Systemic Inflammation, Periodontal Disease & The Paleo Diet: Part I

2 Dec

It was a busy November! I took a little time off from the blog to enjoy the Thanksgiving holiday, and the week before that, I had the opportunity to attend two seminars: one in Portland, OR presented by Nick R. S. Hall, Ph.D. titled, “The Immune System: The Mind-Body Connection. Who Gets Sick and Who Stays Well?” and another in Kirkland, WA presented by Sarah Fragoso and Jason Seib of Everyday Paleo titled, “Living Everyday Paleo”. A key component of both lectures: the role of systemic inflammation in our overall health.

It seems that everyday we are learning more and more how chronic inflammation is present in just about every non-infectious disease we can think of. Google search any disease “AND inflammation” and you’re bound to find more articles and research than you could possibly ever read. Many think of periodontal disease as an isolated area of inflammation only affecting the gums, but we need to think of the body as a whole system rather than separating it into parts. Periodontal disease is no longer viewed as simply a dental disease, but instead as a medical disease associated with increased risk of heart attack, stroke, diabetes, rheumatoid arthritis, Alzheimer’s Disease and preterm births, just to name a few. Cardiovascular disease is the most prevalent of these in our society today, and the blame has long been placed on high cholesterol. But when a recent UCLA School of Medicine study reported that nearly 50% of patients hospitalized for heart attack had LDL cholesterol (the “bad” cholesterol) below 100 mg/dl (well below the recommended “safe” range of 130 mg/dl) many in the medical community turned their focus away from high cholesterol and started pointing the finger at long-term, low-grade inflammation (like the kind present in untreated periodontal disease) as the major factor in cardiovascular disease risk. Physicians now recommend that we take action to reduce inflammation anywhere we can in the body to reduce the amount of total systemic inflammation the body is burdened with, because honestly, how can we expect a burdened body to be healthy or to be able to fight off disease and heal?

In my experience, patients with active periodontal disease never just have periodontal disease, but also have some other inflammatory systemic health issue going on, predominantly either cardiovascular disease, diabetes, or both. Appropriate dental care can help alleviate a great deal of the localized inflammation in the mouth that exists with periodontal disease, but when these patients take steps to also improve these other disease processes (thus reducing the inflammation burden on the body), their periodontal disease becomes much more manageable and the progression of the disease is often halted. However, when these steps are not taken and a patient continues to have a high amount of systemic inflammation present, it is often an uphill battle to halt the progression of periodontal disease for any significant period of time, even despite some patients’ excellent bacterial plaque control through brushing and flossing.

Dental care alone cannot stop periodontal disease. In order to stop periodontal disease progression, patients must combine dental care along with efforts to improve/eliminate their other disease processes in order to reduce the inflammation burden put on the body. Dr. Hall highly recommended eating an “anti-inflammatory diet”, especially for those individuals that have any kind of inflammatory disease process happening in their body. An optimal diet can prevent, alleviate, or even eliminate the other inflammatory diseases present in the body that tend to “give way” to the development of periodontal disease. Jason Seib described exactly what an “anti-inflammatory diet” consists of, or more importantly, what it does not consist of.

Grains

Wheat: Does this look like something we were meant to eat?!© Fredvl | Stock Free Images & Dreamstime Stock Photos

Wheat: Does this look like something we were meant to eat?!© Fredvl | Stock Free Images & Dreamstime Stock Photos 

Jason Seib stated in his lecture that the only species with digestive systems developed to digest grains are birds and rodents, not humans. Jason stated that grains contain “gut-irritating” proteins, called lectins, that damage our intestines causing permeability that allows undigested proteins to pass through the gut wall and into the bloodstream, a process often referred to as “leaky gut” [1]. In a previous post I detailed the work of Dr. Allesio Fasano, a gastroenterologist and pioneering researcher on celiac disease. Dr. Fasano’s research has shown that gluten (one of the most researched and well-known lectins found in wheat, rye, barley, spelt, kamut, triticale and some oats) triggers the opening of the tight junction “doorways” in the intestine in people with celiac disease and in those that do not have celiac disease [2].

Another study stated that WGA (wheat germ agglutninin-another lectin found in wheat) “stimulates the synthesis of pro-inflammatory cytokines and thus the biological activity of WGA should be reconsidered by taking into account the effects of WGA on the immune system at the gastrointestinal interface.” This gut permeability/damage, along with the immune response mounted against undigested proteins (lectins) entering the bloodstream, creates systemic inflammation that puts a burden on the body. If you eat a Standard American Diet based on recommendations from The USDA Food Pyramid/My Plate guidelines that promote eating grains at every meal, you set yourself up for chronic inflammation from the constant intake of these gut-irritating proteins.

Processed Vegetable/Seed Oils

© Galaiko | Stock Free Images & Dreamstime Stock Photos

© Galaiko | Stock Free Images & Dreamstime Stock Photos

For over 50 years, we’ve been taught that saturated fat consumption causes cardiovascular disease. We’ve been told to avoid sources of “unhealthy” animal fat such as butter, cheese and red meat and instead have been offered the so-called “healthy” alternatives of processed, industrial vegetable/seed oils such as corn oil, canola oil, soybean oil, sunflower oil, cottonseed oil, etc.

The first problem? This was all wrong! A recent study published in The American Journal of Clinical Nutrition concluded that there is no significant evidence to conclude that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease [full-text PDF]. Need more? Another study showed that cholesterol levels were not affected in obese patients put on a high saturated fat/no starch diet. What did happen to the individuals in the study? They lost weight.

The second problem? The above mentioned industrial oils are loaded with inflammatory omega-6 fats. Yes, omega-6 fats are essential fats and our bodies needs some…keyword: SOME. Keep reading…

The third problem? These oils are EVERYWHERE! Go into your refrigerator or pantry and look at the labels on those chips, crackers, cookies, mayonnaise, salad dressings, anything in a bag or a box and you will likely find these industrial oils in the ingredients. Reason being, these oils are cheap and have a lasting shelf-life, which is also why restaurants use these oils as well. So if you eat out often, you’re consuming more omega-6 fats there too. The average American consuming the Standard American Diet is taking in an abundance of omega-6 fats vs. omega-3 fats at a ratio close to 15:1, and even upwards of 30:1 in some individuals. When our bodies receive excess omega-6 fats, our cell membranes produce cytokines, which directly cause inflammation. A ratio of 1:1 omega-6 fats to omega-3 fats is ideal, but even a ratio of 3:1 is a major step in the right direction towards better health.

How can you improve your ratio to favor more omega-3 fats in your diet? Eat more fish, use olive oil in homemade mayonnaise and salad dressings (see my recipes below!), cook with unrefined virgin coconut oil (since heat can oxidize/damage olive oil) or grass-fed butter, lard, bacon fat (oh yes!) or tallow and…well…if a “food” comes in a bag or box, don’t eat it…or at least try to greatly reduce these processed foods in your diet.

Continue on to Part II where I discuss carbohydrate/sugar metabolism, diabetes…and you may just learn a tidbit or two about fat loss as a bonus!

Paleo Mayonnaise

2 eggs*

3 tbsp lemon juice

1 tsp mustard powder

2 cups mild tasting olive oil (Do not use extra virgin olive oil; it’ll give you a very strong tasting mayo.)

*Although the risk of salmonella from eggs is actually quite minimal, especially if you are using farm fresh eggs, some people prefer to pasteurize their eggs first, which is very simple to do! Consuming raw eggs is also not advised for pregnant women. Check out this site to learn how to easily pasteurize your eggs before making your mayo. Most recipes for homemade mayo state the mayo will be good for about a week. I pasteurize my store-bought eggs prior to making mayo and we’ve had no problem consuming it for two weeks. The lemon juice in the recipe also keeps it from going bad too quickly. I personally do not feel the need the pasteurize the eggs I purchase from a local farm I trust and still have had no problem consuming the mayo I’ve made with unpasteurized eggs for 2 weeks. Make your own judgement call on this that you are comfortable with.

In a food processor or blender add the eggs, lemon juice and mustard powder and mix together. With the food processor or blender still running, begin to slowly drizzle in the olive oil. I slowly add just a little at first with a spoon. Once I’ve added in about 3-4 spoonfuls, I then slowly pour the rest of the olive oil in. Once you’ve added all the oil…voila! You’ve got mayo! I will often also add in 2 tbsp of dijon mustard and a couple splashes of red wine vinegar (to taste) to make a yummy flavored mayo, or this also makes a great creamy vinaigrette salad dressing! The flavor options with this basic mayo recipe are limitless! Add some cayenne pepper or chipotle to make a spicy aioli dipping sauce, add ginger to make a great topping for fish, or add some pickle relish with a little minced onion and a bit more lemon juice to make tartar sauce! And if you wanna get really crazy, substitute one of the cups of olive oil for one cup of liquid bacon fat to make baconnaise! Get creative!

This recipe yields enough mayo to fill a pint-sized canning jar.

Paleo Ranch Dressing

1 cup Paleo mayonnaise

2-4 tbsp (or more to taste) organic, grass-fed whole-milk plain yogurt* (I love Strauss Family Creamery brand!)

2 tsp dried dill

1 tsp dried parsley

1/2 tsp minced or crushed garlic (or more if you love garlic like I do!)

black pepper to taste

*If you do not consume dairy, you can replace the yogurt with canned coconut milk. I personally do not tolerate conventional dairy very well, but have no issues with fermented dairy products like grass-fed yogurt on occasion. I find that the yogurt gives the dressing more of that homestyle buttermilk ranch flavor!

This one is easy! Mix all ingredients together and enjoy! I made this ranch dressing for my family this past Thanksgiving and was asked what brand it was and where I got it because it was so good! Loved telling my family that it was homemade and healthy to boot!

Cited Sources

1. Fasano, A., Shea-Donohue T. Mechanisms of Disease: The role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat Clin Pract Gastroenterol Hepatol. 2005 Sep; 2 (9): 416-22.

2. Kresser, C. and Fasano, A. 2012. RHR: Pioneering Researcher Alessio Fasano MD on Gluten, Autoimmunity and Leaky Gut. From URL: http://chriskresser.com/pioneering-researcher-alessio-fasano-m-d-on-gluten-autoimmunity-leaky-gut

2 Responses to “Systemic Inflammation, Periodontal Disease & The Paleo Diet: Part I”

  1. kitchen remodel August 9, 2014 at 6:13 pm #

    Hello there I am so happy I found your blog page,
    I really found you by accident, while I was browsing
    on Aol for something else, Anyhow I am here now and would just like to say thanks a lot for a incredible post
    and a all round enjoyable blog (I also love the theme/design), I don’t have time
    to go through it all at the minute but I have book-marked it and
    also added your RSS feeds, so when I have time I will be back to read much more,
    Please do keep up the fantastic work.

    • ThePaleoHygienist August 10, 2014 at 4:32 pm #

      Thank you! I’m on a little hiatus at the moment with my new baby, but hope to be posting more again very soon!

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Everyday Paleo

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Raw Food SOS

Rescuing good health from bad science.

Mark's Daily Apple

Paleo Principles for Optimal Oral Health and Beyond.

Chris Kresser

Paleo Principles for Optimal Oral Health and Beyond.

Nourished Kitchen

Paleo Principles for Optimal Oral Health and Beyond.

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