature, the same fluid balance, the same blood pressure. When these conditions change – a high temperature, for instance – we know at once that something is wrong. But in the normal course of events, the body responds to changing conditions without us even noticing. This is known as homeostasis. It is the body’s dynamic equilibrium with its environment. It is a dynamic rather than a static equilibrium because it is maintained by the body changing its response to the environment. Stress and homeostasis Stress is by no means always bad. Indeed, quite the opposite: it is vital. Stress is the body’s response to a need to change. The change can be something as simple as the sun going down. The temperature drops and the body prepares to go to sleep. It can be something as sudden and dramatic as hearing movement in the long grass and glimpsing tawny fur. Then it’s all systems go as the body triggers its flight/fight reaction. An emergency – spotting a hunting lion or the car skidding – triggers the 20 body’s emergency response system. This is known medically as acute stress and it’s the response to sudden danger. The body responds to acute stress by firing up the autonomic nervous system, which comprises the sympathetic and parasympathetic nervous systems. The sympathetic nervous system (the flight/fight system) releases a range of neurotransmitters and hormones that increase the heart rate, as well as the blood flow to muscles, the brain, and to the senses. Meanwhile, the parasympathetic nervous system (descriptively called the rest/digest system) is closed down. We are ready for action. However, if we are in a situation that triggers this response but the situation does not quickly resolve itself – say the long-term stress of a gaslighting boss – then we are on course for developing hypertension, one of the main causes of chronic inflammation. Acute stress also triggers the hypothalamus, a deep part of the brain, which then stimulates the pituitary gland, which in turn triggers the production of cortisol. Cortisol is the body’s main stress hormone. As a hormone, it facilitates the production of energy and triggers the immune system. The sort of emergencies that we used to face often produced injuries. Cortisol mobilises the body to deal with this: the inflammation surrounding a wound is the body activating white blood cells to deal with pathogens. But when acute stress turns into chronic stress, and the cortisol levels remain consistently high, then the body is in danger of suffering from oxidative stress, leading to chronic inflammation. Symptoms of chronic inflammation Chronic inflammation can affect particular systems and different parts of the body. It can also be generalised, operating at a low level throughout the body. So not surprisingly, the possible symptoms are quite varied. To give you an idea, they can include chronic fatigue, general or local body pain, recurring infections, diarrhoea, constipation, weight loss, weight gain, depression, anxiety, mood disorders and Alzheimer’s. And these are just some of the more common symptoms. Others include skin rashes, low energy and high production of mucus. Since inflammation is the body’s reaction to stress, it can affect almost anything – dry eyes are a symptom of an autoimmune disease called Sjögren’s syndrome. The extraordinary variety of symptoms is due to inflammation being part of the body’s normal
INFLAMMATION: ITS SIGNS AND SYMPTOMS response to stress. It only becomes a problem when prolonged and that can happen anywhere – leading to localised pains in joints and muscles – and everywhere, causing less specific symptoms such as depression and obesity. What makes diagnosis more difficult is that some of these symptoms are both caused by and causative of inflammation. A good example is obesity. Fat is stored in two different places: under the skin and around the organs in the midriff. When it is stored around the organs, fat can start to trigger the body’s immune system, causing inflammation. Thus weight gained for some other reason can cause inflammation. However, a side effect of high levels of cortisol is the storing of fat in the midriff, so obesity can also be caused by high levels of inflammation. When to see a doctor PHOTOS: GETTY IMAGES The essential difference between acute and chronic inflammation is time. Acute inflammation begins quickly, lasts between a few days and a few weeks, and goes away. Chronic inflammation begins slowly, gradually worsening, and then lingers on, often indefinitely. Acute inflammation is usually connected to something definite: an injury, a disease or exposure to a toxin, or a particular shock, which helps to tie down its cause. Chronic inflammation is much more difficult to pin on anything specific as it is usually caused 21
INFLAMMATION by the slow build-up of a number of different factors. So make an appointment to see a doctor if the condition is ongoing, shows no sign of improving, and has no obvious cause. Diagnosing chronic inflammation In diagnosing chronic inflammation, doctors will first look at the symptoms the patient is presenting and try to establish possible causes for these. But if, having considered alternative possibilities, chronic inflammation remains a possibility, the doctor will likely consider one of a number of tests to check for inflammatory markers in the system. Although these tests do not directly check for inflammation, they instead search for signs that the system is inflamed. Among the tests to check for inflammation are: Erythrocyte sedimentation rate (more snappily named sed rate or ESR). This tests how long it takes for red blood cells to settle to the bottom of a test tube. Inflammation makes the red blood cells settle quicker. C-reactive protein (CRP). The levels of this protein usually rise in cases of chronic inflammation, rising from a normal level of 3mg/l to over 100mg/l. Test for ferritin. This is a blood protein linked to iron levels in the body. The test is used to check for anaemia, when levels of ferritin will be very low, but high levels of the protein indicate possible inflammation. Testing fibrinogen. This test checks how well the body’s blood-clotting system is working, but again the level of the protein often rises in cases of chronic inflammation. None of the tests for inflammation confirm, on their own, the presence of chronic inflammation: a doctor will use them alongside other symptoms before making a diagnosis. Helping to tackle the disease will ease the inflammation Diseases of chronic inflammation As already mentioned, it is difficult to work out the causative links of the diseases associated with chronic inflammation. However, what is clear is that these diseases exacerbate inflammation, while chronic inflammation exacerbates the diseases, locking the body into a feedback loop. Therefore, helping to tackle the disease will ease the inflammation and reducing the levels of chronic inflammation will lessen the disease. Among the most common of modern-day diseases is type-2 diabetes, which produces insulin resistance, leading to a reduction in the ability of cells to turn glucose into fat. This might not sound so bad – who wants to turn sugar into fat after all – but allowing glucose to float around in the bloodstream is where the Symptoms of inflammation include chronic fatigue and pain 22 Chronic inflammation plays a role in the development of heart disease
INFLAMMATION: ITS SIGNS AND SYMPTOMS You should see a doctor if your symptoms are not improving connection with chronic inflammation comes in. Glucose molecules, when allowed to circulate in the bloodstream, are very inflammatory. They irritate blood vessels, causing plaques to form, which slowly block blood vessels. When blood vessels become completely blocked, the surrounding tissue dies. This is why people with diabetes can go blind and have to have limbs amputated. Thankfully, a diet cutting out glucose and effective weight loss can stop and even reverse type-2 diabetes, making it one of the disorders amenable to the patient helping themselves. Heart disease is the major cause of death for men in the UK and is high on the list of causes of death in women. In the public mind, it’s not a disease commonly associated with chronic inflammation but inflammation plays a crucial role in the disease’s development. As with diabetes, heart disease results from plaques forming in the blood vessels around the heart. These plaques are often the result of the interior lining of the blood vessels becoming inflamed. Thus reducing inflammation in and around the heart reduces the risk of a heart attack. Statins are prescribed to reduce the build up of plaque in and around the heart and research shows that these are very effective drugs. However, research also indicates that making the switch to a low-inflammatory diet will reduce the inflammation markers around the heart, and help reduce the risk of a heart attack. All the diseases associated with chronic inflammation follow the normal pattern of chronic diseases: being slow to develop and long-lasting. As such, they are strong evidence for the advantages in taking up a low-inflammation diet and lifestyle. Doing so will reduce or curtail many of the factors leading to chronic inflammation, and thus remove many of the diseases that, in the modern world, plague the last years of so many peoples’ lives. No one lives forever but it is possible to live well until the end if we make the right sorts of choices today and from here on in. 23
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26 Bodies on fire Different ways to self-soothe and reduce stress levels 28 Learning to relax Different ways to self-soothe and reduce stress levels 32 Easy breathing Our guide to breathing mindfully for less stress 34 Exercise is good for you The benefits of moving your body to reduce inflammation 36 Time for yoga Build strength, gain flexibility and improve your wellbeing 40 Less pain, more gain! Reap the benefits of gentler exercise to get you moving 44 Walk off the weight How transform a simple stroll into a workout 48 The benefits of sleep Discover how a lack of sleep contributes to inflammation 50 The A-Z of better sleep Get a good night’s rest with these expert bedtime hacks 54 Breathe and sleep How meditation can improve sleep and reduce inflammation 25
LIFESTYLE 26
BODIES ON FIRE How chronic stress can lead to our bodies burning up on the inside PHOTOS: GETTY IMAGES H omeostasis is the key to how our bodies function. It could be raining or freezing, we might be relaxing by reading a book or running for a train but on the inside, the body will be maintaining an astonishingly constant environment. If you took the temperature of a polar explorer and that of a desert Bedouin it would be, within a tiny margin, the same. One of the body’s jobs is to maintain a constant environment on the inside while dealing with a huge range of conditions on the outside. To achieve this stable state, the body employs a huge range of strategies, from shivering to sweating. Having started on the plains of Africa, our bodies had to be ready to deal with emergencies: no good keeping the body stable if that means being eaten by a lion. So in an emergency, the body triggers the autonomic nervous system and gets ready for action. The sympathetic nervous system releases neurotransmitters telling the heart to pump faster, filling our muscles and organs with oxygen so they are ready to react. Our senses go on high alert, as does the brain. Simultaneously, the parasympathetic nervous system is shut down. It’s an emergency. Until it’s over, the body doesn’t need to divert energy to digestion, elimination of waste or any other nonurgent functions. Unfortunately, bodies that evolved to deal with lions still have a similar response when stuck in a traffic jam on the way to a job interview. The body is perfectly adapted to deal with the acute stress of getting away from a hungry lion. It is not so well adapted to dealing with the kind of long-term, chronic stresses that are common in modern life. Whether we are facing acute or chronic stress, the same stress hormones are released. Cortisol is the main stress hormone and it has two jobs: to produce energy and to regulate the immune system. But if the body doesn’t receive a signal telling it that the emergency is over, it will keep stress hormones at a high level. All the functions associated with rest are suppressed. Sugar levels remain high. The immune system becomes less vigilant. Being in constant flight-or-fight mode, all the markers of high inflammation in the body increase. Our bodies are on fire. Living lives of chronic stress, we all need to find ways to switch off the body systems that are trying to do their jobs. It’s not the nervous system’s fault that the world it evolved for no longer exists. It’s our task to find ways to help it come to terms with the modern world. 27
LIFESTYLE Discovering a new way of self-soothing – be it with an activity or natural medication – can swiftly reduce stress levels. So what will suit you best? 28
LEARNING TO RELAX R elaxation is an essential addition to our wellbeing toolkit, but it’s not always easy to accomplish, especially in challenging circumstances. But learning to do it right could help reduce stress and inflammation in our bodies. ‘Relaxation is vital to our health and wellbeing, as well as our immune function,’ says natural health and wellness expert Dr Tim Bond. ‘Researchers at Harvard Medical School discovered that in people practising relaxation methods, such as yoga and meditation, far more “disease-fighting genes” were active, compared to those who didn’t practise. In particular, they found genes were switched on that help to protect from disorders such as pain, infertility, high blood pressure and even rheumatoid arthritis.’ And that’s not all. The art of relaxation also drives higher levels of feel-good chemicals, such as serotonin and growth hormones, which repair cells and tissue. ‘In essence, relaxation has virtually the opposite effect to stress, lowering heart rate, boosting immunity and enabling the body to thrive,’ says Dr Bond. ‘An example is when women menstruate, they often find taking a long bath or doing some gentle relaxation exercises helps their general wellbeing.’ Sounds great, but our hectic lives often prevent us from finding – and utilising – what’s best for us. In order to move away from the sympathetic (fight or flight) response and activate the parasympathetic (rest and digest) response, we must trust our instincts and choose what produces the most satisfaction. ‘It’s about finding out what's right for you,’ says Dr Megan Jones Bell, chief science officer at Headspace (headspace.com). ‘Breathing can be a powerful way to help us reset and activate our natural relaxation response, so one of the easiest and most accessible ways for anyone to relax, in any setting, environment or activity, is to focus on the breath.’ As well as spending time in nature, playing with animals, getting a massage, and praying or meditating, here are some quick and effective ways to put you back on the path to wellness. The art of… creating Creating can be anything, from taking an art class or colouring in, to crafts or jigsaw puzzles. These forms of active mediation allow us to settle our overworked brains and focus on the here and now. ‘Art has the power to heal, increase wellbeing and reduce anxiety. Researchers liken creating art to exercise for the brain, and studies consistently show that creating art helps individuals cope with stressful and difficult situations,’ says Scott Phillips, co-founder of Rise Art (riseart.com). Even doodling is beneficial. Writing in Psychology Today (psychologytoday. com), Cathy Malchiodi, PhD, says: ‘The wonderful thing about doodling is that it is a whole-brain activity – self-soothing, satisfying, exploratory and mindful.’ The art of… yogic breathing Brighton-based yoga practitioner Danny Griffiths (yoga-fit.co.uk) recommends alternate nostril breathing, called nadi shodhana pranayama. It activates the parasympathetic response, 29
LIFESTYLE The art of… sound therapy Sound therapy, such as drumming, singing, chanting and gong baths, has been used for centuries to help people enter a more relaxed, meditative state, and promote wellbeing and healing. Now, thanks to modern technology, there’s a new-ish kid on the block – binaural beats. Through headphones, listeners receive a different sound frequency to each ear, which the brain interprets as a particular rhythmic frequency. These sounds create specific neural responses that, depending on the frequency, induce one of five brainwave states that can aid sleep and ease pain (delta brainwaves), help you relax or meditate (theta), reduce stress (alpha), improve concentration and focus (beta), and enhance memory (gamma). Look up binaural beats on YouTube or sign in to Spotify and search for “the most relaxing songs ever according to science”. Backed by neuroscientists, it’s so effective that it’s strongly recommended you don’t drive while tuning in. strengthening the immune system and providing quick relief from stress. She says, ‘I do this before classes, as I find it really relaxing and calming. It’s meant to balance the “ida” and “pingala” nadis (channels) or the yin and the yang.’ Explaining how to do it, she says, ‘Sit up straight in a crosslegged position with your left hand resting on your thigh, exhale completely then use your right thumb to close your right nostril. Inhale for four to five seconds through your left nostril then close this nostril with your ring finger and exhale for four to five seconds through your right nostril. Inhale through 30 the right nostril then close it with your thumb and breathe out through the left nostril. Repeat for three to five minutes. Finish on the left nostril.’ While this type of breathing can be done at any time, it’s worth combining with yoga. ‘Yoga is more of a work-in than work-out,’ says Danny. ‘Classes are meditative as we move from posture to posture, and for some students it’s the only time they can switch off. After concentrating on how the body feels in the moment, there’s no denying the state of relaxation at the end of practice.’ The art of… organising If your mother ever said “tidy house, tidy mind”, she wasn’t just trying to persuade you to clean your room – the chances are she recognised the positive effects of an ordered environment. And, with many of us taking staycations, it’s more important than ever to create a Zen home. Research has shown that working up a sweat while cleaning improves mental health and boosts mood, while Japanese organising consultant Marie Kondo waxes lyrical about “a comfortable environment, a space that feels good to be in, a place where you can relax” in her bestseller The Life-Changing Magic of Tidying Up (Vermilion). The art of… ASMR For those who enjoy Autonomous Sensory Meridian Response (ASMR), the experience can be nothing short With more of us taking staycations, it’s important to create a Zen home
LEARNING TO RELAX of profound. ASMR enthusiasts love the de-stressing effects of listening to sounds, such as whispering, eating, a cat purring or rainfall, or by watching kinetic sand or soap being sliced, or even pimples being popped. The theory behind these stimuli is the release of feel-good chemicals – endorphins, dopamine, oxytocin and serotonin – into our bodies, which decrease stress and aid relaxation and sleep. ‘ASMR is consistently helpful at bringing comfort, peace and calmness to busy brains when an overactive mind is preventing a desired feeling of calmness. While it can’t cure or prevent any form of illness, it may help reduce feelings of stress or sleeplessness,’ explains Dr Craig Richard, founder of ASMR University (asmruniversity.com). The art of… natural self-medicating with cannabidiol If you self-medicate with alcohol or drugs, try a natural approach instead – it’s better for your body and mental state. ‘Quality, tested CBD [cannabidiol] oil like DragonflyCBD (dragonflycbd. com) has been found to bust anxiety and stress, and help users, along with other self-care tips, to get to that deep relaxation state,’ explains Dr Bond. ‘Evidence from studies has shown that CBD has anti-anxiety effects, may regulate learned fear, and appears to reduce the cardiovascular response to models of stress and reduce resting blood pressure,’ he adds. The art of… salt bathing Salt baths have long been regarded as an elixir to combat stress and encourage relaxation, and the secret lies in magnesium. ‘Individuals who suffer with mental-health illnesses have been found to have lower platelet serotonin levels,’ explains Karen Davis, Westlab chief pharmacist (westlabsalts. co.uk). ‘There are different ways to increase serotonin, including magnesium intake,’ she adds. ‘This is best absorbed through the skin.’ That’s why a soak in a bath filled with salts rich in magnesium, such as Dead Sea, Epsom or Himalayan salts, is advised. ‘This will not only help to calm and de-stress the mind and body, but also improve mood,’ Karen explains. The art of… everyday mindfulness Contrary to popular belief, mindfulness isn’t about sitting quietly and meditating, which can take time and practice. ‘We can introduce relaxation into our daily life by simply trying to be more mindful in our everyday tasks,’ explains Dr Jones Bell. ‘This could be as simple as mindful hand-washing, making a cup of tea or taking moments to pause and check in with yourself. Rather than getting lost in the frustration of a task, acknowledge it, accept it, sit with it, focus on your breathing and bring your attention back to how you’re feeling and why. This will help you be intentional in every interaction and can bring about a more relaxed state of being,’ she says. The art of… neo-Luddism For those of us attached to our phones and laptops, a little neo-Luddism goes a long way, because if you’re constantly distracted by your phone or emails you’ll never relax. Neo-Luddites reject modern technology and so can you. ‘Give it a go, even for an hour, and see what difference it makes,’ says burnout coach Rosie Millen (missnutritionist. com). ‘We live in a comparative age, which is not healthy. From the moment we wake up to the moment we go to bed we are reminded of what everyone is doing and achieving in every 24-hour window. This emphasises the need to switch off to get in touch with real life.’ DO YOU SUFFER FROM RELAXATION REMORSE? Dr Christine Langhoff, clinical psychologist and director of Circle Psychology Partners in south London (circlepsychology partners.co.uk), explains why we sometimes feel guilty just taking it easy… ‘It can come from many places, including our upbringing, schooling, religion, the media and cultural expectations,’ says Dr Langhoff. ‘Our lives have become increasingly busy with both real and perceived pressures that, for many, have led to perfectionism. ‘Whilst striving for high standards is not a bad thing, overly focusing on them increases stress levels and the pressure on ourselves.’ Christine’s tips: % Remember that relaxing is an important part of staying physically and mentally healthy. % What we find relaxing is subjective – what works for you may not for another. Bear this in mind if you tend to compare yourself to others. % Be kind to yourself. It can be hard – but, with practice, relaxing becomes easier. % Set aside allocated time to relax, even if you feel you “don’t deserve it” or “have too much to do”. This could be anything from taking a yoga class to taking regular short breaks. 31
LIFESTYLE It’s as easy as breathing You breathe 22,000 times a day, and by doing it mindfully, you can free yourself from stress Y our breath is the greatest asset you have. Of course, its primary function is to keep us alive by bringing oxygen into your body. But it is also naturally meditative. It reflects your most powerful emotions and if you learn to understand it, can either soothe or harness them. There is an art to breathing correctly, and it’s one that many of us have forgotten. HOW BREATHING WORKS Breathing relies on the big, powerful muscles of the diaphragm, the abdomen and the intercostal muscles that lie between the ribs. It is helped along by the smaller secondary muscles of the neck, shoulders and upper ribs. When you are upset, anxious or stressed, the abdomen tenses and prevents the big primary muscles from working. Instead, they begin tugging against each other, leaving the secondary muscles to do all the work. But the secondary muscles are only designed to shoulder 20% of the burden, so they become stressed. If this continues, it can lead to chronic tension in the shoulders and neck, 32
BREATHING headaches and fatigue, and increasingly shallower breathing. It’s a vicious cycle that lies behind much of our anxiety, stress and unhappiness. But there is an equally powerful virtuous cycle that you can cultivate by learning the art of breathing. It’s at the heart of mindfulness and as old as meditation itself. You can learn the basics in just a few minutes, although mastering it takes a little longer. UNDERSTANDING MINDFULNESS AND YOUR MIND Mindfulness is simply full, conscious awareness of whatever thoughts, feelings and emotions are flowing through your mind, body and breath without judging or criticising them in any way. It is being fully aware of whatever is happening in the present moment. The aim of mindfulness is not to clear the mind of thoughts. It is to understand how your mind works. It teaches you to observe how your thoughts and feelings rise and fall like waves. And in the calm spaces lie moments of piercing insight. You come to learn that happiness is fleeting, while unhappiness lingers. Psychologists call it the negativity bias. It skews perception and makes the world seem far harsher than it actually is. The negativity bias ensures that it takes five positive experiences to balance a single negative one. It’s no more difficult than tuning into the breath while paying attention to the little pleasures of daily life. It means noticing the sights, sounds, smells and textures that surround you, and soaking up the tastes and aromas of everything you consume. And while you do so, gently remind yourself that most of life’s difficulties are only half as bad as they appear, while the good things are two or three times as intense. LISTEN TO YOUR BODY Through mindfulness, you will come to learn that thoughts, feelings and emotions are created by the body as much as the brain. It’s called embodied cognition. A fleeting moment of stress, for example, creates tension in the body. The brain senses this and interprets it as stress. The body tenses a little more, breathing becomes a little shallower, the brain feels more stressed. It’s a downward spiral. Mindful breathing will teach you that your most powerful states of mind are reflected in the body as physical sensations. Anxiety might appear as nausea. Stress as a headache. Depression might trigger physical pain – a broken heart, perhaps. Be aware of these sensations – each one is a message. If you consciously listen to these messages by actively feeling them in your body, you’ll realise that they rise and fall like your breath. And before long they’ll begin to melt away, leaving behind a calmer, happier and more insightful mind. MEDITATE UNDER THE STARS You’ll probably spend 36 minutes worrying today (most people do). Perspective dissolves worry. Instead of worrying, why not go outside and breathe? Even better, gaze at the stars. Take off your shoes and socks. Feel the ground beneath your feet. Look upwards. Breathe. See the stars streaming off into infinity in every direction. Focus on your breath. Feel the cool night air washing over you. Look at the stars… those twinkles may have taken billions of years to reach you. Breathe… love the arriving of the light… breathe. 4 The Art of Breathing by Dr Danny Penman (HQ) is out now. He is also co-author of the 1.5 million-selling book, Mindfulness. Try this little mindful breathing meditation WORDS: DR DANNY PENMAN. PHOTOS: GETTY IMAGES All you need is a chair, a body, some air, your mind… that’s it 4Sit on a straight-backed chair. Place your feet flat on the floor, your spine 2-3cm from the back of the chair. 4Be comfortable, with a relaxed but straight back. Place your hands loosely in your lap. Close your eyes. 4Focus your mind on your breath as it flows in and out. Feel the sensations the air makes. Feel the rise and fall of your chest and stomach. 4Where are the strongest feelings? Nose, mouth, throat, stomach, chest, shoulders? Pay attention and explore the feelings. Don’t try to alter them in any way. 4When your mind wanders, bring it back to your breath. Be kind to yourself. Minds wander. It’s what they do. Realising that your mind has wandered and bringing it back to your breath is the meditation. It’s a little moment of mindfulness. 4After five or ten minutes, gently open your eyes and take in what you can see, hear, feel and smell. You can download or stream this Breathing Meditation from franticworld.com/aob 33
LIFESTYLE is for 34 Why exercise is about the best thing you can do for your overall health
EXERCISE IS GOOD FOR YOU T Considering we were made to move, it’s not surprising that today’s sedentary lifestyles cause health issues. Researchers state that the simplest and most costeffective prophylactic is exercise. And it’s not hard to see why exercise is good for us. What is more difficult to understand is why exercise is helpful in reducing inflammation. After all, we don’t think of sitting around not doing anything as particularly stressful psychologically, and it certainly wouldn’t seem to cause the body physical stress. However, clear evidence has emerged showing that exercise does reduce inflammation, so let us see how this happens. Exercise reduces inflammation directly and indirectly. It does so directly by causing the production of various antiinflammatory cytokines, the proteins that control growth and the immune system. It does not even have to be sustained exercise: 20 minutes of moderate exercise is enough to stimulate the production of the key anti-inflammatory cytokine, TNF (tumour necrosis factor alpha). But even more important are its indirect effects on inflammation. Obesity, and specifically the sort of fat that accumulates around the internal organs, is a key factor in producing chronic inflammation. But lack of physical activity, even if that has not lead to obesity, is independently associated with chronic inflammation. It does not take a genius to work out that exercise will both counteract the inflammatory effects of inactivity as well as helping reduce obesity, thus further reducing inflammation. Finally, chronic stress is another key factor in producing chronic inflammation. The two are so closely connected as to be almost inseparable. The effects of regular exercise on reducing stress have been measured in innumerable studies, with the findings making it clear that exercise is incredibly beneficial. The only caveat is that it is possible to overdo exercise. People who overtrain – and you have to really work to do this – can increase inflammation levels, become more prone to injuries, and find themselves subject to the law of diminishing returns. But for most of us, this will not be a problem. PHOTOS: GETTY IMAGES here are very few animals capable of running a marathon and even fewer capable of beating human beings over that distance. That is because we were made to move – and to keep moving – over long distances for long periods of time. To make that possible, we sweat (which also explains why we aren’t covered in fur). Sweating enables us to keep cool when running. Indeed, in hot climates there’s no other mammal that matches us as longdistance runners (although in temperate climates horses, which also sweat, can outrun us and in cold climates, wolves can pip us to the post). 35
LIFESTYLE Build strength, gain ƔGZKDKNKV[CPFKORTQXG [QWTOGPVCNYGNNDGKPI to take up 36
YOGA t is thought that yoga has a 5,000-year-old history, QTKIKPCVKPIǡKP+PFKCCPFVJKU ancient practice has made a place for itself in our day-to-day lives. +H[QWJCXGPGXGTVTKGF[QICKVECP UGGOSWKVGKPVKOKFCVKPICVƒTUV6JG RKEVWTGUYGQHVGPUGGQHUWRGTƒV people contorting their bodies into various shapes while doing yoga can be quite off-putting – especially to a EQORNGVGPQXKEG$WVVJGƒTUVVJKPIYG should mention is that everyone has to start somewhere, and your yoga routine should be all about you and what your body can do. Yoga is a supremely adaptable exercise and far more CEEGUUKDNGVJCP[QWOKIJVVJKPM+V suits all shapes, ages and abilities, and VJGTGJCUDGGPCPKPETGCUGKPOQFKƒGF versions that are even more inclusive, such as chair or seated yoga. 1PEG[QWŨXGDGGPVQ[QWTƒTUV[QIC class you’ll soon realise that everyone is focusing purely on themselves CPFPQVQPGCEJQVJGT+H[QWCTGUVKNN hesitant, though, there are tons of great online materials that will enable you to practise yoga in your own space. Yoga with Adriene is a great resource on ;QW6WDG XKUKVYYY[QWVWDGEQO WUGT[QICYKVJCFTKGPG  Jennifer Kesik, founder of #NNǡ(NQYǡ;QICKP$QWTPGOQWVJ YYYCNNHNQY[QICEQWM UC[Uū#V#NN (NQY;QICYGDGNKGXGVJCV[QICKU CDQWVWPKQP+VKUCDQWVEQPPGEVKQP+V is about being present, the here and PQY#RRTQCEJKPI[QWTUGNHǡYKVJNQXKPI MKPFPGUUURTGCFKPIǡIQQFXKDGUCPF compassion to the rest of the world. I ū;QICQHHGTUWUCPKPXKVCVKQPVQVCMG time out of your daily routine and immerse yourself in a practice that disconnects us from distraction and noise around us, and brings us in tune with who we are at our core. ū+NKMGVQVJKPMQHRJ[UKECNDGPGƒVU that come from the yoga practice as ‘side-effects’,” Jennifer continues. ū9GQDVCKPCVQPGFDQF[UVTGPIVJ and flexibility through the practice, but it is the essence of yoga – ECPVGTKPIǡOKPFHWNPGUUCPFDGKPICDNG to let go of whatever it is that we are facing in the outer environment that changes our life.” 6JKUCPEKGPVRTCEVKEGKUXGT[IQQF for both our overall health and mental wellbeing, plus, if you are combining yoga with strength training, it is even OQTGDGPGƒEKCNVQ[QWTDQF[+VEQWPVU as a strength workout on its own and will help you to improve your balance, EQTGUVTGPIVJCPFHNGZKDKNKV[6JGUNQY considered movements, combined with deep breathing exercises, helps to increase blood flow and warm up muscles while holding poses will help to build strength. ;QICKURCTVKEWNCTN[DGPGƒEKCNHQT people who sit at a desk for most of their day due to the stretching nature of many of the moves. Day-to-day, many of us forget to stretch our bodies out properly and we’ve probably all been guilty of skipping stretches before or after a workout, so by simply slowing down with yoga and taking time on each move, you’ll make a huge difference to your joints and overall muscle health. Three benefits TO YOGA 1 Community 2 Exercise Going to an actual yoga class will provide you with a community of like-minded connections that we’ve all likely been craving in recent years in the light of the effects of the Covid-19 pandemic. And, if nothing else, this will boost your mood and general OGPVCNaJGCNVJ When you practise yoga regularly, you’ll sleep better due to the meditative properties of the exercise. Not all types of yoga are good to do just before sleep and for optimal relaxation, though: hot yoga and the more athletic vinyasa will get your heart rate pumping, but hatha yoga QTPKFTCaCTGKFGCNRTGUNGGRCPFHQT relaxation purposes. 3 Wellbeing Practising yoga regularly is believed to improve your heart’s health as well as blood pressure due to the fact it helps to reduce stress and overall body inflammation. Plus it helps with aches and pains – particularly lower back pain and arthritis. The mediative aspects of yoga will also help clear your mind and make you more focused. 37
LIFESTYLE It’s a time to focus internally on yourself and forget all of your troubles 9JGP[QWƒTUVUVCTV[QWT[QIC journey, you might feel a little overwhelmed with having to concentrate on the positioning of your body, while remembering to breathe and clear your mind to enter COKPFHWNURCEG+VECPCNNHGGNCNKVVNG EQWPVGTKPVWKVKXGCVƒTUVDWV[QWŨNNUQQP IGVKPVQVJGHNQY SWKVGNKVGTCNN[ QH things. Before you know it, the moves will begin to feel like second nature and so will your ability to escape from your thoughts and life distractions. Types of yoga 6JGTGCTGOCP[FKHHGTGPVV[RGUQH[QIC but here we are going to look closer at the ones you are most likely to come across. Vinyasa yoga is often seen as the most athletic form of yoga as it involves stringing postures together, moving from one to the next in a flow. +VŨUNKMGN[VJCVPQVYQXKP[CUCENCUUGU YKNNDGVJGUCOGWPNKMGƒZGFHQTOUNKMG Bikram yoga, which features the same 26 postures each time, or Ashtanga which has the same sequence every VKOG6JGEJCPIKPIPCVWTGQHXKP[CUC yoga helps to develop a more balanced body and prevent injuries or aches that might occur from performing the same OQXGUGCEJVKOGǡ Yoga nidra is a form of guided meditation also known as ‘a yogic sleep’ and is usually practised while lying down with a teacher guiding you VJTQWIJVJGGZGTEKUG+VKUUWRRQUGF to turn your focus inwards to yourself and float into a relaxed state of UGNHCYCTGPGUU6JKUHQTOQH[QICKU the ultimate mindful exercise. 6JGPVJGTGCTGOQTGXKIQTQWU forms, such as hot yoga which is practised in a humid room at a VGORGTCVWTGQHCTQWPFž%6JGTG are many types of yoga performed in a hot yoga studio, one of which is the previously mentioned Bikram yoga. 38 +VKUWUWCNN[COKPWVGRTQITCOOG that consists of a series of extended UVCPFKPICPFUVTGVEJKPIRQUVWTGU6JG more demanding nature of the poses, combined with the heat, is designed to raise your heart rate and exercise your muscles. Hot yoga is not for everyone, though, as the rooms are WPUWTRTKUKPIN[ UYGNVGTKPIUQEJGEM with a medical professional before giving it a go. Hydration is important for all yoga, but even more so when it comes to hot yoga. Aerial yoga, meanwhile, mixes yoga, Pilates callisthenics and acrobatics using a suspended hammock. Being suspended enables you to stretch deeper than traditional forms of yoga while providing a full-body workout. Practice for mindfulness 6JGCFXCPVCIGUQH[QICCTGUGGOKPIN[ endless, but the fact you’ll be able to combine a mindful activity with GZGTEKUGKUQPGQHVJGOCKPDGPGƒVUKP QWTQRKPKQP+H[QWFGEKFGVQRTCEVKUG yoga at home, we’d recommend creating a space dedicated to it. Even if it isn’t a permanent setup, the very act of creating a mindful environment each time will be a meditative experience. %QPUKFGTNKIJVKPIUQOGUQQVJKPI candles or incense, dim the lights, lay out your mat and perhaps a blanket and cushion, turn off your technology and close the door to any distractions if you can. Normally, yoga studios will create a calming atmosphere for you to begin, or if you can get yourself to a beach session we’d highly recommend VJGOKPFHWNDGPGƒVUQHHGGNKPIVJGUGC breeze and looking out into the ocean while you practise. Yoga will give you an escape from your everyday life; it’s a time to focus internally on yourself and forget all of [QWTVTQWDNGU6T[PQVVQVJKPMCDQWV your workday, or what you might cook for dinner while you practise. Aim to clear your mind and just focus on the movements, breathing, and how your DQF[HGGNUCU[QWOQXG QTNKGKPC [QIKEUNGGR .KUVGPVQVJGOWUKEHGGN the sensations in your body and don’t let any distractions from outside of [QWT[QICDWDDNGETGGRKP+VŨUCVKOGVQ focus entirely on yourself. Breathe… %QPVTQNNKPI[QWTDTGCVJKPIYKNNJGNR cleanse your body and master the positions better. Start by trying to notice how you breathe – do you know when your breath is usually shallow or when it speeds up? Knowing your breathing patterns will help stress management and also just thinking about your breath tends to calm it. .GCTPKPIJQYVQWUG[QWTDTGCVJKP asana practice is important. Different teachers will have different styles and priorities, but generally when to inhale and exhale should be similar… WHEN BENDING FORWARD, YOU SHOULD EXHALE WHEN YOU LIFT OR OPEN YOUR CHEST, YOU SHOULD INHALE WHEN TWISTING, EXHALE
YOGA ALSO TRY PILATES Pilates is very similar to yoga in that it is not only an exercise that sculpts your body, but it also helps to clear your mind, gives you energy and a sense of inner balance. 9JGP[QWCTGRTCEVKUKPI2KNCVGU CPF[QIC [QWYKNNDGEQPEGPVTCVKPI on one thing: your body, and because Pilates in particular can be more strenuous and require more concentration, you will have to clear your mind to focus. Pilates is a great way of meditating without sitting still and feeling like you might be wasting time, plus the feeling of having accomplished something for your body will boost your mood, and the endorphins from the work will leave you feeling amazing. Much like yoga, Pilates also works to relieve stress and tension built up in your muscles VJTQWIJǡIGPVNGUVTGVEJKPICPF gradual conditioning. A Pilates workout will help you to metabolise the stress hormones VJCVDWKNFWRKP[QWTOWUENGU6JG fascial release techniques often featured in a Pilates session will also help loosen tight muscles in ways you are unable to in normal stretching. And, when you release stress from your body, you’ll release it from your mind, too, leaving you feeling more relaxed overall. WORDS REBECCA GREIG PHOTOGRAPHS GETTY IMAGES Get started +HCHVGTTGCFKPIVJKU[QWƒPFVJCV[QWT interest in yoga has been piqued, it’s very easy to get started and experimenting with this popular form of exercise. Most towns and cities will have their own yoga studios which you can join, where you can be guided by an expert and be part of a YKFGT[QICEQOOWPKV[+H[QWFQPŨV want to commit to something like that straight away, however, there are many resources out there which you ECPWUGVQƒPFQWVKH[QICKUHQT[QW (KTUVN[VJGTGCTGCPCTTC[QH;QW6WDG channels you can explore, like the aforementioned Yoga with Adriene. But you want to quickly want to experiment with some moves right now, just turn VJGRCIGVQƒPFCUGVQHGUUGPVKCN moves that you can get started with. So what are you waiting for? Get started on your yoga journey now! 39
LIFESTYLE LESS PAIN, You’ll be pleased to hear that gentler exercise is good for you. Here’s how to reap the benefits… 40
LESS PAIN , MORE GAIN T ake a look at the class list for most gyms and you can expect to see promises to “make you sweat” and “push you to the max”. So it would be easy to think that hard and fast exercise is the only way to see changes. But slowing down your routine doesn’t have to mean putting the break on results. While the ability to get your heart rate soaring is what gives high-intensity training its magical calorie-burning effect, that same intensity can also be its downfall. ‘As your body starts to tire during a session, it will try to find easier ways to complete the moves,’ explains Matt Harras, a group exercise manager for Virgin Active. ‘You might start to rely on momentum (swinging a dumbbell instead of lifting with control), or try to switch the effort to other parts of the body, losing form.’ This loss of form can reduce the effectiveness of the exercise. ‘You can do 100 burpees but if you’re not keeping form you won’t see results. In that respect, slower and more controlled moves can actually be more beneficial.’ ‘It’s a myth that you need to be huffing and puffing to see results,’ says Niki Rein, founder of Barrecore. ‘There are lots of different ways to get the same outcome. Resistance training can actually bring you further, faster than high-intensity cardio. It stimulates mitochondrial production – organisms that help create energy and melt fat. So as well as burning calories in class, you’ll burn even more over the next three to four days.’ High-intensity exercise can also put pressure on joints, increase risk of injury and, when overdone, play havoc with our levels of the stress hormone cortisol. ‘Too much HIIT (high intensity interval training) also puts pressure on the immune system as the body doesn’t get a chance to recover,’ reveals Matt. Take the pace down a few notches and you can turn those risk factors on their head. Low-intensity exercise helps protect joints and has been shown to reduce the level of stress hormones circulating in our bodies. Allow us to introduce you to some gentler but just as effective alternatives. MAKE IT EASY ON YOURSELF Train smarter instead of harder with these clever swaps Swap burpees for sun salutations ‘Like a burpee but slower and with more control, which means you’re holding your body weight for longer and focusing more on strength,’ says Matt. Stand with your feet hip-width apart. Stretch your arms up, then forwards and down towards your toes, keeping your back as flat as possible. Place your palms or fingertips on the floor in front of you (or on your ankles/shins), lift your head and hold for 10 seconds. Plant your hands on the floor, walk your feet back into a plank position and hold for 10 seconds. Slowly lower your knees, chest and chin towards the floor, with your body straight. Hover just above the floor for 10 seconds. Drop your hips to the floor, straighten your arms and look up (upward-facing dog). Hold for 10 seconds. Pushing into your palms, straighten your legs, raising your hips into the air and drop your head (downwardfacing dog). Hold for 10 seconds. Walk your feet back to your hands and slowly roll back up to standing. Pause for 10 seconds then repeat the sequence four to five times. 1 2 3 4 5 6 7 41
LIFESTYLE Swap jumping lunge for warrior pose Jumping lunges are a great leg toner but can be hard on the knees. Matt suggests the warrior pose as a gentle alternative giving the same results. Stand with your feet wider than hip-width apart, arms straight out to the side at shoulder height, palms down. Turn the right foot out and bend the right knee until your thigh is parallel with the floor, making sure your knee doesn’t go past your toes. Hold for 10 breaths. Return to the centre and repeat on the other side. Repeat the sequence 3 times. 1 2 Swap mountain climbers for one-legged down dog ‘It works the same muscle groups as mountain climbers but the slower pace should help you maintain stability and form, and increase the time under tension for your muscles, maximising results,’ says Matt. Start on all fours with your wrists directly under your shoulders and knees under your hips. Spread your fingers, tuck your toes and straighten your arms and legs, raising your hip into the air without locking your knees. Step your feet together then lift your right leg into the air, flexing your foot. Bring your knee in towards the chest and slowly extend back out. Repeat 10 times before switching to the other side. Repeat the sequence 3 times on each side. 1 2 3 Swap squat jump for wide plie with pulse Swap press-ups for plank ‘A press-up just works arms and chest – there’s no time for your back muscles or core to develop,’ says Paulo Pacifici, founder of the Ady Centre and DeRose Method teacher. ‘Hold the plank position and you work the entire body.’ Start on all fours with your hands directly under your shoulders. Step your feet back and tuck your toes. Your body should form a straight line from the top of your head to your heels. Look down at the floor. Hold for 45 seconds, building to 2 minutes. Focus on taking deep abdominal breaths through your nostrils. 1 2 ‘You won’t be huffing and puffing but you’ll feel the deep burning sensation, which is where the results are,’ says Niki. Stand with your legs wider than your hips, feet in a natural turn out. Lower your hips so your thighs are parallel to the floor, and hold your arms straight out at shoulder height (T position). Bend your knees so your hips drop slightly lower than knee height or as low as possible without your knees buckling, raising your arms over your head. Lift your hips up a couple of inches, moving your arms back to the T position. Keep a neutral spine and your knees over your toes. Gently pulse up and down. Repeat 20 times slowly then 20 times at a faster, one-count rate. Finish by holding in the lowest position for 15 seconds. 1 2 3 42
LESS PAIN , MORE GAIN Take a walk SWAP a HIIT class FOR a long walk ‘In a 30-minute HIIT class you can burn around 500-600 cals, but you can get the same results with a 60- to 90-minute walk,’ says Matt. ‘A walk can also clear your mind and give you time to think.’ WORDS CLAIRE FOX. PHOTOGRAPHS ANNE MARIE BICKERTON, GETTY IMAGES Swap squat thrusts for bear crawl Feel exhausted just thinking about squat thrusts? Try a bear crawl instead. ‘It’s a full-body exercise that will sculpt your shoulders and fire up your quads and glutes,’ says Matt. ‘Plus it’s hard to get wrong.’ Crouch down with your hands on the floor, shoulder-width apart, hips in the air and eyes forward. Crawl forward with your right hand and left leg then your left hand and right leg. Go forward five paces then back five paces. Repeat three times. 1 2 Swap sit ups/crunches for dead bug ‘It’s one of the simplest, most effective exercises to strengthen and tone your core,’ says Matt. Lie on your back, arms and thighs straight up to the ceiling, but with your knees bent to form a table top with your shins. Engage the core to avoid rocking and slowly lower your right arm behind you while straightening and lowering your left leg. Tap the floor with your heel and hand then slowly move back to the start position before repeating with the other arm and leg. Repeat 20 times, 10 on each side. Rest for 30 seconds, then repeat. 1 2 Swap high knees for holding leg pose Give high knees a clever makeover with this full-body workout from Paulo, which also improves balance. Stand with your legs hip-width apart, arms by your side. Take a deep breath in and, on the exhale, lift your right knee towards your chest, as close as you can without bending your back. For more of a challenge, raise both arms above your head. Hold for as long as possible, building up to one minute. Breathe through your nostrils and into your abdomen. Inhale as you lower your arm and leg then repeat on the other side. 1 2 43
LIFESTYLE THE Make your walk work for you with our guide to turning a simple stroll into a fat-burning workout 44
WALK OFF THE WEIGHT W hen we think of walking as exercise, it’s usually more of a leisurely stroll or aiming for those coveted 10,000 steps a day. But walking is so much more than going from A to B, and when you do it properly, incorporating different paces, speeds and even elements such as lunges and squats, it can be a way to exercise that you hadn’t thought of and helps the pounds fall away. Walking is free, easy and good for our health. The UK even has a National Walking Month in May, organised by the British Heart Foundation (bhf.org.uk). Just 30 minutes of exercise, including walking, five times a week reduces the risk of cardiovascular disease, cancer and type 2 diabetes, and could help relieve symptoms of depression. Plus, walking boosts circulation, making your skin look fresher and younger. Follow our plan and you’ll be in shape within 30 days and singing the praises of walking to everyone you meet. Your trainers Joanna Hall (joannahall.com), creator of the Walkactive technique Get some walking buddies! Want to make sure you stick to the challenge? Then why not get some of your friends and colleagues to do it with you? Keep a record of who hits their target each day and you could even compete to see who walks the most steps over the 30 days. Lucy Gornall, Freelance fitness writer and personal trainer The challenge on the following pages is all about fitting extra activity into your busy day, and it’s very simple. There are three levels. Choose yours using the test on the next page, then follow the targets on the grid on the following page. If you find that your level is too easy, switch to a more advanced one – the key thing is the consistency of your efforts. Do the daily walks in increments and the weekly walks when you can fit them in (for example, at the weekend – see over the page for details). 45
LIFESTYLE THE 30-DAY CHALLENGE Miss your target one day? Don’t worry – add up the total steps for days 1-7, 8-14 or 15-22, or 23-30 and make sure you’ve achieved the total by the end of that section. Now add in your weekend walks Twice a week, do two brisk walks. Each should take 10-15 minutes, building up to 20-25 minutes. Novice: 1,200-1,500 steps Intermediate: 1,500 steps Whizz: 1,700 steps ✢ DAYS 8-14 Novice: 1,500-1,800 steps; Intermediate: 1,700 steps; Whizz: 1,800 steps ✢ DAYS 15-22 Novice: 1,800 steps; Intermediate: 2,000 steps; Whizz: 2,500 steps ✢ DAYS 23-30 Novice: 2,000 steps; Intermediate: 2,500 steps; Whizz: 3,000 steps Take the test The amount of physical movement you do each day, without long periods of sitting, has the greatest impact on your health and fitness. You can track this by counting steps. Before you start the challenge, use a pedometer to record the number of steps you take for three consecutive days, then divide the total by three. ✢ If your daily average is less than 5,000, opt for the Novice Level. ✢ If your daily average is between 5,000 and 7,500, go for the Intermediate Level. ✢ If your daily average is 7,500+, choose the Whizz Level. Get kitted out Wearing the right kit will help you to focus on your walking journey… ✢ HIKE TIGHTS Sherpa Kalpana Hike Tight, sherpaadventure gear.co.uk. Every item you buy funds a school day for a child in Nepal. ✢ PHONE FRIEND Freetrain V1 phone holder, freetrain.co.uk. Track those steps and free your arms. ✢ HANDY BAG Quecchua Nature walking rucksack, decathlon.co.uk. An absolute steal! ✢ SUPER SHOE Columbia SH/FT OutDry mid shoe, columbia sportswear.co.uk. Special cushioning technology in the sole makes this a lightweight winner. Make it harder If you really want to make your workout harder, Lucy recommends pausing your walk at every 1,000 steps and aiming for either 10 (Novice), 20 (Intermediate) or 30 (Whizz) repetitions of the below. ✢ CURTSY LUNGE (split the rep count between each leg). Feet shoulder-width apart, step your left leg behind you and to the right. Bend both knees so you’re in a curtsy position. From here, jump to the side to switch the position of your legs, ending in a curtsy lunge with leg positions reversed. 46 ✢ SQUAT Stand with feet hip-width apart. Keep your feet flat and back straight, then lower into a sitting position. Lift your arms out in front of you to balance. Hold for 3 seconds, push your heels into the floor and drive up to standing. ✢ EAGLE SQUAT Start with your legs together. Lift your right leg over your left leg, so they’re crossed. Interlink your arms so your right elbow is underneath your left, palms touching. Squat down, hold for 3 seconds, switch sides and repeat.
PHOTOS GETTY IMAGES, TI-MEDIACONTENT.COM WALK OFF THE WEIGHT DAY 1 DAY 2 DAY 3 Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps DAY 4 DAY 5 DAY 6 Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps DAY 7 DAY 8 DAY 9 DAY 10 DAY 11 DAY 12 Novice 5,000 steps Intermediate 7,000 steps Whizz 7,500 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps DAY 13 DAY 14 DAY 15 DAY 16 DAY 17 DAY 18 Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 5,550 steps Intermediate 7,500 steps Whizz 8,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps DAY 19 DAY 20 DAY 21 DAY 22 DAY 23 DAY 24 Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Novice 6,000 steps Intermediate 8,000 steps Whizz 9,000 steps Days 23-30 targets Novice 51,500 steps Intermediate 68,000 steps Whizz 80,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps DAY 25 DAY 26 DAY 27 DAY 28 DAY 29 DAY 30 Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps Novice 6,500 steps Intermediate 8,500 steps Whizz 10,000 steps 47
LIFESTYLE The of It turns out the proverb, ‘early to bed, early to rise makes a man healthy, wealthy and wise’, is true in at least two of its consequences 48
THE BENEFITS OF SLEEP contribute to chronic stress, such as lack of sleep, will also further inflame the body’s immune system, which will lead to further inflammation. But how does a lack of sleep contribute to increased inflammation? Research is continuing but there seem to be a number of pathways. The body’s natural circadian rhythm is mediated by secreting hormones as light levels increase and decrease. Cortisol, which we have already seen plays a crucial role in inflammation, is naturally secreted in the morning as part of our body’s wake-up call: it increases energy levels to deal with the challenges of the day ahead. Another hormone, adenosine, is secreted during the day, making us feel more tired, and as the sun goes down, melatonin is produced to send us off to sleep. Melatonin levels rise during the night and peak between 2am and 4am, while adenosine and cortisol are broken down. However, if we’re not getting enough sleep, then these hormones are not broken down enough, and we wake up feeling tired (adenosine) and with our stress hormone (cortisol) higher than it should be. Sleep is also the time when the body clears up the free radicals that are sometimes generated as a by-product of cellular respiration. In particular, glutathione, produced in the liver, is a powerful antioxidant. However, sleep deprivation reduces the production of glutathione by 20 to 30 percent and therefore leads to an immune system not working at optimal efficiency. The brain also uses sleep time to clear itself out, bathing itself in increased amounts of cerebrospinal fluid to flush out neurotoxins accumulated during the day. These are just some of the benefits of a good night’s sleep. Combined with exercise (which will help aid sleep) and a good diet, the body will take care of itself. We just have to get out of the way and stop sabotaging its efforts to look after us. PHOTOS: GETTY IMAGES S leep is good for you. Scientists have done the research to prove that Shakespeare was quite right when Macbeth says that sleep “knits up the ravell’d sleeve of care,” and proclaim it “balm of hurt minds, great nature’s second course, chief nourisher in life’s feast”. Those eight or so hours when we lie abed are vital to our health and wellbeing. Lack of sleep has been linked to a whole panorama of diseases and disorders, ranging from heart disease and diabetes to obesity and depression. What is notable is that some of these disorders, such as obesity, are independently associated with chronic inflammation. As we know that chronic inflammation often results from chronic stress, conditions that 49
LIFESTYLE of Get a good night’s rest with these expert-backed bedtime hacks 50
SLEEP A FTER-HOURS When it comes to having better, healthier sleep, the first step can simply be going to bed earlier. According to research by The Sleep Council, 19% of Brits aren’t in bed before midnight, with nearly a third of us hitting the hay between 11pm and 12am. However, studies show that people with an early-to-bed, early-to-rise routine are less likely to develop mental-health problems than night owls. Scientists say it takes just two weeks to tweak your body clock so that you fall sleep earlier. B REW UP We already love the sleep-inducing benefits of chamomile, lavender or valerian herbal tea before bed, but according to a study by the Journal of Medicinal Food in 2010, drinking about 500ml (16oz) of tart cherry juice throughout the day can also help you to nod off. CBD You may have heard the hype about CBD, but how can it help you sleep? CBD oil works on the body’s endocannabinoid system (ECS), which maintains stability in processes like sleep, pain perception, digestion, cognition, memory, mood and immunity. ‘Clinical research has found that taking CBD oil at bedtime can alleviate insomnia and help people sleep for longer. What’s more, it doesn’t create the “sleep hangover” effect typical of many sleeping pills,’ explains nutritionist Fiona Lawson. Try 2-4 drops of CannabiGold Classic 500mg, £29.99 for 12ml, natureshealthbox.co.uk. D UST MITES These pesky bedfellows – or, rather, their waste – are the most common cause of allergies in the home, giving us sleep-stealing symptoms like sneezing, stuffy nose, sore eyes and itchy skin. The average mattress contains tens of thousands of mites, and they love the warm, cosy conditions of duvets and pillows. To keep mites at bay, buy anti-allergy bedding, wash bedding at 60C and regularly vacuum the mattress. E NOUGH? Everyone is different, and so is the amount of sleep we need. ‘On average, a normal amount of sleep for an adult is considered to be around seven to nine hours a night,’ says Dr Irshaad Ebrahim of The London Sleep Centre. This usually drops to seven to eight hours for over 65s. Use how you feel mid-morning to gauge your quota. If you’re refreshed and alert, then you’re probably getting enough sleep. F ITNESS FABLE Evidence shows that adults of all ages report sleeping significantly better after doing at least 150 minutes of physical activity per week. But does the timing of your workout affect your ability to drop off? It was previously believed that strenuous exercise in the evening delayed sleep due to the rise in body temperature and the release of adrenaline, norepinephrine and cortisol, but recent findings have dismissed this idea. A study published in the Sports Medicine journal revealed that, as long you have an hour’s recovery before bed, moderate exercise is not detrimental to a good night’s sleep. G UT HEALTH Our gut microbiome produces and releases neurotransmitters linked to sleep, including serotonin and GABA. The sleep hormone melatonin is also produced in the gut. Some research suggests we should focus on gut health for better sleep quality. Eat prebiotic foods, such as onions, garlic, beans, pulses and lentils, and try taking a supplement, such as Healthspan Super 50 Pro (£29.95 for 60 capsules, healthspan.co.uk). 51
LIFESTYLE HOT, HOT, HOT Nearly half of menopausal women suffer with hot flushes andnight sweats, according to a survey by he British Menopause Society. Taking a cool shower, keeping your bedroom cool and avoiding potential triggers such as spicy food, caffeine, nicotine and alcohol before bed can help reduce discomfort. Menopause clothing specialists Become have an anti-flush sleepwear range that boasts moisturewicking properties that it claims keeps skin drier and cooler during a sweat. Become Clothing (from £31.46, becomeclothing.co.uk). INSOMNIA Struggle to fall asleep in under 30 minutes? Wake regularly through the night? Feel that your daytime functioning is negatively impacted? If it’s been happening for over three months, this is insomnia. You don’t have to accept it, though. ‘CBT for insomnia is an NHS-recommended treatment which is so effective that studies show up to 85% of people will see improved sleep, often in under four weeks,’ says Kathryn Pinkham, founder of The Insomnia Clinic (theinsomniaclinic.co.uk). ‘CBT works by tackling the physical side of the condition and re-aligning your body clock.’ JUST EAT Sleep-friendly foods are packed with tryptophan, an amino acid that boosts sleep hormone melatonin. Turkey, milk, walnuts and pumpkin seeds are all good sources to snack on before bed. K EEP CALM ‘If you’re feeling stressed before bed, focus on breathing deeply and slowly, inhaling for a count of four through the nose and exhaling for seven seconds through the mouth,’ says stress and relaxation expert and motivational speaker Carole Spiers. 52 LIFE-SAVING Getting adequate amounts of sleep can add years to your life and reduce the risk of obesity, heart disease, diabetes, cancer and dementia. ‘Almost every known ailment…is linked in some way to poor sleep. Sleep deprivation increases our risk of developing health issues and it reduces our body’s ability to cope with them,’ says Professor Jason Ellis, Director of the Northumbria Centre of Sleep Research. OF MAGNESIUM MAGIC Low magnesium levels are linked to restlessness and frequent waking, and research shows a supplement can improve sleep quality. Up your intake with the Together Night Time Marine Magnesium Complex (£13.99 for 60 capsules, togetherhealth.com) – a calming concoction of ocean-sourced magnesium with calcium and 5-HTP from Griffonia extract. NAKED Only one in five Brits sleeps in the buff despite there being proven advantages to the practice. Reasons to bare include better body temperature regulation, promoting a deeper sleep and faster metabolism. You’ll also get a boost of oxytocin from skin-to-skin contact if sleeping with a naked partner. OILS Aromatherapy oils not only make your bedroom smell good, but relieve stress and promote relaxation, allowing you to drop off faster. Try sleep-inducing classics lavender, ylang-ylang, clary sage or jasmine misted into the air via a diffuser. Our fave? Neom Organic’s Wellbeing Pod Essential Oil Diffuser and oil blends range (from £95, neomorganics.com).
SLEEP POSITION POWER Poor sleep has been linked to raised levels in brain tissue of protein deposits associated with Alzheimer’s disease. Although most are swept away overnight, sleeping position can determine how effectively this happens. One study showed that brain cleansing was more effective in mice that slept on their sides than on their backs. QUIET TIME If you’re one of the 30% of people who can’t snooze in silence, download the noisli app (noisli.com app). The soothing audio includes white, pink and brown noise – everything from a whirring fan to forest noise with birdsong – to help you unwind and nod off gradually. TENSION If you lie in bed with a tensed-up body and jaw, your sleep will suffer. ‘To relax, squeeze the muscles in your feet, hold, then release; move up through your body doing the same until you reach the top of the head,’ suggests Claire Dale and Patricia Peyton, authors of Physical Intelligence (£14.99, Simon & Schuster). RECOVERING SLEEP URINARY URGE Don’t fret about occasional sleep deprivation, as it’s lighter sleep that’s lost. ‘Nearly half of sleep consists of lightsleep, a quarter of deep sleep and a quarter of rapid eye movement (REM) sleep. If you lose sleep one night, deep and REM sleep increases the next,’ says Dr Chris Idzikowski, author of Sleep Well (Eddison Books). One in 10 people under 45 has to urinate in the night, and this increases with age. Needing a wee more than twice at night is called nocturia and can be caused by diabetes, sleep apnoea, hormonal changes, a weak pelvic floor or too much fluid before bed. If nocturia persists, see your GP to rule out a UTI. WIND-DOWN & WAKE-UP 3 sleep lamps for better bedtimes… %Glow lamp, £109, casper. com. Get the Casper Glow app to sync this lamp to your nighttime and morning routine. %Mimics sunset and sunrise with a full-colour spectrum. Someno Sleep and WakeUp Light, £199, phillips.co.uk. %A fading ‘sunset’ with sleep sounds helps you unwind. Bodyclock Luxe 750DAB, £229, lumie.com has built-in wake-up sounds, too. XEROSTOMIA This is the medical term for a dry mouth. Saliva production can decrease by 40% as we age, and fluctuating hormones during menopause may exacerbate things. A dry mouth can disturb sleep and affect tooth and gum health. Drinking plenty during the day, sleeping with a humidifier and avoiding alcohol-based mouthwash will all help. YESTERNIGHT WORDS: ALI HORSFALL. PHOTOS: GETTY VIVID DREAMS SNORING There are approximately 15 million snorers in the UK, according to the British Snoring & Sleep Apnoea Association. Kally Sleep’s Anti-Snore Pillow (£39.99, kallysleep.com) claims to reduce the rumbles by up to 50%, thanks to its ergonomically S-shaped foam core, designed to optimise head and neck position to improve breathing. Ever wondered why we have crazy and memorable dreams? Around 25% of our night’s sleep is spent in rapid eye movement (REM), the sleep stage important for learning and memory. Because brain activity is similar to that of being awake during REM, it’s when we dream intensely, according to scientists. Stress, sleep deprivation, certain medications and hormone fluctuations have all been linked to more vivid dreams says the Sleep Council. ‘If you’re lying awake feeling the hours slip away, turn the clock away or move it to a different room if you can. Seeing time move on will increase your anxiety and keep you awake longer,’ says Carole Spiers. Phenergan Night Time (£5.75, expresschemist.co.uk) can be a short-term insomnia solution. ZINC This essential mineral and antioxidant is key for sleep regulation. Form’s ZZZZs supplement (£19 for 30, formnutrition.com) blends zinc with magnesium and the calming amino acids L-Glycine and L-Theanine for a restorative night’s sleep. 53
LIFESTYLE and How meditation can help people go to sleep and thereby reduce inflammation A lthough sleep is undoubtedly good for health in general and reducing inflammation in particular, it’s not always easy to get to sleep. A third of adults find it difficult to fall or stay asleep at least once a week, with between six and ten percent suffering from clinical insomnia. Sleep difficulties are also strongly correlated with many of the disorders linked to chronic inflammation, including heart disease and obesity. So being able to get to sleep – and stay asleep – will help on many different levels. Meditation is one way of achieving this. A huge range of research has confirmed that meditation produces general benefits to health, so even if it doesn’t help you sleep it will help in other ways. But in most cases it will help, so let’s see how that happens and what to do to gain the most from sleep meditation. A common factor for many people suffering from sleep problems is chronic stress (which is, of course, closely related to chronic inflammation). Meditation relieves stress by helping to reduce the activity in the amygdala, one of the oldest parts of the brain, which is directly connected to the flight-fight stress reaction. Dampening the amygdala reduces the secretion of stress hormones, such as cortisol, and enables the body to switch into its rest/digest state. This helps put the sympathetic and parasympathetic nervous systems back into balance. 54 With the parasympathetic nervous system properly activated, the body slows its heart rate and breathing, and lowers blood pressure, allowing it to relax towards the sleep state. On a purely mental level, people often find that meditation, which focuses concentration upon the present moment, allows them to put aside the jumble of worries and plans that can spin through the mind, preventing them from getting to sleep. There are a number of meditation techniques that are useful in getting to sleep. Mindfulness meditation encourages focus upon the present moment while allowing thoughts and emotions to simply pass through consciousness. When it comes to aiding sleep, we are encouraged to concentrate on breathing, letting thoughts come and go but returning focus to our breath in the present. Guided meditations, which are available on many apps, use a recording to help the listener towards sleep through imagery and the imagination. Body scan meditation involves moving our mental focus through all the different parts of the body, allowing us to become aware of hidden tensions so that we can relax them and move on. There are other forms of meditation, including yoga, qi gong and tai chi, which might prove useful. Online searches will produce links to these should you wish to try them. There is no right or wrong way in this: it’s all about what works for you.
PHOTOS: GETTY IMAGES BREATHE AND SLEEP 55
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58 Gut health and inflammation Improve your diet for a positive impact on your body 64 Anti-inflammatory foods Strengthen your body’s anti-inflammatory shield 80 Taste your way to better health The herbs and spices that can fight inflammation 82 Inflammatory foods to avoid Discover the food and drink that can increase inflammation 86 How to ferment food Uncover the benefits of fermented food for gut health 88 Fibre & vitamin D The importance of fibre and vitamin D for your body 57
NUTRITION Improve your gut health for a positive impact on inflammation in your body T he gut plays an important role in your physical and mental health, and by managing your gut health, you can also help to relieve symptoms of inflammation elsewhere in your body. The term ‘gut’ is another word for your gastrointestinal (GI) system or digestive tract. While we might think about the gut as being in our stomach area, as that is where many symptoms of a problem present themselves, it actually runs from mouth to rectum. Our gut health refers to the healthy function and balance of the entire digestive system. Along with our circulatory system, muscular system and respiratory system, it’s one of the key processes in the human body. Within our body is the microbiome, something that we’re only really beginning to understand the importance of. Studies into the human microbiome has intensified in recent years, as research begins to reveal just how key it is to our health. Some of the most recent studies suggest that the microbiome could contain up to 100 trillion microbes, tiny living organisms that are too small to be seen with the naked eye. Microbes include bacteria, viruses and fungi, and the bulk of these live within the gut, making it an essential organ that we can’t function without. It impacts on everything from your digestion to your brain health and immunity. In fact, you have more 58 bacteria cells than you do human cells in your body, which illustrates just how important they are. Every human gut microbiome is unique and it’s impacted by a multitude of factors, from our diet to our genetics to our lifestyle. For optimum health, you want to have a diverse gut microbiome, made up of a wide variety of microbes all working together to support your body. Research shows that a higher microbiome diversity is linked with better overall health. We often think of bacteria as something that should be avoided because they make us ill, but there are plenty of good bacteria that are protective rather than destructive. The good bacteria in our gut microbiome help us to absorb the vitamins and nutrients vital to our health, and regulate bodily systems like bile levels. A balanced gut microbiome helps us to stay in good physical and mental health, whereas an imbalance has been shown to contribute to inflammatory diseases, obesity, high cholesterol and mental health conditions. Signs of an unhealthy gut One of the most common questions that gets asked is, ‘How do I know if I have a healthy gut?’. There are tests out there that analyse your personal microbiome, which is performed on a
GUT HEALTH AND INFLAMMATION Looking after your gut can improve some health conditions associated with inflammation PHOTOS: GETTY IMAGES For optimum health, you want to have a diverse gut microbiome 59
NUTRITION stool sample. However, you don’t need to go through this process to consider the health of your gut and whether you can make improvements. Some signs of an unhealthy gut include gastrointestinal symptoms like gas, bloating, diarrhoea or constipation. The impact may also be felt outside the gut and present as skin problems, for example, or food sensitivity. You might notice more tiredness than usual and have problems with your sleep, or experience headaches and brain fog. Research suggests that as much as 80 percent of your immune system stems from your gut, so an imbalance could mean you’re more prone to illness. It can also have an impact on your hormones, including the release of serotonin, the ‘feel-good hormone’. It’s important to stress at this point that any of these symptoms can have many other causes, so it’s always worth speaking to your doctor if you have symptoms that you can’t explain to eliminate any underlying causes. An unhealthy gut makes it harder to maintain good overall health and wellbeing. The gut is responsible for digesting everything you eat, extracting and absorbing the nutrients you need, and fuelling your body. It also cleans toxic and metabolic waste from your body, which it can only do efficiently if it’s well balanced. The gut microbiome is linked to inflammation in the body; when it’s out of balance, we can’t regulate our metabolism, strengthen our immune system or defend against infection without the healthy bacteria that we need to protect those systems. The presence of some bacteria (‘bad’ bacteria) are also associated with causing inflammation. Therefore, when it comes to maintaining a healthy gut, it means both maintaining good bacteria and eliminating the bad bacteria. Poor gut health can be linked to intestinal diseases, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), and some 60 people find that working on improving their gut health can help to manage the symptoms of these diseases. There is a lot more work to be done on understanding the role that an unhealthy gut plays within the body, but it has been linked to heart health, blood sugar and risk of diabetes, in addition to brain health. One of the main contributory factors towards good gut health is your diet and eating the right foods. However, there are other lifestyle factors that can impact on your gut health and microbiome. This includes whether you drink alcohol and how much, whether you get enough good-quality sleep and your stress levels. Therefore, if you follow the advice elsewhere in this book to get inflammation under control, you will be helping to improve your gut health, too. Gut health and your diet A healthy, balanced diet is absolutely key when it come to your gut health. There are some specific foods that you can choose to add in for specific benefits, but the most important thing is to eat well most of the time and limit foods that are bad for your gut. The other key thing is diversity – don’t forget you’re trying to feed and fuel millions of microbes that all have a different purpose and need different nutrients to thrive. There are thought to be almost 100 types of fibre and thousands of phytochemicals from plants that aid healthy gut microbiome. The best thing that you can do to immediately start improving your gut health is to make sure that your diet is packed with lots of healthy whole foods. For a start, add in more fruits and vegetables – at least the recommended five-a-day, but more if you can. Don’t just stick to the same fruits and vegetables all the time; try and introduce as many different types and colours as possible. Think about ‘Eating the rainbow’ is a great way to incorporate different types of fruit and vegetables into your diet A happy gut could help ensure you get some quality sleep
GUT HEALTH AND INFLAMMATION Fermented foods such as kimchi are great for gut health Delve into the world of plant-based foods to aid your quest for a gut-healthy diet Stomach pain, gas and bloating are some of the symptoms that indicate an unhealthy gut Fermented foods Eating foods made from live cultures can help your gut microbiome thrive Eating a variety of fermented foods can improve the diversity and health of your gut. They help to introduce a mix of bacteria for optimum health, as well as strengthen the walls of your intestines, which prevents them from leaking any toxins into your bloodstream. Fermented foods can help to bolster the immune system, by introducing new bacteria into the microbiome for the body to learn to work with. If you’re not used to eating fermented foods, start slowly. Introducing a lot all in one go will likely cause an upset stomach. You need to introduce probiotics a little at a time, so your body can learn how to respond to them. Foods you can try include kefir, which is a cultured dairy product that you can eat instead of, or mixed into, yoghurt. Tempeh is made from fermented soy beans, so you can use this instead of tofu, for example. Kombucha is a fermented tea drink; miso is made from fermented soy beans and is a good seasoning for soups or stock; and kimchi is made from fermented cabbage that is great with a salad. Again, variety is important, so look to include a few different fermented foods each week and mix it up. 61
NUTRITION ‘eating the rainbow’ by including a wide range of coloured foods on your plate throughout the day and the week. This doesn’t have to be complicated – if you usually buy red grapes, try green ones. Get a pack of mixed peppers and not just the red ones; exotic mushrooms instead of button. Experiment with purple carrots, sweet potatoes and green tomatoes. You could set yourself a challenge to aim to include one ‘new-to-you’ fruit or vegetable a week to improve your diversity. It’s a good idea to eat seasonal fruit and vegetables if that’s possible. If you’re eating these foods at their peak, when they’re grown in their optimum conditions, then they will have higher concentrations of nutrients. If you find it hard to eat enough fruit and vegetables as it is, then look at ways that you can add them into your usual meals and snacks. For example, switch up your porridge toppings, blend berries into yoghurt or serve your main meal with a side salad. As well as your fruits and vegetables, try and increase your intake of other plant foods as well. A good rule of thumb is to aim for 30 different plant-based foods per week. This includes wholegrains, legumes, pulses, nuts and seeds. You don’t need to eat a vegetarian, vegan or plant-based diet if you don’t want to; you can increase your intake of plant foods alongside lean meats, dairy products and good fats. This way of eating mirrors the Mediterranean diet, which is widely Plump for oily fish, such as salmon, to get a boost of omega-3 Try to ensure that every meal has a diverse selection of gut-friendly food considered to be one of the healthiest, most balanced ways of eating. In addition to what you eat, consider the way in which you eat. Take time with your meals and get in the habit of eating mindfully, chewing your food properly to aid digestion. Try and sit upright at a table, rather than on a sofa, as this also helps your digestive tract to process food. Best foods for gut health While a balanced, healthy and varied diet is best, there are some nutrients that are particularly good for supporting your gut health. Many of us don’t eat enough fibre. Ideally, we want about 30g of dietary fibre per day as an adult. Eating enough fibre has been linked with a lower risk of heart disease, stroke, type 2 diabetes and some cancers. Fibre aids digestion and therefore improves our overall gut health. You can get fibre in your diet by making some simple swaps, for example picking wholemeal bread and pasta, eating porridge oats for breakfast, adding pulses and beans to salads and stews, and eating a small amount of dried fruits. Fibrous vegetables include carrots, beetroot, broccoli, peas, squash and potatoes. You can support your gut health further by eating prebiotics and
GUT HEALTH AND INFLAMMATION Bananas are rich in polyphenols, which tackle inflammation Eating porridge oats for breakfast is a good way to eat more fibre probiotics. You don’t need to take supplements, as you can get these nutrients from your daily diet. Prebiotics feed the healthy bacteria in your body, and you can get this from things like leeks, onions, bananas, garlic, asparagus, spinach and porridge oats. Probiotics are made with live bacterial culture, so will enhance your microbiome’s diversity. These types of foods include yoghurts with live cultures, some pickles, sourdough, kefir, kimchi, miso and other fermented foods (see the boxout for more on this). Plant foods contain polyphenols, which support gut health, have antioxidant properties and help to reduce inflammation. You will get plenty of different polyphenols by eating a diverse range of fruits and vegetables. However, you can also get polyphenols from some spices, like turmeric and ginger; drinks like coffee, green tea and red wine; and even dark chocolate. Finally, make sure that you have enough omega-3 fatty acids, which are though to help balance your microbiome and decrease inflammation. Fish is a major source of omega-3, so opt for oily fish like salmon or mackerel. Plant sources include flaxseeds, chai seeds and walnuts. Of course, there are some foods that have the opposite effect and can negatively impact on gut health. This includes processed foods, those high in sugar, salt and fat. While it’s okay to have a small amount of ‘junk’ foods, they shouldn’t make up the majority of your diet. They lack the nutrients that we need to ensure that our gut microbiome remains healthy and they don’t help to create conditions in which healthy bacteria can thrive. It might seem a lot, but small changes really can make a big difference. If you start to prioritise your gut health, you can also impact on inflammation elsewhere in the body. It doesn’t take long to notice the difference of improved gut health. You may start to have increased energy levels, better digestion, improved skin condition, enhanced focus and concentration, and better sleep. So look after your gut! 63
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ESSENTIAL ANTI-INFLAMMATORY FOODS Essential anti-inflammatory Discover some of the best foods for strengthening your body’s anti-inflammatory shield benefits of foods for controlling inflammation. Some foods trigger inflammation, while others fight it. The inflammatory response is beneficial in some instances, as controlled inflammation after tissue damage and infection ensures that the body heals faster. However, there is a fine balance, and inflammatory food types can escalate inflammation to harmful and chronic levels. Anti-inflammatory foods should be incorporated at some level into all diets as a way to prevent inflammatory diseases from arising. Those who experience the symptoms of such diseases, causing long-lasting or severe pain and swelling, can seek out essential anti-inflammatory foods to be used as central elements of any meal. Here is a breakdown of what you might find on your plate, so that you know which food types to incorporate more of into your meals – and which your body will not thank you for. PHOTOS: GETTY IMAGES T he phrase ‘you are what you eat’ is well known. But, for many, the extent of the influence your diet holds over specific elements of your health is far less known. You are frequently told which foods should be labelled as healthy or junk food, but which micronutrients make different foods healthy? By analysing the nutritional biochemistry of each food type, you will discover the best food combinations for your body. Diet is one of the leading factors in the likelihood of experiencing inflammation and, for sufferers of chronic inflammation, food choices become as vital as taking medication. Mostly, this means consuming a range of foods to ensure that your body is exposed to a multitude of antioxidants and other nutrients. When considering the impact of consumed food on inflammatory health, you must acknowledge the two 65
NUTRITION Protein is essential for all of your body’s cells. Without a good variation of proteins in your diet, cells can’t repair themselves or generate new ones that well. However, unless you have entered into a protein deficiency, in which case any protein will help to reduce the swelling this causes in the body, it is only certain types of protein that are actively anti-inflammatory. By depriving your body of proteinous foods, you are more likely to encounter a severe infection. Yet, you can also consume too much protein – especially if they come from animal sources. To make sure you don’t eat protein in excess, you should follow the recommended daily amount (46 grams for women and 56 grams for men). The most antiinflammatory proteins are lean proteins, such as protein-rich vegetables, legumes and fish. Legumes and beans are plentiful in protein as well as being full of fibre. Both of these macronutrients are recognised for lowering inflammation. Fibre is a type of carbohydrate that the body can’t digest properly. This helps to slow down the uptake of glucose into the blood, inflammation caused by high blood sugar levels. Despite their benefits on paper, beans may cause inflammation in some people. If this is the case for you, try soaking and cooking the beans first in order to remove proteins called lectins. Beans and legumes are some of many food types to contain these proteins. Lectins bind to carbohydrates and can prevent other nutrients from being absorbed. The most effective beans for combating inflammation are chickpeas, lentils, black beans, pinto beans, red beans and black-eyed peas. To add these successfully into your meals, try each one and assess how well your body responds to them. Everyone reacts differently, so you should avoid those you may be sensitive to. On a macronutrient level, fish is a highly proteinous food that is also low The most antiinflammatory proteins are lean proteins, such as vegetables, legumes and fish Powders used to build muscle contain leucine, which also happens to reduce inflammation 66 Fish is a highly proteinous food that is low in fat. Plus, the omega-3 can also reduce the risk of heart disease in fat. But, it is the omega-3 fatty acids in this food type that lower inflammation in their consumers and reduce their chance of heart disease. There are three types of omega-3 fatty acids – alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). DHA and EPA are highly prevalent in fish, with the former believed to produce the strongest anti-inflammatory effect. To obtain DHA and EPA on a plant-based diet, you should eat plants such as seaweed and nori. This is the source of omega-3 that the fish eat themselves to achieve such high levels. Salmon, mackerel and tuna in particular have the highest concentration of these fatty acids. The unsaturated fats in omega-3 improve your heart health by tackling inflammation in blood vessels. Inflammation of the blood vessels is especially harmful because it causes them to narrow. This can lead to a build-up of plaque and increase blood pressure substantially. Incorporating foods that are high in omega-3 regularly
ESSENTIAL ANTI-INFLAMMATORY FOODS into your diet is a great way to assist your heart in functioning the best that it can. This has been proved in many studies, one of which involved analysing the heart health of 51,000 people. The findings showed that fish really can save your life. Those in the study who ate fish at least twice a week had a 16 percent lower rate of experiencing a major cardiovascular event, such as a heart attack, compared to the group who didn’t eat any fish. Of the most anti-inflammatory fish, salmon and mackerel are the best choices because they are less likely to be contaminated with mercury. If you ingest mercury from fish, this can cancel out the anti-inflammatory properties. Other pro-inflammatory ingredients are much less hidden. But, to identify them, you have to get to know exactly what you are eating. With so many plant-based meat substitutes emerging in supermarkets and restaurants, it is becoming easier to buy or order high-protein food without learning what the core ingredients are. Many of these plant-based proteins can prevent inflammation, but some will do the opposite. Anti-inflammatory versions are those that are mostly soy or pea protein-based, while products such as seitan include pro-inflammatory wheat gluten. Always check the packaging of products if you are unsure of their cause muscle damage. By reducing high inflammation around these muscles, the tissue can repair much more quickly and reduce athletes’ time out of training. Whey protein powder is commonly chosen, but for some people it can cause inflammation in the digestive tract. Whey protein is derived from cow’s milk, but there are many plant-based alternatives available, such as hemp and pea-based protein powders to prevent an inflammatory reaction. This can be combined with a low-sugar plant milk. Legumes and beans are high in protein and good for lowering inflammation Although tuna has loads of omega-3, it does have high mercury levels, so don’t eat too much contents. Soy-protein foods such as tempeh and tofu have also been recommended as anti-inflammatory products that can significantly reduce inflammatory pain, such as joint pain. Another protein-based remedy for inflammation is the powder that many use to build muscle. Thanks to its leucine component, a type of amino acid, these products reduce excessive inflammation. This benefit is utilised by many athletes as intense exercise can 67
NUTRITION Sweet potatoes contain vitamin A, which is great for fighting inflammation the the good vs bad As a primary energy source, carbohydrates tend to make up a significant proportion of most meals. Your body needs more calories from carbohydrates than from any other food type, and this is especially true for the brain and muscles. This makes carbohydrate choices even more significant when adapting your diet to an anti-inflammatory one. Some people might take the route of completely avoiding carbohydrates, but that comes at a cost, because this food type is essential for aiding beneficial 68 inflammation and many crucial biological functions. Carbohydrates are neither solely good or bad at preventing chronic inflammation. They can be both. Some carbohydrates play their role in providing great amounts of energy to the body, but can be highly processed and therefore detrimental. Meanwhile, others are packed full of antioxidants, which reduce chronic inflammation. One example of a quick switch you can make to greatly reduce inflammation is switching flour Strawberries are among the fruit that contain inflammation-fighting properties
ESSENTIAL ANTI-INFLAMMATORY FOODS White potatoes aren’t exactly the evil carbohydrate they are made out to be, especially if you leave the skin on tortillas to corn ones. These trigger less of a glycemic response in the body. A glycemic response is the change in your body’s blood glucose level after eating carbohydrates. This is a natural response, as carbohydrates have a primary role in helping to keep the blood glucose level regulated. However, if this process is heightened too much, reaching a state called hyperglycemia (high blood sugar) carbohydrates can become proinflammatory. The carb culprits that cause hyperglycemia are carbohydrates with a low fibre content and processed breads with added sugar. An extra feature of processed carbohydrates which add to unwanted inflammation, is that foods with high sugar are also very calorific and not as nutritious. Incorporating too many of these into your diet leads to an increased likelihood of obesity. As excess calories are stored as fat, when this fat builds up in tissues, it can put your organs under stress. Inflammation may be initiated as a mechanism to break down some of the fat, as your body is trying to return the fat levels to healthier limits. When you consider the carbohydrate food group, your brain might first provide you with images of plain, beigecoloured foods. However, carbohydrate-dense foods are much more varied than potatoes, rice and pasta. Many are loaded with nutrients and antioxidants. One of the top carbohydrate sources you can choose to reduce inflammation in the body is fruit. Raspberries, strawberries and blueberries are packed with antioxidant compounds, which tackle emerging inflammation in the body, while their high fibre levels lower the glycemic response compared with other fruits. You might have seen carbohydrateheavy foods, such as breakfast cereals, being advertised as including ‘whole grains’. This is promoted because this form of grain is considered healthier than refined grains, especially in their anti-inflammatory roles. But, what is the difference between a whole grain and refined grain? And how does this benefit your body? When the entire body of a grain (wheat, corn, rice and oats etc) is used in a food product, they can be labelled as whole grain products. The three components of grain are the bran, endosperm and germ, but refined grain only uses the endosperm. The endosperm is the most substantial and starchy part of a grain, however it is more dilute in nutrition. Consuming just the endosperm means that you are missing out on the B vitamins and anti-inflammatory fibre which is stored in the bran – the outer shell of the grain. Meanwhile, the core of the grain, called the germ, can provide the body with an abundance of vitamins and minerals, when Carbohydratedense foods are more varied than potatoes and pasta. Many are loaded with nutrients incorporated into whole grains. These include protein, fibre, magnesium, zinc, thiamin, folate, potassium, phosphorus and vitamin E. The latter especially is renowned for its benefits in alleviating inflammation. By choosing whole-grain foods as part of your diet, you are helping your body for more than just one day. The anti-inflammatory nutrients found in whole grains usually stay circulating around the body for three to five days after they are eaten, like dedicated bodyguards. Refined carbohydrates are easy to overindulge in, due to low fibre content. This is another factor that increases levels of inflammation. Highcarbohydrate foods that don’t make you feel full as quickly lead to an increased risk of gaining unhealthy weight, encouraging an inflammatory response. Potatoes are a popular staple in global diets. But, if you like potatoes, it is beneficial to know how to maximise their health potential. The main mass of potatoes provides you with the slow-release energy needed to tackle a big day. But, it is the delicate skin surrounding these starchy masses that contains high concentrations of the phytonutrients, flavonoids. One of the anti-inflammatory flavonoids found in potato skin is quercetin. This compound encourages the immune response and acts to stabilise the cells that release histamine during an allergic reaction. In doing so, this flavonoid prevents unnecessary inflammation. In general, and specifically for targeting high inflammation, sweet potatoes have more health benefits than other potatoes thanks to their elevated vitamin and nutrient content. Sweet potatoes have much more vitamin A than white potatoes, which has been proven to reduce inflammation in skin disorders such as acne. The antioxidants in blueberries will fight off emerging inflammation in the body 69
NUTRITION HEALTHY Consuming too many fatty foods creates a daily fight for your body against fat tissue inflammation. But, some fats, when ingested in moderation, work to shield you from forms of inflammation. For example, the omega-3 fats, as mentioned as a key component of proteinous fish, stop inflammation from taking hold by targeting specific enzymes. Omega-3 inhibits the enzyme cyclooxygenase – a protein that releases hormones to relay pain, fever and inflammation. If you prepare your food by cooking it in oil, or maybe drizzle a spoonful onto a salad or other dish, you should take the time to pick out the leasttreated olive oil. Extra virgin olive oil is The monounsaturated fats in avocados are great for heart health 70 unrefined, meaning that many organic compounds, called polyphenols, still remain in the liquid. The main antiinflammatory polyphenols present in extra virgin olive oil are oleuropein, aglycone and oleocanthal. Oleuropein is most appreciated in people who suffer from arthritis. The polyphenol lowers the level of tissue damage that is experienced during arthritis flare-ups. Aglycone prevents diabetes-based inflammation, while oleocanthal could be compared to ibuprofen, with its potential target areas being widespread. In recent decades, the avocado has captured the hearts of many chefs and everyday meal-makers. Turns out that avocados are also saving these very same hearts. This is because avocados are mostly monounsaturated fats. Unlike saturated fatty acids, which cause inflammation in heart tissue over the course of prolonged exposure in the body, monounsaturated fats in avocados can lead to the development of a healthier heart. This pattern was proved in a Harvard University study, carried out in 2022. The scientists’ findings show that people who regularly eat avocados – consuming at least two servings per week – were 16 percent less likely to develop a cardiovascular disease. Similarly, those who didn’t eat any avocados were 21 percent more likely to suffer from a heart attack due to coronary artery disease. Other studies have revealed that the fats in walnuts and walnut oil can reduce the concentration of inflammatory biomarkers in the body. Biomarkers are molecules that increase in the body when a certain process is taking place. By analysing the blood, scientists can monitor the exact levels of inflammation. This is essential in tests, such as monitoring the impacts of different foods, as it allows a statistic to be placed on different scenarios. One of the most commonly assessed biomarkers is a protein called the C-reactive protein, which is released when most forms of inflammation occur. Walnuts are easy to incorporate into your diet by sprinkling them onto meals or simply consuming alone as a light snack. To reap the benefits of walnuts as an anti-inflammatory food, you just need to eat them regularly and make them a repeat feature on your weekly shopping list. The benefits of eating this Some fats, when ingested in moderation, work to shield you from forms of inflammation
ESSENTIAL ANTI-INFLAMMATORY FOODS Is chocolate healthy? Discover the treat that can beat inflammation Extra virgin olive oil is packed with polyphenols A link has been established between consumption of ALA and the prevention of inflammatory-induced bone loss food may be most recognisable in adults in their 60s and 70s, by reducing the likelihood of developing heart disease. The high levels of omega-3 and polyphenols in the nut’s oil is what Give any meal a health boost by adding just a couple of tablespoons of flaxseeds produces these positive results. Walnuts actually contain a different type of omega-3 fatty acid to fish, as ALA is the most commonly-produced omega-3 in plants. ALA has anti-inflammatory effects, especially in the cases of those with multiple sclerosis, metabolic syndrome and diabetes, as well as those who have undergone an organ transplant. By working to reduce inflammation, a positive link has been established between consumption of ALA and the prevention of inflammatory-induced bone loss. Another easy addition to any meal, which drastically increases its healthboosting potential, are seeds called flaxseeds. Flaxseed is 42 percent fat, seven percent water, 18 percent protein and 29 percent carbohydrates. Much of the fat content contains inflammation-zapping omega-3. The concentration of this is so high that just two tablespoons of ground flaxseed gives you 140 percent of your recommended daily intake of omega-3. On top of this, flaxseed contains lignans, which are chemicals made by the flax plant that have cancerfighting properties. Chocolate is often demonised as an unhealthy snack. However, chocoholics will be pleased to learn that the antioxidants in dark chocolate hold great health benefits, especially when it comes to preventing inflammation. This is due to compounds called flavonoids, which prevent and reduce inflammation in the cells surrounding your arteries. Flavonoids are naturally present in the cocoa bean and, when in the body, they block the biological pathways that cause inflammation. Because dark chocolate contains more cocoa than milk chocolate, it is richer in antioxidants. Studies have shown that regularly eating dark chocolate can reduce inflammation in those with diabetes, heart disease and arthritis. However, despite being both tasty and anti-inflammatory, chocolate is also high in calories so you should eat it in moderation. You should aim to eat between 30-60 grams of dark chocolate in a day if you wish to test out its antiinflammatory powers. This equates to just a few squares. Eating too much will have the opposite effect. When choosing your chocolate, make sure to check the packaging to see if it was processed with alkali. This step reduces the acidity of the natural cocoa, however you should avoid the chocolate that is manufactured with this process as it will reduce the flavonoid content. 71
NUTRITION Cherries have high levels of phenolic compounds, which can improve inflammatory pain All fruit has some health-boosting properties as they are natural whole foods and some of the best sources of vitamins and minerals. Not only do they provide a sweet range of snacks with their healthy sugars, but they produce anti-inflammatory compounds. Each type of fruit has its own mixture of antioxidants and by incorporating a variety of fruit into your diet, you can maximise their health impacts. The impressive range of nutrients allocated to different fruits means that they are all capable of preventing disease in some capacity. However, there are some specific fruits you can choose to target inflammation. Berries generally contain a higher concentration of the pigment-inducing phytochemicals, anthocyanins and ellagic acid. Anthocyanins are the phytochemicals that give berries their red, blue or purple colouring. And, when in your body, they shut down the activity of inflammatory enzymes. Ellagic acid, on the other hand, is an antioxidant that can reduce inflammation in the gut. In addition to benefiting the gut, the nutritious powers of berries reduce the risk of developing heart disease, Alzheimer’s disease, and diabetes. 72 People who eat more apples are also at a lower risk of dying from heart disease. The components of an apple that reduce inflammation are fibre, vitamin C, pectin, and polyphenols, which also increase the numbers of ‘good’ bacteria in the gut. As a result, the beneficial bacteria prevent harmful bacteria from making the gut inflamed. The gut is made up of 100 trillion microbial cells, which are part of our complex microbial community that completely covers our bodies. This community is known as the microbiome. There is some evidence to suggest that pomegranates can lower blood cholesterol and sugar levels By taking care of it, and introducing more apples to your diet, you can help to balance out your microbiome in favour of the good bacteria. This is like giving the beneficial bacteria as much of an advantage as you can, to ensure that the chances of you retaining good health are higher. If harmful pathogens enter the body and kill some of the People who eat apples are at a lower risk of dying from heart disease good bacteria, the microbiome becomes unbalanced. This state is called dysbiosis and can lead to inflammatory bowel disease, diabetes, obesity and allergies. If you don’t mind dealing with the stone core of cherries, they are a fantastic anti-inflammatory fruit to add variation into your diet. In fact, many of the stone fruits, such as peaches, plums and apricots, have a similar biological impact to cherries. But, cherries in particular have a high level of phenolic compounds – a form of compound that is produced as a
ESSENTIAL ANTI-INFLAMMATORY FOODS Apples contain fibre, vitamin C, pectin, and polyphenols, which all help to reduce inflammation byproduct of another metabolic process in the cherry. While they may not be so useful to the cherry, the compounds are crucial in the fruit’s anti-inflammatory value. They can alleviate pain caused by skin diseases, rheumatoid arthritis, and inflammatory bowel disease. Additionally, they may be beneficial in preventing allergy-based inflammation that is caused by inhaling small particles in the air. There are many fruits that are well established for their anti-inflammatory properties, but the majority of all fruits hold the potential to reduce pain and swelling in the body. For example, red grapes, citrus fruits and pomegranates have all shown some evidence in research studies that they lower blood cholesterol and blood sugar levels. Apricots, along with other stone fruit, can tackle conditions caused by inflammation 73
NUTRITION Luteolin, which can eliminate inflammation, is found in carrots The vital in Nothing gives off the stereotypical depiction of healthy food more than a plate of dark green, leafy vegetables. And, when studying the impact on chronic inflammation, this is definitely an accurate view. Some of the food products that are classed as leafy greens are kale, spinach, chard, rocket/ arugula, endive, turnip greens, beet greens, and collard greens. The main vitamins in these greens that elevate their importance are the vitamins A, D, E and K. Vitamin A helps the body’s immune response to work 74 more efficiently. This means that beneficial inflammation will keep the body safe, without prolonging inflammation for too long and causing chronic pain. Meanwhile, vitamin D controls the production of inflammatory cytokines and immune cells. Cytokines are proteins that are released in an immune response to trigger a reaction, and some of these cause inflammation at the required sites. People who are deficient in vitamin D risk losing control of inflammatory sites, and too many cytokines may be released. Similarly, the presence of vitamin K in the body has caused suppression in cytokine levels. People with higher vitamin E levels have less C-reactive proteins in their blood, indicating that their presence too is reducing inflammation rates. Eating leafy greens as a regular addition to your meals is a perfect way to boost the levels of these essential vitamins in any of your chosen dishes. For some people, hot chilli peppers can make their mouth feel like it’s on fire, but if you can handle the heat or enjoy a bit of spice, it’s worth knowing that the active component of chilli peppers also works to lower inflammation. Capsaicin is the active ingredient, which is actually a neurotoxin for mammals like humans. The burning sensation is really a trick formulated in the body, designed to make your brain think that you have experienced a real burn. Too much capsaicin would damage your nerve fibres, and so the chemical causes this response to limit the amount that people can eat. If you eat too much capsaicin, the ingredient can cause inflammation, but by knowing your body’s limits and eating a comfortable portion of hot Three plant pigments combat inflammation, with luteolin being found to eliminate inflammation
ESSENTIAL ANTI-INFLAMMATORY FOODS chillies, chronic inflammation can actually improve. The exact reason for the anti-inflammatory impact needs more research to fully establish, but capsaicin is thought to prevent the inflammation-initiating proteins from functioning properly. Broccoli and other cruciferous vegetables take a less fiery antiinflammatory approach. These greens contain a compound called sulforaphane, which you could consider as a peacekeeper for your body. After entering the body, this compound acts to neutralise toxins, which prevents the initial need for an inflammatory response. To truly maximise how much sulforaphane you consume, you should eat broccoli raw. Raw broccoli contains ten times as much of the compound, and can be cut up finely to better distribute any bitterness the lack of cooking can cause. The same antioxidant which is found in the skin of potatoes – quercetin – is also the leading component in onions, which qualifies them as antiinflammatory food. The quercetin in onions is most concentrated at the bulb of the vegetable, in addition to the outermost rings. Quercetin is also found in high volumes in red bell peppers, along with beta-carotene and luteolin. The three plant pigments work together to combat inflammation, with luteolin being found to completely eliminate the presence of inflammation in some instances. Celery, parsley, broccoli, onion leaves, carrots and cabbages are other examples of luteolin-rich vegetables. The extensive health benefits that stem from these vegetables show that many of the anti-inflammatory compounds and nutrients can be harvested from the ground. However, not all of these vegetables are from dry land. As mentioned previously, some of the most advantageous sources of omega-3 fatty acids come from the seas. Like its land-grown relatives, sea moss has a plethora of antioxidants, in addition to the added benefit of increased omega-3. Red bell peppers are packed with quercetin, making them antiinflammatory food Cruciferous vegetables play a key part of any anti-inflammatory diet The capsaicin in chili peppers can improve chronic inflammation 75
NUTRITION BENEFICIAL So, there are many foods to choose from when it comes to providing your body with biological, anti-inflammatory weapons. But, are there any drinks with similar results? One concoction you can make at home should only be used in an attempt to eliminate inflammation as a one-off drink, with expectations of short-term effects. This is a combination of baking soda and water. Creating and consuming this drink as a regular occurrence can result in liver damage and bone loss, and so can be harmful when not taken in moderation. However, baking soda can also reduce inflammation by altering the actions of white blood cells in the body. Macrophages are the white blood cells of the immune system that release signals in the body to cause inflammation. When in the presence of baking soda though, macrophages relax their signals, reducing how much inflammation arises. To test out the body-soothing blend, you should add one quarter of a teaspoon of baking soda to around 30 millilitres of water. Make sure that you eat food before trying this drink, as many people discover that baking soda on an empty stomach ends up being a recipe for nausea. Many nutrient-packed foods are better suited to being blended into a home-made juice or smoothie. Those that you make yourself are the healthiest, as you can ensure that no of celery and five centimetres of ginger. Carnosol is the active ingredient in parsley, which can resist inflammation from rheumatoid arthritis. At the same time, ginger is a highly effective tool when it comes to preventing multiple inflammatory molecules from being released into the body. A strong antioxidant that works well in anti-inflammatory shots or juices is curcumin, which is present in turmeric. By itself, turmeric can serve to boost your health by providing pain relief and limiting inflammation. But, when combined with lemon juice, the two ingredients form a power couple. The vitamin-rich lemon juice aids digestion, which can reduce gut inflammation and assist in the uptake of nutrients. To make this drink at home you can add the juice of one lemon to one tablespoon of grated turmeric, one tablespoon of grated ginger and three cups of water. Some studies have shown that those who are heavy coffee drinkers have less inflammatory biomarkers in their blood. This suggests that coffee has the potential to reduce inflammation. Three of the polyphenols in coffee – chlorogenic acid, diterpenes and trigonelline – prevent damage due to free radicals. Free radicals are atoms with unpaired electrons. When these unstable electrons are present in the body, they can cause damage to surrounding cells. If left unstopped, this damage alerts the immune system and can cause excessive inflammation. You should, however, be careful when consuming coffee, as it can impact each individual’s body very differently. In some instances, coffee Keeping the tissues that surround your joints hydrated means that inflammation due to gout is kept at bay 76 processed foods or refined sugars are contributed to the mix. One such drink with distinctive flavours is a parsley and ginger green juice. This includes juicing one generous handful of parsley, two cups of spinach, one apple, one lemon, one small cucumber, a couple of stalks
ESSENTIAL ANTI-INFLAMMATORY FOODS consumption has been found to cause a slight increase in inflammation. For an alternative anti-inflammatory hot beverage, teas that contain ginger, turmeric, chamomile, cinnamon and rosehips are the most likely to relieve your symptoms. The simplest drink for minimising inflammation is water. This is the most accessible remedy, and it works by keeping your body hydrated and flushing toxins out of your system. Staying hydrated has many other subtle influences on how the body functions. For example, water is used in all cells, tissues and organs. Keeping the tissues that surround your joints hydrated means that they are well lubricated and inflammation due to gout is kept at bay. Drinking enough water can also prevent people from overeating, as it makes you feel full more quickly. Adopting regular hydration as a lifestyle habit reduces your chances of obesity and the tissue inflammation that is paired with it. Water is an anti-inflammatory element that we all consume daily, without always considering its in-depth health benefits. The same applies to most of the foods listed here. Knowing which foods will fight against chronic inflammation – and therefore increase your chances of a healthier and pain free life – will help the new meal additions become second nature. Most of the active ingredients in these foods and drinks work best when consumed regularly as part of your diet. By sampling a variety of nature’s own health products, you will soon discover which work the best for your body. Home-made smoothies are a great way to add more nutrients to your diet 77
NUTRITION A Mediterranean diet is one way to reduce inflammation 78
ESSENTIAL ANTI-INFLAMMATORY FOODS Existing dietary models What diets are anti-inflammatory? If you are looking for a dietry model to improve inflammation, the Mediterranean diet is one of the best There are many individual foods that can help to combat inflammation, but how can you keep track of them all and know that you are incorporating enough into your daily diet? One of the best ways to achieve this, without creating an in-depth checklist, is to follow an existing dietary model that incorporates many of the food types that will benefit you. In general, these are foods that are low in saturated fats, added sugars, refined carbohydrates and sodium. Following a Mediterranean diet is one way to reduce inflammation in the longterm, as research has shown that food from Mediterranean countries like Italy, Greece, southern France and Lebanon share similar anti-inflammatory ingredients. This includes a diverse selection of fruits, vegetables and fish, which you may remember contains inflammation-busting omega-3. The Mediterranean diet is largely based on antioxidant-packed whole food, such as whole grains and a range of herbs and spices. A less prominent location-based diet is the Okinawan Diet of Japan. Okinawa is an island where much of the diet centres around sweet potatoes, vegetables and fish. The sweet potatoes contain betacarotene, anthocyanins and vitamins E and C – all of which help to prevent unwanted inflammation. Both of these diets are heavily centred around a diverse range of fruits, vegetables and lean proteins. For this reason, plant-based diets are also a great way to prevent inflammation from taking hold of your body. Consuming less meat and dairy reduces how much saturated fat enters the body, which can exacerbate inflammation. 79
NUTRITION YourtoWay A little of what tastes good actually helps your health, as well as the food on your plate W ant some good news about inflammation? You can eat your way to improved health and make your food taste better at the same time. Studies are slowly confirming what our ancestors believed: herbs and spices are good for you. While research is continuing, the results so far are impressive. Let’s look at some of the herbs and spices known to boost health, but if your favourite isn’t on this list, go ahead and use it: they all seem to have some benefit! BLACK PEPPER Pepper, and the vast profits the Venetians were making through their monopoly on its trade, was what drove the Portuguese and the Spanish west, into the Atlantic Ocean, searching for new routes to the places where pepper grows. As well as spicing food, pepper was traditionally used as a treatment for asthma, diarrhoea, and stomach problems. Recent research indicates that piperine, the chemical that makes black pepper peppery, is a good antiinflammatory agent as well as having neuroprotective properties. So spice it up. 80
TASTE YOUR WAY TO BETTER HEALTH TURMERIC This yellow spice has a host of active ingredients, including curcumin. Work is ongoing on the benefits of curcumin but one study suggests that it has powerful anti-inflammatory properties, providing as much pain relief to arthritis sufferers as 800mg of ibuprofen, without side effects. Curcumin also works as an anti-oxidant, potentially helping against cancer; India, where it is widely used, has significantly lower rates of cancer than the West. Curcumin is poorly absorbed on its own but is absorbed much better when eaten with black pepper. ROSEMARY This aromatic Mediterranean herb acts as an anti-inflammatory through the many polyphenols it contains, such as rosmarinic acid and carnosol. Polyphenols are compounds that plants produce to protect themselves against excessive UV light and pathogens, and there is mounting research to suggest that a diet containing polyphenols helps to prevent cancers, heart disease, diabetes and osteoporosis. Even the perfume helps: smelling rosemary reduces cortisol levels! The sulphur compounds found in garlic are potent antiinflammatory agents GARLIC Although not, strictly speaking, a herb or a spice, garlic has long been viewed as being beneficial to health. Over the years, it’s been used to treat everything from arthritis, toothache and infections. When it comes to inflammation, the sulphur compounds that garlic contains are potent anti-inflammatory agents. What’s more, it also helps the production of the body’s anti-oxidants, such as glutathione. PHOTOS: GETTY IMAGES GINGER As you might guess from its flavour, ginger contains a host of active ingredients. It has been used in traditional medicine for centuries to treat colds, arthritis, migraine and many other conditions. Researchers have found that it also acts as an excellent anti-inflammatory, with particularly impressive results in people suffering with osteoarthritis. 81
NUTRITION Discover more about the food and drink that can increase the risk of inflammation 82
INFLAMMAT0RY FOODS TO AVOID PHOTOS: GETTY IMAGES T here’s considerable evidence that some foods increase the risk of inflammation. Of course, as with all dietary matters, moderation is the key. No one will suddenly develop arthritis from eating a McDonalds burger after a night out. Problems only arise when these inflammatory foods become major and ongoing parts of our diets. It’s worth remembering that we evolved as hunter-gatherers, eating a huge variety of plants, seeds, nuts, grains, fish, birds and animals. The good news is that our bodies evolved to deal with variety. The more you mix up what you eat, the more new and unfamiliar foods you try, the better. Even the worst foods won’t kill you: they’re food, not poison, although some of the more strident advocates can make it sound as if they are. It’s worth remembering that this is the first generation in human history for whom obesity is a bigger problem than malnutrition. Given a choice, it is better to be fat than to starve. However, there are some foods that it is best to reduce our consumption of. Let’s take a look at them to understand why they can cause inflammation. Red meat, and its proposed link to inflammation, is controversial. You will see articles confidently proclaiming that a single meal containing red meat will set off inflammation within the body. You will see other articles proclaiming, just as confidently, that red meat is good for you, packed with those omega-3 fatty acids that we hear so much about. There are lots of people grinding different axes – it’s not surprising that consumers get confused. As it stands, the evidence is inconclusive. There have been many studies linking the consumption of red meat with inflammation, but these have been mostly observational, noting a correlation between the two. However, in science, correlation is not causation. As hunter-gatherers, meat would certainly have formed part of our ancient diet – but only a part. A big meat kill was infrequent; we likely binged on meat then ate what could be gathered for the next week. On the other hand, we do know that palaeolithic humans consumed industrial quantities of shellfish from excavated mounds of shell – and we don’t eat enough of such foods today. One thing that does seem clear, however, is that excessive consumption of processed meats is bad for you. These meats, which include sausages, bacon, hot dogs and salami, often contain large amounts of salt and fat; regularly eating them in large quantities is likely to cause weight gain, which is also linked to inflammation. However, ignore the food moralists who insist that a single hot dog is a modern-day sin: this is nonsense. Red and processed meats We know excessive consumption of processed meats is bad for us 83
NUTRITION Fast food might be quick but here the evidence is clear: it really isn’t good for you. What we’re talking about with respect to fast food ranges from preprepared microwave and oven meals, through to the multinational chains and ending at the local kebab and fried chicken shops. Such foods are characterised by high amounts of salt, sugar and fats, and low levels of fibre. A recent, much quoted, study from the University of Bonn found that feeding mice this sort of diet led to their immune system being activated: they were treating the food like an infection. As we know that the immune system plays a crucial role in chronic inflammation, it’s clear that we should not overstimulate it by eating too much fast food. As always with such things, the more extreme food puritans tend to overstate the case: a quarter pounder won’t kill you. But two or three a week won’t do you any good. Fast foods It is possible the salt, sugar and fats in fast food can stimulate the immune system, causing inflammation The body likes carbohydrates. They are our main source of nutrition. The body likes carbs because it breaks down these long molecules into their constituent sugars and uses this to fuel itself. However, carbs work best when the body has to put effort into breaking them down. In the case of processed and refined carbohydrates, such as white bread, pastries and breakfast cereals, the constituent carbohydrates have already been broken down a lot, so the body gets the sugar uptake in one huge rush – a sugar high – rather than over a few hours as the food is digested. This sugar influx requires a surge of insulin to process it, which puts strain on the pancreas and can lead to the excess sugar being stored in the liver, producing fatty liver disease. Frequent insulin spikes can also lead to insulin resistance, a precursor to type-2 diabetes. When it comes to gluten, the protein in and of itself is not a problem with respect to inflammation for most people. The exception, of course, are those who suffer from gluten intolerance. People suffering from celiac disease, wheat allergy or non-celiac gluten sensitivity should avoid gluten in what they eat. Sugary sweets and beverages Any reduction you can make to your sugar intake will only be a good thing 84 Processed/refined carbohydrates and gluten When it comes to carbs, choose ones that your body has to break down What we said about processed and refined carbohydrates applies double to sugary sweets and fizzy drinks. With these, there’s no pretence towards complex carbs: what you’re getting is sugar, sweet and pure. Unfortunately, humans have an evolutionary weakness for sugar as it signifies a high-energy food: very useful for running from a lion. But for the vast majority of our history the only common sources of sugar were honey and fruit. The sugar rush of the 17th and 18th centuries led to widespread tooth disease as people started to add sugar to everything. We still do. Most processed foods have sugar added to them, often in startling quantities, while fizzy drinks are basically sugar water with enough carbon dioxide added to make you burp afterwards. If you really do need a sudden burst of energy, then fine. But unless you find yourself facing the modern equivalent of running from a lion, they are best avoided.
INFLAMMAT0RY FOODS TO AVOID Although a lot of margarine manufacturers have stopped using trans fats, always check Margarine The butter versus margarine debate is a good example of how incomplete research can still lead to public health authorities giving the wrong advice. For years, we were told to cut down on the consumption of butter because it was high in saturated fat, which was supposed to increase the risk of heart disease. Margarine, made from vegetable oils, was held up as a healthier alternative. But now it seems that the saturated fats in butter are not nearly as problematic as were once thought, while the trans fats produced in making vegetable oils solid at room temperature raised levels of ‘bad’ LDL-cholesterol (which increases risk of heart disease and stroke) and lowered the levels of ‘good’ HDL cholesterol (which helps with the absorption of cholesterol before flushing it from the body). In light of this discovery, many manufacturers have switched to making margarine without trans fats and lower levels of saturated fats. Margarines still made with trans fats, however, should be avoided. With drinking alcohol, the answer as to whether it is good or bad for you lies in the amount. A significant body of research shows that a moderate amount of alcohol can produce health benefits. However, moderate might be better said to be small: a glass of wine a day (and we’re not talking one of the big restaurant glasses that allows them to charge more) is the limit and is best drunk with a meal. Beyond that, alcohol starts to move into harmful territory. Many of the symptoms of a hangover result from the body’s immune system dealing with the toxic effects of alcohol: they are all related to inflammation. Long-term alcohol abuse brings all the ill effects of inflammation alongside all its other health issues. Alcohol abuse impairs liver and gut function, produces chronic inflammation and, ultimately, organ failure. This is one area where the old maxim that a little of what you fancy does you good holds true. Dairy foods While some dairy food can help with inflammation, most is best left as a treat Alcohol You don’t have to go teetotal, just go small when it comes to how much alcohol you drink Dairy foods is another area where it is easy to get confused. There are conflicting messages about whether or not dairy foods cause inflammation. In part, this is because the term ‘dairy’ covers such a wide area, from probiotic yoghurts to full-fat clotted cream via cheeses and all the different types of milk. But the good news is that, for most people, dairy products do not cause inflammation and they may even have some antiinflammatory properties, particularly yoghurts that promote the growth of our gut bacteria. One review of the literature found a weak anti-inflammatory effect of dairy products, including full-fat dairy products full of saturated fats. Our tolerance to dairy products is comparatively recent in evolutionary terms: most mammals become intolerant to lactose after weaning. Since it’s a new feature of our digestive armoury, a proportion of adults don’t have it and suffer from lactose intolerance. For these people, avoiding dairy products is definitely one way to reduce inflammation. But for the rest of us, we can still bring out the after-dinner cheese board and enjoy one of life’s delights. 85
NUTRITION How to Fermentation is a process that transforms food into nectar for the gut. Learn more about its benefits, as well as how to start fermenting for yourself Fact FERMENTED VEG NOT ONLY RETAINS ALL OF ITS VITAMINS AND NUTRIENTS, IT CAN ACTUALLY MAKE VITAMIN C, B GROUP VITAMINS AND VITAMIN K. 86 E ating fermented vegetables is a supreme way to improve gut health. Fermentation creates enzymes that break down large molecules in the vegetables, which aids digestion and supports healthy bowel movements. But that’s not all. Fermented food improves the gut microbiome, keeping the balance of ‘good’ bacteria that’s essential for a healthy gut and beating inflammation. The process of fermenting vegetables is a breeze. Basically, vegetables are submerged in salty water to remove the oxygen. This briny environment sends bacteria into a frenzy, increasing beneficial microorganisms and probiotics, as well as breaking down sugar into lactic acid. This acid gives the distinctive tang of fermented food – think sourdough bread, tempeh and yoghurt, as well as vegetable dishes like kimchi and sauerkraut. Why not try fermentation for yourself – as we show you on the opposite page, the process for producing your own fermented food is wonderfully
HOW TO FERMENT FOOD HOW TO FERMENT Learn how to transform vegetables into fermented wonder foods Fact What you’ll need OFresh vegetables (cabbage, carrots and cucumber are a good start point) OKnife OMixing bowl OSea salt OSpoon OSterilised screw-top glass jar 1. STERILISE THE JAR BECAUSE FERMENTATION CAUSES BACTERIA TO BREAK DOWN FOOD, IT MEANS THAT NUTRIENTS ARE MORE EASILY ABSORBED. 5. WEIGH IT DOWN Heat your oven to 180°C/160°C fan/gas mark 4. Wash the jars and lids in soapy water, leaving the lids to dry. Pop the jars on a baking tray and in the oven for 15 minutes. Remove and leave to cool while you prepare the vegetables. To ensure the vegetables are submerged, and therefore deprived of oxygen, use a weight. You can buy special fermentation weights, or use a cabbage leaf to act as a kind of cover to keep the veggies in the water. A plastic bag filled with water or ceramic baking beans will also work. 6. BE PATIENT 3. JUST ADD SALT 2. GET CHOPPING WORDS: JO COLE IMAGES: GETTY Grab your vegetables and grate them or cut them into chunks or strips, whatever you prefer. Do your best to not cut them too small, as they will be more difficult to keep submerged. Pop them in your bowl. Salt is needed for the fermentation process to work. If you aren’t following a recipe, weigh the ingredients and work out 2%. That’s how much salt to use. Sprinkle the salt all over the veggies and work it in well. Leave for 30 minutes, give them a massage and leave for another 30 minutes. Put your jar/s somewhere out of the sun. Fermentation takes roughly seven days. Every couple of days, ‘burp’ your jar – basically unscrew the lid slightly to let out the gas caused by the good bacteria. After five days, have a taste. If they need longer, leave for longer. 4. IN THE JAR Transfer the salted vegetables in the jars, being careful not to touch the sides. Pour over any of the salty liquid left in the bowl – this is the fermenting nectar. If there isn’t enough liquid to submerge the vegetables, top up with mineral water. 87
NUTRITION Soluble and insoluble BACK ON THE MENU It’s not just your gut that will benefit from a daily hit, fibre can boost other areas of your health too Gut feeling When we think of fibre, our digestive system instantly springs to mind. After all, it’s essential to ensure the smooth transit of waste through the colon and to aid in preventing issues, such as constipation. Depending on the variety, fibre can act as a pre or probiotic too. ‘Indigestible varieties help feed the bacteria in your gut,’ explains Rob. ‘These prebiotics help promote a healthy microbiota (the bacteria, viruses and fungi that live in your body).’ Beta-glucans, found in oats and barley, act as a prebiotic. What’s more, evidence shows that a diet high in fibre may also help reduce the threat of bowel cancer. Researchers from Imperial College London found that for every 10g a day increase in fibre there was a 10% drop in the risk of bowel cancer. But the benefits of fibre go much further than the 30 feet of our digestive tract. ‘It helps keep our heart healthy and reduces cholesterol,’ says Rob. ‘And it’s key for keeping our weight on track and maintaining balanced blood sugar levels.’ 88 Get your fibre fix It’s easy to up our daily intake. Start swapping white bread, pasta and rice for brown varieties, include plenty of wholegrains (such as oats, quinoa and rye), nuts, seeds and dried fruit, as well as ramping up your vegetable consumption. ‘These are not only a great source of fibre, but contain many of the micronutrients needed to allow your body to function properly and fight disease,’ says Rob. We all need a mix of different types of fibre. Soluble fibre absorbs water to become a gel-like mass. This slows down the rate at which food leaves the stomach, which helps you feel full, plus it prevents spikes in our blood sugar by moderating the absorption of carbohydrates. Insoluble fibre doesn’t absorb fluid, but traps and retains the water pulled from your intestine, adding bulk and moisture to waste and preventing constipation. What does your daily requirement look like? Experts recommend around 30g a day with ¼ (around 7.5g) coming from soluble fibre – that’s a 40g bowl of porridge and 1 medium apple – and ¾ (around 22.5g) from insoluble fibre. Try 40g wheat bran, one medium banana and three spears of broccoli. OR TRY ROB’S GRAIN SALAD 75g cooked quinoa + 50g mixed leaves and 4 cherry tomatoes + ½ avocado + 2tsp pumpkin seeds = a flavoursome fibre fix. Too much? Excess fibre can inhibit the absorption of zinc, iron and magnesium, but this shouldn’t be a problem if you have a balanced diet. WORDS NATALIA LUBOMIRSKI PHOTOGRAPH ALAMY I n all its roughage glory, fibre is back and it’s bigger than ever. ‘Fibre is becoming more popular, as people have woken up to the fact that it’s actually a really important nutrient,’ says Rob Hobson, head of nutrition at Healthspan. But unfortunately we’re just not getting enough in our diets. The experts recommend we aim for 30g of fibre daily. But only 4% of women are managing that. On average, we only get 17g a day – and our bodies are suffering as a result. ✢ SOLUBLE FIBRE absorbs water, and attaches to cholesterol particles and takes them out of the body, reducing the risk of heart disease. Because it isn’t absorbed, it doesn’t spike blood sugar levels. GOOD SOURCES: oats, nuts, seeds, beans, apples and berries. ✢ INSOLUBLE FIBRE doesn’t dissolve in water and remains intact as the food moves through your gut. It acts like a broom through your bowel, speeding up the process and movement of waste and preventing constipation. GOOD SOURCES: brown rice, wheat bran, rye, spelt, fruits and vegetables (esp. the peel and rind).
365 DAYS OF VITAMIN D DAYS OF VITAMIN D Thought you only needed to pop a vitamin D pill for six months of the year? Think again… D WORDS LUCY GORNALL PHOTOGRAPH GETTY IMAGES on’t just wait for the gloomy, dark months to start on the vitamin D supplement bandwagon. It’s time to start taking it all year, through rain, shine, heatwaves – the lot. Dr Sarah Jarvis explains... Vitamin D is essential for bone, teeth and muscle health, as well as aspects of mental health. Low vitamin D levels have been linked to increased inflammation in the body, so it’s vital we get our recommended daily allowance – currently 10 micrograms (μg), according to Public Health England. But how we get that is a tricky balancing act of nutrition, supplements – and sunshine. ‘About 90-95% of the vitamin D we get naturally comes not from our diet – unlike most other vitamins – but from what we make in our skin through sun exposure,’ explains Dr Jarvis. This is because there simply isn’t enough of this nutrient in foods (see box). Without supplements, we rely on the sun for the rest – but in the UK, this can be a challenge. ‘From October to April, the UK sun is too weak for us to make any vitamin D. The rest of the year, it’s only strong enough between 11am and 3pm,’ she adds. During these times, 15-20 minutes of sun exposure with arms and face uncovered provides enough vitamin D, but you shouldn’t have enough sun exposure to burn or even tan – too much sun exposure increases your risk of skin cancer. However, Dr Jarvis explains that while it’s important to use sunscreen, ‘sun creams can block the sun’s rays that enable our skin to produce vitamin D.’ It’s a catch-22 for a lot of us: head out in peak sun but risk skin damage, or stay indoors and risk vitamin D deficiency. This is why supplementing is key. The at-riskers Anyone over 65, anyone who is entirely or largely housebound, and anyone who covers up for religious reasons should absolutely be taking supplements all year, says Dr Jarvis, as should pregnant Improve blood pressure Hard to stomach It’s almost impossible to hit your RDA of vit D with food; you’d have to plough through one of these… ✢ 6-10 boiled eggs ✢ 10+ cans of tuna ✢ 7+ bowls of cereal fortified in vitamin D ✢ 10 rump steaks ✢ 10+ lambs liver ✢ 13+ lumps of reduced-fat spread ✢ 1 portion of oily fish (but the NHS says certain groups should only eat 2 portions a week) and breastfeeding women. Office workers who sit indoors for the entirety of their day also need to supplement. Post-menopause If you’re post-menopausal, then vitamin D is even more valuable. ‘After the menopause, your risk of osteoporosis rises significantly,’ says Dr Jarvis. ‘Getting enough calcium and vitamin D are key to reducing your risk of osteoporosis, which results in at least one in three women over 50 fracturing a bone at some point during her life. Osteoporosis can also lead to severe ongoing pain and disability.’ Are you deficient? Depression, muscle and joint pains, and breast and colorectal cancer have all been linked to low levels of vitamin D. ‘People with low levels may also be at increased risk of dementia and Alzheimer’s disease. Plus, vitamin D deficiency can be detrimental to those who have asthma.’ Taking vitamin D can actually halve the risk of an asthmatic flare-up. A study by University College London has found a link between vitamin D deficiency and hypertension, AKA high blood pressure. So keep those vit D levels topped up! 89
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92 Healthy smoothies 103 Sausage stew with butternut squash 94 Shakshuka 103 Miso cod with tenderstem broccoli 96 Superberry breakfast bowl 104 Turmeric roast chicken 96 Butter & kale breakfast strata 105 Chicken and kale stir fry 97 Flapjack breakfast bars 106 Roast side of salmon with blushing veg 98 Spice Lentil soup 108 Sardine and spinach panzanella 99 Veggie grain boost salad 109 Beetroot balls in Spanish-style sauce 100 Greek-inspired bean burgers 110 Berry and watermelon sorbet 101 Tuna and kimchi jackets 111 Raw chocolate brownie 101 Green goddess chicken salad 112 Frozen berry yoghurt 102 Peri-peri rainbow wraps 91
RECIPES Turmeric latte Reduce inflammation and the risk of developing a range of chronic illnesses with the marvel of turmeric. Serves 1 • Ready in 5 mins • 350ml | 11.8fl oz almond milk, or another milk or milk alternative • 1⁄4 tsp ground turmeric • 1⁄4 tsp ground cinnamon • 1⁄4 tsp ground ginger • 1 star anise (optional) • 1⁄2 tsp vanilla extract • 1 tsp maple syrup • 1 grind of black pepper 92 1 Put all the ingredients in a saucepan over a gentle heat. 2 Whisk the mixture constantly, preferably with a milk frother if you own one. 3 Once the mixture is hot take it off the heat and remove the star anise (if you are using it). 4 Pour the latte into two mugs and sprinkle over a pinch more cinnamon to serve.
DRINKS Pineapple and lime smoothie Relax tired muscles and aid digestion with this summery drink. Serves 1 • Ready in 5 mins TOP TIP Don’t drink your smoothies too cold, it can hinder digestion. • 245g | 9oz | 11⁄4 cups frozen pineapple chunks • 2 tbsp lime juice • 1 tbsp fresh mint • 237ml | 8fl oz | 1 cup coconut water 1 Add all ingredients into a blender and blend until smooth. Herbal smoothies Boost your immune system, soothe indigestion and fight off inflammation. Serves 1 • Ready in 5 mins • Herbs of your choice, fresh or dried • A herbal tea bag (optional) • Fruit of your choice, fresh or frozen • 1 handful ice (optional) • Yoghurt and/or milk, or your choice of dairy-free alternative • Honey, to sweeten (optional) 1 A herbal smoothie can be made using both fresh and dried herbs. Brew your chosen herb(s) as a tea – you could use a herbal tea bag also – then add the tea to your blender or smoothie maker. 2 Add your chosen fruit. A handful of ice is recommended with fresh fruit, but isn’t required if you’re using frozen fruit. 3 Blend everything together, taste and see if you need any honey to sweeten. 93
RECIPES Shakshuka This spicy egg classic is always a popular brunch choice. Serves 2 • Ready in 30 mins • 1 tbsp olive oil • 2 onions chopped • 1 red chilli, deseeded and finely chopped • 1 garlic clove, sliced • Small bunch of coriander, roughly chopped • 2 cans | 400g | 14oz cherry tomatoes • 1 tsp caster sugar • 3-4 eggs • 100g | 3½oz spinach • Pinch Maldon sea salt 1 Heat the oil in a frying pan that has a lid, soften the onions, chilli, garlic and coriander for 5 mins until soft. 2 Stir in the tomatoes and sugar, then bubble for 8-10 mins until thick. Stir in the spinach and coriander and cook for another minute. 3 Using the back of a large spoon, make wells in the sauce, then crack an egg into each one. Put a lid on the pan, then cook over a low heat for 6-8 mins, until the eggs are done to your liking. 4 Add a pinch of Maldon and serve with crusty bread. 94 DAIRY FREE
SHAKSHOUKA SHAKSHUKA 95
RECIPES DAIRY FREE GLUTEN FREE Super berry breakfast bowl The chia seeds and walnut add a lovely textural contrast to the oats and compote. • ½ tsp cocoa nibs • 25g | 0.9oz walnuts, chopped • Handful of berries to garnish Serves 1 • Ready in 25 mins 1 Put the berries, orange zest and juice into a small pan and cook on a medium heat for 5 mins until softened. 2 Stir the oats into the yogurt and leave to sit for 15 mins. Top with the warm compote and garnish with banana, extra berries, chia seeds, cocoa nibs and walnut. • 80g | 2.8oz frozen berries • Zest ½ orange and a squeeze of juice • 50g | 1.8oz gluten free oats • 100ml | 3.3fl oz coconut yoghurt • ¼ banana, sliced • ½ tsp chia seeds DAIRY FREE GLUTEN FREE Butternut and kale breakfast strata A healthy and filling breakfast for busy days. Serves 2 • Ready in 20 mins  • 250g | 8.8oz peeled and seeded butternut squash, diced into approximately 1cm | ½in cubes • 30g | 1oz roughly chopped curly kale leaves • 120ml | 4fl oz liquid egg white or 4 free-range egg whites • ¼ tsp chilli flakes • 2 sage leaves, finely chopped • Salt and pepper • 1 tbsp olive oil • 6 baby cherry tomatoes, cut in half • 20g | 0.7oz sprouting seeds, like Good4U Super Sprouts mix 1 Put the diced squash in a vegetable steamer placed over a pan of barely boiling water, then cover and steam for 5 mins. Add the kale leaves and steam for a further 5-8 mins, or until both the squash and kale are just tender. 2 Whisk the egg white lightly with the chilli flakes, chopped sage leaves and a pinch of salt and pepper. Add 96 oil into a non-stick frying pan with oil, then place over a medium heat and tip the squash and kale into the pan. Pour over the egg-white mixture and shake the pan gently to combine. 3 Scatter the cherry tomatoes over the top, then cook over a low heat for 3-5 mins, until just set. Remove from the heat, slide on to a plate and serve immediately, garnished with a handful of sprouting seeds.
FLAPJACK BREAKFAST BARS DAIRY FREE GLUTEN FREE Flapjack breakfast bars These gluten free bars make for an easy on the go brekkie or mid morning snack. Makes 15 • Ready in 40 mins • Cooking spray • 50g | 1.7oz coconut oil, melted • 200ml | 6.7fl oz apple juice • 1 tsp vanilla extract • 300g | 10.6oz gluten-free \ jumbo oats • 40g | 1.4oz sunflower seeds • 40g | 1.4oz pumpkin seeds • 40g | 1.4oz dried dates, chopped • 40g | 1.4oz dried apricots, finely chopped 1 Heat the oven to 180°C/350°F/ Gas 4. Grease a 20cm | 8in square tin with the cooking spray and line with baking parchment. Blend the coconut oil, apple juice and vanilla extract in a jug with a stick blender. 2 In a large bowl, stir the oats, sunflower and pumpkin seeds, dates and apricots together. Pour the apple juice into the mixture and mix well – it will start to look sticky. Spread into the tin, press down well and bake for 25-30 mins. 97
RECIPES TOP TIP If reheating leftover soup, add a little water to adjust the consistency. Spiced lentil soup Comforting, creamy and packed full of goodness. Serves 4 • Ready in 40 mins • 2 tbsp olive oil, plus extra • ½ tbsp garam masala • Pinch of turmeric • 1 tbsp black mustard seeds • 2 onions, 1 diced and 1 sliced into half moons • 1 garlic clove, crushed 98 • 1 large carrot, diced • 2 celery sticks, diced • 200g | 7oz canned tomatoes • 200ml | 7fl oz coconut milk • 160g | 5½oz kale, shredded • 400g | 7oz can green lentils in water, drained • 30g | 1oz coriander, roughly chopped • Mini naan bread, to serve, optional 1 Heat the olive oil in a large pot, add the spices and mustard seeds. Once the mustard seeds begin to pop, add the diced onion, garlic, carrot and the celery. Cook for 10 mins or until the veg is softened. 2 Add the tomatoes, coconut milk, half the kale and 60ml (2fl oz) water. With a hand blender, blitz until smooth. 3 Stir in the rest of the kale and the lentils, and season to taste. Warm the soup through. 4 Heat the extra oil in a frying pan and fry the sliced onions until crisp. Then drain on kitchen towel. 5 To serve, top the soup with fried onions and coriander, and enjoy with mini naan bread, if liked.
VEGGIE SALAD Veggie boost grain salad A diet rich in fibrous ‘roughage’ is good for your gut, so introducing beans, pulses and a variety of vegetables is a great way to start. Serves 4 • Ready in 20 mins • 150g | 5oz edamame (soya) beans • 250g | 9oz cooked, mixed grains (e.g Merchant Gourmet Quinoa, lentils and wheatberries) • 250g | 9oz tomatoes, cut in slices • 250g | 9oz cooked baby beetroot, cut into wedges • 25g | 1oz toasted peanuts, chopped • Fresh mint, to serve FOR THE DRESSING • 1 tbsp sesame oil • 1 tbsp olive oil • 1 tsp rice vinegar • 1 tsp soy sauce 1 Blanch edamame beans in boiling water for 2 mins, refresh under cold running water. Put grains in a large bowl. Mix the dressing ingredients and stir through the grains. 2 Add the remaining ingredients and serve. TOP TIP Feel free to serve it as a side dish to go with grilled fish, chicken or lamb. 99
RECIPES Greek-inspired bean burgers These burgers are a great meat-free option for lunch or dinner! Serves 2 • Ready in 20 mins • 1 tbsp red wine vinegar • 75g | 2½oz 0% fat Greek style natural yoghurt or vegan alternative • 2 tbsp roughly chopped fresh mint • ½ cucumber, finely diced • 2 wholemeal pitta breads, halved 100 • Bag mixed salad leaves, to serve FOR THE BURGERS • 1½ tbsp olive oil • 1 red onion, ½ diced and ½ finely sliced • 1 garlic clove, crushed • 400g | 14oz tin mixed beans, drained and rinsed • 30g | 1oz fresh wholemeal breadcrumbs • 1 tbsp dried oregano • 1 tsp chilli flakes • ½ tsp dried mint • Zest and juice of ½ lemon • 75g | 2½oz reduced-fat Greek-style salad cheese or vegan alternative 1 For the burgers, heat ½ tbsp of the oil in a frying pan and cook the diced onion and the garlic until soft. Add the mixed beans to the pan to warm through. Use a potato masher to crush them into a paste. Mix in the breadcrumbs, oregano, chilli flakes, mint, lemon zest and juice, and cheese. Press and shape into 4 patties. 2 Pour the vinegar over the sliced onion. Mix together and set aside. 3 Heat the remaining 1 tbsp oil in the frying pan and cook the burgers for 4 mins on each side until cooked through. 4 Meanwhile, mix the yogurt, mint and cucumber. Toast the pitta breads and open up the pockets. Top the bean burgers with some of the sliced onion. Serve with the salad leaves, the pittas and the refreshing minty yoghurt.
Tuna and kimchi sweet potato jackets This dish contains omega 3 and potassium, as well as gut-loving kimchi. Serves 4 • Ready in 1 hour • 4 large sweet potatoes, 1kg | 2¼lb total • 400g | 14oz tin cannellini beans, drained and rinsed • 200g | 7oz tin tuna steak in spring water, drained • Bunch spring onions, sliced • 100g | 3½oz raw kimchi, roughly chopped • 1 tbsp low-salt soy sauce • 30g | 1oz reduced-fat mature Cheddar, grated 1 Heat the oven to 200°C/400°F/Gas 6. Prick the potatoes and roast on a baking tray for 45 mins until softened. 2 Meanwhile, stir together the beans, tuna, most of the spring onions, the kimchi and soy sauce. 3 Keeping the potatoes on the baking tray, slice down the middle and open out. Top with the kimchi mix and the cheese, then return to the oven for 10-15 mins, until the filling has warmed through and the cheese has melted. Scatter over the reserved spring onions. Green goddess chicken salad The avocado in the dressing creates a thick sauce that reminds us of Caesar salad. Serves 2 • Ready in 10 mins • 150g | 5oz Tenderstem broccoli • 2 Little Gem lettuce, leaves separated • 6cm | 2½in piece cucumber, thinly sliced • 6 radishes, thinly sliced • 150g | 5oz leftover roast chicken, shredded, any skin removed • 4 salad onions, thinly sliced • ½ tbsp crispy onions • Salad cress FOR THE DRESSING • 1 baby avocado, stoned and diced • 1 small garlic clove • 4 tbsp 0% fat Greek-style natural yoghurt • Zest and juice of ½ lemon • 1 tbsp roughly chopped fresh tarragon or coriander 1 For the dressing, whizz all the ingredients in a blender until smooth. Check the seasoning and add a splash of water if it’s a little thick. 2 Blanch the broccoli in a pan of boiling, lightly salted water for 3-4 mins until tender. Drain and cool under running water. 3 Arrange the lettuce, cucumber, radishes, broccoli, chicken and salad onions onto 2 serving plates. Drizzle over the dressing, then scatter with crispy onions and salad cress. 101
RECIPES Peri-peri rainbow wrap Bursting with colourful veg, this healthy meal is quick to make. Serves 2 • Ready in 25 mins • Olive oil spray • 400g | 14oz can black-eyed beans, drained and rinsed • 1 tsp peri-peri seasoning • 1 avocado, stoned, peeled and chopped • Juice of ½ lime • 2 wholemeal or corn tortilla wraps • 150g | 5.3oz red cabbage, shredded • 1 large carrot, grated • ⅓ cucumber, cut into julienne strips • 4 radishes, quartered • 100g | 3.5oz feta • Few sprigs of mint • 75g | 2.6oz beetroot, cut in wedges 1 Spray a non-stick pan with oil and gently fry the beans and peri-peri seasoning for 10 mins until crispy. 2 In a bowl, mash the avocado with the lime juice. 3 Warm the wraps according to pack instructions and spread with avocado. 4 Combine cabbage, carrot, cucumber and radishes, then stir in the beans. Pile on top of the tortillas, sprinkle over the feta, mint and beetroot to serve. To make this vegan, replace the feta with vegan cheese. 102
MISO COD WITH TENDERSTEM BROCCOLI DAIRY FREE Sausage stew with butternut squash & cannellini beans Stay full for longer with this healthy dish packed with protein and vitamins. Serves 4 • Ready in 55 mins • 8 extra-lean sausages (ideally 50% reduced fat) • 350g | 12.3oz butternut squash, peeled, deseeded and diced • 1 red onion, cut into wedges • 400g | 14oz can cherry tomatoes • 100ml | 3.4floz balsamic vinegar • 400g | 14oz can cannellini beans • 2 rosemary sprigs 1 Heat oven to 200°C/390°F/Gas 6. Arrange the sausages, squash and red onion in a large roasting tin and roast in the oven for 30 mins. 2 Turn the sausages and veg over, add the tomatoes and stir in the balsamic vinegar, drained cannellini beans and rosemary sprigs. 3 Cook for 15 mins until everything is piping hot, then serve. Miso cod with Tenderstem broccoli Not only is broccoli tasty and vibrant, it’s great for the gut and supports immunity. Serves 2 • Ready in 35 mins • 30g | 1oz panko breadcrumbs • 1 tsp brown rice miso • 1 tbsp olive oil • Small handful chopped fresh coriander • 2 pieces of cod loin • 200g | 7oz Tenderstem broccoli • 100g | 3.5oz edamame beans • 8-10 radishes, cut in half • Miso soup sachet – we used Itsu • 1 tbsp rice wine vinegar • 1 tsp sesame oil • 1 tsp honey • ½ tsp light soy sauce 1 Heat the oven to 200°C/390°F/Gas 6. Mix the breadcrumbs with the miso, oil and coriander. Coat the top of each cod loin with the panko mixture and set aside. 2 Layer the bottom of a deep roasting tin with the broccoli, beans and radishes. 3 Mix the miso soup sachet with 200ml boiling water, rice wine vinegar, sesame oil, honey and soy sauce. Pour over the veg and roast for 5 mins. Remove from the oven and place the cod on top. Bake for a further 20 mins. 103
RECIPES Serves 4 • Ready in 1 hr 30 mins • 4 medium sweet potatoes, sliced into rounds • 80g | 3oz dried apricots, roughly chopped • 1 orange, thickly sliced • 1 bulb fennel, cut into chunks • 1 glass of white wine • 1 bunch of parsley, roughly chopped • 4 spring onions, sliced • 1 whole free-range chicken, spatchcocked • 125ml | 5fl oz olive oil • 2 garlic cloves • 1 tbsp coriander seeds • 1 tsp dried turmeric or 1 tbsp peeled and finely grated fresh turmeric 1 Blitz the olive oil, garlic, coriander seeds and turmeric together in a small processor. Score the chicken skin a few times, then rub with the marinade. Cover and chill for at least 1 hour or overnight. 2 Heat the oven to 180°C Fan/ 200°C/ 400°F/Gas 6. Put the potatoes, Turmeric roast chicken with orange and fennel A comforting one-pot dish that will help you to beat inflammation. DAIRY FREE 104 apricots, orange slices and fennel in a large roasting tin. Then put the marinated chicken on top, skin side up, and pour over the wine along with as any leftover marinade. Season well and cover with foil. 3 Roast for 30 mins. Remove the foil and reduce the heat to 160°C Fan/ 180°C/ 350°F/Gas 4. Roast for another 45 mins, until the chicken is cooked through and golden. Garnish with parsley and spring onions to serve. TOP TIP Thanks to its high levels of curcumin, turmeric has powerful antioxidant and anti-inflammatory qualities.
CHICKEN AND KALE STIR FRY DAIRY FREE Chicken and kale stir fry This flavourful and simple meal contains anti-inflammatory turmeric and miso. Serves 4 • Ready in 25 mins • 425g | 15oz mini chicken breast fillets, or regular sized fillets sliced into smaller pieces • 2.5cm | 1in root ginger, peeled, grated • 2 garlic cloves, grated • 1 lemon, grated zest and juice • 2 tbsp rapeseed oil • ¼ tsp turmeric • 2 red onions, sliced • 250g | 8.8oz curly kale, chopped • 1 tbsp miso paste • 2 carrots, peeled 1 Put chicken into a shallow dish and season. Sprinkle over ginger, garlic and lemon zest. Squeeze on the lemon juice and stir to mix evenly. 2 Heat oil in a wok and fry the chicken for 3 mins without stirring. Sprinkle with the turmeric, turn and cook for 3 more mins. 3 Push the chicken to the side and add onions. Cook for 3 mins. Add the kale. Stir miso into 200ml | 7fl oz boiling water, cook for 3 mins. 4 Use a peeler on the carrots to create ribbons. Add to the wok for 2 mins. Serve with quinoa. 105
RECIPES 106
ROAST SIDE OF SALMON WITH BLUSHING VEG Roast side of salmon with blushing veg This mouthwatering salmon is so easy to prepare and will make a delightful, impressive centrepiece at your table. Serves 8 • Ready in 40 mins • 450g | 1lb mixed radishes • 250g | 8¾oz asparagus tips • 300g | 10½oz baby leeks • 3 tbsp olive oil • Zest of 1 lemon • 1kg | 2lb 3¼oz side salmon, skin on FOR THE DRESSING • 1 banana shallot, finely chopped • Large bunch of fresh herbs (we used parsley, dill and lemon thyme) • 50g | 1¾oz olive oil • Juice of 1 lemon • 1 tsp cracked pink peppercorns, to garnish 1 Heat the oven to 200°C | 400°F | Gas 6. Place the radishes, asparagus and baby leeks on a large baking tray, and drizzle with 2tbsp of the oil, and season with salt and pepper. Toss everything together with the lemon zest to coat the vegetables evenly. 2 On a separate baking tray lined with parchment, place the salmon on top, skin-side down, and brush with the remaining olive oil. Season well. 3 Place both trays in the oven for 25 minutes, until the salmon is just cooked through and the vegetables are nicely roasted. Serve hot or at room temperature with the dressing. 4 For the dressing, simply blitz all the ingredients together, and drizzle over the salmon and vegetables. 107
RECIPES Sardine and spinach panzanella A hearty salad that is packed full of flavour and nutrition. • 3 tbsp white wine vinegar • 1 tsp Dijon mustard Serves 4 • Ready in 35 mins 1 Heat the oven to 180°C/350°F/ Gas 4. Place the onion wedges on a baking tray, drizzle with 1tbsp olive oil and roast for 15 mins. Add the tomatoes and roast for 10 mins. 2 Put the bread on a separate baking tray, drizzle with 1tbsp oil, scatter over the garlic and lemon rind and roast for 10 mins. 3 Combine all the dressing ingredients, stir in the roasted tomatoes and season to taste. Mix together the onion, bread, sardines, spinach, olives and basil on a platter and pour over the tomato dressing to serve. • 1 red onion, cut into wedges • 2 tbsp olive oil • 250g | 9oz tomatoes, halved • 150g | 5oz wholemeal bread, roughly torn into chunks • 1 garlic clove, crushed • Thin strips of rind from ½ lemon • 2 x 120g | 4½oz cans sardines • 75g | 3oz spinach leaves • 45g | 1½oz black olives • 30g | 1oz basil leaves, torn FOR THE DRESSING • 1 garlic clove, crushed • 125ml | 4½fl oz olive oil DAIRY FREE 108 TOP TIP Sardines are a nutritional bargain – rich in fatty acids, protein and calcium.
BEETROOT BALLS IN A SPANISH-STYLE SAUCE Beetroot balls in a Spanish-style sauce Meatless meatballs doesn't mean flavourless with these balls! Serves 4 • Ready in 50 mins • 400g | 14.1oz raw beetroot, trimmed and peeled • 400g | 14.1oz sweet or waxy potatoes • 400g | 14.1oz can chickpeas, drained, rinsed and dried • 3 garlic cloves, crushed • A good pinch of chilli powder • 2 tbsp polenta • 1 tbsp sesame seeds • 3 tbsp sunflower oil • 1 onion, thinly sliced • 1 small carrot, finely chopped • 1 red pepper, deseeded and thinly sliced • 2 x 200g | 7oz cartons passata • 200ml | 6.8fl oz veg stock • ¾ tsp sweet smoked paprika • Small handful of oregano leaves 1 Wearing clean rubber gloves, coarsely grate the beetroot, then squeeze out the excess water with your hands. 2 Pierce the potatoes all over, then cook in the microwave on High for 6 mins, or until cooked through. Leave to cool. 3 Put the chickpeas in a mixing bowl and roughly break up with the back of a fork. Scoop out potato flesh and add to the mix, along with the beetroot, garlic and chilli powder. Mix well with your hands, then shape into 16 balls. 4 Mix the polenta and sesame seeds together, then roll the balls in this mixture, one at a time, and cover loosely with foil. Leave to firm up in the fridge for around 1 hr (or more if you like). 5 Heat 1 tbsp of the oil in a pan over a medium heat, add the onion and cook for 4 mins, or until softened and browning. Add the carrot and red pepper, mix and cook for 2 mins more. Add the passata, stock, a pinch of sugar and the paprika. Bring to the boil, cover and simmer for 25 mins. 6 Heat the rest of the oil in a frying pan over a medium heat. Brown the beetroot balls, in batches, on all sides. Add to the sauce with the oregano. DAIRY FREE 109
RECIPES Quick berry and watermelon sorbet The perfect treat to have stored in your freezer. Serves 4-5 • Ready in 10 mins (plus chilling time) • 450g | 16oz | 3 cups frozen berries • 175g | 6oz | 1 cups prepared watermelon chunks, frozen • Juice of 1 lemon • 2 tbsp icing sugar • Mint leaves, for garnish 1 Remove the frozen fruits from the freezer and leave them until they just start to soften slightly. Tip them into a blender, along with the lemon juice and sugar, and then purée until smooth. 2 If the mixture is very soft, return it to the freezer until it’s firm enough to scoop into balls. Serve sorbet garnished with mint. DF GF VE 110
RAW CHOCOLATE BROWNIE Raw chocolate brownie These no-bake fudgy brownies are the perfect sweet treat. Serves 4 Ready in 10 mins • 450g | 16oz | 3 cups Medjool dates, pitted • 220g | 7¾oz | 1½ cups blanched hazelnuts • 6 tbsp cacao powder • 2 tbsp date syrup (or maple syrup) • 110g | 4oz | 1 cup goji berries, roughly chopped • 125g | 4¼oz | ½ cup crushed pistachio nuts • 100g | 3½oz vegan dark chocolate • Pinch sea salt, to garnish 1 Toast the hazelnuts in a dry pan over a medium-high heat (alternatively, roast them in a hot oven) for about 5 minutes or until golden and fragrant. Set aside to cool. 2 Once the hazelnuts are cooled, blitz them in a food processor until they form a crumbly sandlike mixture. 3 Add the dates and blend again before adding the cacao and date syrup. Blend further until everything is mixed together. 4 Pour the brownie mix into a large bowl, and mix in the chopped goji berries and crushed pistachios. Stir it together until everything is evenly distributed. 5 Press the mix into a baking tray and pop it in the fridge for 3-4 hours to set. 6 Once chilled, melt the chocolate and drizzle it over the top, chill again until the chocolate has set, then serve with a sprinkling of sea salt. DAIRY FREE 111
RECIPES DAIRY FREE Berry Frozen Yoghurt This easy dessert is so quick to put together and works well as a treat. Serves 8 • Ready in 10 mins, plus freezing • 250ml | 9oz | 1 can coconut cream • 375ml | 12¾fl oz coconut milk yoghurt • 3 tbsp icing sugar or sweetener • 300g | 10½oz mixed frozen berries 1 Whisk the coconut cream, yoghurt and icing sugar together until smooth. Stir in the berries and crush slightly. Turn into a container and freeze until firm, preferably overnight. 2 Allow to soften at room temperature for half an hour before serving. 112
BERRY FROZEN YOGURT 113
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