Sunscreen Safety and The Sun for Health

• Summary and Conclusions
• Overview
• The Sun and Sunscreen Facts
• The Sun and Sunscreen Safety
• Sunshine, Vitamin D, and Health
• Hormones and Full-Spectrum Light

July Recipes:  Blueberries… July is National Blueberry Month

July and August are the classic vacation months when we question how to be safe in the sun.   We are told to protect ourselves from the sun’s damaging UV rays.  But, the sun can also be an ally, particularly as we age, since moderate exposure can provide health benefits for the prevention of a variety of chronic diseases.

Most people experience 50% to 80% of their lifetime exposure to the sun before the age of 18.  Also, melanoma-type skin cancers are associated with severe sunburn experienced before the age of 20.¹ But as we age, we especially require vitamin D to support health:  Vitamin D partners with calcium to support healthy bones and works as an ally in the prevention of depression, osteoporosis, cancers (since vitamin D regulates cell growth), diabetes, heart disease, multiple sclerosis, and other inflammatory and chronic diseases.  The most natural, non-toxic form of vitamin D comes from the sun, because the body makes vitamin D from sunshine only in amounts that are needed. “…sunlight destroys any excess vitamin D that your body makes, so you could never become vitamin D intoxicated from sun exposure.”²

Obviously, balancing the risks and the benefits of exposure to the sun, particularly with the erosion of the ozone layer, is challenging.  This newsletter covers sunscreen safety, as well as the role of sunshine and vitamin D in supporting health.  Since interests vary, I have summarized and placed first  the key ideas of this newsletter to allow you to read selectively:

Summary…Sunshine Safety and Measures for Health?

• Children and teens can err on the side of less sun and more sunscreens.  With children generally, we do not need to think too much about the sun as a healer of chronic disease.  These are the years to be sensible in order to avoid melanoma cancers in later life.  At the same time, through gradually building up to the sun, sunshine can be very helpful in reducing childhood asthma and wheezing disorders while it enhances growth, bone formation, energy, and mood.
• For adults, sunlight is a major agent that can help prevent a host of chronic diseases. These are the years when the risk/reward appears to tip toward seeking moderate exposure to the sun…particularly since the seeds of melanoma skin cancer were already laid down during childhood.  On the positive side, moderate doses of sunshine can help protect against internal cancers and chronic, inflammatory diseases perhaps to outweigh the risks of skin cancers, many of which can be managed by periodic visits to the dermatologist, and through prudent year-round exposure to the sun and adequate antioxidant nutrition.  So, you may want to get 15-30 minutes of sun exposure and then apply sunscreen.  Since the face and head account for less than 10% of your total skin surface, applying a sunscreen to your face (especially in the summer) before going out in the sun can help prevent aging, while you absorb for a time helpful rays on exposed areas of other parts of your body before applying sunscreen.
• No matter your age, build up with gradual exposure to the sun. Begin in the spring with 5-15 minutes, progressing to 30 minutes a day, exposing face and arms, when possible.  Darker skinned people with more melanin in their skin can handle more sun than those who are fair.
• Eat nutrient-dense, antioxidant-rich organic fruits and vegetables to boost your internal defenses to the sun’s free radical effects. Some experts believe that the sun’s rays work as a catalyst for the body to release internal toxins through the skin and that sunburn is exacerbated by nutritional deficiencies that leave the skin vulnerable to DNA mutations from radiation.³ So avoid foods with a heavy pesticide load, choosing instead fruits and vegetables that provide a rich array of antioxidants, as well as foods and supplements that provide high-quality oils.
• Skin cancer versus chronic disease. While it is true that excessive exposure to the sun (you should never expose your skin to the point of burning or blistering) does increase your risk of basal and squamous cell skin cancer and can prematurely age the skin, sensible and frequent mild exposure, combined with an antioxidant-rich diet, may be the best strategy to avoid serious chronic diseases.
• The most effective sunscreens contain zinc oxide or titanium dioxide. These two ingredients “create a physical barrier that sits on the skin’s surface and are not absorbed into the body.  They reflect light away from the skin, the way a mirror would.”  Try to look for a sunscreen that contains antioxidant vitamins like vitamins C and alpha-lipoic acid, which can be helpful in parrying any stray free-radical damage to the skin.⁴
• To derive the most health benefits, frequent, short exposure to sunshine is best.  There are no set rules about how much sun is optimal, since this will vary with your age (vitamin D deficiency increases as we age), skin color (longer exposure for darker skin)⁵, with where you are located on the globe (less is needed at the equator and more toward the poles), and your state of health (sunshine can be helpful for depression, inflammation, high blood sugar, fragility fractures, chronic pain, PMS, psoriasis, and diabetes and obesity, to name just a few.
• Light rays absorbed through the eyes stimulate the pineal gland (called the “third eye” because of its link to hormone function).  You might consider wearing glasses that allow UV light to pass through, and sunglasses tinted a neutral grey in order to decrease uniformly the amount of light across the broad spectrum.⁶
• Scientific studies suggest that sunshine exposure both through the iris of the eye and on unprotected skin is important for general health.  For anyone with a chronic disease, sunshine can be used medicinally, often with very positive results.

Overview

It is vacation time again when the prior months of short-winter and rainy-spring days have depleted us of vitamin D, so we naturally crave the sun.  Weekends and vacations tempt us to stretch out to feel the sun’s energy penetrate our being.  Every cell of out body is equipped with vitamin D receptors, and perhaps this explains why we broadly sense its deeply restorative power.

Traditional cultures worshipped the sun.  Without building temples, we do too, in our own informal ways.  But what distinguished traditional cultures was their respect for the sun’s power:  Each spring, they adapted gradually to the sun, building up protective melanin in their skin⁷ to be able to tolerate its power well before the strongest days of summer.  They planned outdoor work to avoid the sun at its most intense hours.   Work started early in the day, with a break for a long noon meal and rest, before resuming again in mid-afternoon.  And, they ate whole foods rich in antioxidant protections.  To expose our “virgin” skin to the vacation sun lying flat on a reflective sandy beach or on a float in a pool while consuming the Standard American Diet is a modern phenomenon.

Today, while our need for vitamin D is as great as ever (we are more deficient in vitamin D than any other vitamin—some  80 percent of Americans, 90 percent of Hispanics, and 97 percent of African Americans are vitamin D deficient) we must worry about our exposure to the sun.  It is not only the erosion of the ozone layer, but also our modern indoor lifestyle that make us ill-suited for the quick shift to long vacation days in the sun, especially at a beach or pool.  The best strategy is to begin in the spring to work into the sun, if possible, by exposing your skin to the sun for 15-30 minutes a day, before or after the hours of 10 a.m. to 2 p.m.   This will help build your resilience and also your vitamin D levels.

The Sun and Sunscreen Facts:

Sunlight’s three rays, UVA, UVB, and UVC:

UVA radiation is a major concern because it easily travels through the ozone layer, with few sunscreens offering UVA protection.  UVA rays cause wrinkles and aging; damage the immune system; and foster skin cancers.

UVB rays appear less lethal than UVA rays since the ozone layer absorbs the majority and sunscreens provide protection.  Excessive UVB radiation that does get through causes sunburn, damage to the immune system, and can lead to cataracts and skin cancer.  But we do need some UVB exposure (which sunscreens parry) since it is UVB rays hitting unprotected skin that enables the body to create vitamin D.

UVC rays, the shortest wave length, can damage tissue, but they are largely screened out by the ozone layer.  We do need trace amounts for good health.  UVC rays perform a positive role in science and industry through their ability to kill bacteria.

Melanin in our skin helps to protect us against the sun.  Sunlight stimulates the body to make melanin, its effort to protect skin cells from ultraviolet radiation. The darker your skin, the more protection you have from the sun.  With increasing exposure to the sun, melanin builds up for many people, so the risk of sunburn often decreases as the summer season progresses:   Sun exposure that would burn us on Memorial Day or in June may be easy to handle in August, at least from the standpoint of sunburn.  People with a lighter natural skin color have less melanin and need to take more care.  The same is true of adults and children who have a lot of moles and/or a family history of skin cancers.

Babies and the Sun. Sunscreen should not be applied to babies under 6 months of age.  Babies need to be kept out of the sun.  Their skin is very thin, they are not able to fend off toxins in sunscreens, and melanin has not built up in their skin to offer sun protection.

SPF (sun protection factor), a measure only of UVB protection. What is SPF?  If you would normally begin to burn after 10 minutes in the sun, then an SPF of 30 would theoretically allow you to be in the sun 300 minutes (10×30) before burning.  This calculation is an estimate and is influenced by whether you perspire, or engage in water sports, and by the strength of the sunlight.  There is little need to pay for higher than SPF 30, since higher levels add little additional protection.  (An SPF of 8 is enough to block out 93% of UVB radiation, while an SPF of 15 blocks 99%, so either would be sufficient to blunt the potential vitamin D benefits.)⁸

There is no such thing as a “sun block.”  The FDA plans to ban this label.  Also, tanning lotions and suntan products do not generally provide protection from UV rays.

The Sun and Sunscreen Safety

Activities that take you to the sun for prolonged periods of time are best handled by covering up with a hat and clothing, or seeking shade.  If you are engaged in sports that do not allow for cover, you will want  a good sunscreen that effectively blocks out damaging UVA and UVB rays AND does not breakdown in the sun.  Sunburn and skin damage are not the same issue…

Sunburn is caused by UVB rays, but skin is especially damaged by UVA rays that SPF ratings do not speak to.  Sunlight is made up of three types of radiation, so just because we use a sunscreen to prevent a tan or burn does not mean our skin is safe from the sun. (See discussion above.)

Unlike UVB, UVA rays leave no overt footprint.  But, UVA rays damage the skin and the immune system by intense exposure.   Few sunscreens protect against UVA.  The best protection is offered by zinc oxide and titanium dioxide.  (Avobenzone and Merxoryl SX, two UVA-screening ingredients approved by the FDA, break down in the sun.)

A sunscreen’s “sun protection factor” (SPF) can be misleading:  It does indicate its protection against UVB tanning/burning rays, but little about its screening of UVA radiation.  Sunscreens that do protect against both are normally denoted as “UVA/UVB” or “broad spectrum” sunscreens, but the SPF number applies only to UVB radiation. There is no numerical rating system of UVA protection.

The United States is behind Europe in analyzing and authorizing sunscreen ingredients.⁹ With few effective agents, every year new ingredients appear, some of which break down in the sun and pose the risk of free radical damage, both to the skin and to the environment.  For every active sunscreen ingredient, there are 100 non-sunscreen “fillers.”  (Especially, BEWARE OF PARABEN.  It is a carcinogenic agent that is put in many skin creams and lotions for creamy smoothness.)  Some added ingredients react with each other.  Some are absorbed through the skin and enter the blood stream and can cause toxic effects, create allergic reactions, or disrupt hormone function.¹⁰ Testing is left to the manufacturer:  the government does not require companies to test their sunscreens for safety before they are allowed to be marketed on store shelves.

Without government sunscreen regulations, we are fortunate that in 2004, the non-profit Environmental Working Group (EWG) stepped in to begin to test sunscreen ingredients and to offer advice and help.  In its 2010 update, only 39, or 8 percent of the 500 products tested were approved for use.  EWG bases its ratings on three criteria:

1. Effectiveness at blocking both UVA and UVB radiation;
2. Stability of the active ingredients when exposed to the heat and light of the sun; and
3. Safety of the active and inactive ingredients with respect to the health risks of children and adults, alike.

Of the 500 major sunscreens tested by the non-profit Environmental Working Group (EWG), only 39, or eight percent of the total, tested well.  The following list includes the makers of some of the top brands of approved sunscreens:

[Note that Banana Boat, Neutrogena, and Hawaiian Tropic are not on the approved list.]

Look for a sunscreen that provides protection at a 30+ SPF level (higher brings little additional advantage) and with the stability to stand up to the sun’s rays…the ones that contain zinc or titanium dioxide. Avoid oxybenzone (a synthetic estrogen) and retinyle palmitate. Retinyle palmitate (vitamin A) appears in some 40 percent of all sunscreens on the market this year and is believed to foster skin cancer when applied to skin that is then exposed to the sun.  To find the rating of your current sunscreen see http://www.ewg.org/2010sunscreen .

Sunshine, Vitamin D, and Health

What is vitamin D? Vitamin D in its active form is actually a hormone.  Our body makes vitamin D in a multi-step process that involves the liver and kidney, but it all starts with unprotected skin absorbing the sun’s UVB rays.  Interestingly, vitamin D is the only vitamin that we can make all on our own,¹¹ and virtually all the cells and tissues of the body [as well as the kidneys] have the capability to activate vitamin D.¹²

Vitamin D is important, particularly in infancy and childhood but also throughout life, for healthy bone formation, for mood, for a vibrant nervous system, for thyroid function and fertility, for normal blood clotting, for healthy skin and teeth, and even for the prevention of some forms of internal cancers.  Vitamin D also enhances vitamin A and vitamin C, as well as a host of minerals, especially calcium, phosphorus, and choline.  Since vitamin D is fat-soluble, it is stored and retained by the body over a prolonged period, even up to a year.  Vitamin D synthesis declines 80% between the winter and summer, but most people can gain enough sun exposure from spring, summer, and fall to store vitamin D in body fat for release during the winter months. ¹³ So while we may enjoy warmth and the feeling of sunshine on our skin, it is not critical to experience the sun every day in order to be healthy.  The amount of sunshine on unprotected skin that is in keeping with good health depends on a person’s age and skin color, the time of year, the geographic latitude, as well as the person’s state of health (since the sun can be used medicinally for chronic illness).

Since vitamin D appears in only a few foods (cod liver oil, egg yolks, liver, and oily fish like salmon and sardines¹⁴ ), for all practical purposes, and unlike vitamins A, C, and E, it is hard to find adequate amounts of vitamin D through food.¹⁵ Also, vitamin D is a fat soluble vitamin, which means, when taken orally, it could accumulate to potentially toxic levels.¹⁶. Thankfully, this does not happen with sunshine, since our body is able to self-regulate to stop making vitamin D when it is no longer needed.  So, the very best source is from sunshine, and it is the only source that assures that vitamin D cannot build to toxic levels.

Vitamin D and Cancer.

Vitamin D helps the body utilize calcium to grow bone and support the normal functioning of the heart and nervous system.  Vitamin D also partners with calcium in its role to support cell differentiation when the body makes new ones.¹⁷ This explains vitamin D’s important role in the prevention and remission of internal cancers, particularly colon, breast, prostate, and ovary.¹⁸

In 1979, the DeLuca Group reported that “essentially every tissue in your body appeared to recognize the active form of vitamin D.” (Holick, 66.) This led to an understanding that “because every tissue and cell in your body has a vitamin D receptor, we think that vitamin D acts as a sentinel for your health in that it will control cell growth.  If the cell growth becomes malignant, it will either return the cell to normal or induce apoptosis, cell death.” (Holick, 69.)

As early as the 1940s, it was reported that it was easy to find and treat non-melanoma skin cancers and that this might be a reasonable risk/benefit strategy to seek some sun exposed in view of the danger of undetected internal cancers developing due to lack of exposure to sunshine.¹⁹ Research suggests that most people who develop skin cancer are not as inclined to develop deadly internal cancers.  And, even most melanomas occur in areas that receive virtually no sun exposure.²⁰ In addition, most cancer patients are deficient in vitamin D and a vitamin D deficiency increases the risk by “30%-50% of developing some of the most deadly cancers.”²¹

Hormones and Full-Spectrum Light Through the Eye?

Full spectrum light through the iris of our eye stimulates the pineal and pituitary glands for proper hormone and brain function.  John Nash Ott was an early pioneer who explored more than 40 years ago the benefits of full-spectrum light.  He concluded that, “There are neuro-chemical channels from the retina to the pineal and pituitary glands, the master glands of the whole endocrine system that control the production and release of hormones. This regulates your body chemistry and its growth, all organs of your body, including your brain, and how they function.”²²

Ott derived his conclusions from observing changes in reproduction in plants and animals when they were deprived of full-spectrum light.  He also discovered that his arthritis disappeared when he broke his glasses so his eyes were exposed to direct sunlight.  (UVB rays do not pass through glass.)  In 1959, Dr. Jane C. Wright, working at the Bellevue Memorial Medical Center in New York City, picked up on Ott’s work.  In her cancer research work, she instructed 15 women with cancer to be out in the sun as much as possible, without wearing sunglasses. At the end of the summer, 14 women experienced no growth of their tumors, some of which improved.  The one woman, who did not get better, misunderstood the instructions and wore her regular glasses in the place of sunglasses.

Whether the exposure of the eye to full spectrum light is a positive for health may be a function of a person’s diet and general nutrition.  It is possible that nutrient-dense, antioxidant-rich whole foods equip the body to deal with the oxidative stress and free-radical effects of the sun’s rays, enabling the positive benefits of full-spectrum light to outweigh the negatives for people with a superior diet. There is much still to be explored in this field to better understand the potential health benefits of sunlight.

For some stimulating reading on this under-researched topic, see John Nash Ott’s, Health and Light (1973) and Light, Radiation and You:  How to Stay Healthy (1990).  For more information on vitamin D and cancer and chronic disease, see The UA Advantage and The Vitamin D Solution by Dr. Michael Holick, as well as his interview article in the May/June 2008 issue of Alternative Therapies.   Holick, a pioneer in vitamin D research, discovered the mechanisms for its synthesis in the body.  Continuing on the forefront of vitamin D/health research today, he is a voice worth listening to.

July Recipes:  Blueberries, a Truly National Fruit

Blueberries are a fitting way to greet the July 4^th Holiday since blueberries are a true national treasure, a fruit native only to North America.

Blueberries are loaded with iron and provide a variety of antioxidants and anti-inflammatory compounds, including vitamins A and C and a host of health-supporting phytochemicals.  Nutrient dense, they are thought to play a role in the prevention of a variety of chronic disease, from cancer to Alzheimer’s.  Blueberries’ role in brain health is associated with its anthocyanin, which gives blueberries their deep color and appears to protect the signaling neurons in the brain from oxidative stress, aiding neurological function and memory.  See  http://pathways4health.org/2010/04/09/blueberries/

Copyright 2011 Pathways4Health.org

1. www.kidshealth.org [↩]
2. Alternative Therapies, May/June 2008. [↩]
3. The Gigantic Sunscreen Hoax. [↩]
4. Ralph W. Moss, PhD, “New Evidence that Vitamin D Fights Cancer.” [↩]
5. Archives of Internal Medicine [↩]
6. www.healingcancernatually.com [↩]
7. Nature also designed humanity to accommodate to the sun’s rays.  People living at the equator had more melanin and therefore darker skin to provide greater protection than lighter-skinned peoples living in northern latitudes.  The same phenomenon applies to eye color, with people living at the equator having a naturally deep-brown/black iris, compared to light-blue tones of Scandinavians.  www.second-opinion.co.uk/full_spectrum_sunlight [↩]
8. Holick,70. [↩]
9. The FDA has approved just 17 sunscreen ingredients, compared to 29 that are authorized in Europe.  We also permit just 4 UVA-screening chemicals.  The only two viable and effective UVA ingredients are zinc oxide and titanium dioxide, two stable components that do not penetrate healthy skin. [↩]
10. The EWG comments:  “ …consumers who use sunscreens without zinc and titanium are likely exposed to more UV radiation and greater numbers of hazardous ingredients than consumers relying on zinc and titanium-based products.  Sunscreens without these two ingredients contain four times as many high-hazard ingredients known or strongly suspected to cause cancer or birth defects, disrupt human reproduction, or damage the growing brain of a child. [↩]
11. Jeremy Laurance, www.healingcancernaturally.com. [↩]
12. Holick, 73. [↩]
13. Holick, 67. [↩]
14. Farm-raised salmon, fed a diet of pellets, has only 10%-25% of the vitamin D levels of wild salmon….Holick. [↩]
15. There is essentially no vitamin D from any dietary source.  It’s principally found in oily fish or in sun-dried mushrooms and in fortified foods, like milk and orange juice.  But there are only 100 international units (IU) in a glass of milk or vitamin D-fortified orange juice.  We now recognize that for every hundred IU you ingest, you raise your blood level of 25-hydroxyvitamin D [a precursor of the active hormone form] by 1 nonogram per milliliter (ng/mL).”…Holick. [↩]
16. This is a widely-recognized view.  However, Holick believes the risks are exaggerated, “Vitamin D intoxication is one of the most rare medical conditions worldwide.” 72.  Holick recommends “at least 400 IU for adults over the age of 50, and 600 IU for people aged 70 and older.  But now many experts agree that both children and adults need a minimum of 100 IU of vitamin D a day to maintain a blood level of 25-dydroxyvitamin D that we consider to be healthful, which is above 30 ng/mL.” [↩]
17. Suzanne VanDeGrift, “Calcium and Vitamin D:  Partners in Health.” [↩]
18. Laurance, www.healingcancernaturally.com. [↩]
19. Holick, 68. [↩]
20. Holick, 74. [↩]
21. Holick, 73. [↩]
22. www.second-opinions.co.uk/full_spectrum_sunlight [↩]

…Simple “How’s” and Scientific “Why’s”

• Balancing the Inflammatory Response: A Few Simple Steps You Can Take
• Dietary Ways to Manage Inflammation
• Lifestyle Approaches to Manage Inflammation
• Balancing Anti-Inflammatory Omega-3 and Pro-Inflammatory Omega-6 Essential Fatty Acids
• Refined Flour, Blood Sugar, and Insulin
• A Segue to Science…For a Few Underlying Concepts and “Why’s”
• Glossary of Terms
• Summary Guidelines
• Reading Resources
• Omega-3 Recipes

This article aims to outline specific strategies to address pain, inflammation, and chronic disease.  But the greater question remains: why is inflammation so pervasive today?  Why, in a time of great affluence and food abundance should inflammation and chronic disease be so widespread?  The answer lies largely in our modern lifestyle and diet, particularly in the postwar shift away from healthy fats to denatured vegetable oils that foster inflammation while they disrupt the body’s natural metabolism.  I will leave this for next month’s newsletter—for now my focus will be limited to  natural ways to control inflammation.

If you are concerned about inflammation, the overarching idea is to try to eliminate inflammatory foods—refined vegetable oils, trans fats, refined flour, sugar, and high fructose corn syrup.  These are not whole foods and they are not in keeping with tradition.  They are fractured, empty-calorie foods that  fuel the fires of inflammation and chronic disease.

If you take time to read this newsletter, please keep several things in mind.  First, that we do need omega-6 oils, but the goal should be to bring these back in better alignment respect to omega-3s, in a ratio of about 3:1 compared to the 20:1 ratio of today:

“…our balance of omega-6 to omega-3 affects our health as much as any other aspect of dietary fat…Because the ratio of omega-6s to omega-3s helps determine the flexibility of cell membranes, nearly all chemical communication throughout the body depends at least in part on the correct balance between omega-6s and omega-3s.  Within this context, it is difficult to imagine any health problem that isn’t partly related to the ratio of omega-6 to omega-3.” ¹

 

A second idea to remember is that we need both stable saturated fats like butter and coconut oil for the structural integrity of cell walls, as well as omega-3s and omega-6 fats for the flexibility of cell membranes.  Unsaturated omega-3 and omega-6 fats are needed for cells to carry out highly sophisticated neurological and electrical communication functions.

Finally, I mention in this newsletter fish oils and the role that they can play to help cool inflammation, but a supplement like this works best against a supportive diet.  The most important step we can take is to shift away from inflammatory foods.  By doing so, we remove logs from inflammation’s burning fire.  A fish oil supplement is like placing our trust upon a candle snuffer to put out the flames.  Far more important is to stop feeding the fire with inflammatory foods.

Realistically, to eliminate inflammatory foods means that we need to know where our food comes from.  This is the very best way to eliminate pro-inflammatory vegetable oils and trans fats that are hidden in prepared foods—as well as inflammatory refined sugars and white flour products.

When we shop for and cook with whole foods that are in keeping with tradition, we naturally incorporate plant foods’  vital force energy, as well as their antioxidants, phytonutrients, and fiber (July08 newsletter).   Plant foods help prevent oxidation and inflammation as they regulate the immune system and assist its proper functioning.  Whole foods, sunshine, fresh air, moderate exercise, meaningful life work, and a sense of gratitude are all natural nutrients to build a fertile terrain for our proper genetic expression.

The body’s inflammatory response is vital for survival.  It is always on guard and comes to our defense against foreign bacteria, viruses, and other invaders.  It also goes to work immediately to help us recover from injury and traumas.  Through natural selection, we are genetically prone to inflammation since before the days of antibiotics and modern medicine a strong inflammatory response was necessary in order to survive.

Even though inflammation safeguards our health and wellbeing, in modern times it has acquired a bad reputation.  Science tells us to blame inflammation anytime we feel pain, since pain is a sign of inflammation.  And,  we also know that inflammation, the subtle ongoing “silent” kind that we do not feel, plays an important role in most, if not all chronic disease—heart disease, type 2 diabetes, cancer, Alzheimer’s, arthritis and joint pain, auto-immune disorders, and allergic diseases—to name a few.

If inflammation helped our forebears to survive in a hostile world, why is it now seen as such a health threat?  The answer again comes from the science lab.  Research tells us that our modern diet and inactive lifestyle are the two factors most to blame for silent inflammation and chronic disease.

In my mind, the diet part of the inflammation story has two sides:

1. The shift that has happened in just a few decades away from grass-fed animal products and other foods with healthy omega-3 fats toward processed foods rich in inflammatory omega-6 refined vegetable oils:  Today, we consume 25 times more pro-inflammatory refined liquid vegetable oils than a century ago, but only a third as much stable, nutrient-dense butter.
2. The transition over the same period away from whole grains and other antioxidant-rich whole foods toward sugars and refined flour products that provide calories but are stripped of vital nutrients.  It is really the simple matter of refined products…oils, sugars, and grains…both “crowding out” the traditional whole foods that we are genetically programmed to eat, as well as the massive quantities of fractured products in the modern diet that overwhelm the modest levels of good nutrition that we still take in.

Like diet, our lack of exercise also plays a role in the inflammation/chronic disease story.  This is because exercise is necessary to moderate insulin, contain abdominal fat,² and control the body’s natural inflammatory response.  Moderate daily exercise and a healthy diet are two of the most powerful anti-inflammatory strategies of all.

Just think.  There is so much that we alone can do to manage and even reverse pain and inflammation without having to rely upon medications.  Medications, while sometimes required, work by interfering with the body’s normal processes and their synthetic nature makes them foreign and, to varying degrees, toxic.  In contrast, whole foods, with their vital force energy intact, are ideally suited to nourish the human body, cleanse it, and restore it to health.

Because I see inflammation as an underlying factor in many people’s health concerns, I want to use this newsletter to share some thoughts on inflammation.   My goal is to keep things simple.  Then for those of you who are interested in science, to support these ideas with some underlying concepts related to insulin, “belly” fat, cortisol, and oxidative stress—and the role they play in the inflammatory process (found below).

Balancing the Inflammatory Response: A Few Simple Steps You Can Take

It is true that inflammation is a complex topic, but we do not have to understand it and its underlying dynamics to take actions to overcome its dark side.  As mentioned, many scientists have been at work to unravel its mysteries and then guide us in what we should do.  Perhaps none is more famous than Dr. Barry Sears.   I am indebted to him, as well as to the pioneering work of Mary Enig, Paul Pitchford, Mark Hyman, and a host of others for helping me shape my own thoughts into the following list.  While I do not intend to tell you what to eat (we each need different foods), if you are concerned about inflammation, the following measures can be helpful. [Supporting reasons found below.]

Return to the table of contents.

Dietary Ways to Manage Inflammation

• Cut out inflammatory foods.  These include processed refined sugars, grains, and flours; high fructose corn syrup (HFCS); products from grain-fed animals; trans fats; and refined “white” vegetable oils—especially those derived from corn, soybean, and cottonseed.  These and other “cheap, stripped” oils are often found in commercial salad dressings and processed foods and are loaded with omega-6 inflammatory fatty acids (Tables 1 and 2, below).  Limit consumption of the nightshade vegetables—potatoes, tomatoes, eggplant, peppers, tobacco—which have an alkaloid, solanine, which can exacerbate pain caused by inflammation.
• Eat whole foods, especially colorful, nutrient-dense plant-based foods rich in anti-oxidant phytonutrients (to contain oxidative stress) and with a low glycemic index (to control insulin).   Or, combine higher glycemic color-rich personal favorites with good fats and proteins, which also work to control blood sugar and insulin. [October '07 Newsletter]
• When possible, choose grass-fed animal products, which have an ideal 1:1 ratio of omega-3/ omega-6 fatty acids.  This healthy balance of omega-3 and -6 fatty acids means that grass-fed animal products are “neutral” with respect to inflammation.  [September '09 Newsletter]
• Use good fats and oils.  For the dinner table choose extra-virgin olive oil—low in omega-6 fatty acids, it is essentially “neutral” concerning inflammation.  Also at the table consider flax oil and flax meal [See recipes, below].  For cooking, try stable fats like butter or ghee from grass-fed animals, as well as unrefined coconut oil.  Coconut oil is high in lauric acid, an anti-microbial that fights bacteria and viruses that can lead to inflammation.³ ( Table 2, below)
• Consider a daily fish oil supplement.  Fish oil is the most powerful and efficient way to reduce inflammation.  Supplementing with fish oil is important because you cannot get enough by eating fish.  This is because most beneficial fish oil is in the skin and is lost in cooking; and, of course, the skin is often not eaten.  I prefer fermented cod liver oil⁴ as a rich source of vitamin A, vitamin D, EPA and DHA.  EPA inhibits enzymes that foster inflammation, while DHA is vital for brain function.  Fish oil is the only direct source of EPA and DHA.  For specific tips on using fish oil, see below. [Flax oil is not a comparable substitute for fish oil since it must be converted to EPA.  This requires healthy functioning cells and adequate levels of vitamins B3, B6, and C, and magnesium and zinc—which cannot be counted on.]
• Cook with anti-inflammatory herbs, and spices such as turmeric and ginger.  These inhibit the enzyme that makes arachidonic acid (AA), the precursor for inflammatory hormones.  Turmeric, ginger, and rosemary are also powerful antioxidants.
• Eliminate any potential food allergens (e.g., wheat, corn, soy, egg whites, gluten, dairy, yeast, peanuts) in order to support and restore both intestinal health and immunity (see Probiotics, below).
• Try to buy organic produce, especially when purchasing fruits and vegetables with very high pesticide levels (See Table 3, below).   Pesticides and toxins disrupt good intestinal flora and weaken the immune system.  Both of these factors create inflammation.
• Consider probiotics (e.g., fermented foods [July '09] or a high-grade probiotic supplement) to maintain and/or to restore good intestinal bacteria.  Inflammation is tied to “gut” health in several ways:   First, because “good” intestinal bacteria are the backbone of the immune system;⁵ and a healthy immune system is important to manage the inflammatory response.    And second, because good bacteria are essential to protect the delicate intestinal wall. The intestine works as a sentry—no food enters the blood stream without passing through the mucosal lining of the digestive system.  Nothing “gets into” the body without passing through this barrier.  But, this lining is fragile; it is only one cell in depth, and stretched out, spans the size of a tennis court.  If the barrier is damaged, toxins and undigested foods can enter the blood stream (“leaky-gut syndrome”) ⁶ to create allergic reactions and autoimmune disorders.
• Eat adequate protein with each meal to balance blood sugar. The concept of a Barry Sear’s “Zone Diet” is to have every meal include moderate portions of protein, carbohydrate, and fat, where a protein serving is defined as 3-4 ounces.   This balance curbs insulin (the nutrient/fat storage hormone that responds to blood sugar spikes from carbohydrates) and stimulates the secretion of glucagon (the hormone that assures the flow of glucose for the brain by causing the release of glycogen from the liver).

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Lifestyle Approaches to Manage Inflammation

• Moderate aerobic exercise 5-6 days a week helps prevent insulin resistance. A brisk 45-60 minute walk is perfect. [Excessive exercise, no matter how good the diet, is inflammatory and does more harm than good.⁷ ]  Moderate aerobic exercise raises your heart rate and stress level, which forces your cells to become more responsive to taking up glucose from the bloodstream.  When this happens, it relieves the pancreas, allowing it to secrete less insulin into the bloodstream.  It is important to keep insulin at bay, because insulin boosts arachidonic acid (AA), a precursor of inflammatory hormones.⁸
• Weight trainingseveral days a weekcan help reduce insulin levels and strengthen immunity.  Unlike aerobic exercise which burns fat, strength training burns glucose so it does not directly melt away fat stores.  But, by building muscle, what it does do is to make it easier for the body to gobble up glucose from the bloodstream, so less insulin is required.  Greater muscle mass also boosts immunity because the body stores amino acids in the muscles, including glutamine, which is a major building block of specialized immune cells.⁹
• Avoiding “visceral” (belly) fatcurbs chronic inflammation. This is because the body uses visceral fat as a place to store excess AA (a precursor of inflammatory hormones) in order to prevent high AA levels and inflammation from affecting vital cells.  Visceral fat is metabolically active and allows for the steady release of stored AA into the bloodstream, where it can then be taken up by the cells.”¹⁰ In short, belly fat fosters inflammation, which leads to more fat deposits, which creates more inflammation.
• A regular relaxation strategy helps  lower cortisol levels. Cortisol is an anti-stress hormone whose job it is to turn off the inflammatory response, but constant stress and chronic inflammation keep it elevated.   Mediation, yoga, deep breathing or any quiet relaxation for 20-30 minutes a day can help normalize cortisol.  And, deep breathing helps to expel toxins, free radicals, and inflammatory agents from the body.
• An early bedtime and enough sleep honors the body’s natural biorhythms. The hours before midnight are the most efficient for restoring the body.  Sleep is the body’s own form of natural mediation.   Sufficient nighttime sleep allows cortisol to follow its natural cyclical ebb and flow, dropping off around midnight and peaking about sunrise.¹¹

Balancing Anti-Inflammatory Omega-3 and Pro-Inflammatory Omega-6 Essential Fatty Acids

If you are a regular reader of this newsletter, you may recall that our forebears consumed a diet that was balanced with respect to omega-6 and omega-3 fatty acids., something around 1:1 or 2:1.   But today, for the typical American, this ratio is now is around 20:1, weighted toward inflammatory omega-6 oils.  Our modern diet of processed, convenience foods is one factor that explains this shift, since food companies rely upon refined, white vegetable oils like corn, soy, and cottonseed because they are cheap and have a long shelf life (there is nothing left to go rancid).  Another aspect is that many modern households have grown to fear healthy saturated fats like butter and unrefined coconut oil and have switched to inexpensive vegetable oils, often believing that they are a healthier choice, and perhaps, too, because they have a long shelf life.   Looking at the table below, which outlines the omega-6/omega-3 ratios of a variety of oils, we can easily see how this omega-6/-3 ratio could soar to 20:1.  Corn, safflower, and cottonseed oils are frequent ingredients in salad dressings and other prepared foods, and their omega-6/-3 ratios range from 72:1 for corn to 234:1 for cottonseed oil (Table 1, below).

Table 1: Competition of Omega-6s “Crowding Out” Omega-3s in a Variety of Cooking and Salad Oils

Source: Pathways4Health, Derived from Mary Enig’s Know Your Fats

Note:  These simply reflect omega-6 versus omega-3s.  For a more complete picture and overview, see Table 2 that follows.

Table 2 provides a broader profile of nut and seed oils.  It shows omega-3s and -6s fatty acids within the context of other fat components.  Note that most oils are a composite of a variety of types of fatty acids.  Try to avoid those where the majority of the oil is pro-inflammatory omega-6 such as safflower, sunflower, corn, and soybean—between half to three-quarters of these oils are inflammatory omega-6s, with little to no anti-inflammatory omega-3 offset.  Olive oil and saturated fats such as butter and coconut oil have very little omega-6s, and are therefore thought to be “neutral” with respect to inflammation.  [Most experts believe saturated fats like butter from grass-fed animals and unrefined coconut oil are good choices unless chronic inflammatory conditions are deeply rooted.¹² ]

Table 2:  Composition of Nut and Seed Oils; A Guide to Choosing Oils to Fight Inflammation

Source:  Udo Eramus and Pathways4Health

Refined Flour, Blood Sugar, and Insulin

The chart above suggests that whole grains are a better choice than refined flour products for controlling blood sugar.  Fracturing a grain raises it blood sugar impact: for example, instant oatmeal (a fractured product) has a glycemic index (GI) of 82 about twice that of steel cut oats (42).   If we do choose to eat refined flour products like white bread we can reduce the insulin effect by combining these with low-glycemic proteins/fats (e.g., turkey, eggs, and nut butter).  Refined flour is, of course, not eaten alone.  It is often baked with ingredients such as eggs, fats, nuts, which lower its GI—a sweetened whole-grain muffin can have less impact on blood sugar than a serving of soaked, whole grain brown rice!  This may sound strange but I learned this from research on grains and blood sugar by my friend Ellen Arian, a teacher, consultant, and professional whole foods chef.

Table 3:  Produce to Buy Organic to Avoid Pesticide/Herbicides

The Test: The data used to construct the list considered how people normally wash, peel, and prepare the specific produce before eating.  The results are compiled from some 42,000 tests for pesticides on produce gathered between 2000 and 2004.

A Segue to Science…For a Few Underlying Concepts and “Why’s”

Insulin’s Tie to Inflammation: Insulin controls the metabolism and uptake of nutrients by the cells—so it is really a storage hormone, both for fat and for nutrients. A high carbohydrate diet of refined grains/flours and sugars forces the pancreas to speed up insulin production to contain blood sugar levels.  Also, with the aging process, people tend to become more resistant to insulin, so the pancreas must produce more insulin to assure that nutrients are taken up by vital cells.  When chronically elevated, insulin increases AA levels¹³, and AA is a building block of pro-inflammatory hormones. [High insulin levels do not allow the burning of fat since insulin (a storage hormone) prevents the release of fat into the bloodstream.  Eating sufficient protein can be helpful for weight loss, both by controlling blood sugar and by stimulating the production of glucagon (See glossary, below).

Abdominal Fat’s Role in Inflammation: Through natural selection, we are genetically prone to produce large quantities of insulin—a necessary trait for survival when the efficient storage of calories was critical in times of food scarcity.  Now, of course, we live in an environment with readily available refined carbohydrates and sugars and where this traditional fat-storage survival mechanism can easily work against good health, through the accumulation of excess, active fat.

Inflammation and belly fat are closely related because insulin increases AA levels.  When this happens, abdominal fat cells are programmed to sequester AA in order to protect vital cells from excessive AA, the precursor of pro-inflammatory hormones.  But, when AA accumulates and becomes heavily concentrated in “belly fat” (the body’s dumping ground for AA), this visceral fat can begin to actively produce pro-inflammatory hormones, which then leads to the production of pro-inflammatory cytokines, which can enter the blood stream and fuel inflammation. As Barry Sears explains:  “Fat cells can work like immune cells, releasing cytokines as you gain weight.  Cytokines make cells resistant to insulin, so the body pumps out more and more insulin, which increases the production of more and more cytokines.”¹⁴

Cortisol’s Tie to Inflammation:  Cortisol leads to insulin resistance and lowered immune function. Cortisol is the major anti-inflammatory/anti-stress hormone assigned to turn off excess inflammation and the “fight-to-flight” response.  But, under the conditions of chronic inflammation or chronic stress—either emotional or physical—quite the opposite happens.  Stress causes cells to produce pro-inflammatory hormones—and, in response, the adrenals pump out more cortisol to try to extinguish the fire.  The constant fires that result from chronic stress (stress can stem from excessive exercise, overeating, missing meals, caffeine and other stimulants, excessive weight, etc.) forces the body to counter with more and more cortisol.  Thus, chronic stress leads to persistent high cortisol levels—and as your body adapts, you become more cortisol resistant and you need more cortisol.  More cortisol leads to more abdominal fat (since high cortisol fosters insulin resistance), as well as a depressed immune system (since cortisol’s job is to shut off the immune system).  Persistently elevated cortisol levels pose a variety of risks, including muscle and bone loss, fat gain, elevated blood sugar, high blood pressure, weakened immune function, loss of memory, and mood swings.¹⁵ Mediation and other forms of relaxation help to reduce cortisol levels and give the body some breathing time to normalize.  A helpful tip when you are unavoidably stressed is to increase your intake of fish oil, as a natural way to help cool and curb inflammation.

Oxidative Stress and Inflammation.  Diet is a key underlying factor of oxidative stress and weight gain.  A diet centered on sugars and refined carbohydrates and without sufficient antioxidants from whole vegetables and fruits allows free radical damage, known as “oxidative stress.”  Oxidation is a normal process:  an apple slice browns when exposed to oxygen, but if dipped in lemon juice, its antioxidants keep an apple slice looking fresh.  Oxidation like this also happens inside the body if antioxidants are not sufficient. Oxidation disrupts metabolism, making it less efficient, setting the stage for weight gain. Weight gain and inflammation are, thus, set in motion (see comments about abdominal fat, above).

Plant Foods for Inflammation. Plants are the leading adaptagens.  Plants are at the forefront of nutritional innovation, adapting to new environmental conditions and creating the anti-oxidants and phyto-nutrients to survive change.  Eating plant foods, especially from our local area, helps us to adapt to the seasons and to longer-term climate shifts.  Choosing a wide variety of plant foods across the color spectrum also helps prevent free-radical damage and inflammation. (Table 4, below; and July '08 Newsletter for complete discussion.)

Glossary of Terms

EPA… eicosapentaenoic acid, a prominent ingredient of fish oil, it inhibits the enzyme that converts by-products of omega-6 oils into arachidonic acid (AA), a precursor of inflammation.

DHA… dihomo-gamma-linolenic acid, found in fish oil, is vital for normal brain function and can be converted to EPA, so it also plays a role in fighting inflammation.

AA… arachidonic acid, is a building block of inflammatory hormones.  Excessive dietary levels of omega-6 oils (linoleic acid) relative to EPA and GLA (found in evening primrose oil) fosters AA and inflammation.

ALA… alpha-linolenic acid…in flaxseed oil, which inhibits the delta-6-desaturase enzymes that decreases both anti-and pro-inflammatory hormones but does little to disarm AA.

Insulin…the nutrient/fat storage hormone that responds to spikes in blood sugar. It has an indirect affect on inflammation by increasing AA levels.

Cortisol… an anti-stress, anti-inflammation hormone produced by the adrenals.  Its job is to turn off the inflammatory response (the immune system) when it is no longer needed.

Glucagon… the major hormone that controls the flow of glucose energy to the brain by signaling the liver to release glycogen.

For a comprehensive scientific explanation of these terms and a thorough discussion of inflammation dynamics, see Barry Sear’s The Anti-Inflammation Zone.

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Table 4:  A Color Spectrum of Fruits and Vegetables

Source: Textbook of Natural Medicine, J. Pizzorno Jr. and Michael T. Murray

Summary Guidelines

The most important step you can take is to know where your food comes from.  This is the best way to avoid excessive pro-inflammatory omega-6 oils and trans fats—and to limit the consumption of refined flours, sugars, and high fructose corn syrup. More specifically:

1. Eat good protein (e.g., from grass-fed land animals) with meals to help control blood sugar and insulin;
2. Know the “good” fats and oils. Consider a high-quality fish oil supplement.  Use omega-3s and omega-9s (at the table) and saturated fats (for cooking) while you limit pro-inflammatory omega-6s fatty acids.
3. Rely on whole grains and fruits and vegetables  as carbohydrate sources, rather than sugars and refined flour products, to control blood sugar and insulin as well as oxidative stress.
4. Get Moderate Daily Exercise: Do aerobics 5-6 times and strength training 3 times a week, to control insulin and inflammation.
5. Get enough sleep to synchronize cortisol and to curb cravings for sugar and refined carbohydrates.  The most efficient sleep hours are those before midnight.
6. If you take a fish oil supplement, quality matters. Fish oil is best absorbed when taken with other foods.  Orange juice or sucking an orange slice helps to dissipate the taste.  I believe reliable sources of cod liver oil to be Green Pastures and Radiant Life;  and for fish oil, Vital Choice, Omax3, and Pharmax (orange flavored).  You may want to research these and others on your own.

If you are concerned about inflammation, ask your doctor for a C-reactive protein (CRP) blood test.

Reading Resources

• Natasha Campbell-McBride, Gut and Psychology Syndrome
• Mary Enig, Know Your Fats
• Udo Erasmus, Fats that Heal, Fats that Kill
• Mark Hyman, UltraMetabolism
• Bruce McEwen, The End of Stress As We Know It
• Paul Pitchford, Healing with Whole Foods
• Joseph Pizzorno, Jr. and Michael T. Murray, Textbook of Natural Medicine
• Barry Sears, The Anti-Inflammation Zone
• Shawn Talbott, The Cortisol Connection

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Omega-3 Recipes¹⁶

Flax is the richest source of omega-3 fatty acids, but its conversion to EPA and anti-inflammatory prostaglandins requires the presence of vitamins B3, B6, and C, as well as zinc and magnesium.  It is useful for the treatment of a variety of issues including inflammatory conditions, cancer, diabetes, high blood pressure and heart disease, immunity, and weight loss (since supports energy metabolism).¹⁷

Omega Pesto Sauce

[Omega3: Omega-6 Ratio  1.0 to 0.8 ]

3 cloves garlic
3 T. chopped walnuts
3 T. flaxseed oil
1 T. flax meal
2 T. balsamic vinegar
2 cups fresh basil leaves
½ cup grated Parmesan cheese
1/3 cup extra-virgin olive oil

In a food processor or blender, add ingredient on at a time, blending after each addition until smooth.  Pesto can be stored in an air-tight container in the refrigerator for use within a couple of days.

Can be served as a garnish with fish.

Flax-Olive Oil Vinaigrette

[Omega-3 to -6 ratio  1.0 to 0.4 ]

2 T. flaxseed oil
¼ cup balsamic vinegar
2 T. extra-virgin olive oil

Whisk together.  Use on salads and steamed vegetables.

Omega Mixed Green Salad

[Omega-3 to -6 ratio  1.0 to 1.5 ]

8 cups romaine lettuce
2 medium cucumbers
4 cups baby spinach
½ cup grated carrots
1 cup chopped fresh basil
2 T. chopped walnuts
1 cup chopped fresh parsley
4 T. flax meal

In a large bowl, toss together the romaine, spinach, basil, parsley, cucumbers, and carrots.  Scatter walnuts and flax meal over the salad.

Copyright 2010 Pathways4Health.org

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1. Haas, Staying Healthy With Nutrition, 68. [↩]
2. “Inflammation and abdominal fat accumulation are inextricably linked,” Shawn Talbot, The Cortisol Connection, 35. [↩]
3. Enig [↩]
4. Available from Green Pastures and Radiant Life. See January 2010 Shopping Guide. [↩]
5. See Natasha Campbell-McBride, Gut and Psychology Syndrome, 25-30. [↩]
6. Primary causes of “leaky-gut” syndrome include low-fiber, high-sugar, refined-flour, and processed foods; overuse of medications, such as NSAIS, antibiotics, acid blockers, hormones, steroids, and birth control pills; toxins such as mercury and molds; low-grade imbalances, such as yeasts, parasites, and bad bacteria; and stress…Mark Hyman. [↩]
7. Dr. Barry Sears, The Anti-Inflammation Zone. [↩]
8. Sears, 24. [↩]
9. Sears, 106. [↩]
10. Sears, 238. [↩]
11. See Bruce McEwen, The End of Stress as We Know It. [↩]
12. Art Akers, PhD, “Cooling Inflammation;” and Mary Enig. [↩]
13. Sears, 24. [↩]
14. Sears, 18. [↩]
15. Talbott, 41. [↩]
16. Source:  Evelyn Tribole, The Ultimate Omega-3 Diet [↩]
17. Udo Eramus, Fats the Heal, Fats that Kill, 282-3. [↩]