A couple of weeks ago, I wrapped up a three week stent on the Mediterranean Diet. The guidelines of the Mediterranean Diet recommend that your primary fat source be olive oil, supplemented by fatty fish, nuts, and seeds. Olive oil is an excellent choice of fat – it’s loaded with monounsaturated fatty acids (MUFAs).¹ Benefits of diets high in MUFAs include:

• improved blood sugar and insulin sensitivity²
• lower total cholesterol and LDL cholesterol²
• blood vessels less prone to blockages²
• possibly lower blood pressure²
• reduced inflammatory responses³

The discovery and publication of these benefits led to a surge in the use of olive oil in all kinds of cooking and baking, for good reason! Who wouldn’t want to reap these benefits? There was, however, one concern looming regarding the use of olive oil in promoting health.

Smoke Points and Health

‘Smoke point’ is a term frequently discussed in the culinary world. Different oils have different temperatures at which they begin to create smoke and their aromas and flavors begin to change. This temperature is unique to each oil depending on its chemical composition and level of refinement/processing (and even varietal of the plant source⁴). They can also vary depending on what foods are being cooked in the oils.

Culinary experts recommend not cooking an oil beyond its smoke point largely because of the change in flavor. In addition, some voice concerns about the change in chemical composition that occurs when oils are heated beyond their smoke points.^5-7 The general school of thought is that if an oil is heated beyond this point, it produces inflammatory, potentially carcinogenic compounds and some of the oil’s healthful properties can be diminished.^8-9

Here’s where things start to get a bit dicey. Depending on who you ask, the smoke point of olive oil can be anywhere from 390-468° F, with the smoke point of extra virgin olive oil (EVOO) being anywhere from 325-410° F.^{5, 7, 10}  Pretty significant ranges! Different cooking methods require different cooking temperatures, shown below.

• Saute: 300-320° F
• Pan-Fry: 350-400° F
• Deep Fry: 350-400° F

Now you might conclude that olive oil is a good choice for a saute and possibly not the best choice for a good hot fry (depending on whose smoke point you go with). A 2018 study by Modern Olives Laboratory Services found that the negative changes that can occur with oils in heating are not so much related to their smoke points as to their general chemical stability.¹¹ After heating many different oils and testing their chemical compositions at high heats for over 24 hours, the researchers found that EVOO was the most stable cooking oil, producing the lowest amounts of oxidative compounds when heated. I’m always hesitant to trust studies whose authors have significant financial stock in the outcome, but this claim is backed by other studies which found that virgin and extra virgin olive oils contained fewer harmful compounds and more antioxidants after frying for several hours, though the antioxidants are less effective after heating.^{4, 9, 12-14} 

So, should I cook with olive oil or not?

Yes – it turns out cooking with olive oil (particularly extra virgin olive oil) seems to be both a safe and nutritious way to saute or to fry foods. This newer information about olive oil’s stability helps to reconcile the health of those who follow a Mediterranean Diet with previous health concerns about the potential dangers of heating it. As a general rule, try not to use more heat than is necessary for your cooking job and limit time spent on the heat when you can.

Writing this post has actually changed the recommendations I will make to my clients, because I previously subscribed to the “smoke point” theory until I updated myself with this new research. That’s one of the many reasons I make sure to continue to keep up with this blog – it forces me to stay up to date and back up my recommendations!

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References

1. https://www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good

2. https://www.sciencedirect.com/science/article/pii/B9781855739659500042

3. https://europepmc.org/abstract/med/9558730

4. https://www.ncbi.nlm.nih.gov/pubmed/21714128

5. https://www.jessicagavin.com/smoke-points-cooking-oils

6. https://www.seriouseats.com/2014/05/cooking-fats-101-whats-a-smoke-point-and-why-does-it-matter.html

7. https://www.theglobeandmail.com/life/health-and-fitness/health/smoke-point-matters-in-cooking-with-oil/article26569060/

8. https://www.ncbi.nlm.nih.gov/pubmed/21714128

9. https://www.ncbi.nlm.nih.gov/pubmed/17995742

10. https://www.aboutoliveoil.org/olive-oil-smoke-point

11. https://actascientific.com/ASNH/pdf/ASNH-02-0083.pdf

12. https://www.sciencedirect.com/science/article/pii/S0308814615006810?via%3Dihub

13. https://onlinelibrary.wiley.com/doi/pdf/10.1111/1541-4337.12268

14. https://hortintl.cals.ncsu.edu/sites/default/files/documents/2017novemberchangesinchemicalcompositionsofoliveoilunderdifferentheatingtemperaturessimilartohomecoo.pdf

This delicious dish is a copycat of a breakfast from a favorite restaurant of ours – the Ironwork Grill at McMenamin’s Grand Lodge in Forest Grove, Oregon. The original is made with a dill sauce but I always swap it for this dijon aioli, and I’ve never been disappointed!

The salmon, veggies, and potatoes make this a complete, protein- and potassium-laden anti-inflammatory power meal. Plus, it is so, so tasty and very easy to make!

I’ve been busy researching, reading, and compiling more information from scientific studies done on intermittent fasting and its potential benefits. This is part two, but you can go here to read about more research on fasting or here if you’re not sure what intermittent fasting is all about.

Can intermittent fasting…

…improve blood sugars and prevent/manage diabetes?

• Animals that ate intermittently exhibited resistance to diabetes and improved blood glucose and insulin sensitivity, even if they did not achieve caloric restriction (Anson et al 2003; Duan et al 2003)
• Animals on daily caloric restriction have lower fasting blood glucose, fasting insulin, reduced inflammatory markers, and improved insulin sensitivity (Lane, Ingram, Roth 1999; Imai 2010; Hursting et al 2003; Lane et al 1995; Wang et al 2007; Bonkowski et al 2006; Okauchi et al 1995; Walford et al 1999; Walford et al 2002; Wang et al 2007; Kalani et al 2006)
• Human results on intermittent fasting are mixed:
  • One study found no change in glucose but lower fasting insulin after 22 days of intermittent fasting (Hielbronn et al Jan 2005).
  • One study found that, while fasting, subjects with diabetes had higher blood sugar levels (Saada et al 2010).
  • Another found that after 22 days of intermittent fasting, women’s bodies showed more difficulty clearing blood glucose but that there was no difference in men. Men also had a decreased insulin response, but women didn’t. (Hielbronn et al Mar 2005).
  • Another study found no change in glucose or insulin in men after 14 days of intermittent fasting (Halberg et al 2005).
  • Two studies found that in humans, insulin sensitivity is more improved with fasting than with caloric restriction (Varady & Hellerstein 2007; Harvie et al 2010)
• Humans on caloric restriction showed lower fasting insulin levels, improved insulin sensitivity, and lower blood glucose. (Hielbronn et al 2006; Weiss et al 2006; Fontana et al 2004).
• The boiled-down verdict: Animals show improvements in blood glucose, insulin sensitivity, and resistance to diabetes with both intermittent fasting (without caloric restriction) as well as caloric restriction (without intermittent fasting). In humans, research on intermittent fasting and blood sugars delivers mixed messages, which probably means there are other factors involved that we don’t understand yet. There might be a gender difference in the blood glucose response to intermittent fasting. Several studies showed that daily caloric restriction can improve fasting insulin levels, insulin sensitivity, and blood glucose in humans.

…treat asthma?

• In one study, intermittent fasting reduced airway resistance, reduced inflammation, and improved the medicinal effects of albuterol in patients with asthma. (Johnson et al 2007)
• The boiled-down verdict: We need more research, but intermittent fasting may have some promising benefits for those with asthma.

…decrease risk of heart disease?

• In animals, caloric restriction has led to lower triglycerides, better cholesterol panels, and reduced inflammatory markers (Edwards et al 1998; Wang et al 2007; Kalani et al 2006; Lane, Ingram, Roth 1999).
• Animals on intermittent fasting and caloric restriction have lower blood pressures and heart rates (Tikoo et al 2007; Wan et al 2003; Lane, Ingram, Roth 1999; Wang et al 2007; Fontana et al 2004; Mager et al 2004).
• In humans, similar improvement is seen in cholesterol, inflammatory markers, and blood pressure with caloric restriction via intermittent fasting (Harvie et al 2011, Varady et al 2009; Walford et al 1999, Walford et al 2002).
• The boiled-down verdict: It seems you can protect your heart with lowered cholesterol, inflammation, and blood pressure by reducing calories, either by eating a little less every day or by intermittent fasting.

…slow cancer?

• Animals that eat intermittently exhibit slowed tumor growth, improved the effectiveness of chemotherapy, and reduced side effects of chemotherapy (Berrigan et al 2002;Lee at al 2012).
• In mice, intermittent fasting without caloric restriction reduced the occurrence and growth of lymphoma (Descamps et al 2005).
• Several studies show that animals with tumors had slower tumor growth and lived longer when calorically restricted with adequate protein, vitamin, and mineral intakes (Weindruch et al 1986; Pashko & Shwartz 1996; Pugh et al 1999; Imai 2010; Hursting et al 2003); however, one study showed mice had no slowing of tumor growth when on caloric restriction (Keenan et al 1997).
• Reviews of animal research conclude that the cancer prevention/slowing benefits are similar between intermittent fasting and calorie restriction (Varady & Hellerstein 2007).
• The boiled-down verdict: Research on the benefits of caloric restriction for cancer is mixed. Intermittent fasting may slow tumor growth and improve the effects of cancer treatment in animals. We need more research to know how these effects may transfer over to humans.

Be sure to enter your vote for Dietitian on a Diet’s next feature! The runners-up are:

High Intensity Interval Training (HIIT)

This is a style of exercise training that involves training at…well, high-intensity intervals. This pattern of exercise involves alternating between lower- and higher-intensity bouts of exercise. Research shows that incorporating high intensity intervals can provide many of the same benefits as lower-intensity exercise, but with a shorter amount of time spent exercising. HIIT workouts are often promoted for fat loss, aerobic fitness, blood sugar management, decreasing inflammation, and improving cholesterol.

Intermittent Fasting

The term “intermittent fasting” has been used to describe a wide variety of eating styles and schedules, all based on the premise that fasting has metabolic benefits. These eating styles incorporate regularly scheduled “fasts”; some include complete fasts for 1 or more days per week or 1 week per month, but often (and for the style I would be following) intermittent fasting involves limiting the “eating window” to a certain part of the day and fasting for the remainder. The primary goals with intermittent fasting are often to 1) lose weight, 2) increase energy, or 3) reduce inflammation.

Budget-driven Meal Planning

This is actually a brain-child of mine, compiled from everything I have learned about how to drive the cost of healthful groceries down as far as possible. This way of purchasing food and eating has cut many of my clients’ grocery costs by 25%, even while eating healthful food. One particular client, with a family of 8, decreased her grocery bill by 50%! In this I will share what we spend on groceries, where we shop, how I save money, and how I do it all while eating healthfully.

Be sure to vote for the diet or exercise plan you most want to learn more about!

When you’re aiming to be less inflamed, it can be worthwhile to look beyond regular foods to supplements and what I’m calling “add-ins” – foods/condiments to intentionally put on or in your food because of their anti-inflammatory benefits. Check out all the options:

1. Brightly-Colored Spices (like ginger, cinnamon, turmeric, etc)

Brightly-colored spices have high antioxidant content that can be powerfully anti-inflammatory. Several have specifically been researched and tested for efficacy in managing blood sugar in diabetes, though their anti-inflammatory properties can be beneficial for muscle soreness, recovery after exercise, and metabolic syndrome.^1-4

You can take these supplements in concentrated capsules (stick to the recommended dosage) or make a concerted effort to add brightly-colored spices to your food regularly.

2. Fish Oil/Omega-3s/Borage Oil

Increasing intakes of omega-3 fatty acids have been demonstrated to reduce inflammation. They are currently being researched and tested for treatment of many health factors, from prevention of dementia (dementia rates decreased in 19 out of 22 reported studies in a review)⁵ and cancer to lower cholesterol.^6-7

To increase your intake of omega-3s, you can eat more fish, walnuts, flax seed, and chia seeds. Chia is one of my personal favorites because it contains a high concentration of omega-3s and has nearly no flavor. I mix them into oatmeal, smoothies, and yogurt. If you take a capsule supplement, be sure to find one that states it is “burpless” or “enteric-coated.” That ensures the capsules go alllllll the way into your intestines before dissolving, preventing unpleasantly fishy-tasting burps/breath.

3. Tart Cherries

These tart little guys are becoming big news in the anti-inflammatory scene, largely for treatment of inflammatory joint pain caused by conditions like arthritis and gout. Some research with dosing tart cherry has shown similar decreases in pain to leading medications for arthritis and gout.^8-10

You can eat them canned, dried, in supplement form, or drink 100% tart cherry juice.

4. Vitamin D

Vitamin D has been shown to be important not only for preventing cardiovascular disease, osteoporosis, and many types of cancers, but also plays a role in improving depression.⁵

We get a lot less vitamin D these days than we used to. Our primary sources are sunlight (15-20 minutes of sunlight helps our skin make its own vitamin D!) and fortified foods like milk, other dairy, and fruit juices. Supplements are also an option. Ask your doctor to check your vitamin D levels and if they are low, consider working on boosting your intake with food or supplementation.

1. http://journals.sagepub.com/doi/abs/10.3181/0902-MR-78

2. http://journals.sagepub.com/doi/abs/10.1177/193229681000400324

3. http://www.sciencedirect.com/science/article/pii/S2225411016300670

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665015/

5. Pawlak, Laura. The Hungry Brain. 2012. Biomed Books. p. 177.

6. http://europepmc.org/abstract/med/2836574

7. http://www.tandfonline.com/doi/abs/10.1080/07315724.2002.10719248

8. http://www.sciencedirect.com/science/article/pii/S1756464614002886

9. http://www.sciencedirect.com/science/article/pii/S0166432803004650

10. http://www.tandfonline.com/doi/abs/10.1080/03009740600704155

Need some help with an anti-inflammatory diet? Here are my top tips and my two favorite recipe websites from my experiences:

1. Look for Asian, Indian, and Mexican recipes made with lean meats. They will usually contain plenty of anti-inflammatory spices and avoiding fatty meats means avoiding inflammatory saturated fat.

2. Can you put veggies in that? Sure you can! It helped me to have a container of cut-up veggies in the fridge or freezer all the time to put in pretty much whatever I was making to make my fruit + veggie quota for the day.

3. Snack on fruit. Fruit makes a great stand-alone snack and adds a nice dose of anti-inflammatory antioxidants throughout the day.

4. Evaluate each meal for the possibility of an anti-inflammatory “add-in.” By that I mean something you can put in it or on it to boost its anti-inflammatory properties (like cinnamon, turmeric, chia seeds, flax seeds, or walnuts). Most dishes will do nicely with at least one of these guys, and often more than one. Sneaking little bits into each meal and snack will increase the overall anti-inflammatory power of your diet. Read this post for more tips on add-ins.

5. Find at least one fish you like, and eat it a few times a week. Fish is an excellent anti-inflammatory protein that is also low in saturated fat. Experiment – maybe you prefer whitefish like cod or tilapia, or maybe you prefer pink fish like salmon. Tuna? Mackerel?

6. Cook with an oil that has a high omega-3 content and tolerates high heat well. Canola oil is my favorite! FYI – olive oil contains a much high ratio of pro-inflammatory omega-6s to anti-inflammatory omega-3s (1:11) than canola oil (1:2), plus it is not stable at high heats. Save olive oil for low-temp sauteing and salad dressings.

7. Recognize when you tend to crave sweets and have a plan to avoid excessive sugar intake. Find anti-inflammatory alternatives, like an enjoyable exercise, social activity, or tasty fruit-based snack.

8. Seriously and honestly assess your stress relief practices. Stress relief is more than just functioning in spite of stress, it’s making an intentional effort to work through and eliminate mental and emotional stressors. Stress can wreak havoc on your body through many ways besides inflammation!

Looking for Anti-Inflammatory Recipes? Check out these websites for great information and inspiration.

1. The Anti-Inflammatory Diet by Epicurious
2. Healthline’s 7-Day Anti-Inflammatory Meal Plan

Did you find these helpful? What tips do you have for living on an anti-inflammatory diet?