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He soon emails me an article from European Review of Medical and Pharmacological Sciences. I click it open.
‘The inflammatory response was developed over millions of years and allowed us to coexist with a number of microbes. The same inflammatory response also made it possible to repair physical damage . . .’
Okay, I think, acute inflammation is an ancient mechanism with benefits, millions of years old . . .
‘But there are also equally important anti-inflammatory mechanisms in the inflammation cycle that allow cell repair and renewal. Only when these two phases are continually balanced can the cells effectively repair the small damages that arise with inflammation.’
This is new to me. Does this mean there’s a need for balance inside the system itself – perhaps that just as there’s an inflammation yin, there also needs to be an inflammation yang?
‘But if the proinflammatory phase continues in a low but chronic level under the pain threshold, it can drive many chronic illnesses. In the end it can result in organ damage, loss of organ function and lead to severe illness, in spite of the fact that the initiating illness-causing events may have taken place decades earlier, triggered by an underlying and ongoing chronic inflammation process.’
So, low-grade inflammation arises from imbalance – from a steadily ongoing inflammation that doesn’t cause a ‘fire department’ type of acute inflammatory response but in the long run can act as a catalyst for small seeds of illness that have been germinating in the body for a long time.
Is this the type of inflammation that we bring about through an unhealthy lifestyle? In other words, might bad nutrition, stress, environmental toxins and other lifestyle factors give us inflammation, which in turn makes us sick? Perhaps that’s why the wrong food can lead to illness and not just to us ingesting too many calories.
And is it true that long before we actually become ill, the low-grade inflammation affects us so that we start to ‘lose steam’? When I went to the doctor complaining about my back pain, depression and listlessness and looked for explanations based on external things (‘the kids are moving away from home’), maybe it was actually a low-grade inflammation, an imbalance in my immune defence caused by a number of lifestyle choices, leading to my bad back, blue mood and bloated stomach. And maybe this is what I’ve ‘cured’ with my new lifestyle choices?
I go on looking to see if my symptoms, like back pain, fatigue and a ‘low’ feeling, could have been signs of low-grade inflammation. I find the following symptom list:
• The skin looks older, is drier, and has more wrinkles
• Lower energy
• Less stamina when exercising
• Swelling in the face
• Swelling around the belly
• Increased risk of either constipation or loose bowels
• Less ability to concentrate
• Fluctuating appetite
• Fluctuating blood sugar levels
• Weaker immune defence
• Joint pain
• More depressed mood
I can tick off several of the points but not all. So far, we’re just talking about what a doctor would call ‘everyday troubles’. But how does inflammation work in relation to serious illnesses?
I realise that I’ll have to become a detective in order to get to the bottom of this riddle. No single researcher seems to have the whole picture. I will have to solve a jigsaw puzzle.
A few years earlier, an editor in a publishing house gave me a book called Anticancer. I didn’t read it then, but one day it falls off the bookshelf as if some friendly soul in there wants to help me on my way. It turns out to be a good lead.
The book is by the French neurologist and Médecins Sans Frontières activist David Servan-Schreiber, who developed a brain tumour at the age of thirty and set out on a journey of knowledge to save himself. In the book, which became a bestseller in many countries, he reported on some of the leading research about the essence of cancer, as well as strategies for keeping up resistance. Servan-Schreiber eloquently describes how cancer and inflammation are intertwined and drive each other on in a kind of evil witch dance.
‘I realise that I’ll have to become a detective in order to get to the bottom of this riddle. No single researcher seems to have the whole picture. I will have to solve a jigsaw puzzle.’
A tumour is a number of cells that begin to grow wildly and unchecked. In the beginning, there’s enough nourishment for the tumour in its immediate surroundings, but after a while it outgrows its small neighbourhood. The tumour now begins to operate with a devilish intelligence, causing an inflammation around itself. Why? Fascinated, I continue reading. The tumour uses the inflammation to manipulate the immune defence and make it ‘attack’ the tumour from inside.
Once the immune defence has got into the tumour, it faithfully begins to work according to its usual procedure when it encounters inflammation, which involves, among other things, producing certain substances that are going to help repair the tissue. It’s just that the tissue being repaired this time is an enemy – the tumour itself. The immune defence is literally fooled by the tumour. Instead of protecting the body against the tumour, it begins to fuel its further growth out into the body. New blood vessels are built to bring new nourishment to the tumour, and little supporting structures help to anchor the tumour even further.
To sum up, the tumour creates an inflammation that in turn feeds the tumour, which in turn creates even more inflammation in its surroundings, spreading the disease further. The effect of the inflammation is like pouring petrol on the cancer fire. That’s why cancer is such a diabolical disease and so hard to fight.
Professor Björck has also explained that inflammation is linked to coronary artery disease, obesity, diabetes 2 and joint problems. Is it true then that inflammation is either the basic cause, or least the promoter, of our main public health diseases – the diseases that cause so much human suffering – as well as ageing and human breakdown?
And how does inflammation work, generally? Is it like a wildfire that burns down the healthy parts of a human being? Or more like a flood wave that beats and beats against a barricade until it finally falls apart? Or is it more like a low-level conflict between two people that distracts and weakens them so they are no longer able to defend themselves against an external threat?
Which one is the most reasonable scenario? I must keep searching.
But right now, I can state one thing that seems obvious: low-grade systemic inflammation is harmful and either triggers or speeds up disease. At this stage it’s also apparent that there are foods that counteract the broad negative effects of inflammation and that these foods to some extent are similar to the Rita Diet, which is like the Inger Björck Diet – and also like the David Servan-Schreiber Diet, which kept him alive for almost twenty years after his brain tumour diagnosis, even though he was supposed to survive for only a few months.
I have found a lot to think about, and I’m encouraged about my new lifestyle. In general, I’ve started to like the ‘Rita programme,’ as I still call it. And I’ve begun to feel results. They are modest results, but noticeable. My body is stronger, my belly flatter and I’m sturdier both in my psyche and across my shoulders.
‘You seem stronger, Mum,’ says my older daughter, unexpectedly.
That’s good. I want to feel strong, and my new lifestyle grounds me with a new feeling of security. I’m slowly gaining more insights into this lifestyle, about what it is and what it’s like to live it and not just talk about it. It’s both surprisingly simple and complex, since it demands a new kind of awareness.
To have an anti-inflammatory lifestyle was never a goal in itself for me. I hadn’t even heard of this as a lifestyle until that fresh spring evening in Lund, when I was already a few months into my new lifestyle. I just thought I would get a training programme via the internet.
The fact is that I don’t have time to spend dealing with food and exercise, I don’t feel like losing weight and I can’t spend all my energy on it since I have a life to live too. You have to live your life in the human village, as Mowgli says in The Jungle Book. You can’t live a life that’s too different, because that’s like settling down on a dry little patch of grass by yourself outside the village, surrounded by your pills, protein powders and strange food. As a mother of four, I neither can nor want to live like that. After all, I live in a very loud and lively human village that consists of family, job and friends, a context that’s much bigger than just me.
But still I’m driven onwards by this new feelgood sensation. The biggest change is that I have to start planning for eating well, to go from a lifestyle where I eat whatever I happen to find, or what tastes good, to strategically planning my food intake for health.
People say that if you fail at planning, you plan to fail. Everyone who has children learns to plan food at home to some degree. It doesn’t work to come home from work tired and have hungry kids digging through the fridge. (Those evenings always end with fries, fish sticks and ice cream . . .) You just have to learn to be a few steps ahead. It’s easy when it’s about the children, but to think like that about my own nutritional needs is something I’ve never done.
The first thing I need to learn is how to eat in a more conscious and planned way, and that also includes thinking about my specific needs. It sounds pretentious and, above all, time-consuming. Let me explain.
We humans have a limited window from the time a feeling arises to when we want to act on it. The more we’re aware of that window, the more impulse control we have and the smarter we get. But when it comes to food, hunger and eating, this control is being disabled by the miraculous innovations of the modern food industry.
Today we can get hungry one minute and theoretically find food within the hour, as long as we don’t find ourselves in a kayak on an expedition along the northeastern coast of Greenland, or looking for hidden treasure in inner Amazonia. There are little biscuits in the pantry and fig marmalade in the fridge. At work, there are some leftover biscuits by the coffeemaker. At the counter at the 7-Eleven are ready-made sandwiches. Our ability to plan food and think strategically about food doesn’t bother trying anymore. It simply isn’t needed.
I begin to think about how I in particular, and human beings in general, have ended up here.
Just imagine if we were as spontaneous about getting ourselves to work. We would get up and get ready, and just as we were leaving the house, we would begin to think about how to get there and what address we’re going to. But of course we don’t do that.
Most people check the calendar in advance to see what time the meeting is, Google addresses, check that the car has petrol, look up the tube lines, and see how far we have to go between the station and the meeting place. Not many of us would get to our jobs or our meetings on time if we didn’t do all this. We need an inner map. A road plan.
We need this for food as well.
This is what I have to learn – that in the pause between feeling and action, there’s a rainbow leading to a pot of gold, and it’s easier to find that pot if I’m well prepared.
My basic plan becomes this: I plan how I’m going to eat as soon as I wake up in the morning. I plan for a good day. Many people do that anyway when it comes to work, family and leisure activities. Why not do it for your own health as well?
In Rita’s plan I wasn’t given calories, quantities or forbidden foods. Instead, I have a number of guidelines. The most important thing is to eat food that is as unprocessed as possible – food that you could pick, fish or hunt. ‘Made by nature, not by man,’ as someone I met said.
Rita doesn’t just want me to reduce sugar – something that I’ve known I should be doing for a long time – but also to avoid bread and pasta, which get broken down into glucose, or sugar. She wants me to replace these with sweet potato, quinoa and brown rice. She wants me to eat protein-rich foods, often and in large quantities. Four or five times every day, I’m supposed to eat eggs, turkey, mussels, prawns, fish, meat or vegetarian protein. Can I even eat that much protein? I’m supposed to eat lots of leafy greens and vegetables, preferably four times a day. And good fats like olive oil, coconut oil and nuts. All this advice goes into planning four or five meals per day.
Now this advice needs to be transformed into habits that will work in my everyday life. Then I have to have time for work and also exercise four times a week. It’s stressful. How is that supposed to happen?
I can be undisciplined and lazy, with a tendency to overeat. Even worse, I tend to eat for emotional reasons: when I’m anxious, bored or exhausted; or when I just have a craving for something good and make the usual mistake of satisfying this craving with food that ends up giving me only momentary relief.
How am I supposed to manage to eat in such a disciplined way?
I face several big challenges, which begin as soon as I wake up. I continue to look for a new standard breakfast. I don’t want to have to think in the morning, when I’m a little sleepy and everything’s spinning around in my head. What can I come up with?
Most of what goes into a typical Swedish or British breakfast is wrong, according to the new thinking. Juice, bread, yogurt, cheese, rolls, cereal – none of that works anymore. So I look for something that can become the new breakfast.
I test different things and arrive at smoothies for breakfast. Almond milk, berries, nuts and protein powder. It breaks up our family’s mornings, since my habits are so different.
Snacks are simple: a couple of hardboiled eggs and a tomato; nuts and fruit. But dinner demands more thought.
I was no cook before I became a mother, but once I had children I became interested in cooking to nourish the family and create a happy mealtime. In my old life, it was easy to make food taste good and dress things up with extra butter, sugar, cheese and breading, or by frying, adding good bread toasted with garlic butter, and so on. There were soup and pancakes on Thursdays. My husband cooks just as often, usually with extra everything.
ANTI-INFLAMMATORY VEGETABLES AND MUSHROOMS
Think of the rainbow – purple, blue, green, yellow, orange and red. The more colours you eat every day, the prettier your plate and the more beautiful you will be, inside and out, since each colour represents a certain kind of active polyphenol.
• Asparagus
• Aubergine
• Beetroots
• Pak choi
• Broccoli
• Brussels sprouts
• Cabbage – white, red, cauliflower, green cabbage
• Celery – celery root and stalks
• Courgettes
• Cucumber
• Dandelion leaves
• Endive
• Fennel
• Kohlrabi
• Mushrooms – white mushrooms, ceps, oyster mushrooms, chanterelles
• Nasturtium
• Nettles
• Onion – red, yellow, garlic, leeks, spring onions
• Parsnips
• Peppers – red, orange, yellow and green
• Radishes
• Salad – rocket, iceberg, mâche – go wild!
• Spinach
• Sprouts – alfalfa and all others
• Tomatoes
• Watercress
Certain vegetables, like beetroots, parsnips and celery root, have a higher glycaemic index (GI) value than others. Mix them with vegetables that have a lower GI value, for example beetroots on a bed of rocket with a dressing of vinaigrette and nuts. Perfect!
I still want to eat good food, feel satisfied and enjoy food together with my family, by myself or with friends or colleagues, so I have to become more creative. But I don’t have all the time in the world.
I decide to compromise. I plan meals with food that is natural but with a little glamorous twist. A little more taste, a little more spice, good sauces and dips made of tomatoes, avocado, grilled vegetables, spices, oils and garlic.
The trick is to achieve good proportions. A plate divided into four parts, where 25 per cent is protein, 25 per cent salad, 25 per cent other vegetables and 25 per cent rice or quinoa – more or less.
But there are many challenges.
‘Where’s dessert?’ asks my son, with his big brown eyes. ‘You used to make that good chocolate cake.’
It’s true. Since I started cooking with my new method, I’ve increasingly lost interest in baking big, fluffy cakes. It’s not about body weight but just the feeling that I want to serve my family something other than 2 cups of sugar, which my former prize cake contained.
So I experiment, with mixed results.
‘Sorry, Mum, but this is a failure,’ my blue-eyed son laughs when I serve his best friend some courgette cake.
The friend is too polite to say anything, but he stares listlessly at his piece of cake. A few strips of courgette are swimming around like threads in the dry almond flour.
My brown-eyed son brings his new girlfriend home, and I serve them some protein muffins. I’ve found a recipe with protein powder, sweet potato and almond flour. The new girlfriend smiles but doesn’t take seconds.
My son grunts.
