Inflammation is a protective response of the body to clear infections, repair tissues, and heal itself after injury. But when inflammation sticks around too long and becomes chronic, it can negatively impact your health. Read on for more information about inflammation and how dietary changes can help.

What Is Inflammation?

Inflammation is a protective response of the body to clear infections, repair tissues, and heal itself after injury. Signs of inflammation include redness and warmth from increased blood flow; swelling from increased blood vessel permeability; pain; and loss of function. A common example of inflammation occurs after spraining an ankle. When injured, the ankle may swell up and become red, warm, and painful. The inflammatory process is necessary for efficient healing and restoration of function.

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Types of Inflammation

Inflammation can be divided into two broad categories: acute and chronic. Acute inflammation is characterized by rapid onset and resolution, such as a sprained ankle or strep throat. For example, when you get strep throat, one of the first responses of the body is acute inflammation. Inflammatory mediators in the body promote increased blood flow and vessel permeability, which helps get specialized immune cells to the infection site. As the body clears the infection, the inflammation subsides.

Chronic inflammation is more persistent, lasting several weeks, months, or even years. Chronic inflammation can follow acute inflammation, such as when infections are difficult to clear, or it can develop slowly over time. This smoldering inflammatory process is what we see in many chronic diseases, such as atherosclerosis or some autoimmune conditions. If inflammation sticks around for too long, it can cause damage to the body, scarring of tissues, chronic pain, and overall dysfunction.

The Causes of Inflammation

Inflammation has a number of causes: infectious agents, such as bacteria, viruses, and parasites; tissue injury and damage; disease processes, such as autoimmune conditions; and toxins and pollutants, such as alcohol, tobacco products, medications, and air pollution.

What Does Inflammation Have to Do with Diet?

Inflammation is at the root of many chronic diseases, and diet plays an important role in this process. In a 2013 systematic review of 46 individual studies, German researchers looked at blood levels of an inflammation marker called C-reactive protein (CRP). CRP is often used by doctors to get a sense of inflammation levels in the body and to help determine the risk of cardiovascular problems, such as a heart attack. The researchers found that CRP was consistently elevated in meat-based “Western” patterns of eating and decreased in diets rich in fruits and vegetables. In a 2015 interventional study published in Complementary Therapies in Medicine, researchers put over 600 people on a whole-food, plant-based diet and saw CRP levels plummet, along with total cholesterol, blood pressure, and BMI.

Taken together, the studies suggest eating a healthy diet can reduce inflammation in the body. But the question remains: Does a plant-based diet directly reduce inflammation, or does eating plants just not inflame the body in the first place? The answer might be both. Whole plant foods are loaded with phytonutrients, many of which have anti-inflammatory properties and may help the body to heal more quickly and put the brakes on inflammation. However, plant-based diets also lack or are low in many inflammatory triggers. Animal products contain high amounts of fat, a likely cause of inflammation. However, plant foods are low in fat, so eating these foods doesn’t cause a huge inflammatory response. Plant-based diets are also lower in toxins such as industrial pollutants, which would otherwise cause damage to tissues in the body and trigger inflammation. Lastly, plant-based diets have a low bacterial load. Many bacteria produce toxins called lipopolysaccharides that get released when the bacterium dies. Animal products are a breeding ground for bacteria and their pro-inflammatory bacterial toxins. By choosing plants, we reduce the amount of bacteria, pollutants, and other pro-inflammatory components in our diet, and can, therefore, avoid the reactive inflammatory response that is so characteristic of animal-based foods.

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

This article was originally published on Nov. 27, 2018, and has been updated.

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Polycystic ovary syndrome (PCOS) is the most common hormone-driven condition in women and those assigned female at birth, affecting up to a quarter of women of reproductive age. It is the number one cause of subfertility in that population group. PCOS is chronic, meaning there is no cure, but making diet and lifestyle changes can help to manage symptoms.

Editor’s Note: This article is adapted from The Plant-Based Dietitian’s Guide to Fertility, by Lisa Simon, RD. 

What Is PCOS?

PCOS is a complex chronic condition. Rather than PCOS being a syndrome caused by a disorder of the ovaries, it is actually an endocrine (hormone) system disorder that affects the function of the ovaries. It also causes general metabolic symptoms. 

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What Are the Signs and Symptoms of PCOS?

Higher circulating levels of androgens (sex hormones) is one of the main diagnostic criteria for PCOS and is thought to affect up to 80% of patients with the condition. This is why so many women with PCOS experience difficulties conceiving, as it causes disruptions to the menstrual cycle, resulting in many turning to fertility treatments to help them conceive. Other symptoms include weight gain, excess body hair, skin problems, hair loss, fatigue, depression, and insulin resistance.

Insulin Resistance and PCOS

Our bodies produce insulin, a hormone, to allow our fat and muscle cells to take up glucose from our bloodstream. It also allows our liver to store it. In insulin resistance, the hormone is less effective and we have to produce more and more insulin from our pancreas to encourage our cells to take up glucose. Initially this isn’t a problem, but over time, if it continues to happen, the cells in the pancreas that produce the insulin can wear out and fail to produce enough insulin to overcome the resistance. This then results in high blood glucose levels and ultimately the development of Type 2 diabetes. (Learn more about insulin resistance here.) The incidence of insulin resistance in the general population is around 10–25% but in women with PCOS it may be as high as 95%.

PCOS is a complex condition; we know it involves a combination of lifestyle and genetic factors, but the cause is not fully understood. While there is no cure for PCOS, making positive diet and lifestyle changes can help the body’s tissues use insulin more effectively and improve PCOS symptoms, because as insulin levels drop, so do androgen levels.

The Role of Advanced Glycation End-Products (AGEs)

Harmful compounds known as advanced glycation end-products are an important dietary factor when it comes to PCOS. On a basic level, AGEs are formed in the body when sugars attach to proteins. There are many routes for the entry of AGEs into our bodies: They are made internally but there are also outside sources, including diet, alcohol, and smoking. These compounds are a known risk factor for heart disease and stroke, as they can stiffen our arteries, but they are also associated with decreased male and female fertility.

We have receptors for AGEs throughout our body, including throughout the male and female reproductive tract. When AGEs attach to these receptors they can cause damage to cells and DNA, and cause inflammation. In men, they may cause damage to the DNA in sperm and reduce sperm quality, and in women they can accumulate around the ovaries and inside the uterus. This can lead to early ovarian aging and failure of the embryo to implant. Women with PCOS have been shown to have more than twice the average circulating level of AGEs.

Reducing dietary AGEs is vital for all women and men trying to conceive, but especially for women with PCOS. The highest dietary sources are cooked meat and animal products, as, although they are naturally present in raw animal foods, when they are heated, especially if they are cooked with dry heat, new AGEs are formed. If you are considering reducing the animal products in your diet, meat is the best place to start. It is worth noting that although plant foods are much lower in AGEs, there are certain foods that can contain significant amounts, and these include roasted nuts and toasted bread. My advice would always be to eat nuts in their whole, natural form as these are packed with fertility-friendly nutrients, and to avoid over-browning your toast.

The Importance of Fiber for Managing PCOS

Increasing fiber intake is an important part of dietary management of PCOS, as lower fiber intakes are associated with an increased risk of insulin resistance. Fiber slows down the absorption of glucose and can therefore help to regulate blood glucose levels. It can also aid weight management, with one reason being that some of the energy contained in high-fiber foods becomes a component of your poo rather than being absorbed. In the UK, adults’ average daily fiber intake is around 18 grams (in the U.S., it’s around 15 grams), much lower than the recommended 30 grams per day. It is important to highlight that the only foods that contain fiber are plant foods. There is no fiber in meat, fish, dairy, or eggs.

Benefits of Healthy Lifestyle Changes for PCOS

PCOS is chronic, meaning there is no cure. However, making positive diet and lifestyle changes can help manage the condition and significantly reduce symptoms.

As many women with PCOS are above what is considered the healthy weight range, interventions that help manage weight are vital. Losing as little as 5–10% of body weight has been shown to benefit reproductive and overall physical health, including the restoration of a normal menstrual cycle, achieving pregnancy, and a reduction in miscarriage rates. It can also reduce the risk of metabolic syndrome, which is common in women with PCOS.

The key is focusing on healthy lifestyle changes that will result in gradual, sustainable weight loss. The problem is there are lots of crash diets out there, promising to deliver rapid weight loss, and this can be very tempting. If women seek support and follow a weight loss program purely aimed at calorie restriction, although weight loss may initially happen, most of the weight is likely to be regained within one year. We know that, on the whole, “diets” do not work, as the basis of every weight-loss diet is restriction. Certain foods may be demonized, some meals may be replaced by shakes, and often calorie restriction is significant, leading to hunger, despondency and ultimately a return to previous eating habits. Many weight-loss diets also tend to focus on increasing animal protein and reducing carbohydrate foods, an approach that will exacerbate rather than help manage symptoms of PCOS and can even lead to disordered eating.

A predominantly whole-food, plant-based diet, on the other hand, is not a “diet” in the traditional sense but rather a dietary pattern that, although it minimizes or eliminates animal products, focuses on what you can add into your diet to make every meal colorful, tasty, and satisfying. Such foods contain key nutrients in terms of PCOS, including vitamin A and magnesium. Lower intakes of these micronutrients are associated with insulin resistance. A plant-based eating pattern focuses on including a huge variety of different grains, vegetables, fruits, nuts, seeds and legumes; after all, there are around 2,000 plant species in the world that are cultivated by humans for food. That is incredible, right? The choice is almost endless!

Excerpted with permission from Hammersmith Health Books from The Plant-Based Dietitian’s Guide to Fertility, a brand-new book in which Lisa Simon, RD, draws on her personal experiences with infertility and IVF, her expertise as a dietitian, and a wealth of scientific research to offer easy-to-understand guidance for optimizing fertility and achieving healthy pregnancy using a whole-food, plant-based diet and other lifestyle interventions. Learn more here.

The post What Is Polycystic Ovary Syndrome? <br>Unpacking the Connections Between Diet and PCOS appeared first on Forks Over Knives.

Cholesterol is a little molecule with huge implications for human health. Read on for a breakdown of how cholesterol works—including why HDL (“good”) cholesterol might not be as good as you think—and learn the most important steps you can take right now if you’re among the 38% of Americans who have high cholesterol.

What Is Cholesterol?

Cholesterol is a waxy type of lipid found in almost every cell of the body. A building block of animal life, cholesterol helps form cell membranes and plays a key role in the production of hormones, vitamin D, skin oils, and digestive acids.

The liver makes all the cholesterol that the body needs. Some factors can cause excessive levels of cholesterol to enter the bloodstream; over time, this can seriously impair our cardiovascular systems.

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‘Good’ Cholesterol vs. ‘Bad’ Cholesterol

Cholesterol is not water-soluble, meaning it can’t travel through the bloodstream on its own. For transport, it gets bundled with particles called lipoproteins. The main types of lipoproteins that carry cholesterol are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What About Triglycerides?

Like cholesterol, triglycerides are a type of fatty acid that come from our liver and from the foods we eat. They, too, get bundled with lipoproteins and carried through the body so cells can extract the fat and protein for use. When we consume more calories than we need, we take in excess triglycerides, which our body stores as fat. Because elevated triglycerides can contribute to atherosclerosis, triglyceride levels are typically measured alongside LDL and HDL cholesterol. Lifestyle measures aimed at reducing LDL cholesterol can also bring down triglycerides.

What Causes High Cholesterol?

For most people, high cholesterol is primarily lifestyle-related, the American Heart Association notes. Lifestyle factors that drive up LDL cholesterol (or decrease HDL cholesterol) include:

• Unhealthy diet
• Being overweight or obese
• Sedentary lifestyle
• Cigarette smoking

Genes play a role in the amount of cholesterol that your liver produces. Familial hypercholesterolemia, an inherited genetic condition, impacts an estimated .05% of the population. Genetics can also influence cholesterol levels in indirect ways, such as by predisposing someone to be overweight.

Having Type 2 diabetes is a risk factor for high cholesterol, though more research is needed to understand the connection.

Diet and Cholesterol

Among the lifestyle factors that can influence LDL cholesterol levels, diet plays a major role.

“Studies have shown that one of the strongest contributors to our blood levels of cholesterol, from a dietary standpoint, is our intake of saturated fat, which is found predominantly in animal products, particularly red meat (processed and unprocessed) and dairy.” Harkin adds that palm oil and coconut oil, which are found in many highly processed foods, are also high in saturated fat.

Trans fats also drive up cholesterol levels. Historically, these fats could be found in the form of partially hydrogenated oils in margarine, shortening, butter, cakes, cookies, and salty snack foods. In 2018, the Food and Drug Administration banned manufacturers from using trans fats, but these fats may still occur in deep-fried foods due to the extreme temperature at which oils are heated.

Does Eating Cholesterol Raise Cholesterol Levels?

There’s been some debate about the degree to which dietary cholesterol raises blood cholesterol levels. Because foods high in cholesterol are also typically high in saturated fat, it’s difficult to tease apart the effects of each.

However, a large 2019 study looked for associations between the consumption of cholesterol and rates of cardiovascular disease in 29,615 participants over a median of 17.5 years. They found that, independent of fat and overall diet quality, higher cholesterol intake was in fact associated with a higher risk of CVD. They identified a dose-response relationship: For every additional 300 milligrams of cholesterol consumed daily, there was a 17% increase in the risk of CVD and 18% increase in the risk of death from all causes. (For reference, a single egg contains around 180 milligrams of cholesterol.)

The easiest way to keep cholesterol out of your diet is to steer clear of animal products. All animals produce cholesterol in their livers, so when we eat other animals or animal-based products, we consume their cholesterol. (This is why, when checking nutrition labels, the presence of any cholesterol is a telltale sign that an item isn’t vegan—though the absence of it doesn’t guarantee that a product is vegan.)

What Are Normal Cholesterol Levels?

Ranges for “normal” cholesterol levels vary based on age, sex, and medical history, but according to the Mayo Clinic, adults age 20 and older should aim for the following numbers.

Interpreting Total Cholesterol Numbers

Source: Mayo Clinic

Interpreting LDL Cholesterol Numbers

Source: Mayo Clinic

Interpreting HDL Cholesterol Numbers

Source: Mayo Clinic

*Note: There is some debate about whether HDL cholesterol in excess of 60 mg/dL is truly beneficial. LDL cholesterol levels may be a more reliable indicator of cardiovascular health. 

For more detailed information about normal cholesterol levels, see the American Heart Association and American College of Cardiology guidelines for clinicians.

Complications of High Cholesterol

The primary complication arising from high cholesterol is cardiovascular disease, including coronary artery disease, stroke, and myocardial infarction (heart attack). Strokes and heart attacks follow a similar chain of events: An arterial plaque ruptures. A blood clot forms on the ruptured plaque. The blood clot completely blocks blood from flowing through the artery, preventing blood from getting to the brain (in the case of stroke) or the heart (in the case of heart attack).

High cholesterol and resulting atherosclerosis may contribute to high blood pressure, as the heart has to work harder to pump blood through constricted, plaque-laden blood vessels.

In addition to cardiovascular complications, a number of studies suggest that high cholesterol may impair insulin sensitivity, leading to insulin resistance. Insulin resistance significantly increases the risk of several chronic diseases including Type 2 diabetes, fatty liver disease, chronic kidney disease, and Alzheimer’s disease.

How to Lower Cholesterol

For patients with extremely high cholesterol and/or established cardiovascular disease, lipid-lowering medications, such as statins, may be necessary. For many people, lifestyle modifications alone may be enough to bring cholesterol down into the healthy range.

“For the vast majority of patients who have elevated cholesterol and who do not yet have heart disease, the first-line therapy is lifestyle modifications,” says Harkin. “That involves changes in diet, exercise, and all the other lifestyle factors, but diet [is] one of the biggest levers that we can pull.”

Success Stories

Forks Over Knives has heard from many readers over the years who have reduced their cholesterol after adopting a whole-food, plant-based lifestyle.

• I Put High Cholesterol, Severe Arthritis Behind Me by Changing My Diet
• LDL Cholesterol Cut in Half on a Plant-Based Diet
• What Giving Up Meat, Dairy, and Processed Foods Did for My BMI, Blood Pressure, and Cholesterol
• Since Going Plant-Based, I’ve Lost 45 Pounds, Lowered My Cholesterol, and Stopped Getting Uterine Fibroids
• How I Curbed High Cholesterol, Fibroids, Heartburn, and Anemia
• I Suffered a Widowmaker Heart Attack at 45. Today I’m Thriving on a Plant-Based Diet

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post What Is Cholesterol? How It Works, Foods to Avoid, and the Truth About HDL appeared first on Forks Over Knives.

As scary as it sounds, half of U.S. adults now have high blood pressure, and more will have it as they age. Read on to learn what constitutes high blood pressure and what you can do to bring yours down.

Blood Pressure: How High Is Too High?

In November of 2017, the American Heart Association and the American College of Cardiology released new guidelines on high blood pressure, or hypertension, stating that the cutoff for diagnosis is now 130/80. (Previously, the cutoff was 140/90.)

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As a result of this change, millions of people with blood pressures that were previously considered normal, like 134/82, now meet the clinical definition for high blood pressure. Under the current guidelines, even a blood pressure with the top number in the 120s is considered to be “elevated,” which means it carries a higher risk for heart disease and death.

Source: American Heart Association

High blood pressure is common, affecting 116 million Americans.

Under the current guidelines, 30% of men and 19% of women under age 45 have high blood pressure. If you don’t have it, you likely will sooner or later: Nearly 90% of U.S. adults develop high blood pressure during their lifetimes.

The scary part is how dangerous the condition can be over time. Often described as a “silent killer,” high blood pressure doesn’t always cause symptoms, which is why having your blood pressure checked is vital. Untreated high blood pressure can lead to heart failure, stroke, kidney disease, heart attack, and even death.

Proven Strategies for Lowering Blood Pressure Naturally

If you are diagnosed as having high blood pressure, you may not need blood pressure medications immediately. Whether you need medication depends on how high your blood pressure is, if you have other diseases (like kidney disease or diabetes), and your long-term risk for having complications from high blood pressure.

More importantly, basic lifestyle changes can help prevent or reverse high blood pressure for many people. The most important changes to make include the following:

Lifestyle Changes Are an Effective Tool

These interventions can be effective depending on the magnitude of the lifestyle change. In one study, 76% of participants who followed a vegan diet for one year were able to discontinue or drastically reduce their medications. However, adhering to these seemingly simple changes can be difficult.

Nevertheless, many of these “lifestyle interventions” are routine for traditional societies that generally have low rates of hypertension. High blood pressure is not a natural part of the human aging process. For example, populations in rural China and rural Africa do not have age-related increases in blood pressure, although this is rapidly changing as Western habits percolate globally.

Immigrants to Western countries develop an increased risk of high blood pressure after arriving, which only continues to rise as more time is spent in the West. This pattern is thought to be caused by adopting a Western diet and decreasing physical activity. Changes in lifestyle can undoubtedly raise—–or lower—–your blood pressure.

Even though statistics say you will probably develop high blood pressure during your lifetime, it doesn’t necessarily have to be that way.

The post Got High Blood Pressure? Here’s How to Bring It Down Naturally appeared first on Forks Over Knives.

Affecting 24 million people nationwide, autoimmune diseases can severely impact a person’s quality of life. More than 80 conditions—including lupus, rheumatoid arthritis, and Type 1 diabetes—fall under the umbrella of autoimmune diseases, and while most of them have no cure, simple lifestyle changes can make symptoms more manageable.

What Are Autoimmune Diseases?

Your immune system plays a critical role in protecting your body against infection and disease. In autoimmune diseases, an unknown trigger causes the immune system to produce antibodies that—rather than fight infections and ward off diseases—attack the body’s own tissue. The following list comprises just a few of the vast number of known autoimmune diseases.

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Autoimmune Disease Risk Factors

While the exact causes of autoimmune diseases remain unknown, researchers point to the following noted risk factors, which may occur alone or in combination with others.

• Your genes. Autoimmune diseases tend to run in families; however, the gene inheritance pattern is typically unknown.
• Your sex. Women make up 78% of those affected by autoimmune diseases.
• Having another autoimmune disease. Roughly one-quarter of autoimmune disease patients have multiple autoimmune syndrome, an accumulation of three or more autoimmune conditions.
• Some viruses. Influenza A viruses, measles, and hepatitis C are among the viruses that may trigger the development of autoimmune diseases.
• Some medications. Certain blood pressure medications, statins, and antibiotics can induce conditions such as autoimmune hepatitis and drug-induced lupus erythematosus.
• Smoking. Tobacco smoking has been linked to multiple autoimmune diseases.
• Obesity. More than 10 autoimmune diseases are known to be associated with being overweight or obese. Research suggests that obesity may promote inflammation while reducing the body’s ability to recognize its own antigens as a non-threat when responding to foreign substances.

How Does Diet Affect Autoimmune Diseases?

“Diet plays a huge role in autoimmune diseases because the immune system is affected by food, and two-thirds of your immune system is located in the gut,” says triple board-certified rheumatologist Micah Yu, MD, who also practices integrative medicine. “Whatever food passes through your gut will talk to your immune system.”

Gut dysbiosis—an imbalance in the gut microbiome, the naturally occurring population of bacteria and other microorganisms within the GI tract—has been closely associated with multiple autoimmune diseases, suggesting that maintaining a healthy gut microbiome benefits autoimmune health.

According to 2021 research published in Lupus Science & Medicine, a dietary fiber called resistant starch (commonly found in bananas, plantains, legumes, and whole grains) may positively affect the gut microbiome of people with lupus. Researchers collected stool samples and dietary information from 12 SLE patients and 15 SLE-related antiphospholipid syndrome (APS) patients to see if resistant starch in their regular diets impacted their gut bacteria makeup. While no one consumed high quantities (more than 15 grams) of resistant starch, medium levels (between 2.5 and 15 grams daily) of dietary starch were associated in SLE with increased Bifidobacterium, which is beneficial to the immune system. And people with APS who ate medium levels of resistant starch exhibited lower quantities of harmful bacteria linked to the disease.

Conversely, ultra-processed foods—such as soft drinks, refined sweetened foods, salty snacks, and processed meats—have been demonstrated to promote gut dysbiosis. A 2017 review published in Foods concluded that the resulting imbalance might be associated with an increased risk of at least two autoimmune diseases—Type 1 diabetes and celiac disease—in predisposed children. Additionally, a 2021 study published in The BMJ suggested that eating ultra-processed foods can significantly heighten the risk of developing IBD.

One reason these foods are so detrimental is that they produce inflammation, which can trigger an abnormal immune response, says Yu. “With your immune system, you have something called immune tolerance, where your immune system’s supposed to see its own cells and just ignore it. But [in autoimmune diseases] over time, because of chronic inflammation, your body will start reacting to its own cells. That’s where [the body] can attack its own joints, its own brain cells, its own nervous system cells, and so forth.”

Yu says that one way to combat that inflammation is by consuming more anti-inflammatory foods. Research has shown that fruits and vegetables are associated with anti-inflammatory properties. And there is evidence that a vegan diet rich in fruits, vegetables, and whole grains reduces inflammation.

A plant-based diet may also reduce autoimmune disease symptoms, such as fatigue. A 2004 study had 24 middle-aged people with rheumatoid arthritis follow a low-fat vegan diet for four weeks. At the end of the study, participants saw a significant reduction in all RA symptoms, except for the duration of morning stiffness. A more recent study, published in Lupus in January 2022, looked at extensive data from 420 SLE patients who completed a 26-question survey on their diets and SLE symptoms. Researchers found that patients “who changed their eating patterns to incorporate more plant-based foods while limiting processed foods and animal products reported improvements in their disease symptoms.”

Real-Life Success Stories

Have you been diagnosed with an autoimmune disease? You may be able to improve your outcomes by eating more whole plant foods and avoiding animal products and highly processed foods. For inspiration, check out the following first-person testimonials from people with autoimmune diseases who benefitted from a whole-food, plant-based diet.

“I Resolved a Decade of Rheumatoid Arthritis Pain Within Months on a Plant-Based Diet”

After 10 years of painful rheumatoid arthritis, Andrea Kane changed her diet and dramatically reduced her rheumatoid arthritis symptoms. Read her story.

“How I Reversed Crippling Rheumatoid Arthritis With a Plant-Based Diet”

In August 2015, at 35 years old, Emily Brandehart was diagnosed with rheumatoid arthritis, with symptoms so painful that she couldn’t sleep. Then she did some research and discovered the benefits of a plant-based diet. Read her story.

• I Overcame Lupus and Freed Myself from Medications with a Plant-Based Diet
• For 26 Years, I’ve Managed Type 1 Diabetes With a Plant-Based Diet
• I Used to Have MS Relapses Every 6 Months. After Going Plant-Based, I Haven’t Relapsed in 10 Years
• Overcoming Myasthenia Gravis Symptoms on a Plant-Based Diet
• Plant-Based Diet Has Me Winning My Long, Hard Battle with Ulcerative Colitis

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

The post Autoimmune Diseases and Diet: Here’s What You Need To Know appeared first on Forks Over Knives.

Affecting 1 in 3 adults, metabolic syndrome is fairly common in the United States. A constellation of conditions, it puts people at higher risk of cardiovascular disease, diabetes, stroke, and other serious health problems, like atherosclerosis. The good news? Simple lifestyle changes and healthy habits can reduce that risk and may even be able to reverse the damage that has already been done.

What Is Metabolic Syndrome?

Doctors have long been interested in uncovering a connection between obesity, diabetes, and heart disease. Metabolic syndrome, also known as Syndrome X or insulin resistance syndrome, emerged as a way to describe shared underlying characteristics.

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Metabolic Syndrome Symptoms

You may be diagnosed with metabolic syndrome if you have at least three of the five following conditions.

• A large waist circumference: You have an “apple-shaped” body, or your waist circumference measures greater than 35 inches for women or greater than 40 inches for men.
• High blood glucose (sugar): Your blood sugar measures 100 mg/dL or more, or you take medicine for high blood glucose.
• Low levels of HDL (“good”) cholesterol: Your HDL levels are less than 40 mg/dL for men or less than 50 mg/dL for women.
• High levels of triglycerides: Your triglyceride levels measure 150 mg/dL or more, or you take medicine for high triglycerides.
• High blood pressure: Your blood pressure measures 130/85 mmHg or more, or you take medicine for hypertension.

Risk Factors

A variety of traits, conditions, and lifestyle behaviors put you at greater risk of developing metabolic syndrome. The following may occur on their own or in combination with other risk factors.

• Excessive fat in and around the abdomen
• Inactivity (less than the recommended 150 minutes per week of exercise)
• Too much or too little sleep (more than 10 hours or less than six hours)
• Smoking and/or heavy alcohol consumption
• Age: Your risk increases as you get older.
• Gender: Men are at a greater risk than women, although women are more likely to have low HDL.
• Ethnicity: Metabolic syndrome is most prevalent among Hispanic adults.
• A family history of diabetes or metabolic syndrome
• Insulin resistance, which occurs when cells don’t respond normally to insulin
• Polycystic ovary syndrome, a condition that causes cysts to grow on the ovaries
• Chemotherapy: Women treated with chemotherapy before or after breast cancer surgery are at a higher risk.

How Does Diet Affect Metabolic Syndrome?

“Metabolic syndrome is certainly very much impacted by diet,” says Nicole Harkin, MD, FACC, founder of Whole Heart Cardiology. “The central component to it is weight gain which is often created by a combination of genetic factors, a sedentary lifestyle, and then dietary factors that really go into developing insulin resistance and a body weight that’s above ideal.”

A primary culprit, she says, is the standard American diet, which tends to be rich in highly processed foods.

A 2021 study published in Liver International investigated the connection between ultra-processed foods and metabolic syndrome. A total of 789 male and female participants (59 years old on average) received a food frequency questionnaire, an abdominal ultrasound, body measurements, blood pressure measurements, and fasting blood tests. Researchers found that eating more ultra-processed foods was associated with higher odds for metabolic syndrome and its components—hypertension, hypertriglyceridemia, and low HDL.

Another culprit, according to at least two studies, is the high consumption of red meat and processed meats.

On the flip side, evidence shows that a whole-food, plant-based diet can play a protective role against metabolic syndrome. Not only is it low in saturated fat; it’s also high in fiber, which could be effective in the management of metabolic syndrome for its ability to control body weight through its effect on satiety (among other health benefits). And research indicates that eating greater quantities of fruits and vegetables is associated with a lower risk of metabolic syndrome.

How to Reverse Metabolic Syndrome

“While [metabolic syndrome] might sound like a scary diagnosis, it’s definitely something that you can turn around with lifestyle changes,” says Harkin.

A healthy diet and regular exercise are keys to doing just that, according to a 2007 study published in the Journal of General Internal Medicine.

Researchers divided 335 metabolic syndrome patients aged 45 to 64 in northwest Italy into an intervention group and a control group. The intervention group reduced saturated fat intake and increased polyunsaturated fat and fiber intake, along with exercise levels. After 12 months, researchers saw weight, waist circumference, high-sensitivity C-reactive protein (a marker of inflammation), and most metabolic syndrome components decrease in the intervention group and increase in the control group.

“Getting an adequate amount of exercise is a great part of preventing and reversing metabolic syndrome,” says Harkin.

And it doesn’t need to be vigorous exercise, which may be especially challenging for overweight or more sedentary individuals. Instead, according to a 2007 study published in the American Journal of Cardiology, even moderate exercise, such as walking about 12 miles per week, can sufficiently improve metabolic syndrome. Alternately, the American Heart Association recommends 30 to 60 minutes per day of moderate-intensity physical activity supplemented by two days per week of resistance training.

“If you lose somewhere between just 5–10% of your body weight, that can really improve your insulin sensitivity and reverse some of the cardiometabolic abnormalities that we see in association with metabolic syndrome,” says Harkin.

Real-Life Success Stories

By adopting a healthier lifestyle, it’s possible to avoid and even reverse metabolic syndrome and its risk factors. For inspiration, check out the following first-person testimonials from individuals who have—with the help of a whole-food, plant-based diet—done just that:

• I’m Reversing Metabolic Syndrome on a Plant-Based Diet
• I’ve Normalized Sky-High Triglycerides and Begun Reversing Kidney Disease in Just 12 Weeks
• What a Plant-Based Diet Did to My Cholesterol, Blood Sugar, and Triglycerides
• From Cheese-Loving Vegetarian with Sky-High Blood Pressure to Whole-Food, Plant-Based and Healthy
• What Giving Up Meat, Dairy, and Processed Foods Did for My BMI, Blood Pressure, and Cholesterol

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

The post Metabolic Syndrome and Diet: Here’s What You Need To Know appeared first on Forks Over Knives.

Stroke is the fifth-leading cause of death and a leading cause of disability in the United States. Here, learn about the different kinds of strokes, what symptoms to recognize, and how to lower your risk. Stroke is a serious medical emergency. If you believe that you may be experiencing a stroke, call 911 immediately.

What Is a Stroke?

A stroke results when an artery supplying blood to the brain becomes blocked or ruptured. Without blood to provide oxygen and nutrients, brain cells begin to die. A stroke on the left side of the brain affects the right side of the body, and a stroke on the right side affects the left side of the body. According to the American Stroke Association, this damage to brain cells may lead to death or debilitating after-effects, such as:

• Neuropathic pain
• Problems with movement, speech, and language
• Trouble reading, writing, doing math, organizing, reasoning, and learning new information 
• A change in depth perception, the ability to recognize emotion in someone’s voice, the propensity for creativity
• Difficulties seeing or sleeping
• Trouble controlling bladder or bowels
• Fatigue and depression

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How Is a Stroke Different from a Heart Attack?

Both stroke and heart attack are caused by an interrupted blood supply. A heart attack occurs when there is a blockage in the artery leading to the heart; a stroke happens when there is a blockage or rupture of an artery, which interferes with blood flow to the brain. A stroke, sometimes called a brain attack, can even result from a blood clot that first forms in the chest, but, instead of blocking blood flow to the heart, breaks loose and travels through the bloodstream until it reaches an artery that supplies the brain but is too narrow to allow the clot to pass. Stroke and heart attack have many of the same risk factors and prevention strategies. (See “Causes and Risk Factors,” below.)

Types of Stroke

There are three main types of stroke: ischemic, hemorrhagic, and transient ischemic attack.

Symptoms of Stroke

The sooner you recognize signs that you may be having a stroke and seek medical care, the better the chance of survival and recovery. According to the Centers for Disease Control, stroke symptoms include:

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
• Sudden confusion, trouble speaking, or difficulty understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination
• Sudden severe headache with no known cause

If you have any doubt, err on the side of caution and call an ambulance. The most effective treatments are available if the stroke is diagnosed within three hours of the first symptoms. The American Stroke Association recommends using the acronym F.A.S.T. to gauge whether a stroke might be occurring: 

F: Face drooping. Does one side of the face droop or feel numb? Ask the person to smile. Is the person’s smile uneven?

A: Arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S: Speech difficulty. Is speech slurred?

T: Time to call 911. If any of the above symptoms are present, call 911.

Causes and Risk Factors

Many of the mechanisms that lead to heart disease also can lead to a stroke. The following factors increase the risk of a stroke.

• Cardiovascular disease, including heart failure, heart defects, heart infection, or irregular heart rhythm, such as atrial fibrillation
• High blood pressure. Hypertension causes a two- to four-fold increase in the risk of stroke before age 80, according to the National Institutes of Health. 
• High cholesterol
• Diabetes
• Smoking. Smoking has been linked to fatty buildup in the carotid artery, which is the main neck artery supplying blood to the brain; blockage in this artery is the main cause of stroke in Americans. Smoking also thickens blood and makes it more likely to clot.
• Being overweight or obese
• Being physically inactive
• Heavy or binge drinking or use of illegal drugs such as cocaine and methamphetamine
• Obstructive sleep apnea
• Personal or family history of stroke, heart attack, or TIA
• COVID-19. A large study of nearly 20,000 people age 65 and older found that the risk for ischemic stroke in patients with COVID-19 was significantly higher the first three days after the infection (compared with the control period of seven days before a COVID-19 diagnosis or 28 days afterward).

Preventing a Stroke

The most critical step you can take in preventing stroke is controlling blood pressure. Other important steps you can take to lower your risk of stroke:

• Maintain a healthy weight.
• Control cholesterol.
• Treat atrial fibrillation (an irregular heartbeat that can lead to blood clots).
• Keep blood sugar in a healthy range, as diabetes compromises blood vessels.
• Quit smoking.
• If you drink, drink in moderation. Heavy alcohol consumption increases the risk of high blood pressure, ischemic strokes, and hemorrhagic strokes.
• Exercise: The American Stroke Association recommends at least 40 minutes of moderate to vigorous aerobic exercise three or four days a week.
• Eat a healthy diet. Limit animal products and highly processed foods containing saturated fat, trans fat, and cholesterol, since they promote a buildup of cholesterol and plaque in the arteries, which increases the risk of strokes. Cut back on foods containing high levels of sodium to help keep blood pressure in check.

Can a Plant-Based Diet Help Prevent Stroke?

A 2021 study out of Harvard found that healthy plant-based diets—rich in foods such as leafy greens, whole grains, and beans, and low in foods such as refined grains and added sugars—may lower overall stroke risk by up to 10 percent compared with lower-quality diets. The researchers analyzed health data from more than 200,000 people who were followed for more than 25 years and completed diet questionnaires every two to four years.

Additionally, scientific studies have linked diets rich in whole plant foods to reduced rates of hypertension, obesity, cardiovascular disease, and diabetes, all of which are contributing factors for stroke.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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Irritable bowel syndrome (IBS) affects as many as 45 million people in the United States. It is the most common diagnosis in gastroenterology practices: 1 out of 3 patients seen are suffering from IBS. More people miss work as a result of irritable bowel syndrome than any other reason other than the common cold. In this article, we’ll review the symptoms of IBS and the scientific research regarding IBS and diet.

What Is Irritable Bowel Syndrome?

IBS is a chronic condition that affects the large intestine, causing symptoms that range from mild to debilitating. It is considered a functional bowel disorder, which means the problem isn’t with the structure of the bowels; it’s with how they work. Because symptoms are present without any visible signs of damage to the digestive tract, it is not diagnosed through testing such as blood tests, X-rays, or endoscopy. Doctors may order tests to rule out other digestive problems, such as celiac disease, but IBS is not a diagnosis of exclusion. Instead, diagnosis is made using a well-accepted set diagnostic criteria called the Rome criteria.

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Symptoms of IBS

According to the Rome criteria, to be diagnosed with IBS, a patient should have abdominal pain and discomfort lasting on average at least one day a week for the last three months. The pain or discomfort should be related to defecation, associated with a change in frequency of bowel movements, and/or associated with a change in stool consistency. Other symptoms of IBS can include bloating, gas, passage of mucus, straining, urgency, or a feeling of incomplete evacuation.

What Causes IBS?

The exact cause of IBS is not known, though we know at the root is a disturbance in the interaction between the gut, brain, and nervous system. “There are millions of neurons in our gut, and the gut and brain are talking to each other all the time through the vagus nerve,” says Dr. Sarina Pasricha, MD, MSCR, a gastroenterologist specializing in gut motility. “The gut, the brain, and the nervous system are like three legs of a stool. If one part is not working properly, the whole thing weakens and falls apart.” 

Two of the biggest factors behind IBS are gut dysbiosis, an imbalance of the bacteria in the GI tract, and stress and anxiety. Studies show that people with IBS have unusually sensitive nerve endings in the GI system and are prone to feeling more intense pain at lower thresholds. This can lead symptoms to flare up in conditions—dealing with a stressful situation or even simply eating a meal—that would not trigger symptoms in those without IBS.

Trigger Foods

“The first thing I usually recommend to my patients is cutting out dairy,” says Pasricha. “Dairy for most people is quite inflammatory. With just that switch alone my patients will have symptom improvement.” Other common triggers include consuming large meals, high-fat meals, caffeine, alcohol, and carbonated drinks. 

It can be helpful for patients with IBS to keep a food diary to uncover their personal food triggers. However, it is important to not jump to conclusions, because foods aren’t the only triggers. “Patients with IBS may be able to eat one food item one day and not have an issue, but the exact same food item on a different day will create an issue,” says Pasricha. “That’s where environment and stress play a role as triggers. It is always worth reintroducing and retrying foods to see if it’s the food or that environment—like eating too quickly that day—causing the issue.”

It is often recommended for people to try a diet low in certain carbohydrates called FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). FODMAPs are found in dairy products and certain grains, vegetables, and fruits. However, since so many healthy plant foods fall into the FODMAP category, totally cutting them out—while it may reduce symptoms in the short term—will lower the number of healthy microbes in the gut, increase the number of unhealthy ones, and leave you worse off in the long term, says Pasricha. 

“When necessary, the low-FODMAP diet can help reset the gut microbiome, but I only recommend this for 4 to 6 weeks and only for the most severe cases of IBS,” says Pasricha. “After that it is really important that you slowly try to incorporate FODMAPS back into the diet in order to provide the right type of food for your gut microbiome.” 

For severe cases of IBS, Pasricha recommends working with a plant-based dietitian.

IBS and Plant-Based Diets

A whole-food, plant-based diet improves the gut microbiome, which can improve IBS symptoms. “I always recommend a whole-food, plant-based diet for my patients and counsel them that the more variety you can eat in fruits and vegetables, the healthier the gut microbiome will be,” says Pasricha. In 2018, the American Gut Project released the largest study of the microbiome to date and found that subjects who ate more than 30 different types of plants (including whole grains) in a week had significantly healthier gut microbiomes compared with those who ate 10 or fewer types of plants each week, with more beneficial gut microbes and fewer harmful microbes. 

Studies show that compared with people eating an animal-based diet, a plant-based diet increases microbiota diversity in part because it provides more fiber. Fiber is considered a first-line therapy in treatment recommendations for patients with IBS, according to the 2021 American College of Gastroenterology clinical guidelines. “A whole-food, plant-based diet that is rich in fiber helps to produce short chain fatty acids, which is the key to building a robust gut microbiome,” says Pasricha. Fiber adds bulk to stool, speeds up its transit through the colon, and can help regulate bowel movements. A 2018 study found that the more fiber participants consumed, the less likely they were to have IBS. Soluble fiber—found beans, oats, lentils, and certain fruits—may serve as a prebiotic, feeding beneficial bacteria in the gut. Research suggests that insoluble fiber, the “roughage” that whole grains and vegetables tend to be rich in, has a laxative effect that can relieve constipation. 

However, most people with IBS will need to go slowly when beginning a plant-based diet. “I always tell my patients not to go from 0 to 100 really quickly,” says Pasricha. “It’s OK to go gradually, to slowly increase fiber intake and slowly transition to a whole-food, plant-based diet, especially if they experience gas and bloating to begin with. It’s important to counsel our patients that when they are transitioning to a whole-food, plant-based diet they might experience some worsening of their gas and bloating. That is expected. It is not harmful.” As noted above (see “Trigger Foods”), it’s important to keep an open mind and remember that it’s not always food causing the issue. “People will have a symptom when eating an apple or broccoli and assume it’s the food, but it doesn’t mean they have to eliminate it permanently,” says Pasricha. “They need to retry those foods again.”

IBS Treatments

While a change in diet is the first powerful step in alleviating symptoms of IBS, studies have found improvements with a range of lifestyle strategies including exercise, yoga, stress reduction, biofeedback, and psychological therapies such as cognitive behavioral therapy. “IBS requires a multifactorial approach to treatment and management,” says Pasricha. “Mind, body, soul, and gut health care are all important.” 

For people suffering from more severe IBS, treatment may include prescription antispasmodic or antidiarrheal medications, or low-dose antidepressants. “The last resort is medication,” says Pasricha. “We don’t want our patients to be on medications lifelong if they don’t need to be. After transitioning to a whole-food, plant-based diet and making lifestyle changes, many of my patients are able to decrease the dose of medications or come off of them entirely.”

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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More than 26 million Americans have asthma. Worldwide, as many as 400 million people are projected to have asthma by 2025, an increase of 100 million in just 20 years, according to a report by the Global Initiative For Asthma (GINA) Dissemination Committee. Studies show that these increases are related to environmental changes such as urbanization as well as unhealthy lifestyle behaviors including the growth of the Westernized diet, sedentary lifestyle, and obesity. In this article, we’ll review the connections between diet and asthma.

What Is Asthma?

Asthma is a chronic lung disease that can start at any age. It causes the lining of the bronchial tubes—the airways leading into your lungs—to become red, swollen, and sensitive. Once these airways are inflamed, they become hypersensitive to triggers that may not bother others. Under these circumstances, triggers can lead to an asthma attack: The airways’ lining further swells, the muscles that wrap around the bronchial tubes tighten or spasm, and more mucus than usual is produced, which can clog the airways. As a result, the airways become even narrower, making it harder to get air into the lungs.

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What Are the Symptoms of Asthma?

Asthma-related inflammation can be present in the airways without any obvious symptoms. When this inflammation escalates during an asthma attack, symptoms can include shortness of breath, rapid breathing, chest tightness, coughing, or wheezing.

What Are the Triggers?

Asthma attacks can be triggered by different factors in different people. Common triggers include air pollution, tobacco smoke, dust mites, pets, mold, cleaning products, exercise, and strong emotions, according to the Centers for Disease Control.

What Are the Dangers of Uncontrolled Asthma?

When not properly managed, asthma can be dangerous and potentially fatal. According to the most recent numbers from the World Health Organization, asthma caused 461,000 deaths worldwide in 2019. Avoiding triggers and using medications are the primary interventions for managing asthma. Researchers are investigating healthy lifestyle behaviors, including diet, that may help prevent or manage asthma, lower morbidity and mortality, and improve quality of life. 

How Does Diet Affect Asthma?

There is rising interest in the impact of diet on an asthma patient’s condition. “While lifestyle medicine in pulmonary disease is in its infancy, evidence-based practice and lessons learned from lifestyle interventions in other chronic diseases, such as diabetes and atherothrombotic vascular disease, should impart critical insights for lifestyle interventions in asthma,” says Sharmilee Nyenhui, MD, a researcher from the University of Illinois at Chicago’s Division of Pulmonary, Critical Care, Sleep and Allergy, who recently co-authored a commentary on the subject.

Existing evidence points to some clear patterns.

Global rates of asthma began steadily rising in the 1980s with the spread of the Westernized diet (aka the Standard American Diet), characterized by highly processed convenience foods, fried foods, refined grains, sweets, processed and red meats, and high-fat dairy products, with low intake of fruits, vegetables, and whole grains. 

In 2015, researchers from Harvard surveyed the eating patterns and asthma rates of children in Puerto Rico. They found that a dietary pattern including frequent consumption of dairy products and sweets, sodas, and snacks, with infrequent intake of vegetables or grains, led to increased odds of asthma in the children. 

Fast food, a hallmark of the Westernized diet, has also been implicated in asthma. The International Study of Asthma and Allergies in Childhood, a large-scale epidemiological study, leveraged data on the dietary habits of a half million children and adolescents from around the world. Those who consumed fast food three or more times per week had an increased risk of severe asthma, according to the results.

Does Eating a Plant-Based Diet Help Prevent Asthma?

A systematic review by the European Academy of Allergy and Clinical Immunology Lifestyle and Asthma Task Force concluded that the existing evidence supports recommendations in clinical practice to increase the intake of fruits and vegetables as a way of reducing the risk of asthma, particularly in children.

In the Harvard study of Puerto Rican children, the children with a healthy diet (defined in the study as frequent consumption of vegetables or grains and infrequent consumption of dairy products and sweets) had, on average, 83 percent lower odds of asthma than children eating an unhealthy diet. The researchers found that a healthier diet was associated with lower inflammatory cytokine levels. 

Fruits and vegetables—and other plant foods such as whole grains, seeds, nuts, and legumes—are high in antioxidants, which protect against inflammation. They also are rich in fiber. When you consume fiber, your gut microbes produce short-chain fatty acids that reduce inflammation, such as butyrate. “Plant-based foods support the biodiversity of the gut microbiome and also promote the bacteria that are anti-inflammatory,” says Kahleova of the Physicians Committee for Responsible Medicine. 

Can Dietary Changes Reduce Symptoms in People Who Already Have Asthma?

In a study of asthmatic adults conducted by Wood’s team in Australia, patients were assigned for two weeks to diets with varying levels of antioxidants: one group ate a high-antioxidant diet with five servings of vegetables and two servings of fruit daily; a second group ate a low-antioxidant diet with two or fewer servings of vegetables and one serving of fruit daily. After the two weeks were up, researchers continued to monitor the subjects for three months. They found that the high-antioxidant group, on average, went significantly longer without experiencing an asthma attack. The low-antioxidant diet group was more than twice as likely to have an asthma attack. 

Anecdotally, Forks Over Knives has heard from people who have had success in controlling their asthma after adopting a whole-food, plant-based diet:

• Asthma Held Me Back Until I Tried a Plant-Based Diet
• Eczema, Arthritis, Asthma, Migraines—All Gone After Going Plant-Based
• How a Plant-Based Diet Reversed My Asthma

Experts continue to research just how much of an effect diet has on asthma, with the goal of someday developing standardized dietary guidelines. The available research shows that eating a plant-predominant diet rich in fruits, vegetables, whole grains, and other fiber-rich foods can help mitigate asthma by contributing to a healthy weight, balancing a healthy gut environment, and protecting against systemic and airway inflammation. 

“The best dietary strategy for asthma is to consume a diet high in fruits and vegetables and low in fast foods, whilst achieving and maintaining a healthy weight,” says Wood. “This strategy will protect against inflammation, which is the underlying cause of asthma.”

Ready to get started? Check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

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One in 3 Americans are cutting back on gluten. If you’re plant-based or vegan and considering going gluten-free, read this first-person report by a WFPB health journalist who didn’t figure out she had celiac until after her own daughter was diagnosed with the disease.

Eating a Whole-Food, Plant-Based Diet and Still Experiencing Gastrointestinal Problems?

After I transitioned to a whole-food, plant-based diet six years ago, I felt great overall, and my total cholesterol dropped 60 points. But I was discouraged that I continued to experience intrusive digestive issues like bloating and gassiness. When I complained to my sister, she suggested that I try cutting gluten.

“But what will I eat?” I asked, assuming that combining my plant-based diet with a gluten-free lifestyle would be way too restrictive. I decided it wasn’t worth it. I relied on foods like whole wheat pasta and couscous to help keep me satiated, and I’d begun experimenting with new-to-me grains such as farro and wheat berries. Besides, I’d always heard that you shouldn’t jump on the gluten-free bandwagon unless you had a medical reason.

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The Nutritional Hazards of the Gluten-Free Boom

Turns out, I had heard right. “When we make the decision to eliminate gluten, we are throwing the baby out with the bathwater,” says Will Bulsiewicz, MD, MSCI, a gastroenterologist in Charleston, South Carolina, and author of Fiber Fueled.

“Gluten-containing foods contain many things that are incredibly healthy for us.” Foods that contain wheat, barley, and rye—the three sources of gluten—are also among the leading sources of whole grains in the United States, Bulsiewicz says. They provide B vitamins, protein, and minerals including iron, zinc, and magnesium. They are also excellent sources of fiber, something 96 percent of people in the United States are deficient in, according to the National Health and Nutrition Examination Survey.

In one study in the British Journal of Nutrition, healthy subjects who ate gluten-free for a month measured lower levels of beneficial bacteria and higher levels of unhealthy bacteria in their guts. Another study found that people who followed gluten-free diets when it wasn’t medically necessary reported an overall lower intake of whole grains, something the study authors warned increased the risk of heart disease. Nevertheless, many people with no medical reason to avoid gluten swear they feel better when they do. Why is that?

“Almost all gluten-containing foods are processed foods—bread, pasta, pizza, and cereal,” Bulsiewicz says. To feel better, you don’t have to shun healthful whole grains—just ditch the processed varieties as much as you can.

5 THINGS YOU NEED TO KNOW

Unfortunately, I was forced to reexamine my own relationship with gluten last year when my daughter was diagnosed with celiac disease, an autoimmune disorder for which eliminating gluten is the only treatment. Celiac is hereditary and my blood work confirmed that I carry the gene. That and my lingering symptoms suggest that I’m at high risk of developing celiac if I continue to eat gluten. We quickly transitioned our already vegan, plant-based kitchen to gluten-free, and I discovered that merging the two lifestyles is totally doable. Here are the five most important things I’ve learned through our journey.

1. A Gluten Problem Isn’t Always Obvious

When I Googled symptoms of celiac disease, they included digestive issues like mine and more extreme ones like diarrhea, abdominal pain, and malnutrition. My daughter had none of these, so I never suspected gluten was at the root of the crawl-out-of-her-skin nighttime anxiety, rashes, and insomnia. But more than 200 symptoms are associated with celiac, including brain fog, joint pain, iron-deficiency anemia, and infertility, according to the University of Chicago Celiac Disease Center. “It’s a chameleon disease,” says Melinda Dennis, MS, RDN, LDN, nutrition coordinator of the Celiac Center at Beth Israel Deaconess Medical Center in Boston. “You could fill pages of a PowerPoint with symptoms.”

2. Get tested before cutting gluten.

Celiac is a serious disease that ups your risk for other serious diseases, and if you aren’t sure you have it, you may not be as faithful about avoiding gluten as you need to be. A positive diagnosis also clues in family members that they need to get screened since it can silently run in families. Gluten has to be ingested daily for weeks or months to receive an accurate diagnosis. That’s why the last thing you should do is go gluten-free before getting tested. “You lose the opportunity for the clinician to rule out or diagnose celiac disease,” Dennis says. 

3. Going GF “to eat healthy” can put others in harm’s way.

Restaurant dining is a minefield for people with celiac. When a customer makes a gluten-free request, the kitchen staff has to switch into high alert to avoid cross contamination: changing gloves and using separate utensils, griddles, and counter space. If a customer orders gluten-free, but the restaurant staff later sees him drinking a beer or eating a gluten-containing dessert, they may shrug off future requests. A 2019 study in The American Journal of Gastroenterology found that one in three restaurant dishes labeled gluten-free contained gluten.

4. Get to know gluten-free whole grains.

Cutting out gluten can create a whole-grain void in your diet that can lead to gut dysbiosis. Instead of limiting your menu to gluten-free standbys like rice and quinoa, make a concerted effort to add gluten-free whole grains that you haven’t tried before. “If you rotate several choices of gluten-free grains in your diet, you can greatly improve your nutritional profile,” Dennis says. Rather than giving up the old gluten-containing dishes you love, adapt them using GF grains, says Carol Fenster, a consultant and cookbook author who specializes in gluten-free recipes. “Replace barley in soup with sorghum. Mix buckwheat and teff into gluten-free oats. Incorporate amaranth into Taco Tuesday.” Check out our list of gluten-free whole grains below.

5. Watch out for processed foods.

Most gluten-free breads, pastas, crackers, and other packaged goods contain long lists of refined starches and fillers. “In 2020, we have ultra-processed Frankenstein foods being marketed as gluten-free and healthy,” Bulsiewicz says. As with all foods, the healthiest gluten-free choices are whole plant foods. WFPB eaters have an advantage here because we already avoid processed foods. Done right, a gluten-free lifestyle reinforces WFPB habits like cutting back on processed sauces and salad dressings that harbor gluten; cooking more at home; and thinking ahead when you’ll be away from your kitchen. It also gives you an extra push to open up dialogue with waiters to make sure your restaurant order meets all of your dietary needs.

Testing 1, 2, 3: Pinpointing Gluten Issues

If you suspect gluten might be causing problems for you, ask your doctor about testing. According to Bulsiewicz, three out of the four scenarios below warrant wholesale removal of gluten from the diet. Read on for the breakdown.

Gluten-Free Whole Grains

The following whole grains are all gluten-free.

For a healthier gut, incorporate at least a few different kinds into your meal routine. Tip: While you’re familiarizing yourself with a new grain, we recommend batch cooking a large amount and making a few different recipes that use it. Forks Over Knives Meal Planner—which has 1,000+ GF recipes and uses batch cooking and other Weekend Prep steps to make weekday cooking easier—is a great source of guidance. Try Forks Meal Planner for free today.

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