Portrait by Stephen Denton Dr. Andrew Weil

What happens when diet-minded doctors and celebrity chefs team up to fight inflammation and Alzheimer’s?
All kale breaks loose. Deliciously.

It’s a typical lunchtime at True Food Kitchen, and diners cram the entryway like vegetables jammed into a juicer. Fresh-faced waitresses in scallion-green shorts squeeze between patrons, carrying plates of tofu-shiitake lettuce wraps and kale salad topped with omega-3-rich wild-caught salmon. No one thought a health food eatery would become this popular, least of all founders Dr. Andrew Weil and restaurateur Sam Fox, the oil and vinegar partnership that’s shaking up the nation. A restaurant based on the tenets of the anti-inflammatory diet? How do you make that sexy?

“I wasn’t convinced,” Fox writes in True Food: Seasonal, Sustainable, Simple, Pure (Little, Brown and Company), the new best-selling cookbook based on the restaurant’s menu. “When I thought of Andy Weil, I thought: hippie, Birkenstocks, vegan food. That wasn’t how I ate or lived.” Now, he can’t seem to sling sea buckthorn elixirs fast enough.

Unlikely chef-doctor partnerships are catching on like the kale craze. Dr. Marwan Sabbagh, a geriatric neurologist, dementia specialist and director of the Banner-Sun Health Research Institute in Sun City – about as unappetizing a title as you can imagine – has partnered with Beau MacMillan, chef at Elements at Sanctuary Resort, to create The Alzheimer’s Prevention Cookbook (Ten Speed Press). It’s based on a particularly brain-boosting version of the anti-inflammatory diet, and it’s filled with recipes like mushroom soba soup and spaghetti squash with caramelized onions – the kind of fare Hippocrates might have had in mind when he said, “Let food be thy medicine and medicine be thy food.”

More and more physicians and scientists are coming to the conclusion that inflammation is a root cause of a multitude of maladies – from heart disease and cancer to Parkinson’s and Alzheimer’s diseases – and that reducing inflammation through diet is a crucial component in the prevention and treatment of these diseases. But that’s a pretty sterile-sounding prescription. So doctors like Weil and Sabbagh found a way to bust out of the doctor’s office environment and the stigma of the preachy, pontificating physician to reach real people in a real way.
 
With cookbooks and restaurants, their recommendations are no longer dry lists of dos and don’ts. They are nutrition come to life, in Technicolor – emerald kale leaves bathed in sunny lemon juice and tangy balsamic vinegar, moist johnnycakes flecked with quinoa and topped with a snowdrift of Greek yogurt and juicy blueberries. At its core, the anti-inflammatory diet is a foodie’s philosophy, based on fresh, natural, delicious superfoods that fight disease and make you feel good. “It’s not a traditional diet in the way that people think of that word, where it’s a dirty word,” Weil says. “It’s an eating plan for life.”

Its focus on flavor is why it’s won over so many converts, from popcorn-addict Chef MacMillan to the yuppie-not-hippie diners at True Food to former kale-hater Weil himself.

“I would never touch raw kale growing up,” Weil says. Neither would most of us. Kale was the culinary equivalent of a throw blanket – a garnish stuffed into the sides of salad bars to cover up the stainless steel. Weil’s kale awakening came with the first forkful of a salad in Italy. “I had never had raw kale prepared like that before, with the extra-virgin olive oil, fresh lemon juice, garlic, black pepper, red pepper flakes, pecorino cheese and toasted bread crumbs, and it got me thinking. With most greens and vegetables, it’s simply a matter of preparing them properly so that their true flavors shine through.”
 

Anti-Inflammatory Superfoods These foods have earned prominent spots on Dr. Andrew Weil’s Anti-Inflammatory Food Pyramid:  • Olive oil • Kale and other leafy greens • Turmeric and other spices and herbs,     such as ginger, garlic and astragalus root • Sea buckthorn • Whole grains • Beans • Sweet potatoes • Winter squashes • Cool-climate fruits: berries, cherries, apples     and pears • Salmon and other fish high in omega-3 fatty acids • Splurges: red wine, dark chocolate and tea     (white, green or oolong)

That salad became the basis for True Food’s beloved side dish, and kale became one of the biggest building blocks in Weil’s nutritional pyramid. Now, with his anti-inflammatory diet and health empire, and in conjunction with True Food Chef Michael Stebner, he’s trying to give us all a similar awakening – introducing the true, delicious flavors of natural foods to a nation slowly being killed by inflammation.

You wouldn’t toss a lit match into a tumbler of vodka, or spritz a burning house with gasoline. But that’s figuratively what people do in their diets – with a cheeseburger and fries replacing flame and fuel as instruments of inner inflammation. Of course, one sinfully delicious meal will not inflame your body systems and strike you down with disease with quite the alacrity of a Molotov cocktail. But a constant, overall diet high in saturated fats, simple carbohydrates and refined sugars promotes unhealthy inflammation that can cause or exacerbate disease.
 
Inflammation occurs in the body naturally and, on a fundamental level, is a healthy process. It helps the body and its myriad organs, systems, blood vessels, tissue and nerves to heal by directing nourishment and immune responses (i.e. white blood cells) to the site of any wound or infection. Inflammation is at work when flesh reddens and pulses after being burned, when a lip puffs up and gets numb after a brawl, and when a toe throbs and tingles with pain after a collision with a curb. This is the body’s way of saying it acknowledges what happened and is taking steps to restore comfort and well-being.

Inflammation becomes a problem when it occurs even after the body has healed and should have cued it to stop. Chronic inflammation – that which persists, unfettered, beyond the fulfillment of its immune-boosting duties – actually damages the body and causes illness, much as cells that grow rapidly and unchecked can develop into cancer.

In autoimmune diseases such as lupus, rheumatoid arthritis, multiple sclerosis and type 1 diabetes, chronic inflammation causes the immune system to attack normal tissue. Inflammation has also been shown to be a contributing cause in the development of Alzheimer’s, dementia, Parkinson’s, heart disease, stroke, and cancer.

“There is growing evidence that chronic, low-level inflammation is the root cause of most serious illnesses,” says Weil, also founder of the Arizona Center for Integrative Medicine at U of A and an internationally renowned health guru. “Minimizing and eliminating this inflammation is the key to achieving optimum health and longevity.”

Photo Courtesy of Sanctuary Chef Beau MacMillan

Several factors contribute to inflammation, some of which are beyond human control. Genetics, age, stress and exposure to environmental factors like toxins and pollutants all play a part in causing chronic inflammation. The biggest catalyst, though, is entirely controllable: diet.

“The mainstream American diet is too inflammatory,” says Weil, who cites the predominance of processed, chemical-laden and nutrient-deficient foods as the culprit. These “pro-inflammatory foods” – namely fats and carbohydrates from industrialized foods – induce chronic inflammation and provide no anti-inflammatory nutrients to counteract the damage. To continue the fire metaphor, they light a blaze and then throw away the fire extinguisher. 

The main culprits of inflammation in the American diet are excessive consumption of omega-6 fatty acids, refined carbohydrates, and meats high in saturated fats. “Most people consume an excess of omega-6 fatty acids, from which the body synthesizes hormones that promote inflammation,” Weil writes on his website. “These fats are found in oil-rich seeds and the oils extracted from them, which are used in almost all snack foods and fast foods.” These oils include palm, corn, sunflower, safflower, soy, and cottonseed.

Omega-6 fatty acids can be balanced with consumption of omega-3 fatty acids, which are anti-inflammatory and are found in oily fish, flax, hemp, omega-3 or pastured eggs, and walnuts. They help to offset the inflammation caused by the hormone haywire of the omega-6s.

Food and drinks that contain quick-digesting flour and sugar – including bread, pastries, cookies, snack foods, sugary sodas and sports drinks – also trigger a chain reaction that causes inflammation. “These are classified as high-glycemic-load foods,” Weil writes in True Food, “because they raise blood sugar quickly, boost insulin resistance in the many of us who are genetically at risk for it, and increase inflammation.” Refined carbohydrates produce inflammatory compounds called advanced glycation end products (AGEs), which occur when the sugars react chemically with protein in the body. When the body tries to break the AGEs apart, immune cells release large amounts of cytokines, which cause inflammation.
 
The saturated fats found in meat – especially cows and chickens raised on grain-rich diets – spike cholesterol, which causes inflammation when the immune system defends itself from the cholesterol for longer than necessary. Any possible chemical interference in meats can be inflammatory as well, which is why farm-raised salmon can be inflammatory while wild-caught salmon is highly anti-inflammatory. When salmon are raised in a tightly-packed pen, they can be exposed to contaminated fish meal (which can contain toxic PCB chemicals – i.e. chemical runoff from electrical and coolant fluids, factories, etc.), plus antibiotics pumped into the excrement-filled pens to help the fish survive the unsanitary living conditions. Weil hasn’t eaten beef for more than 20 years and instead lauds anti-inflammatory proteins from vegetables (beans, lentils and other legumes), omega-3-rich oily fish and the occasional free-range, grass-fed bison burger, a popular menu item at True Food Kitchen.
 
With its meat-heavy meals, empty carbs and processed foods, Weil found the average American diet a poor bedrock on which to base his ideas. For a more model menu, he had to venture farther away. He had taken a year off between high school and college to travel the world, and has been an intrepid traveler, student and eater ever since. His journeys through Latin America and Africa were instrumental in his food education, but his food philosophy is more directly attributable to Asia and the Mediterranean. Weil observed the effects of the Mediterranean diet – laden with fruits, vegetables, fish and olive oil and light on heavy animal proteins and dairy – and studied it for years, eventually adopting it himself. A recent study from the New England Journal of Medicine found that at-risk individuals who adopted a Mediterranean diet cut their risk of cardiovascular problems including heart attack and stroke by 30 percent. Weil’s studies on health, disease, food and aging led him to pen a plethora of bestselling books and develop his own twist on the Mediterranean diet, geared toward disease prevention: the anti-inflammatory diet. 
    

Photo Courtesy True Food Superfood Spotlight: Turmeric Turmeric is the sleeping giant of American spice racks, poised for a breakthrough in 2013. The ginger-related plant grows throughout southern Asia and is harvested, dried and crushed into a dusty goldenrod powder. Weil calls it “the most potent anti-inflammatory agent” and recommends adding a level tablespoon to soups, stews and bean dishes. Dr. Marwan Sabbagh, a geriatric neurologist and dementia specialist at Banner-Sun Health Research Institute, says Indian cuisine has led the way with turmeric in curries, marinades, chutneys and vegetable dishes. “The subcontinent of India has the lowest incidence of Alzheimer’s disease, which doctors attribute to three factors – one, their BMIs (body mass indices) are lower; two, their saturated fat is lower; and three, they consume more amounts of turmeric than anywhere in the world.” Add turmeric to your favorite recipes for a twist of flavor. “I love it in broth and stews,” MacMillan says, echoing Weil. “I’ll even plop some into my tea.”

“I used the Mediterranean diet as a template and tweaked it using Asian ingredients,” Weil says. His anti-inflammatory diet – complete with its own creative riff on the FDA’s food pyramid of yore – is chockablock with vegetables, fruits, whole grains, beans, high-quality dairy products, oily fish and healthy fats, especially olive oil. Asian touches are evident in the anti-inflammatory spice rack.
 
In his travels, Weil discovered some obscure superfoods and is bringing them into the mainstream. At True Food, diners can order a drink called Andy’s Elixir, made from sea buckthorn, a sour berry high in Vitamin C and antioxidants that inhibits histamines, allowing healing to occur at a normal and healthy rate. He also promotes astragalus root, common in Chinese medicine and cuisine, which boosts immunity and blocks the release of inflammatory histamines.

Weil also spotlights the inflammation-combating compounds of familiar favorites such as ginger, garlic and turmeric. Ginger inhibits inflammation by blocking lipoxygenase, an enzyme that increases production of inflammatory compounds. It also contains Kaempferol, an antioxidant that blocks another inflammatory agent, the Cox-2 enzyme. Garlic is a great source of sulfur and selenium, which promote a healthy immune system by helping produce a powerful antioxidant and an enzyme that aids in the breakdown of toxins. Turmeric contains curcumin, which blocks inflammation through nine biological processes, including blocking the buildup of beta-amyloid plaque, which can lead to the development of Alzheimer’s. Many spices, in fact, burst with brain-health benefits, which is why they’re also a hallmark of the Alzheimer’s prevention diet.

Like kale-hater-turned-kale-evangelist Dr. Andrew Weil, Dr. Marwan Sabbagh has revamped his eating habits, embracing once-shunned foods for their salutary rewards. “I was not a cinnamon fan,” Sabbagh says, “but now I add a teaspoon to my coffee every morning. I added more spices to my food for flavor and their health benefits – cloves, rosemary, thyme and turmeric. I add turmeric to Egg Beaters and spinach for breakfast every day. I eat more vegetables, I’ve cut out saturated fat in my diet by about 80 percent and, you know what? I don’t miss it.”


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