Dr Dingle's Blog / diabetes

Depression caused by inflammation and oxidation. Not a serotonin imbalance

Depression caused by inflammation and oxidation. Not a serotonin imbalance

Depression itself is not a disease, but a symptom of an underlying problem. A new theory called the “Immune Cytokine Model of Depression” holds that depression is a “multifaceted sign of chronic immune system activation,” inflammation. Depression may be a symptom of chronic inflammation. And a large body of research now suggests that depression is associated with a low-grade, chronic inflammatory response and is accompanied by increased oxidative stress—not a serotonin imbalance.

Researchers discovered in the early 1980s that inflammatory cytokines produce a wide variety of psychiatric and neurological symptoms that perfectly mirror the defining characteristics of depression. Cytokines have been shown to access the brain and interact with virtually every mechanism known to be involved in depression[1] including neurotransmitter metabolism, neuroendocrine function, and neural plasticity.

This is now supported by increasing lines of scientific evidence[2] including:

  • Depression is often present in acute, inflammatory illnesses.
  • Higher levels of inflammation increase the risk of developing depression.
  • Administering endotoxins that provoke inflammation in healthy people triggers classic depressive symptoms.
  • One-quarter of patients who take interferon, a medication used to treat hepatitis C that causes significant inflammation, develop major depression.
  • Up to 50% of patients who received the cytokine IFN-alpha therapy to help treat cancer or infectious diseases developed “clinically significant depression.”[3]
  • An experiment involving the administration of a Salmonella typhi vaccine to healthy individuals produced symptoms of fatigue, mental confusion, psychomotor slowing and a depressed mood.[4] These symptoms correlated with the increase in cytokine concentrations.
  • Remission of clinical depression is often associated with a normalization of inflammatory markers.
  • There is now a large body of literature regarding laboratory animals demonstrating that cytokines … can lead to a host of behavioural changes overlapping with those found in depression. These behavioral changes include decreased activity, cognitive dysfunction and altered sleep.[5]
  • All the activities associated with reducing the prevalence of depression and depression symptoms are anti-inflammatory. These include increased sunlight and time spent outside, exercise and physical activity, relaxation and meditation techniques, healthy eating as well as administering anti-inflammatory nutritionals.

There is further support from large epidemiological studies. A number of longitudinal studies have now shown that inflammation in early adulthood predicts depression at a later stage in life. In a large longitudinal study, the risk for depression and psychotic experiences in adolescence was almost two-fold higher in individuals with the highest compared to the lowest levels of inflammation as indicated by interleukin-6 (IL-6) levels in childhood. Children who were in the top third of IL-6 levels at the age of 9 years were 55% more likely to be diagnosed with depression at the age of 18 than those with the lowest childhood levels of IL-6. Children in the highest level of IL-6 levels at the age of 9 were also 81% more likely to report psychotic experiences at the age of 18.[6] A study of more than 73,000 men and women showed increasing inflammation levels were associated with increasing risk for psychological distress and depression. Increasing inflammation (CRP) levels were also associated with increasing risk for hospitalization with depression.[7]

In support of the inflammation depression link, recent studies have found a significant link between the dietary inflammatory index (DII) and risk of depression. In an Australian study of 6,438 middle-aged women, those with the most anti-inflammatory diet had an approximately 26% lower risk of developing depression compared with women with the most pro-inflammatory diet.[8] Similarly, a study in the UK examined the DII and recurrent depressive symptoms over five years in 3,178 middle-aged men and 1,068 women. Researchers found that for each increment of 1 level of DII score (increased inflammation), odds of depression increased by 66% in women, whereas in men the risk increased by only 12%.[9] In a study of 15,093 university graduates in Spain, those on the highest DII (strongly pro-inflammatory diet) had a 47% risk of depression compared with those in the bottom, with a significant dose-response relationship, which means as the diet became more inflammatory it increased the risk of depression. Further analysis also showed the association between DII (the inflammatory diet) and depression was stronger among participants older than 55 years, with an increased risk of 270% and those with cardiometabolic comorbidities (high blood pressure, diabetes, etc.) had an 80% increased risk of depression.[10] In a study of 43,685 women (aged 50–77) without depression at baseline, the risk of developing depression was 41% higher if they were on the highest compared to the lowest Dietary Inflammatory Index diet.[11]

Oxidative stress is closely related to the inflammatory pathway in particular. Pro-inflammatory cytokines are produced in reaction to oxidative stress and oxidative stress in turn amplifies the inflammatory response. High cortisol levels have been associated with increased levels of oxidative damage.[12] Depression has been associated with increased oxidative stress and increased severity of depression is associated with increased systemic oxidatively generated DNA and RNA damage.[13] Severe depression is associated with increased systemic oxidatively generated RNA damage, which may be an additional factor underlying the somatic morbidity and neurodegenerative features associated with depression. In a meta-analysis, 1,308 subjects depressed persons had increased oxidative stress and decreased anti-oxidant defences (as measured by 8-OHdG and F2-isoprostanes).[14] The results indicate that depression is associated with increased oxidative damage to DNA and lipids. The brain is particularly vulnerable to oxidative damage due to its high oxygen consumption and low antioxidant defences. Sustained oxidative brain damage during a depressive episode may make a sufferer prone to developing another depressive episode. Therefore, it has been hypothesized that exposure to oxidative stress could be an explanatory mechanism in the remitting and chronic course of depressive disorders.[15] There is also evidence from post-mortem studies suggesting that in depression oxidative stress is increased[16] and antioxidants are decreased[17] in the brain.

A study of 37 patients with bipolar disorder showed that bipolar disorder is associated with increased oxidatively generated damage to nucleosides, which could be contributing to the increased risk of medical disorders, shortened life expectancy, and the progressive course of illness observed in bipolar disorder.[18] Another study showed increased oxidative stress as indicated by increased nitric oxide (NO) and lipid peroxidation, measured by thiobarbituric acidic reactive substance (TBARS) assay in patients with bipolar disorder.[19]

There is evidence suggesting that antioxidants are decreased in depression, illustrated by lower antioxidant levels,[20] including carotenoids,[21] and antioxidant enzymes.[22] There is some evidence to suggest that antidepressants have antioxidant properties and may act through reducing pro-inflammatory cytokines and ROS production and improving levels of antioxidants such as superoxide dismutase.[23]

 

[1] Miller et al. 2009.

[2] Berk et al. 2011.

[3] Miller 2009.

[4] Brydon et al. 2008.

[5] Dantzer et al. 2008.

[6] JAMA Psychiatry 13, 2014.

[7] Wium-Anderson et al. 2013.

[8] Nitin Shivappa et al. 2016 British Journal of Nutrition.

[9] Akbaraly et al. Clinical Psychological Science 2016.

[10] Sanchez-Villegas A et al. British Journal of Nutrition 2015.

[11] Lucas et al. 2014.

[12] Joergensen et al. 2011.

[13] Jorgensen et al. 2013; Pandya et al. 2013.

[14] Black et al. 2014; Palta et al. 2014.

[15] Moylan et al. 2013.

[16] Wange et al. 2009; Michel et al. 2012.

[17] Gawryluk et al. 2011.

[18] Munkholm et al. 2015.

[19] Andreazza et al. 2008.

[20] Palta et al. 2014.

[21] Milaneschi et al. 2012.

[22] Sarandol et al. 2007.

[23] Khanzode et al. 2003; Lee et al. 2013.

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Gut health impacts all health conditions

Gut health impacts all health conditions

Your gut microbiome has an astonishing ability to keep you healthy or ill. The list of diseases that we know of that are linked to the intestinal microbiota grows every day and these diseases are usually complex in terms of both how the disease develops and complications. Having the right balance of good microorganisms in our gut and good gut health is not only essential for good digestion but also in the prevention of or reversing chronic diseases, including.

Poor gut health has been linked with a long list of illnesses including

ADHD

Autism

Asthma and Allergies

Alzheimer’s

Parkinson’s

Multiple sclerosis

Arthritis

Cancers (especially digestive cancers, i.e. bowel and colon and brain tumours)

Inflammatory Bowel Disease including SIBO, Crohn’s and Ulcerative colitis

Metabolic health

Metabolic syndrome

Cardio vascular disease

High blood pressure

Weight Loss

Diabetes 2

Diabetes 1

Depression, Anxiety and Stress

Skin health and ageing

Eczema, Dermatitis and Psoriasis

Immune system function including susceptibility and tolerance to viruses and bacterial infections like cold and flu.

Colic, Constipation and Diarrhea

Celiac disease and Gluten and lactose intolerance

Liver disease

Dental Health

 

The list goes on. For example, even in the area of mental illness we have conditions such as

Depression, Anxiety and Stress

Bipolar,

Schizophrenia

ADHD & Autism

Focus and memory

Learning, mental productivity and cognitive decline. As well as controlling some of our needs and desires i.e. food cravings and appetite, our relationships and our social interactions.

These are all impacted by gut health. Because of the role of inflammation, oxidation nutrition and the many functions of the gut microbiome there is not a health condition that is not influenced by the gut microbiome either directly or indirectly.

Because of the multiple functions of the microbiota dysbiosis can manifest as many and multiple health conditions often termed comormidity or multi morbidity. It is not one disease it manifests as many. For example, large studies have shown the multi-morbidity of eczema, rhinitis, and asthma. Inflammatory Bowel Disease (IBD) patients will also frequently suffer from rheumatologic manifestations, liver multimorbidities and lung, namely chronic obstructive pulmonary disease and bronchial asthma, bronchitis and other chronic respiratory disorders in the adult population, gallbladder disease, heart disease and associated morbidity and mortality, anxiety, stress and depression, as well as arthritis, psoriasis, and pericarditis. In one study of 47325 patients they reported 20 different immune mediate diseases associated with IBD including some of those mentioned above and celiac disease, type 1 diabetes, rheumatoid arthritis, and ankylosing spondylitis.

This evidence strongly shows any health condition will have many layers of disease occurring throughout the body at any one time that are related but not connected at the time of diagnosis.

 

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Gut Health Gut Healing an Modern Perspective

Gut Health Gut Healing an Modern Perspective

Arguable the biggest health problem facing us today is gut health rivaling the current obesity crisis and tobacco smoking in its impact on our health. Every health condition is linked to gut health and gut healing either directly or indirectly through inflammation and oxidation. Historically every culture understood this and were involved in extensive practices of gut healing and even our own up until 60 or so years ago. The first thing health practitioners throughout history would do is to start to fix the gut.

Until recently the positive effects of the gut microbiome on our digestive system and health has been severely under rated. Wisdom of Chinese doctors from centuries ago, who somehow knew that the intestines were not merely a digestive organ, but the centre of health and wellbeing. Hippocrates was recorded as saying that all illness begins in the gut. Throughout history from the Egyptians till around 80 years ago medicine and the bowels were frequently mentioned in the same sentence and good health revolved around gut health.

Even today the nomadic Maasai tribes in Africa attribute most illnesses to the effect of “pollutants” that block or inhibit digestion. In these communities the plants are used to cure diseases served mainly as strong purgatives and emetics; they "cleanse" the body and digestive system from polluting substances.

With thousands of studies released each year the gut is known to play a major role in many health conditions including mental health issues, cardiovascular disease, allergies and asthma, autoimmune diseases, some cancers and even diabetes and weight gain. Many of these conditions which are now reaching epidemic proportions have been linked to a dysfunctional gut. Studies have shown a strong link between mental health issues including depression and what is called the gut brain axis. We also know the gut is the centre of our immune system and is strongly influenced by the gut microbiome. As a result the gut has a strong link with allergies and asthma. Peanut allergies for example are not caused by peanuts they are brought about by a dysfunctional gut microbiome.

Antibiotics and many gut medications used for controlling acid reflux have been shown to be devastating to gut health a healthy gut microbiome, as well as many of the chemicals we use around the homes and even the personal care products we apply to our skin. Even our activities either promote gut health and gut healing or harm it. Stress sends messages to the opportunistic (bad) microorganisms in the gut to tell them to start to take over from the good ones. Exercise promotes gut health and healing while no exercise or too much exercise does the exact opposite.

Fortunately, in animal studies we know that many of these conditions can be improved and even reversed if the gut microbiome is repaired. 50% of Parkinson’s Disease has been directly linked with poor gut health while improving the gut microbiome has been shown to dramatically improve symptoms.

The research also shows that while probiotics can be useful in gut healing, repairing the gut microbiome requires an understanding of what encourages a healthy gut microbiome in our diet and lifestyle as well as what causes a dysfunctional microbiome. We now know that all the healthy foods we eat, the vegetables, nuts, seeds, herbs, spices and fruit all feed the gut microbiome which then feeds us and looks after our health. All the studies on healthy diets from the Mediterranean to the original Japanese or the low inflammatory diet (DII) benefit us because they work through the gut to promote gut health and subsequently our health.

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Nutrition and lifestyle can reverse IBS

Nutrition and lifestyle can reverse IBS

Irritable or Inflammatory Bowel Syndrome (IBS) affects an estimated 14.1% of the US population and 11% of the global population. IBS is characterized by chronic abdominal pain, gas, cramping, bloating, constipation, and diarrhea. More than one-half of all patients with IBS suffer from depression or anxiety. Missed work, social interactions, and travel are among the top stressors for these individuals. Many studies have shown a compromised gut microbiome to be associated with IBS.

In this study a 53-y-old Caucasian patient had signs of irritable bowel syndrome (IBS; gas/bloating, gastroesophageal reflux), fatigue, and sleep disturbances. He also noted a history of chronic sinusitis, seasonal allergies, multiple chemical sensitivities, and right knee pain (3 surgeries).

Over the course of 6 mo, the patient was treated using an elimination diet, lifestyle modifications, botanicals, and dietary supplements to address the underlying cause of issues. His symptoms decreased and quality of life increased, resulting in the resolution of his IBS symptoms, improved sleep, and increased energy levels.

This case illustrates the usefulness of diet and lifestyle changes to improve and eliminate  chronic gut issues.

Here is a quote from the patient

Patient Perspective. “I feel better than ever—even better than in my 20s. I went into this process with a high desire to feel better since my gut symptoms and fatigue began to impact everything I enjoy in life—golf, cycling, and the outdoors, but I was a little hesitant knowing it would involve so many changes. I thought it would be a difficult process, but it really wasn’t once I established my lifestyle, diet, and supplement routines. The hardest part of treatment was going 100% gluten free. Had I known I would feel this good, I would’ve done this long ago. Finding the root causes and making lasting lifestyle changes are the key to health. Working with a knowledgeable practitioner makes all the difference!”

 

Source.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5145014/

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Eating fewer calories extends life in yet another animal study.

Eating fewer calories extends life in yet another animal study.

There is little doubt about the dangers of overeating but growing research on more than half a dozen animals groups including mice, flies and worms have shown eating fewer calories can extend an animals life by up to 50%.

The latest tests have been carried out on two grey mouse lemurs (Microcebus murinus, lemurid primate). One group had a normal diet for nine years and the other was fed a similar balanced diet that had 30 per cent fewer calories. The lifespan of the calorie-restricted lemur increased by nearly 50 per cent (from 6.4 to 9.6 years, median survival), and its motor capacities remained healthy its whole life, while its brains resembled that of a younger animal.

They reported that the calorie restricted animals had reduced aging-associated diseases and preserved loss of brain white matter in several brain regions. However, caloric restriction accelerated loss of grey matter throughout much of the cerebrum without affecting cognitive performances. What this means they are not sure.

The health benefits of chronic caloric restriction resulting in lifespan extension are well established in many short-lived species. However, the effects in humans and other primates remain unknown and controversial. Beneficial effects of caloric restriction on age-related diseases have also been reported for long-lived species, including rhesus monkeys (Macaca mulatta). However, increased survival was only reported in one study. 

At the very least this suggests that you should not over eat and as I always say make sure you eat nutrient dense foods. 50% of the diseases we now suffer are a result of what we eat.

 

 

Source

Caloric restriction increases lifespan but affects brain integrity in grey mouse lemur primates. April 2018

https://www.nature.com/articles/s42003-018-0024-8

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Our society is the sickest it has ever been

Our society is the sickest it has ever been


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Your plate colour influences how many calories women consume.

Your plate colour influences how many calories women consume.

What colour is your plate?

Plate colour has been shown to alter the amount of food consumption due to its environmental effect on food intake. This study was a crossover study conducted with 54 female participants aged 18–30 years of normal weight. The results showed that plate colour exerted a significant effect on food intake during the test days. The average total energy intake with red and black plates were around 1113.19  kcal and was almost 20% higher than with white plates (945.72  kcal). There were no differences between red and black plates. 

Another study found that individuals drank and ate less from red labelled cups and red plates than from blue labelled cups and blue and white plates, while another study showed reduced consumption of popcorn and chocolate chips when the foods were served on red plates.

But it is not just the colour of the plate. Other studies have shown colour to have a significant impact on food consumption including the colour of the of the plate, packaging, and of the surrounding environment.

Other factors, such as the presence of other people, location, portion size and time of consumption, appear to affect food intake and food choice. 

So choose who you eat with, where you eat and the colours around you carefully.

Source

Impact of three different plate colours on short-term satiety and energy intake: a randomized controlled trial

https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0350-1

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The Gut Microbiome. Old wisdom and new science

The Gut Microbiome. Old wisdom and new science

If I came home sick from anywhere as a child my mums first question was always, “have you been to the toilet?” I didn’t realize the significance of this until much later and I don’t think my mother even realized what she fully meant. Except that our poo is one of the best and of course the simplest signs of our inner health and therefore our outer health as well. Our poo (feces) can tell a lot about our health and is made up primarily of microorganisms, fibre other undigested materials and water. Living bacteria represent 80% of fecal dry weight. The regularity and frequency also tells you a lot about your internal operating system and the likelihood of you suffering chronic illness. Well, before it may even be diagnosed by modern medical systems. Luckily I learnt this lesson well. Around 2009 I was called over to see my mother as the doctors thought she was dying. When I arrived she was in a delirious state and getting worse. She hadn’t been to the toilet for 10 days in hospital and we were all worried about her. I went into town brought a vegetable smoothie and carried it back to the hospital. I was able to mix in some “super probiotics” (1 trillion) into her smoothie and later which she sipped through the day. The following day, less than 24 hours she had regained her composure. We repeated this twice a day for the week and she walked out of hospital. At this stage the nurses had cottoned on to what we were doing and were asking questions but did not want to take it past that.

Until recently the positive effects of the gut microbiome on our digestive system and health has been severely under rated. Wisdom of Chinese doctors from centuries ago, who somehow knew that the intestines were not merely a digestive organ, but the centre of health and well being. Hippocrates was recoded as saying that all illness begins in the gut. Throughout history from the Egyptians till around 80 years ago medicine and the bowels were frequently mentioned in the same sentence.

Even today the nomadic Maasai tribes in Africa attribute most illnesses to the effect of “pollutants” that block or inhibit digestion. In these communities the plants are used to cure diseases served mainly as strong purgatives and emetics; they "cleanse" the body and digestive system from polluting substances.[1] While studies of the great apes show they self-medication to control intestinal parasite infections and gut problems across Africa.[2] Chimpanzees (Pan troglodytes) for example, swallow the leaves of certain plant species whole, without chewing to aid expulsion of certain parasites. Swallowing rough or bristly leaves increases gut motility causing expulsion of adult worms, which disrupts the nematode’s life cycle and likely reduces worm burdens.[3]

 

[1] Bussmann et al., 2006.

[2] MCLennan and Huffman, 2012.

[3] Huffman and Caton, 2001.

 

Dr Dingle's WA. Gut Healing Tour

Perth May 9

http://tix.yt/gutsecrets-perth

Bunbury May 29

http://tix.yt/guthealingbunbury29-5

Busselton May 31

http://tix.yt/guthealingbusselton31-5

Albany June 6

http://tix.yt/guthealingalbany6-6

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A Pecan a day keeps the diabetes and cardiovascular disease away.

A Pecan a day keeps the diabetes and cardiovascular disease away.

A large amount of evidence has shown a high intake of tree nuts is associated with a reduced risk of cardiovascular disease (CVD), mortality from type 2 diabetes (T2DM), and all-cause mortality.

In this study after 4 weeks on a pecan-rich diet the researchers saw beneficial changes in serum insulin, insulin resistance (HOMA-IR) and beta cell function (HOMA-β) as well as cardiometabolic disease. That is a significant reduction in the risk of diabetes2, heart attacks and stroke.

Cardiovascular diseases (CVD) are a leading cause of death worldwide, and is primarly caused by inflammation and oxidation. Within the past few decades, there has also been a dramatic increase in diet-related chronic diseases related to CVD risk, i.e., diabetes, obesity, and hypertension, in both industrialized and developing nations. The problem is only getting worse even though we spend more money on pharmaceuticals and the medical system than ever before. Increased production of reactive oxygen species, oxidative stress, and inflammation, are the leading causes of type 2 diabetes mellitus (T2DM), arterial hypertension, and dyslipidemia.

A growing body of evidence has shown that a high intake of nuts (all types) is associated with a reduced risk of CVD development, all-cause mortality, and mortality from diabetes. Indeed, a nut-containing diet also contributes to weight control and weight loss despite the large number of calories.

Bioactive compounds present in nuts, include essential fatty acids, vitamins and minerals, fiber, and phytochemicals, have all been shown to reduce inflammation, improving vascular reactivity as well as fasting glucose and insulin sensitivity, and by lowering oxidative stress. Numerous studies have now shown that consumption of nuts is effective in reducing oxidative stress and inflammation. Other studies have shown frequent nut consumption is associated with lower concentrations of inflammation (CRP, IL-6) and some endothelial (the artery lining) markers in clinical trials. In a study of 5,013 participants, a greater intake of nuts was associated with lower amounts of inflammatory biomarkers. Subjects with nut intake of five or more times per week had a 20% nearly 20% reduction in inflammation compared to those who never or almost never consumed nuts. Pistachio nuts, for example, reduce oxidative stress and inflammation. Pistachio kernels have anti-inflammatory and antioxidant properties at lower doses than reported previously and decreased inflammation (TNF-α and IL-1β) in a dose-dependent way. That is, the more the participants consumed, the lower the inflammation.

EAT MORE NUTS

But not peanuts and cashews

For much more information on how to reverse diabetes and cardiovascular disease (and all chronic illness) “Overcoming Illness” our latest book is a must read.

https://www.drdingle.com/collections/frontpage/products/overcoming-illness-pre-order

 

Source

A Pecan-Rich Diet Improves Cardiometabolic Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial

Diane L. McKay 1,*, Misha Eliasziw 2, C. Y. Oliver Chen 1 and Jeffrey B. Blumberg 1http://www.mdpi.com/2072-6643/10/3/339/htm

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Inflammation increses your risk of heart disease (and everything else)

Inflammation increses your risk of heart disease (and everything else)

Chronic inflammation is known to play a major role in the development of cardiovascular diseases (CVD) and related mortality. Various dietary components also have been implicated in playing a major role in the development of various CVDs and research has shown that whole diet and various dietary components have a direct association with inflammation. Consumption of fruit and vegetables has been shown to reduce levels of inflammation. Increased adherence to healthier dietary patterns characterized by increased intake of plant-based foods such as fruit and vegetables, nuts, and whole grains and adherence to a healthier dietary pattern has been shown to help prevent and to manage CVD. An increased intake of polyphenols, anti-oxidants with ability to decreases oxidative stress and inflammation through scavenging free radicals, found in fruits, vegetables and nuts, has also shown to be associated with decreased risk of overall and CVD-related mortality.

While consumption of red meat has been shown to increase inflammation. In a recent meta-analysis, increased intake of processed meat has been shown to be associated with increased risk of CVD mortality.

The Dietary Inflammatory Index (DII) has also been shown to be associated with various chronic inflammation-related health outcomes such as cancer incidence, all-cause and cancer-specific mortality, respiratory conditions such as asthma and cognitive disorders. A recent meta-analysis from nine studies found individuals in the highest versus the lowest DII category showed an overall 40% increased risk of colorectal cancer.

In this study data from 14 studies showed a 36% increase in the risk of CVD between the highest and lowest DII scores and there was an increased risk of CVD risk and mortality of 8% for each one-point increase in the DII score.

Results of this meta-analysis support the importance of adopting a healthier anti-inflammatory diet for preventing CVD incidence and related mortality and a pro-inflammatory diet is associated with increased risk of CVD and CVD mortality.

We are running a course on Inflammation, the DII and inflammation for other aspects of our environment and lifestyle to celebrate the release of our new book "Overcoming Illness" which explains all the information behind inflammation and oxidation and how to reduce your risk of all chronic illness for Diabetes to Dementia.

Overcoming Illness the course

7:00 PM - 9:05 PM Tuesday 6th March 2018

http://tix.yt/overcoming-illness

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