Because we’re all so biochemically different, there can’t possibly be one single correct diet that will improve RA. But in the world of nutrition there are certain foods that either exacerbate inflammation or help to reduce it. My research into foods that increase and promote inflammation has led me straight to the subject of sugar and refined and high-glycemic carbohydrates.
I probably don’t have to tell you that we’re a nation that is addicted to sugar. On average Canadians consume 26 teaspoons of sugar per day. (Canadian teenage boys average 41 teaspoons of added sugar every day and girls aren’t far behind). Not only does sugar taste good but it also makes us physically feel good as it stimulates the release of dopamine in the brain. For this very reason food manufacturers put it in everything, from tomato sauce and ketchup to salad dressing, applesauce, lemonade, fruit juice, cough syrup, and the list goes on. How can we not be addicted to it? The over-consumption of sugar has been linked to tooth decay, hyperactivity, obesity, and diseases like cancer. (Cancer cells utilize sugar to stay alive). But what about inflammation? The predominant theme in all of my reading is this: Dietary sugars of all kinds have an inflammatory effect in the body. In Kris Carr’s book Crazy Sexy Diet, guest writer and doctor Lilli B. Link writes:
“In medical school I was thrilled to learn that, unless you had diabetes, the only problem with sugar was that it caused cavities. Ah, if that were only true! In a 2004 study of patients with diabetes that appeared in the journal Metabolism, participants were given a sugar drink, and then their blood was tested for inflammation. Within one hour of drinking the sugar, the level of inflammation in their bodies rose, and the effect lasted three hours. You can just imagine what might happen if you are snacking on sweetened food throughout the day for months on end.”
In the world of carbohydrates, which ones promote inflammation in the body? First of all, what are carbohydrates exactly? Carbohydrates are the sugary and starchy part of plant foods. (Dairy products are also carbohydrates and the only carbs that come from animals). Some plant foods contain large amounts of carbs (rice, corn, potatoes, for example) while others, like beans, broccoli, and carrots have smaller amounts. Some carbs give your body a whopping glycemic punch, meaning they’re easily digested and quickly converted to blood glucose (blood sugar), while other carbs are digested slowly, providing your body with a more balanced, even energy. Carbohydrates that have been refined into flour and made into food (like most breads, cakes, cookies, and pizza crust, for example) act the same way in the body that pure sugar does. Once digested these carbs turn into blood glucose so quickly it really isn’t much different from eating sugar itself.
We all need carbs for the very reason that they’re converted to glucose. Glucose is fuel for our tissues, organs, brain, and red blood cells. We can’t survive without it. But carbohydrates that spike our blood glucose quickly not only stress our cells but they also flood our system with excess insulin, which happens to be a pro-inflammatory hormone. Dr. Alejandro Junger, author of Clean: The Revolutionary Program to Restore the Body’s Natural Ability to Heal Itself, advocates the elimination of pro-inflammatory foods from our diet. He writes:
“Simple carbohydrates such as sugars and grains, especially refined grains (white flour, white rice), cause the body to release greater amounts of insulin into the blood to regulate absorption of the sugars into the cells. Insulin is a pro-inflammatory hormone.”
In his bestselling book Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health, preventative cardiologist Dr. William Davis writes that wheat increases blood sugar and insulin more than any other carbohydrate, from beans to candy bars. He also warns against food products (typically gluten free) made with cornstarch, rice starch, potato starch, and tapioca starch as these are among the few foods that actually increase blood sugar even more than wheat products. The extremes of blood sugar and insulin that occur after eating wheat are responsible for the growth of fat, he says, specifically deep visceral fat that visibly encircles the abdomen, and it is this type of fat that produces high levels of inflammatory signals and abnormal cytokines. He writes:
“Visceral fat not only produces abnormally high levels of inflammatory signals but is also itself inflamed, containing bountiful collections of inflammatory white blood cells (machrophages). The endocrine and inflammatory molecules produced by visceral fat empty…directly into the liver, which then responds by producing yet another sequence of inflammatory signals and abnormal proteins.”
Davis links wheat consumption and visceral fat with abnormal insulin responses, diabetes, hypertension, heart disease, dementia, colon cancer, and (you guessed it) rheumatoid arthritis.
Listen to him speak here.
So how do we know which carbohydrates won’t spike blood glucose? The Glycemic Index (GI) is a numeral ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Carbs with a high GI are those which are digested rapidly and result in fluctuations in blood sugar levels. Low-GI foods, with their slow digestion, produce gradual rises in blood sugar and insulin levels. A low GI value is 55 or less and includes foods like nuts and seeds, beans and legumes, most vegetables, and some fruits. A high GI value is 70 or more and includes foods like watermelon, jasmine rice, baked, fried, or mashed potato, and white and whole-wheat sandwich breads.
The world’s foremost authorities on the Glycemic Index Dr. Jennie Brand-Miller and Kaye Foster-Powell have written many books on the benefits of low GI eating, including The New Glucose Revolution: Low GI Eating Made Easy. When looking through their books, I noticed that not all food that has a low GI value is healthy. For example, sugar-laden Coca-Cola has a low GI value of 53. How that happens, I don’t have the faintest. The authors do make it clear though that the glycemic index isn’t intended to be used in isolation, which basically means we have to base our food choices on the overall nutritional content of a food, considering the saturated fats, salt, and fiber in addition to GI.
As someone with RA, I avoid refined sugar, which means I study food labels carefully and reject anything that includes table sugar (sucrose), brown sugar, dextrose, fructose, fruit juice concentrate, glucose, malt, maltose, molasses, raw sugar, syrups of any kind, and the list goes on. I walk away from all refined carbs and lean toward low-GI carbohydrate-containing foods that are whole, unrefined, and high fiber. For me, eating carbs is all about moving back to staple foods like beans and legumes, nuts and seeds, vegetables, vegetables, more vegetables, and most fruit. It’s about being extra picky about the quality of grains I eat and leaning more toward root vegetables to stay full. (We’ll look at the impact cereal grains have on inflammation later). It’s about saying sayonara to rice cakes and reaching for an apple with some whole almonds on the side instead. And it’s about finding new recipes for bread (like this one) that don’t use refined flour (no flour at all!) but rely on nuts, seeds, and rolled oats.
I’m creating a list of some common carbohydrates with Glycemic Index values that I’ll show to you soon. In the meantime, Dr. Jennie Brand-Miller and Kaye Foster-Powell’s book The Low GI Shopper’s Guide to GI Values, 2013 is an excellent reference to consult and have closeby.
Brand-Miller, Jennie and Kaye Foster-Powell. The Low GI Shopper’s Guide to GI Values, 2013. Australia: Hodder Australia, 2013. Print.
Brand-Miller, Jennie and Kaye Foster-Powell, The New Glucose Revolution: Low GI Eating Made Easy. Cambridge: Da Capo Press, 2005. Print.
Carr, Kris. Crazy Sexy Diet: Eat Your Veggies, Ignite Your Spark, and Live Like you Mean it! Connecticut: Skirt, 2011. Print.
Davis, William. Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health. Toronto: HarperCollins, 2011. Print.
Junger, Alejandro. Clean: The Revolutionary Program to Restore the Body’s Natural Ability to Heal Itself. New York: HarperCollins, 2012. Print.