The Good Gut Anti-Inflammatory Diet E-Book

Phil Hansbro

• Herausgeber: Pantera Press
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2023

Seitenzahl: 269

Beschreibung

At last, a book that shows you how to reverse the negative effects of inflammation, so you look and feel younger and live longer, happier and healthier.For over four decades, world-leading independent medical research organisation the Centenary Institute has been producing breakthroughs in our biggest health challenges. Out of their mission to make people's lives better comes The Good Gut Anti-Inflammatory Diet.• Understand inflammation, a fundamental cause of many life-altering diseases, and the various factors causing it• Learn how balancing your gut with the right food choices can help manage inflammation and change your life• Enjoy 50 versatile, delicious recipes from Aussie author and chef Fast Ed Halmagyi• Benefit from nutrition tips and recipes from Dr Clare BaileyRefocus on your health and energy, prevent sickness and reset yourself one delicious meal at a time.

Leseprobe

At last, a book that shows you how to reverse the negative effects of inflammation, so you look and feel younger and live longer, happier and healthier.

For over four decades, world-leading independent medical research organisation the Centenary Institute has been producing breakthroughs in our biggest health challenges - cancer, cardiovascular disease and the many other problems stemming from inflammation. Out of their mission to make people’s lives better comes The Good Gut Anti-Inflammatory Diet. It explains that inflammation is the fundamental cause of all disease, and what you and your gut can do about it.

Inflammation, if left unchecked, can do untold damage. This book outlines the various factors causing inflammation, and dives deep on the one you can control the most: your food. The talented researchers at the Centenary Institute have gathered the best of their life-changing knowledge and joined forces with beloved Aussie author and chef ‘Fast Ed’ Hamalgyi. He shares 50 versatile, delicious recipes to show you that taking control of your nutrition - and your life - can be easy and enjoyable, along with nutrition tips from Dr Clare Bailey.

Refocus on your health and energy, prevent sickness and reset yourself, one delicious meal at a time.

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Foreword

Dr Michael Mosley

I am delighted to have this chance to write a foreword to The Good Gut Anti-Inflammatory Diet, as inflammation and the gut are subjects I have a particular interest in. I am also a long-term fan of the work of Professor Mathew Vadas and the Centenary Institute, where he is Executive Director. The Centenary Institute is a world-leading independent medical research organisation that does groundbreaking work with a special focus on cancer, inflammation and heart disease. As you will discover when you read this book, these areas of health are intimately linked and closely tied into gut health.

I first got interested in the gut and the mysterious microbes that live down in the murky depths of our intestines when I made a TV documentary called Ulcer Wars for the BBC and the ABC, way back in 1994. As the title suggests, the program was about gastric ulcers, which were once very common in the Western world and widely believed to be triggered by stress and a poor diet. Gastric ulcers were seen as an incurable condition that was best treated by taking medication that could reduce levels of acid in the stomach. viii

But as the documentary revealed, in Perth, Western Australia, there were a couple of doctors, Robin Warren and Barry Marshall, who were convinced that existing theories about the causes of gastric ulcers were wrong and that most gastric ulcers happen as the result of a gut infection by a previously unknown bacterium that they had identified and named Helicobacter pylori (H. pylori). They believed that one of the main reasons gastric ulcers occur is because the body responds to infection by producing more stomach acid, which fails to kill the bugs, but which can cause ulcers.

Their theory was largely dismissed by the scientific community, so Dr Marshall decided to take matters into his own hands and attempt a bold, eye-catching experiment. He asked a technician to brew up a flask of H. pylori, which he then swallowed. ‘It didn’t taste good,’ Barry told me. ‘Like swamp water.’

A few days later, feeling seriously ill, Dr Marshall had himself endoscoped; a small tube was passed down his throat and into his stomach. Samples of his now inflamed stomach lining were biopsied, and these revealed that his gut had indeed been colonised by H. pylori. Barry took a course of antibiotics, which he had previously shown could kill H. pylori, and soon his stomach was back to normal.

When the documentary was first broadcast in 1994 it got a hostile reaction from some parts of the medical community, while others sat up and paid notice. Over time views changed, and I’m delighted to be able to report that in 2005, 11 years after this brave self-experiment, Marshall and Warren won the Nobel Prize for Medicine for their work, which completely transformed the way that gastric ulcers are treated, and improved the lives of millions. ix

Their work also inspired a new generation of scientists who, in the 1990s, began seriously exploring the wonderful world of the microbiome, the 2–3 kilos of microbes that live in your gut and play such a critical role in our health.

The microbiome explorers were helped by the development of cheap and sensitive technology which meant it became possible to detect fragments of DNA and RNA in samples of people’s faeces, and from that infer the sort of microbes that must be living in that person’s gut. I have had my faeces sampled on a couple of occasions and found the results revealing.

But it wasn’t until 2012, when I discovered that I had type 2 diabetes, that my interest in diet, and the impact that what you eat (or don’t eat) has on your microbiome and metabolic health, really took off. Again the turning point was making a documentary for the BBC, this time called Eat, Fast, Live Longer.

In the course of making that documentary I came across research on the benefits of intermittent fasting and put myself on what I called a 5:2 diet, eating around a quarter of my normal calories two days a week. I also gave up sugary snacks and switched to eating a healthy Mediterranean-style diet, rich in vegetables, olive oil, oily fish and nuts.

Thanks to a combination of intermittent fasting and a healthier diet, I lost nine kilograms in eight weeks and 10 centimetres around my waist. Even better, my blood sugars returned to normal, where they have stayed ever since. And, interestingly enough, my gut microbiome also improved, with a marked increase in something called the Simpson index, which is a mark of microbe diversity.

Since then there have been multiple studies which have shown that switching from a typical Australian diet to a Mediterranean xdiet has multiple benefits, not only for your body but also for your brain. The SMILEs Study, published by researchers from the Food and Mood Centre at Deakin University in Victoria in 2017, was one of the first to show that a change in diet can have a profound beneficial effect on people with moderate to severe depression.1

And as for intermittent fasting and the gut, studies by the Erasmus University Medical Center in the Netherlands, among others, have shown that intermittent fasting boosts levels of ‘good’ bacteria, like Lachnospiraceae, which in turn make a short‑chain fatty acid called butyrate, which sends anti-inflammatory signals to the immune system.2 You’ll be reading more about butyrate later in the book.

This is a hugely interesting area of research, and I hope I have whetted your appetite for what is to come.

Contents

Title PageForewordIntroduction1:Inflammation overload – what it looks like, and why it matters2:How does chronic inflammation cause disease?3:Ageing and inflammation: inflammageing4:Welcome to the microbiome5:How our gut microbiome influences inflammation6:How diet shapes our microbiome7:The rise of the modern Western diet8:Minimising inflammation: lifestyle and microbiome approaches9:What to eat – and why10:Meal plannerBreakfastLunchDinnerDessert & snacksDr Clare Bailey’s bonus day of recipesContributors listEndnotesReferencesIndexAbout the AuthorCopyright

1

Introduction

Professor Mathew Vadas AO MB BS FRACP FRCPA PhD DSc FAHMS Executive Director, Centenary Institute

The Centenary Institute is a world-leading research organisation working on the most complex health challenges of cancer, inflammation and cardiovascular disease. It was formed under an Act of the New South Wales Parliament to mark the 100th anniversary of the dual foundation of Royal Prince Alfred Hospital and the Faculty of Medicine at the University of Sydney.

Scientists here at the Centenary Institute and around the world work tirelessly to better understand the causes of – and therefore potential treatments for – the diseases that continue to affect our lives and the lives of those we love. Enormous gains have been made: breakthroughs in medical research have led to our lifespans doubling in the last 100 years, and we’ve made significant leaps in our understanding of the biology and mechanisms of disease. Thanks to this work, we now understand many ways to address the problem of disease, including lifestyle changes, new or repurposed drugs, and biological therapies.

But this book is about one particular area of study that has been a major focus of the Centenary Institute: inflammation. While 2it may seem mundane at first, we believe that understanding inflammation is the key to unlocking a new era of treatments and cures for many of the deadliest and most prominent diseases affecting humanity today.

Inflammation is fundamental to the way that our body’s immune system reacts to injury and is critical in resolving infection or trauma. However, it also forms the foundation of many prevalent acute and chronic conditions. Chronic smouldering inflammation – moderate inflammation that lasts a significant period of time – leads to shorter lifespans and lower quality of life, as well as contributing to some forms of dementia, lung diseases, allergies, autoimmune diseases, and the progression of cancer and cardiovascular disease.

Happily, even in the face of such a list, there are things that we know:

First, gut health can affect chronic inflammation – both for good and for bad.

Second, we can affect our gut health through our diet and the foods we eat.

Third, scientists are learning more about gut health and how to harness it every day.

At the forefront of this research is one of the world’s leading inflammation researchers, Professor Philip Hansbro, Director of the Centenary UTS Centre for Inflammation, Australia’s first research organisation dedicated exclusively to studying the mechanisms underlying inflammation.

Professor Hansbro and his team have more than 25 years’ experience exploring how the immune system, and in particular 3inflammation, contributes to the progression of chronic respiratory diseases. Professor Hansbro has come to the realisation that inflammation can be managed. While we can use drugs when things have seriously gone wrong, a healthy lifestyle, including attention to our diet, can help prevent diseases before they take hold. Therefore, it’s important for everyone to understand some of the ways inflammation arises and where it can be controlled.

This book delivers practical information about how inflammation works in your body, and gives a lifelong framework that will provide you with tools to limit inflammation now, and when facing challenges in the future. In closing, please enjoy The Good Gut Anti-Inflammatory Diet and the knowledge within its pages, from the charts and illustrations, the nutrition and lifestyle advice, and especially the delicious recipes from Ed Halmagyi and Dr Clare Bailey. I hope it helps you lead a happier, healthier, and younger life. 4

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1

Inflammation overload – what it looks like, and why it matters

For the first time in global history, our life expectancy is getting shorter the wealthier we get. Despite major advances in healthcare, modernisation – the move away from an agricultural-based society to an industrial one – came with an epidemic of chronic diseases.

We now know that inflammatory processes in the body are behind many common and serious diseases – a very long, and surprisingly varied, list that includes infectious diseases like pneumonia, influenza and COVID-19, as well as chronic diseases like asthma, chronic obstructive pulmonary disease (COPD), arthritis, heart/cardiovascular disease, inflammatory bowel diseases, neurological disease, kidney disease and liver disease. We suspect many cancers also have an inflammatory component.

Most of these diseases aren’t single-organ diseases affecting just one part of the body. It might be hard to visualise, but 6these diseases actually involve an underlying state of whole-body inflammation (that is, involving many of our bodily systems – also known as ‘systemic’ inflammation).

The health burden associated with the modern upsurge in inflammatory diseases, both for individual sufferers themselves and for public health systems all over the world, is staggering. It really isn’t an exaggeration to say we’re living in an inflammation pandemic.

But what’s causing this modern health disaster? What does it have to do with our gastrointestinal system and gut bacteria? What is inflammation, and what can we do about it?

Good inflammation: our guardian angel

‘Good’ inflammation is our immune system’s natural defence against harmful microbes, irritants, chemicals and toxins. Good inflammation keeps us alive and is essential for healing us when we’re injured. It’s short-acting and purposeful – a specific and appropriate response to natural stimuli (e.g. healing a cut or fighting off a cold or other infection).

Chronic inflammation: snapshot of a silent killer

You can think of ‘bad’ inflammation as the fundamental cause of most disease: a lot of common, serious diseases are driven by inflammatory processes in the body. Bad inflammation happens when the body over-reacts to stimuli in the modern world, or when our immune system is over-activated for a long time. Inflammation overload can affect all our organs and damage our health – or worse, even kill us. 7

Inflammation breakthrough!

By reducing inflammation in our bodies, we can help prevent and treat disease.

Respiratory diseases

Respiratory diseases are the most common cause of poor health and death worldwide. Like most inflammatory conditions, respiratory diseases can be both acute (short-term) and chronic (long-term or constantly recurring).

The common cold, pneumonia, influenza and COVID-19 are all acute respiratory diseases, although some might have long-term effects (like long COVID). Like other conditions caused by an infection, they’re a result of excessive inflammation brought on by the immune system working overtime to clear the infection. Asthma, COPD and tuberculosis are more chronic.

People who already have high levels of underlying inflammation in their body are more likely to develop respiratory diseases. Once they develop a chronic respiratory disease, they can also experience short-term, quick flare-ups in symptoms (‘exacerbations’ or ‘attacks’) – like an asthma attack, for example.

Let’s look at some of these diseases in more detail.

Asthma

Asthma is an allergic disease of the airways. People with asthma are more sensitive to infection, smoke, and other stimuli that don’t affect other people. Some asthma is linked to acute viral infections that cause inflammation when we’re very young (0–2 years old) and get worse when we develop allergies to things like dust, smoke, infection, house dust mites and pollen (which is 8especially noteworthy, given that global warming means pollen seasons last longer).

Being exposed to these allergens and other stimuli inflames and tightens the airways, leading to the wheezing and difficulty breathing typical of an asthma attack.

Asthma affects over 330 million people around the world. In Europe and the US,3 it costs about $1900–$3100 per person every year; in Australia, the yearly cost is $28 billion.

Emphysema (COPD)

Emphysema is a main feature of chronic obstructive pulmonary disease (COPD), which also involves chronic bronchitis (chronic inflammation of the airways). It’s caused by smoking and long-term exposure to air pollution, both indoor (e.g. cooking smoke) and outdoor (e.g. environmental smoke such as from diesel or petrol fumes, brushfire, and infection). Emphysema is the third most common cause of death globally.4

Low-grade inflammation happens every time we’re exposed to cigarettes, air pollution and other challenges. Although it goes away easily, repeated or constant exposure overwhelms our lungs’ ability to repair itself, causing irreparable damage to the airways and gas exchange cells (alveoli). This leads to severe breathing difficulties and eventually death.

COPD is becoming more common as the global population ages, air pollution levels soar, forests burn due to land clearing for farming, and bushfires related to global warming become more frequent. Over 50% of people with COPD have never smoked.

COPD affects about 300 million people worldwide. For a group of 28 European countries, the combined cost of COPD 9is €48.4 billion.5 About 20% of people die from COPD-related issues, like heart disease and stroke.

At a glance

DiseaseCauseNumbersCommon coldMostly rhinoviruses, some coronaviruses and other virusesPeople get two to three colds each year on average, costing the global economy about $25 billion a year.6COVID-19Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)In the first year of the pandemic, 1.9 million people died. The global costs have been astronomical. Roughly two years into the pandemic, the International Monetary Fund estimated that $28 trillion was lost in revenue alone.Flu (influenza)Influenza A virusAbout 250,000–500,000 people die every year from seasonal influenza. The virus can also cause pandemics. Spanish influenza killed 20–40 million people in 1918–19: that’s more deaths than the whole First World War.PneumoniaStreptococcus pneumoniae, Haemophilus influenzae and other bacteria, and some viruses

Kills about 2.5 million people each year, mostly children and older adults.7

It’s estimated to cost Europe €10.1 billion a year, and the US $17 billion a year.

TuberculosisMycobacterium tuberculosisCauses 1.4 million deaths every year, costing about $15 billion in prevention, treatment and research.810

Allergic conditions

People who have eczema, hives, hay fever, sinusitis, asthma or a food or drug allergy tend to have multiple allergic conditions, since the same underlying inflammatory process affects different tissues in different ways. In fact, allergies often develop in a sequence known as the atopic (or allergic) march.9

Breathing in or swallowing the offending allergen releases defensive chemicals (e.g. histamine), setting off symptoms ranging in severity from mildly irritating to life threatening.

About half of school-aged children have an allergy of some kind.10 Over 170 different foods can cause allergic reactions; 2.7% of kids have peanut allergies. Interestingly, people raised with pets – particularly dogs or farm animals – seem to be protected from developing allergies.11 Food allergies cost individuals about $8000 per year,12 while hay fever costs about $5 billion globally every year.13

Atopic march

The progression of allergic diseases from infancy to adulthood. For example, you might get hives as a baby, which progress to a peanut allergy when you’re a toddler, then develops into asthma when you hit school age.

Inflammatory bowel diseases

Inflammatory conditions of the gut, like Crohn’s disease and ulcerative colitis,14 have become far more common over the past few decades. Crohn’s disease causes deep inflammation in the gut wall (usually at the end of the small intestine). It’s associated with 11smoking – the inflammation is similar to lung inflammation in smokers. Ulcerative colitis causes ulcers and a chronic surface inflammation of the gut wall (colon/large intestine) and has more of an allergic component.

Collectively known as inflammatory bowel diseases (IBDs), these conditions have serious symptoms: diarrhoea and urgent bowel movements, stomach pain, rectal bleeding from ulcers and weight loss, to name a few. IBDs now affect almost seven million people globally.15 The lifetime cost of having an IBD is about $400,000–$600,000.16

Autoimmune conditions

Inflammation is the underlying factor in over 100 autoimmune diseases,17 which affect about 50 million Americans and cost over $100 billion per year.18

In autoimmune diseases, our bodies see our own healthy cells and tissues as foreign invaders and try to remove them. Autoimmunity also plays a part in COPD (see page 8) and inflammatory bowel diseases (see page 7).

At a glance

DiseaseCauseSymptoms include:ArthritisOur body’s immune cells (B cells) produce antibodies that attach themselves to the surface of joints. They cause inflammatory responses that destroy the joints’ surfaces.Joint pain Swelling Stiffness and erosion 12Lupus (systemic lupus erythematosus)Antibodies attach themselves to different tissues. They cause inflammation and damage the respiratory tract and joints along with blood cells, nerves and kidneys.Aching and swollen joints Fever Fatigue Chest pain/pleurisy Hair loss Seizures Light sensitivityMultiple sclerosis (MS)Inflammation and parts of the immune system attack, and eventually destroy, nerve cells (which weakens muscle function). Infections are likely to be the initial driver.Pain Muscle weakness and spasms Impaired coordination BlindnessPsoriasisInflammatory responses make skin cells reproduce too quickly, causing a build-up of T cells in our skin.Dry, itchy, raised skin patches with silvery-white flakes (called scales).Type 1 diabetes (diabetes mellitus)Inflammation and the immune system damage the beta cells that produce insulin in the pancreas, making it harder for our bodies to metabolise glucose.

Mainly frequent urination, thirst and hunger.

Other symptoms include unexplained weight loss, upset stomach, vomiting, fatigue, and frequent skin or genital tract infections.

Vasculitis/angiitis/arteritis

Inflammation and the immune system damages blood vessels, enlarging them and making them leaky or likely to collapse anywhere in the body.

It can affect several organs at the same time (e.g. skin, brain, eyes). It’s linked to allergic responses, arthritis and lupus.

Relatively mild fever Appetite and weight loss Fatigue and skin rashes More severe outcomes include stroke, heart attack and kidney disease. 13

Other, rarer, autoimmune conditions include Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, Graves’ disease, thyroiditis and myasthenia gravis.

Heart disease

Inflammation is common in heart disease, though research into the role inflammation plays in heart attacks is ongoing. Major risk factors include smoking and smoke exposure, high blood pressure and high blood cholesterol. These risk factors lead to fats (called plaques) being deposited in blood vessels, thickening or hardening the arteries, which induces inflammatory responses. It can also lead to a heart attack if the plaques rupture and form blood clots.

Cardiovascular disease is the single most common cause of illness and death. By 2030, the global cost of heart disease is estimated to reach $1.04 trillion.

Neurological conditions

Inflammation is also common in neurological conditions, for example stroke, Alzheimer’s disease, Parkinson’s disease, Huntington’s disease and traumatic brain injury.

Neurological conditions have gone up almost 30% in the last two decades.19 They cause nine million deaths a year, mainly from stroke, Alzheimer’s disease, other forms of dementia, and meningitis. In Australia, brain disorders cost $74 billion a year, and $800 billion in the US.2014

Stroke

Inflammation can play an important role in stroke. Inflammatory cells, and the chemical signals they release, build up in the walls of blood vessels; this build-up becomes systemic, meaning it happens throughout our body. Eventually, the plaque ruptures and forms blood clots that stop blood flow to the brain. Stroke can result in severe brain damage and death.21 Symptoms include sudden weakness in the arm and/or leg on one side of the body, weakness in the face (with drooping), speaking difficulties, loss of vision, trouble walking and severe headache.

Alzheimer’s disease

We now think brain inflammation is important in Alzheimer’s disease, which is characterised by the build-up of a molecule called beta-amyloid in the brain. We don’t yet know what causes it. At normal levels, beta-amyloid has antimicrobial and antiviral effects, and is brought on by inflammatory responses, suggesting a link between beta-amyloid levels, infections and inflammation.22 Beta-amyloid (and the inflammatory responses involved) also increases with ageing. Symptoms include memory loss, mood changes, confusion, disorientation and difficulty problem-solving or finding the right words.

Parkinson’s disease

Parkinson’s disease involves losing a specific type of brain neuron that controls body movement. Infection and inflammation are increasingly linked to the destruction of these cells.

When we study the brains of Parkinson’s disease patients, we see antibodies present against these neurons, as well as elevated levels of inflammatory cells and their chemical signals.2315Symptoms include speech and writing difficulties, uncontrollable tremors and slow movement, with rigid muscles, stooped posture and balance issues.

Huntington’s disease

Changes in the huntingtin protein in the brain, as well as different organs and tissues, lead to Huntington’s disease. We think peripheral inflammation precedes symptoms of the disease.24 Symptoms involve muscle and functional impairment, cognitive decline and psychiatric issues.

Traumatic brain injury

High-impact blows to the head and injuries from car crashes or other head traumas can lead to brain injury, with significant physical impairments that last weeks, months or years after the injury.25 These ongoing issues are related to inflammation in the brain, which also causes swelling. The inflammation is similar to inflammation in multiple sclerosis and Alzheimer’s disease.

Brain injuries are the most common cause of disability and death in children and young adults. Symptoms include cognitive impairment, dementia, muscle dysfunction and psychiatric issues.

Meningitis

Meningitis has many forms, and all are bacterial or viral infectious diseases. The bacteria that usually cause these diseases are part of the normal bacteria that happily live in our throat – in fact, at any one time, 10% of us have these bacteria. But when they make it into our bloodstream, these same bacteria trigger inflammatory responses that circulate to the brain and cause meningitis, a serious (and potentially fatal) that requires immediate medical 16attention. Symptoms include very sudden high fever, severe headache, stiff neck and light sensitivity.

Reproductive tract conditions

Inflammation from infections can affect our reproductive tracts. This includes pelvic inflammatory disease, tubal infertility, prostatitis, epididymitis and orchitis, among other things. Sexually transmitted infections like chlamydia and gonorrhoea are a common cause of reproductive tract inflammation.

In pelvic inflammatory disease and tubal infertility, these infections trigger low-grade chronic inflammation that, over time, causes changes in uterine tissues, fallopian tubes and ovaries. These organs try to repair themselves but in doing so stiffen the tissues and cause loss of function and fertility. These issues are usually noticed for the first time during infertility investigations. Typical symptoms are abdominal pain, menstrual disturbance, changes in vaginal discharge and urine, pain during sex and fever.26

Fertility issues are higher in people with internal reproductive organs, but they’re very common.27 Chronic inflammation can develop at different points in people’s reproductive organs. Infertility is often attributed to inflammation along the extratesticular ducts and accessory sex organs, for example, although we don’t really understand yet how this inflammation causes infertility. Even second-hand exposure to smoke kills cells that produce sperm and can lead to abnormal testicular development, DNA damage and lower sperm counts. It also causes oxidative stress-induced damage to ovaries and eggs that also drives infertility. Infertility issues affect one in four couples – between 1750–120 million people – globally.28 Treatments cost around $30,000–$40,000 for every live birth.29

Chronic kidney disease

Chronic inflammation in kidney disease is closely linked to poor nutrition.30 Other factors include bacterial infections in our bloodstream from dialysis, dental issues, foot ulcers, low levels of red blood cells (anaemia), chronic infection, exposure to pollutants, smoke and lack of exercise.

People with chronic kidney disease tend to have poor appetites and lower intake of protein and calories, contributing to weight and muscle loss. As well as the usual symptoms of inflammation, they can also experience anorexia, muscle wasting and weakness.

Chronic kidney disease affects 10% of the global population. About two million patients are treated every day, mostly in the US, Germany, Italy, Japan and Brazil, with even higher numbers in India and China. It costs the US about $48 billion a year, China $56 billion, and Australia $2 billion. One million people die every year from untreated chronic kidney disease.31

Liver disease

Inflammation is a major part of liver disease. The initial damage can happen through an infection, the use of some medications, exposure to toxins or drinking too much alcohol over a long period of time, which causes scarring (cirrhosis). The scarring causes inflammation that makes the damage worse, sometimes to the point of becoming life-threatening.3218

Autoimmunity can also contribute to liver disease. Obesity and diabetes are risk factors in non-alcoholic fatty liver disease and liver cancer. Hepatitis is a specific infection-induced inflammatory liver disease caused by the hepatitis virus (hepatitis A–E, especially hepatitis B and C).

Symptoms of the disease include jaundice (a yellow tinge to the skin and eyes) and liver failure. Other symptoms are nausea, fatigue, diarrhoea, confusion, breathing difficulties, rectal bleeding, abdominal and leg swelling, muscle tremors and loss of consciousness.

Liver disease affects over 120 million people. It causes two million deaths worldwide each year – one million to cirrhosis, and another million to viral hepatitis, non-alcoholic fatty liver disease and liver cancer combined.33 Hospitalised inpatients alone cost up to $20 billion a year in the US, or $20,000 per patient.34

Cancers

Inflammation is thought to be a main risk factor in many types of cancer.35 Researchers recently linked inflammation (including low-level chronic or ‘smouldering’ inflammation, which may not have any obvious symptoms) to up to one in five cancers.36

Inflammation may damage DNA, which can lead to DNA mutations that cause tumours. Inflammation’s main purpose is to promote the growth of cells that repair damage: it makes DNA replicate faster, increasing the chance of mutations and the uncontrolled growth of cells that lead to tumours and cancer.

Cancer often develops as a consequence of an inflammatory disease. People with COPD, for example, are six times more likely to develop lung cancer; colitis is strongly associated with 19colon cancer, and hepatitis with liver cancer. Chronic infection with Helicobacter pylori bacteria (and the chronic inflammation associated with it) is now known to cause stomach cancer, while chronic human papillomavirus infection (and the inflammation associated with it) can lead to cervical cancer. Exposure to asbestos drives mesothelioma, a lung disease, and exposure to silica is behind another lung disease, silicosis, both through the inflammatory responses they provoke.

Twenty per cent of all cancers are linked to chronic infections. Thirty per cent are linked to smoking or smoke exposure and air pollution, and 35% to diet and obesity.37

Cancer symptoms are different depending on where in your body the cancer is, but generally include:38

feverfatiguepersistent cougheating difficultiesneurological issuesskin changes and jaundiceweight loss or gain for no obvious reasonunexplained bleeding or bruisingblood in the urine or stool, pain or difficulty urinating or defecatingswelling/lumps, especially in the breasts, underarms, groin, neck and stomach.

Cancer is the second most common cause of death globally, accounting for around 10 million deaths every year. Smoking or smoke exposure, infections and poor diet are common causes.3920

Lung cancer is the most common type of cancer, killing about 1.8 million people each year, followed by colorectal cancer (900,000 people), stomach cancer (800,000 people), liver cancer (800,000 people) and breast cancer (600,000 people).40 In 2010, cancer treatments and care cost about $1.2 trillion worldwide.41

The common link between all these diseases? Inflammation!

As you can see, inflammation is an aspect of the major diseases that are all too prevalent in industrialised nations. Lifestyle is often a contributing element, with factors like smoking or smoke exposure, air pollution and poor diet making people more vulnerable to these diseases.

It’s important to remember that most of these diseases don’t just affect a single organ: they involve whole-body (systemic) inflammation. They may be driven by low-level smouldering chronic inflammation that you might not even be aware of, without obvious physical symptoms.

But all hope is not lost – there are concrete changes we can all make to our diet and lifestyles that suppress these harmful inflammatory responses.

As we’ll see in the next few chapters, supporting the health of our gut microbiome by enjoying a healthy diet and lifestyle is one simple but powerful way we can really help drive down unnecessary and harmful inflammation in our bodies. We can fight the signs of ageing and live longer, healthier lives with an enhanced sense of wellbeing while avoiding and treating acute and chronic disease.

At the Centenary Institute, we firmly believe prevention is better than cure. We hope this book will help persuade you 21that you can enjoy better physical and mental health simply by looking after your gut.

We’re committed to fully understanding the basic molecular and cellular processes that drive disease. We want to find what exactly causes disease development and progression, then create and test completely new ways of preventing and treating disease based on well-understood molecular mechanisms. That way, we’ll be better able to explain the new treatments we develop, to help people understand why the specific medications and treatments we advise will work for them.

A good example is probiotics. We’ve been told to up our intake of ‘good bacteria’ for a long time based on the assumed benefits of good bacteria – but we didn’t really understand how they work.