How to eat to lower inflammation: The top 5 foods to boost energy, stop pain, and live longer with Prof. Luke O’Neill

Chronic inflammation can drain your energy, affect your health over the years, and even lead to heart disease. Eventually, 1 in 3 of us will develop an inflammatory disease.

In today's episode, Prof. Luke O'Neill — one of the world's top 1% immunologists — explains why that matters and what you can do about it.

He explores how everyday foods can push inflammation up, or help calm it. He also explains why balance matters more than banning foods like sugar, red meat, gluten, and dairy.

As for your gut, you’ll learn how anti-inflammatory foods like plants, fiber, and a healthy microbiome can help keep inflammation down. 

Try our science-backed and tasty wholefood supplement, Daily30.

Let your gut microbes snack on the ZOE Gut Health Bar

Build healthy habits. Download the ZOE app today and start your trial for just £2.30 for your first week. Join ZOE

Follow ZOE on Instagram.

Jonathan: Luke, should listeners aim to get rid of all inflammation?

Luke: No.

Jonathan: Can inflammation save your life?

Luke: Yes, it can.

Jonathan: Are some forms of sugar worse than others when it comes to inflammation?

Luke: Yes.

Jonathan: Are inflammatory health conditions more common than they were in the past?

Luke: Very much so.

Jonathan: Can eating plants lower inflammation?

Luke: Yes.

Jonathan: And finally, what's the most common misconception that you hear about inflammation?

Luke: That inflammation is somewhat benign. It's not. It can be very dangerous and can shorten your life.

Jonathan: I think inflammation seems to be a very hot topic at the moment. Online, I seem to be being bombarded by people trying to sell me all sorts of different products that promise to reduce my inflammation. That's very confusing. On the other hand, like I know inflammation is a big deal because across all of these podcasts, I feel more and more scientists in all different areas are talking about inflammation and telling me that it's a problem that is going to lead to their particular, like, disease area. So the net result is like I sort of know it's bad, but I'm very confused about what to do about it. So I'm therefore delighted to be in the hands of someone who truly understands the topic. So Luke, can you just remind us what is inflammation and why did it evolve in the first place?

Luke: The Ancient Greeks defined it actually. If you sprain your ankle, it gets red, it gets swollen, it gets sore, you can't really use it. You know, these are the cardinal signs of inflammation. You know, and that was discovered 2,000 years ago. So it's a normal process in response to tissue injury if you hurt yourself or an infection. Imagine a bacteria in your skin. It'll go a bit red, it'll be sore, it'll be swollen. They're the key features there. The purpose of it is to fight the germs, number one, and secondly, repair the tissue. It's got a wonderful way to fix things that are broken. In many ways, inflammation is the body's healer. Without it, we wouldn't be here 'cause infections would've killed us, our injuries would've wiped us out basically. So it evolved many millennia. Every organism on Earth actually has some kind of inflammatory process going on, but that's how we see it as a normal process. The problem, though, is if it goes wrong, the same weapons that it's using to fight germs and repair tissue is now destroying your own tissues, and that's what these diseases are. And I'm talking about MS in the brain, the inflammatory process out of control there. In your skin it could be psoriasis and eczema. In your joints, arthritis. By the way, any disease ending in itis, that means inflammation in case people don't know. It was configured as a way to describe them, you know? So many diseases we now know over, what, 30, 40 years' work involves the inflammatory process now doing harm, you know, and actually damaging your own tissue. One in three people will have an inflammatory disease in their lifetime. One in three. Includes heart disease, by the way. Your heart gets inflamed, gives you a heart attack, and they're very common. You know, your liver gets inflamed in certain situations. So we put them all under one big umbrella of inflammatory diseases, so they're very, very important to people.

Jonathan: So you're saying we really need inflammation, like fight the germs, repair the tissue, it's our healing process. It sounds incredibly important.

Luke: Yeah.

Jonathan: But then you just sort of flipped it around and said but by the way. It's now causing one in three, like, inflammatory diseases and it's really terrible. Yeah. So why does this thing that's designed to make me stay healthy become this thing where suddenly- Yeah ... we're all getting sick from it?

Luke: We don't know. I mean, it's a bit of a mystery why these... There wasn't much arthritis 1,000 years ago. You can look at skeletons you see and there wasn't much going on, you know? So it seems to be a consequence of modern living somehow, you know? First of all, infectious diseases were known to be inflammatory odd 200, 300 years ago. So for example, if I can mention the dreaded COVID, you know, that goes into your lungs, the inflammatory process kicks off to fight the virus, but now you get this sort of collateral damage happening in tissues. So we knew infections could trigger an overactive inflammatory process. Again, not fully clear why. It can be too much of a germ is in your system, and that goes into overdrive. That's one idea. We think genetics are very important. We're all a bit different. But in terms of things like rheumatoid arthritis, why would your own immune system begin to think parts of your joint are foreign? Because remember, it's as if there's an infection there and there isn't, hence the word autoimmune. That means self-immune response. I got it. We use analogies, Jonathan, all the time, which can get a bit tedious sometimes, but it's an army to fight infection that becomes a civil war. It turns on your own tissues and destroys different parts of your body, and the big mystery is why does this happen and why is it going up in incidents all the time? They're some of the things we wonder about.

Jonathan: And so is that what inflammation gone wrong is my own inflammatory response is no longer fighting the germ or the wound, but actually attacking my own body?

Luke: You've got it. So for example, in infection, your immune system makes something called TNF. Now the mouthfuls get challenging, it must be said. TNF is a signal to wake up inflammation, help you fight the infection. The very same molecule is very high in the rheumatoid joint. You can measure TNF there. There's no infection, though. That's what the mystery is. And the TNF is again causing the same inflammation as if there was an infection. So the same weapons, if you like, are now turning on your own tissues in a kind of friendly fire type scenario. And that was the big advance, I suppose, about 40 years ago when we realized it was your own body and your own molecules and your own immune system are now making too much or going out of control in some way.

Jonathan: At what point does it stop being helpful and start becoming harmful? 'Cause I'm also picturing that if I don't have any of this inflammation, then, you know, I'm sort of like the boy in the bubble and I'm gonna, like, die of the common cold presumably.

Luke: You've asked the killer question. You've done your homework. So we think sometimes they're called wounds that won't heal. See, in your joint in rheumatoid arthritis, it's like a big wound. You know, there's blood going in, all the white blood cells are there. It's just like a wound, and it doesn't heal, so it can't resolve. And resolution of inflammation is the final part of this process. Once you've cleared up the mischievous thing, you now get what's called resolution, and there's all these repair processes are part of it. And for some reason, they aren't kicking in, and that's actually a sub-subdivision of inflammation researchers. They just work on resolution and repair specifically, although other people work on the initiation. There's all different stages. But you're quite right. There's something going wrong with the better end of this in a way. And it can't really get repaired properly, and now the injury persists and can cause all other kinds of symptoms.

Jonathan: Imagine a version of you in six months' time, someone who's made a few small changes and feels dramatically better because of it. That's why we make this show, to give you the science and tools to get there. But to keep doing that, we need your support. If you've gotten value from this episode, please hit Subscribe. You'll get a front row seat to the latest science, and we'll keep doing the work to bring it straight to you. Okay, now back to the show. So you've talked a bit about rheumatoid arthritis, and obviously that's one example of a response to inflammation. But then you talked more broadly. You said, like, one in three people get an inflammatory disease, and you talked about heart disease. And I've heard people talk about inflammation, you know, as a risk factor for all sorts of things, I understand. Like, what are the different things that inflammation, if it's sort of staying on like this, can end up causing that a listener would be aware of?

Luke: Well, arthritis is obvious, 'cause you're swollen, your knee. Anybody listening with osteoarthritis, it's very painful. Pain is a key feature. It's swollen, it's red, and hot to touch. I mean, these are the cardinal signs again. The surprise was heart disease will be the same. You can't see the heart getting swollen, can you? You know? And yet we know in a heart that's heading towards a heart attack, white blood cells have gone in. They're chewing up cholesterol. That's a key noxious thing that's building up, and the immune system is trying to clear the cholesterol. And now you get the inflammation that damages the heart and promotes a heart attack, and that was a slight sort of surprise to people. People thought heart disease was all about lipids, as you would know, and statins would lower cholesterol. That's true, but it's actually provoking an overactive inflammatory response in the heart. The other surprise there was Parkinson's disease. In that disease, another noxious thing builds up in the brain. It's a protein. It's called alpha-synuclein, another mouthful, alpha-synuclein. That builds up. The immune system goes in, tries to clear it, and now causes massive inflammation in that part of the brain. And that inflammation is so hot in that part of the brain, it destroys the neurons, and those neurons control movement. So the first symptom of Parkinson's is often tremor, 'cause you're destroying the... Your own immune system is going in to destroy the neurons in that part of the brain. So it turns out that even disease like Parkinson's has this inflammatory component as well. Even though you can't say it's swollen like you would a knee, similar cells are there. A good analogy I use is like a vacuum cleaner, actually. So it's going to Hoover up the stuff, right?

Jonathan: Okay.

Luke: It gets clogged. Gets too hot and now starts to burn your living room down or whatever it is. In this case, the vacuum cleaner's in your brain and it's burning your hippocampus and Alzheimer's.

Jonathan: One of the things I feel I've learned over the last decade is just how incredibly clever my body is. It's clearly been off for my ancestors- Yeah ... for millions of years. So why is it that suddenly it's burning up when it's trying to clear this cholesterol in my heart or these things in my brain, whereas it feels like it should have evolved to do a good job?

Luke: Well, we probably go back way to the Stone Age. So 300,000 years ago, there wasn't too much cholesterol around. The diet, which we'll come onto, I'm sure, was a bit different.

Jonathan: Okay.

Luke: You move to the 20th century and where our diet changes and now cholesterol starts to build up and the very same process goes in, but now there's so much cholesterol the vacuum cleaner overheats and now causes heart damage. That's one reason why we're transitioning from a normal process into this more disease-like state.

Jonathan: So let's say I go in, I clean the house. It's not very dirty, so I clean it.

Luke: Yeah.

Jonathan: But then one night my son, who's now 18, has a massive party with 100 of his friends. I wake up in the morning, everything is trashed. The tool that should have worked is now just broken because the amount- You've got it ... of cholesterol that we get today in the 21st century is just out of any idea of what we could have eaten in the past.

Luke: Absolutely. That's the exact situation in that particular case. Now, if you take a disease like lupus, now lupus is a much more complicated thing than heart disease. It's a multi-organ systemic, we call this, inflammatory disease. SLE, systemic lupus erythematosus. It's one of the more common inflammatory conditions. In that disease, Jonathan, it's a horrible disease, it happens in the skin. It's because of a skin rash. Again, redness and soreness. Goes to the eyes. They get inflamed. Your kidneys get inflamed. Your joints get inflamed. Every part of your body can become inflamed. The immune system is completely out of control, attacking all these different parts of the body. What's happening there is bits of your own body are being seen as if they're a bit of a virus, and now things called T-cells go in, another type of cell. They go in and they begin to react with these things. Now, there's a name if you're an immunologist for bits of viruses, they're called antigens. These are called autoantigens. They're bits of your own body now suddenly being misrecognized as if it's a piece of a virus. And in that situation, absolute havoc is being wreaked. It's almost like every tissue has lots of viruses in it, you know? And the immune system's gone in, it's trying to kill the viruses of course, and again we're getting this collateral overactivation that's the biggest mystery of all. Why does the immune system begin to see bits of your cells as what's called non-self?

Jonathan: And I've heard a number of my guests over the last few years talk about low-grade constant inflammation now being almost like the norm for us, and that this in their particular area of study is sort of triggering things that wouldn't have happened otherwise. How does that fit into this picture? 'Cause that feels different than, like, the specific cholesterol example. Yeah, yeah. It's sort of almost like, I don't know, like the vacuum cleaner is on all the time. Or what's going- Yeah, got it ... what's going on?

Luke: Yeah, that's the other concern we have, this low-grade burning away in the back, and there's no fire going on here, by the way.

Jonathan: Okay.

Luke: It's overheating a little bit, right? And over time, and that's chronic in your living room with your vacuum cleaner, even though it's not ramped up to 11 or whatever, it might be set on 6, and that low burn will begin to cause a little bit of smoldering here and there, and that smoldering translates into milder symptoms. I mean, that chronic low-grade burn seems to be a feature of modern life as well. And what does that mean for people? Fatigue is a key feature, actually. And that, one of the key symptoms of systemic inflammation is fatigue, and the reason for that is interesting. When you get an infection, you get what's called sickness behavior. Now what does that mean? Imagine you've got the flu. You get under the duvet. You feel a bit depressed, actually. You lose interest in things. You don't want to socialize. Your appetite goes. You feel exhausted. That's a standard response to infection. It evolved, Jonathan, to get you away from the herd, interestingly. So when you felt really sick, you'd crawl into a burrow. Other animals do this to stop it spreading. Isn't that wonderful? Evolution in action. If you're a pack animal. And one animal gets infected, evolution will get them away from the go in under the duvet equivalent. It's your own immune system that's triggering those responses. If you don't crawl away, you can infect everybody, the whole herd dies. And we are a social species that evolved to be social. So this evolved to maintain our social sort of structures, as it were, you know? Now, we knew this from COVID, by the way. In COVID, that was a malign virus, 'cause you'd carry it and have no symptoms, and now spread it, and that's why the pandemic began. Ebola, you're really sick. You don't go near the rest of your friends. A few people get infected. It doesn't spread like wildfire, you know? So this business of what's called sickness behavior is actually a key part of stopping infections spreading is the idea.

Jonathan: And so Luke, how does that fit with chronic inflammation?

Luke: So now the same molecules are kicking off in the chronic sort of burning sort of, you know, state and making you feel tired, just like they would if you had an infection, you know? So it's very similar. And again, we'd like to know, of course, why you're having this low-grade inflammation burning away in the background. The exact same molecules are being made as if you're infected, and you get low-grade fatigue, low-grade depression, and lack of appetite. That's a feature of low-grade inflammation anyway. It's the exact same molecules, by the way. Now, it's very exciting. There may be new treatments for depression in this. They're now targeting some of these immune pathways to relieve depression. Wouldn't that be marvelous? We could have a new class of antidepressants that are targeting the very same things that are happening during infection, you know? So it's a really exciting part of immunology really.

Jonathan: You're saying that you could be living with a low level of this sort of chronic inflammation, like on for a long period of time, that is triggering the same chemicals in my body as if, you know, I got flu- Yep or some sort of like serious virus, and then it's gonna trigger a low-grade level of fatigue, but also like depression.

Luke: Absolutely. Lack of appetite is a feature of inflammation anyway. The reason for that, we think, is you stop eating stuff just in case there's germs in the food, you see. You may have picked up the thing from eating contaminated food, so you lose your appetite. That's one reason why we think you might lose your appetite during an infection. But the trouble is, there's no infection. Something's happening, and the same molecules in your body are triggering a similar response, and it's a really important finding, really. And you may have heard of things like ME and chronic fatigue syndrome. They're more than likely low-grade inflammation making the same kinds of molecules. The trouble is they can be hard to measure. The levels can be very low, you know, but it's in the same realm, I guess, that we're talking about here.

Jonathan: And I've heard people telling me that almost all of us today living, like in the Western world are probably living with a level of chronic inflammation that is much higher than our ancestors. Is that just all scaremongering, or is this true?

Luke: There is evidence for that. It's a bit too fast to be genetic, all this, remember. So let's say for instance, lupus. That's gone up, that's doubled in society over the past 40 years. Why would it double? It's too fast to be genetic. It has to be environmental. And then the big question is what's in modern living, again, that's causing this low-grade inflammation? That's a really important consideration in this whole debate, really.

Jonathan: What can it do in terms of my health? I think you talked about like fatigue and depression. But if I have this sort of long-term inflammation, and let's say that I don't maybe have arthritis. I'm listening to this- Yeah ... going, "Well, I haven't got arthritis. Do I need to worry about impact on my health otherwise?"

Luke: You do. You do. This is the issue really, because it can damage your heart. For heart disease, is it, this is a big part of heart disease we think. The increasing incidence of heart disease is probably low-grade inflammation as part of it, you know? And then who knows, it could become Parkinson's or Alzheimer's. We know there's early signs of those diseases with no symptoms, you know? When you're in your 30s even and 40s, you can see hints of it, you know? Again, is that this low-grade inflammation that's sort of pushing it. And then it builds up, and then it gets worse and worse. And then finally there's a tipping point, and now the symptoms begin. So it's many different diseases really. There's a thing called inflammaging, if you come across this idea, where the aging process itself is being driven by low-grade inflammation, right? And there is some evidence for this. So if you have models of inflammation and model organisms, and you make them inflamed, they age more quickly. You know? You can measure markers of inflammation going up as slowly as we age. It could like get higher and higher and higher over time. There's a rationale that says inflammation speeds up the aging process

Jonathan: So does that mean if we were able to reduce inflammation, we could actually slow down the rate of aging?

Luke: 100%, and that's a very exciting area, longevity, isn't it? And we'll be coming onto this, I'm sure. Can you slow down the inflammatory process and live longer? That's the overall. Can you increase your health span, we call this, by the way. Not your life span, it's called your health span. What's fascinating as well, you know your organs age at different rates. You may be a 40-year-old man or whatever it is, but your lungs could be a 50-year-old, 'cause you've been smoking, you know? Or whatever it is. So we know now tissues age at different rates, incredibly. You've got your biological age, which is your date of birth, but turns out your actual chronological age is that. The biological age might be different, you know. Might be slightly older. That's a really interesting area as well. The whole aging business is being intensively studied for that reason. The dread of smoking ages the skin terribly, right? There's toxins in the smoke, it's speeding up the aging process, and if you're in your 50s, you've been smoking since you were 20, you'll have the skin of a 70-year-old. Now what that means is if you don't smoke, you'll slow down the aging of the skin. There's really good evidence for that one. But can we extend that to the heart, the liver, the brain? That's the hope that all this research will head in that direction.

Jonathan: That sounds fascinating. Last question before we go and talk about things you can do to change this. Is it easy to tell if you have this chronic inflammation?

Luke: It's tricky if you haven't got a disease. So if you got, if you've got rheumatoid arthritis, say for, the one I mentioned, or lupus, you will see in the blood very clear signs of that, and doctors will diagnose it. You go to your GP, they'll take a blood sample, and a consultant might see you and measure things, you know? And that's easy to see. The low-grade stuff bumps around a bit. It varies between us, you know, so it's a bit more difficult to pin it down. There's one global marker that's called CRP, C-reactive protein. When that goes up, you're definitely inflamed, and you see that in all these diseases. And lo and behold, as you age, there's more and more CRP. We'd love to see better measurements, actually. One of the frontiers is could you spot markers more robustly before symptoms emerge? Wouldn't that be great? Then you go in and treat more quickly. You know, you probably know the earlier you treat these diseases, the more likely you'll succeed. It's tricky to take a blood sample of someone who's got no other symptoms. Oh, that person's inflamed. It's not as simple as that at the moment.

Jonathan: What do you look at to see if somebody's got this inflammation?

Luke: A simple way to describe, all I've done for 42 years is identify the component parts, the bits of the engine. Imagine the body's a huge, big engine. The job of a biochemist is to get the biochemicals. Once you identify them, then you measure them in disease. That's your next step, try to see if they're elevated or not, you know, or changing in disease. That's the next thing you do. And then of course, Jonathan, what I do a lot of is can you turn them down to normal levels and restore things to factory settings? We use that term sometimes strangely.

Jonathan: Does that mean that you could take my blood and measure things in there that would tell you whether or not I have this low-grade inflammation?

Luke: Absolutely, and there's more and more evidence, and I could take a sample of your blood now, maybe measure 1,000 things. Can you believe it? And it's the combination of those 1,000 and how the ratios between them. Can you imagine the complexity? It's such a complicated system, and the ratios might be as important as the absolute amount.

Jonathan: It's very interesting. It reminds me of the microbiome. We talk about the microbiome a lot, and we work with some amazing scientists and, you know, it's gigabytes of data. We have these really big machine learning models to understand what's going on and have been able to start to understand the difference between what's good and bad, but it's very complicated. And it sounds like you're saying that- Exactly ... you know, what's going on in my inflammation is the same.

Luke: Yeah, but a bit, and you may have done this with the microbiome. Even worse, you'll see things in your blood from the microbiome, remember, and they're changing as well. So what you're seeing in the blood then is a readout of your own body and the bugs in your gut, which are really important for all this of course, since it's that, it's that profile that you're trying to get. And it's very active now. You wouldn't believe the amount of work that's going on with wearables, for instance, that would detect the stuff in your sweat. Wouldn't that be great? And maybe you will see this tiny signal, this, "Oh, that person is at risk of a heart attack" or whatever. Let's get in there. And cholesterol was the very first thing we used to measure years ago. It's getting much more sophisticated now though.

Jonathan: Can you help me to understand why the food I eat would affect my inflammation? It's not obvious, right? I think people listening to this say, "Well, I can understand that the food I eat can determine whether I'm fat." Like, I can sort of- Yeah ... understand that. But, like, the inflammation- Yeah ... how does that fit together?

Luke: Well, number one is obesity. Where a country mile, it begins with all that, and this began about 30, 40 years ago. If you're obese, there's loads of fat in your tissues. Guess what happens? The immune system doesn't like it. And if you take a sample of fat tissue from someone, visceral fat in particular in the middle, it's full of immune cells. That was the discovery 30 years ago, which surprised people. What's the immune system doing in fat, was the question. The answer is it wants to, again, the vacuum cleaner, get rid of it. These fats are noxious. You know, they're overstimulating your body. Again, they're making byproducts. You may have come across, reactive oxygen is a huge area. These oxygen radical, bits of bleach are being made amazingly from fat, and that will bleach your tissues and injure them. So the immune system wants to get rid of this. So it goes in now and tries to get rid of the fat, and guess what? Overheats again, and now we get the inflammatory process being triggered because of all this fat tissue that's there. Now, the latest stuff, John, that's very exciting, is the semaglutide class of drugs, as you probably well know, GLP-1, Ozempic, Mounjaro. They work in part by getting rid of fat and lowering inflammation. Isn't that amazing? So they're actually anti-inflammatory as well. And that was more scientific evidence then that fat is the part of the problem here. So too much fat in your diet, lack of exercise, the fat builds up, and that drives the immune system crazy, and now begins to explode in the wrong place at the wrong time. So there's no doubt that's one big factor. The second one is carbohydrates, of course, 'cause if you have too much sugar in your diet, that will irritate the body as well. Things get modified by sugar, and that begins to irritate the immune system as well. And we knew this for hundreds of years. Moderation is always your friend. And a great line I saw, I think it was in The Guardian, to give them credit, "If you eat like the Stone Age and behave like it's the Stone Age, you're less likely to get inflamed." And there was a big link into that then, you know? So again, it's that kind of business of the diet being imbalanced and not being the natural diet. 'Cause your body is the body of a person who evolved 300,000 years ago, remember. Not much has happened in that time, really, you know? And yet you're exposing yourself to things that wouldn't have been around 300,000 years ago, and then your body goes into overdrive.

Jonathan: It's really fascinating listening to you talk about that. So I think what I heard you say is there's a number of different ways in which the food we eat can lead to inflammation. One is that if we end up living with obesity, then the fat in our body isn't this completely inert thing. It's both creating, I think you said, like, something almost like bleach. Is that what you said?

Luke: It is like bleach.

Jonathan: But then our immune system is responding to that. Yeah. And so it's, like, being triggered by this level of excess fat, and therefore that's creating inflammation.

Luke: Yeah.

Jonathan: But then you also talked, I think, about, you know, diet high in a lot of sugar, and I'd like to come on in a minute to understand that in more detail. Yeah. But that's another example.

Luke: Yeah, yeah.

Jonathan: Do we understand what the role of the microbiome is in all of this?

Luke: We do. Oh, very important, and that's been a breakthrough. If you list the breakthroughs in this business I'm in, the breakthroughs became discovering the bits of the machine, right? And then we realized the gut is a very complicated place, millions of species, and it's changing dynamically, and it's a huge area, as you know. And now we know there's a healthy microbiome and a very unhealthy one, and diet allows certain bugs to grow, you know? So certain food stuffs promote the good bugs. And you know this from fermented foods are a good example. That was discovered by the ancient people, and now we know why. It brings out certain species. Guess what those are doing? They're making molecules that are anti-inflammatory it turns out, right? There's things called short chain fatty acids. That's the area for this. One is called butyrate for instance. Now that's bacteria digesting your food and making a byproduct that's protecting your gut. Now again, evolution probably set that off. You know, we were selected out to have these bugs in our gut to allow us to do that. Now you can imagine then if you get an imbalance in the microbiome, there's nasty guys down there. Now they're making different things, and they're making molecules that are pro-inflammatory, that are irritating the system, and they can go into your circulation, not just in the gut by the way. They can go to your liver. They can even go to your brain. There's a theory, John, that Parkinson's begins in the gut. Have you come across this? There's certain bacteria that make a noxious thing, gets into the nerves, traffics up into your brain. Now you begin to develop that disease. So the role of the gut and the microbiome is so important. The problem is there's no credible therapeutics yet that have come from that understanding. So it's still a work in progress. Many people are trying to uncover this to get a medicine out of it if you like, you know? It's unlikely it'll be either bacteria 'cause the analogy I use, your gut's like the Amazon rainforest, right? There's so many species. If you drop a single marmoset in the middle, they won't breed and take over the whole forest, will it you know? So it's quite hard to control the microbiome by sticking in certain bacteria, even if you eat loads of them, you know? The only one that works is Clostridium for food poisoning. That can work. You can counter that one. But overall hasn't been the progress we'd have liked so far there

Jonathan: I think this is why we're convinced about food as the way- Yeah ... to influence the microbiome. And I think actually that's a brilliant transition to, let's talk about the foods that we should be trying to reduce first.

Luke: Yep.

Jonathan: And then I'd love to talk later about all the things we could add. I asked you about ultra-processed foods at the beginning. Yeah. From your perspective, are they real? And if so, what is it about ultra-processed foods that might tie into inflammation?

Luke: I was badly caught myself recently in Ireland. Oh, I do things in the media sometimes, and I went on about them. And they're a very eminent nutritionist, you can't just use this blanket term ultra-processed food. All that means is you're taking a natural food stuff and doing something to it. As long as it can be good, you can't say they're all bad. What it comes down to in the end is high sugar, high fat. They're the two nasties. And if you drink a soft drink, it's full of fructose, it's full of corn syrup. That's far too much carbohydrate, and that's been ultra-processed. You've concentrated the natural sugar into this drink, you know, and you drink a glass of it, then you're taking a huge amount of sugar, and your body gets overwhelmed by the sugar. So there's, again, there's very good evidence that those types of things. We've done the fat one already, that will drive fat tissue. But people don't realize if you drink too much sugar, that gets turned into fat. There's a biochemical process that takes glucose and makes a thing called citrate, and that finally makes fats. So that's one reason you put on weight is eating just from sugar itself, 'cause the body's very clever biochemically. You're doing that, by the way. Again, it's evolutional. In ancient times, if you saw loads of sugar, you gorged, right? Because you mightn't see sugar again for a month, and you stored some of it as fat. So we evolved to gorge, in a sense, in an environment where it was sparse. But now we're gorging all the time, and now we're laying down too much fat. The second reason why sugar is dangerous is if you've got an inflamed tissue, like an arthritic joint, that will burn the glucose in a funny way. And that was one of my big discoveries, actually, in my lab back in 2013. So if I inject some sugar into an inflamed joint, the inflamed joint is voracious, by the way, 'cause it's burning away. It's like shoveling coal into an engine, right? 'Cause it's really voracious. But now fumes begin coming off. And we found one particular fume, it's called succinate, is the name of it. It's a product from glucose, and that's very inflammatory. So now you can see if you're feeding an inflamed tissue loads of sugar exhaust fumes are coming off the engine, now damaging the tissue. And that's one reason why too much sugar is bad for you, because it actually exacerbates the inflammatory process.

Jonathan: One thing you've already said is like, if I'm overweight, I'm living with obesity, that's gonna increase my levels of inflammation. So in general, eating food that's gonna cause me to put on weight is gonna be a problem. Yeah. But now you're talking about sugar specifically. You're saying separately from whether or not I'm just having so much sugar that I'm gonna put on weight, actually if I've got inflammation already turned on in my body, then the sugar, adding it into my bloodstream can actually cause that inflammation. It's almost like throwing petrol on a fire.

Luke: Exactly. That's what it is precisely. The reason it's happening is, you can imagine sugar is like a type, like coal going into an engine. If you've got too much coal in, you get a lot more fumes coming off. And they now become damaging. And we can measure these fumes in the blood, the thing succinate, for example. We can measure in the rheumatoid joint. If you ... Again, if you take a rheumatoid joint from someone and a normal joint, this is full of succinate. It's come from glucose. We showed in our lab it came from the glucose. You fed the thing. You know, you're making this sort of product in a way. These are normal things, by the way. They aren't unnatural. Again, it's just too many of them. The level has gone far too high. So one reason why a lot of sugar is dangerous is you're making these byproducts, if you will, that become toxic to the body in a way, you know? And again, it's a consequence of overeating too much sugar, really.

Jonathan: What's the byproduct of this? So I've got this low-grade inflammation. I'm adding the sugar on top. I'm getting these fumes you're describing. Yeah. What does that do?

Luke: Well, they're now irritating the immune cells, 'cause the immune cells can sense the fumes. The immune system is there to sense noxious things anyway. It can be bacteria. It can be whatever. It can be cholesterol. They also sense metabolic products. And now those immune cells ratchet up a bit in a way, and they get even more active. It's a bit like a feed forward loop, we call this, in a way. You're pushing it in a positive way all the time into this more dangerous state, is the way to think of it. Biological systems often have these loops. They have negative feedback, turn off, positive to turn them on. And this feeds into that sort of overarching idea that you're propagating the whole thing even further. So the one thing you don't want to do then is to have a bad diet, especially if you've got an inflammatory disease. You're just adding petrol to the fire. And exactly as you said, that's a good analogy.

Jonathan: One of the things I've learned is that, you know, I have blood sugar in my blood anyway, right? Yep. Like, I have to have some blood sugar- Yeah ... or I understand I fall over and die. Yeah. So it's not just having any blood sugar that is the problem, presumably. No. What exactly is the-

Luke: When it's too much, the system goes into overdrive. It's too much. That's one problem. If it's too high, your body doesn't like it. You know, there's a normal level of sugar that we need all the time. We use sugar as a source of energy. It's really important. But if it goes too high, now we begin to see these negative consequences. Getting back to my Stone Age analogy, it rarely got too high in the Stone Age, you know? If it did get too high, it came down quickly, turned into fat as a storage thing, and you carried on regardless. And, but now modern living, it's far too high, and that begins to push the machine a bit too hard, is the way to think of it. It will get broken down eventually by the body, of course, having wreaked a bit of havoc along the way, is the way to think of it. So the goal is to keep it low. The big one is insulin, as you probably know as well. So insulin's job is to lower blood glucose. But that's why you make insulin. After a meal, your pancreas makes it to suck up the glucose into your cells to use as a source of energy. Guess what inflammation does? It makes you less sensitive to your own insulin. It's called insulin resistance. This is the feature of type 2 diabetes. And now blood glucose skyrockets 'cause the cells can't take it up. That promotes more inflammation, promoting yet more resistance to insulin, and you get type 2 diabetes. That's that disease in a nutshell, in a way, 'cause your body gets overwhelmed, if you like, and you become insensitive to your own insulin.

Jonathan: So there's a sort of vicious cycle here where you have some inflammation, therefore, when you have high blood sugar, it makes it higher. Then your body itself gets worse at dealing with the blood sugar and it's sort of like ramping up worse and worse.

Luke: You've got it. And then the immune cells are now destroying your tissue. They're destroying your joints, they're destroying your skin, and in lupus, whatever it is, and the whole thing gets out of control really.

Jonathan: Are all sugars equally bad in terms of causing- Too much ... inflammation?

Luke: Too much is bad. Too much glucose is bad. But certain sugars are worse. And fructose, as you would have come across as well. Now, strangely, that's a natural sugar in fruit. So when you eat an apple or a pear, you're taking in fructose, right? Again, if it's too much fructose, that's even more toxic than too much glucose. And one reason for that is fructose will generate even worse byproducts than glucose, you know? So therefore you get even more toxic buildup of things, and that's been well worked out now. So we think fructose is especially troublesome among the sugars. Too high levels of fructose. Now, fruit's good for you. Never forget it is a natural thing and you wanna be taking in fructose. It's a good source of energy. But too much fructose... If you have a gram of glucose versus a gram of fructose, in an inflammatory context, the fructose is doing more damage than the glucose. So that's why we don't like fructose. Too much fructose is a bad thing.

Jonathan: So someone listening to this, I think is gonna be like, "Well, hang on a minute. You said I find fructose in fruit- Yeah ... that's good for me, but I should worry about fructose. So how could I even get fructose if I'm not eating fruit?"

Luke: A lot of processed, a lot of processed foods have fructose added as an additive. Look at the label, you'll see fructose is added in, you know? So that's the first thing you would say. The second thing is, it's interesting, if fructose is there with fiber and other things, it's less toxic. So if you eat fructose in a normal food, like an apple, the other bits of the apple, if you will, make the fructose less damaging, you know? And it's partly the microbiome actually, because the fiber in the fruit, the microbiome begins to burn the fructose. Isn't that great? So you're building up a microbiome there that can metabolize some of this fructose. If you take neat fructose, then too much of it is gonna go into overdrive and cause all kinds of problems, especially if you drink it every day. I mean, as you know, people with ultra ... We feel sorry for some people, they can afford this ultra-processed food, you know? If you take it chronically, the thing gets worse and worse, if you're having it every day, you know?

Jonathan: Is fructose always in drinks or can it also be in my food as well?

Luke: It can be in food as well. Yeah. You see, we crave sweetness, remember. What's happening here is, again, on the plains of Africa 300,000 years ago, we evolved to eat sweet things. So what do food manufacturers do? They put loads of sweet things in their food, and fructose is one of those sweet things that's put in food. Other sugars as well. And then we like the taste of them, we eat more of them. So we're kind of, they're kind of leveraging a normal thing, in a way. Now remember, moderation is good. You can have some fructose, of course. These things aren't all bad. Again, the case that you can have the odd cake now and again. I'm a big fan of enjoying yourself as well, you know? 'Cause your mental health's very important. So you can't be too slavish to it either. But too much is when the problems kick in. And again, certain types of sugars are really bad, and fructose is on that list.

Jonathan: But it's not just fructose. If I had a sugary drink that is normal table sugar-

Luke: Yes ...

Jonathan: that is still going to be bad and cause this inflammation.

Luke: Exactly. If there's too much. Precisely. If there's 10 teaspoons of sugar in a drink, that's too much sugar to be taken. Maybe one day in five it's okay, but if you drink that drink all the time, you're gonna be in real trouble, you know?

Jonathan: I think everyone listening is not really surprised that sugary food is bad for them, right? Yeah. So I think maybe surprised that it's got this tie to inflammation- Yeah ... and that it's not just about weight gain. But I'd love to talk about some other foods, many of which I think are quite controversial. And can I start with red meat?

Luke: Yeah.

Jonathan: Is red meat good for us in terms of inflammation? What's the situation?

Luke: Well, again, you've got teeth in your mouth that evolved to allow you to eat meat, okay? So we are omnivores. You can choose not to and live off, you know, vegetables, I suppose. But we did evolve to eat meat 'cause we have these teeth that can tear it up. So eating meat is a normal thing that we do. But yet again, the dreaded moderation comes in. If you eat too much meat, protein, too much protein can be bad for your kidneys for a start, as you probably know. And one of the fears of these protein drinks is, that people drink, is they damage, they can damage the kidneys. Now you'd need to have a lot of meat for that to happen, but still too much protein can overwhelm the system again. Iron is in meat. The redness of meat is based on hemoglobin, you see. And in the muscle there's levels of iron. Too much iron can cause the body, again, to get a bit irritated. You know, so again, too much meat, we know a lot about eating too much meat can be damaging. And most importantly of all is the balanced diet, for obvious reasons. If you just eat meat, you're gonna be in trouble 'cause you need the other fiber from other places and other things for another reason, yeah? So meat itself isn't bad. Too much of it is, and then all of a sudden when it's your main source of nutrients, it's gonna be more damaging.

Jonathan: Eating meat is fine. We're evolved to do that. Yeah. But eating too much- Can actually cause inflammation in our body?

Luke: Yeah. One thing it does cause is this oxygen damage, these oxygen radicals they call reactive oxygen species. This is bleach actually. That's not a bad analogy. We use oxygen all the time, of course we do. Oxygen is needed for us to burn glucose and burn fat, you know? The trouble is you can get byproducts from the oxygen, and these can be very damaging, and they are like bleach molecules really. Now, meat can promote some of that bleach to be made. Now, guess what's in vegetables, John? Antioxidant. They suppress the bleach. They're antioxidant. So if you eat meat with vegetables, you're gonna counter some of the risk of the oxygen that's gonna get toxic in a way. And a big reason for the vegetables is the microbiome because that will allow the right bugs to grow in your gut that maintain your health. So that's all very clear. If you just eat meat, your microbiome's gonna look very different because the species actually can't grow because they need fiber, you see. So now all the evidence would suggest you need a balance of the two really.

Jonathan: I'd love to talk about some foods that people cut out because they're worried that they are causing inflammation. And the first one that I see a lot of is gluten. And obviously, there are people with celiac disease, but there are a lot of other people avoiding gluten because they're worried that it's going to be causing inflammation anyway. Yeah. You know, what does the latest science say about this?

Luke: There's a protein in gluten. It's called alpha gliadin, another mouthful. And for some reason, some people's immune system react to the gliadin, and they go into overdrive. Now, you get a big immune response to the gliadin in the gluten. And even worse then, it turns into an autoimmune disease. Can you believe it? So celiac eventually becomes autoimmune because the immune system is off-kilter. The gliadin's getting recognized, and one of your own proteins is also a bit like gliadin. That gets recognized as well, and now you get your own tissues now generating an immune response. So celiac is well worked out, and you got to cut gluten out. By the way, there's lots of research to allow people to eat gluten, though, have you know. And there's ways now to desensitize celiac people to gluten, and now they can eat whatever they like. We're not there yet, but there's progress. Amazing. And in fact, if that works, you might desensitize to other things that cause arthritis or lupus if these autoantigens. I mean, that could give rise to breakthroughs in autoimmune disease. Now, if you haven't got celiac, gluten is just another source of nutrients, really, you know? And to my knowledge, there's limited evidence that gluten in someone without celiac, they shouldn't see any ill effects, really. You know, the trouble is there may be a subset of people who are pre-clinically celiac, you know what I mean? They mightn't have all the symptoms, and maybe they feel a bit bloated and a bit funny on the gluten. You can test for celiac now. If anybody feels they're reacting to gluten, I would go and get it tested. But overall, for healthy people with no celiac for definite, gluten is like any other source of nutrients, really, in a plant. I wouldn't worry about it too much.

Jonathan: By really improving my microbiome and really changing my diet in a big way, suddenly actually I've found I can eat loads of things that I thought I was having a problem with. Yeah. And so I do think it's easy to focus on being intolerant to a particular issue, and potentially your issue is actually really your gut is just not in good shape. And if you can get it into a healthier place and suddenly have these microbes that are gonna help you out, you know, you can be in a different place. Absolutely, yeah. That's obviously very different from having autoimmune diseases, as you're describing.

Luke: Yeah, yeah. More than likely, it's a combination of things that are going off-kilter for some reason, you know? And then people begin to say, "Oh, it must be this or that or the other." It may not be as simple as that for them. But it's a tricky one because some people do have real problems with these things, and they want to be helped, I suppose.

Jonathan: I'd love to talk about a couple of other foods where a lot of people give them up because they're worried that they're inflammatory. One is dairy. What's the situation there?

Luke: Well, there is lactose intolerance as well, remember, which is a really, again, that's an immune response. We've discussed fructose and glucose already. Lactose is the main sugar in milk, and we love it. Babies suck up the lactose. They use that sugar to, for energy and to build things. So it's a great, very natural thing. For some strange reason, a percent of people have lactose intolerance, and their immune system now, like an allergy to the lactose, and that's a real thing. We probably evolved, interestingly, John, in maybe, I don't know, tens of thousands of years ago in Europe, the ones who were lactose tolerant survived 'cause there was loads of dairy products around, and the ones who were intolerant died out, and that, there's a genetic basis for this, by the way, as well. You can tell from their genes if they're lactose tolerant or intolerant. So again, it's a bit like celiac. Again, there's a group of people out there who can't take lactose. Again, that can be tested for. You can test for lactose tolerance or intolerance. It is a type of allergy. Remember, allergy, if you're an immunologist, is you're overreacting to something in the environment. It can be peanuts. It can be crustaceans. In those people, some are overreacting to lactose. So that's another one that's a food intolerance that's through the immune system.

Jonathan: Got it. So unlike, it seems like you're saying there are foods that are just sort of gonna be inflammatory for everybody. Like, if I keep drinking Coca-Cola- Yeah ... that's going to be inflammatory. But it sounds like you're saying bread or, you know, full-fat milk is more personalized. Some people, this may be inflammatory, but actually for the majority of people, this is a perfectly healthy whole food. Yeah.

Luke: Most people, most foodstuffs are fine, unless you eat too much of them and then you're in trouble, and don't balance them with other things.

Jonathan: Last food that I think, you know, the internet is awash with fear that it causes inflammation is seed oils. What's the truth about seed oils from your research?

Luke: Oil from vegetables is uniformly good. Let's start with that fact, right? Olive oil and all those oils are great. Loads of evidence for that, right? You got to look us on the label, I suppose. If they're natural oils from natural plants like sunflower, these are pretty healthy for the vast majority of people.

Jonathan: I'd love to switch now to about what we can add into our diets to reduce inflammation. So I guess my first question would be, if you were just gonna describe like a sort of overall sort of anti-inflammatory diet to somebody who has never thought about this before, what would you be telling them to eat?

Luke: A balanced diet will mean your immune system is being fed the right kind of things and will keep your immune system in tip-top shape. If it's imbalanced with various things that we discussed, the immune system will like it and will begin to overreact. Secondly, the calories, of course. If you eat too much, the system goes into overdrive, as we discussed as well. So moderation is always your friend here. But never forget, I always quote Jonathan Swift. Remember he wrote Gulliver's Travels? Remember he wrote a famous thing. He said, "All you want is three doctors to look after you. Dr. Diet," which we're just discussing, "Dr. Sleep," and that can be a huge confounder in these studies, "and Dr. Mirth," which means have a bit of a laugh and enjoy yourself occasionally. Now, this is where we get to the problem of someone saying it's gluten. It could be a bad night's sleep all the time is affecting them in a way, and all three may interact, by the way. You got to look at it in the context of other things as well.

Jonathan: I love the idea of Dr. Mirth-

Luke: Yeah ...

Jonathan: 'cause I feel that a lot of people talking about wellness, it's like all incredibly serious and there's like no room to have any fun. So I wasn't, I thought you were about to say Dr. Exercise, but I love the fact that you went to Dr. Mirth-

Luke: Yeah ...

Jonathan: and the idea that actually happiness itself

Luke: might be

Jonathan: healthy

Luke: for us. Really important, and I would put the premium on that, John, to be honest, because if you get stressed, then cortisol, all the usual things, and depression, anxiety, they have massive negative effects on your health. In fact, that could swamp out any bad diet effect, for instance, you know? Now, there's, again, people are very interested in the interaction between them. And a big area that many are involved in is the brain immune connection. More and more evidence that your mood affects your immune system. If you're stressed, that could put the immune system off kilter and you get inflammation, you know? So it goes beyond the notion of diet, but again, they probably interact. And that's why I'm a big fan of a little bit of what you fancy. Even though you might think, "Oh, I shouldn't have that cake. I shouldn't have that cream bun." Now and again, you get a bit of earth, you know? And that can counterbalance any of your negative effects. You know in our own lives, if you're in a bad mood or you're depressed even, you may get indigestion from normal foods. And that's a really important fact, isn't it, you know? That's the brain talking to the digestive system here, you know? And you might have a balanced diet, but if you've got the stress thing going on, that balanced diet might become noxious to you. You know, how your body is responding to the food. So the interplay between these things is a real frontier that people are very interested in. So I think I'll remember all three. He did, he didn't say exercise, 'cause everybody exercised in those... There were no cars. You know? You didn't

Jonathan: have any choice.

Luke: Everybody is doing some exercise. You'd walk five miles a day to school and back or whatever it was, you know? So we, the natural state was to be exercising, I suppose.

Jonathan: That's really interesting. So it's another example of how we're having to worry about things now that, like, 200 years ago you wouldn't even think about.

Luke: Yep, exactly.

Jonathan: I feel I have to talk about plants- Yep ... because at ZOE, you know, we're really big fans of eating a diverse range of plants because of the way that this is food for our microbiome. But can that help in any way the inflammation?

Luke: We love them. Let's

Jonathan: start with that. We

Luke: love them. The first anti-inflammatories, remember, were plant-based. The very first drugs from plants were anti-inflammatories.

Jonathan: Is that right?

Luke: The reason for that is the ancients could see the inflammatory wound. You didn't need a microscope, did you? And they'd rub in things. The most famous one of all being willow bark. Now, willow bark was known to be anti-inflammatory. Finally in the 1870s, they purify the active ingredient. It was called salicin from willow. That was the basis for aspirin. So aspirin is anti-inflammatory, but it began with the herbal remedy willow bark, you know? The other one we love is curcumin and turmeric. Those kind of herbal-based things have got a very strong foundation through antiquity. The problem is, if you go to your health food shop and buy it, you're not sure what the dose is. That's one issue. It's a bit unregulated. It worries me slightly. But we start with those herbal things. Rosemary has benefits. Coriander. Those sorts of Mediterranean herbs, which only grow there because of the temperature. Maybe they'll grow here eventually with global warming. They're very rich in oils, and they're purifying things from those herbs as well. That could be beneficial, too. So a balanced diet and all these herbs and olive oil, that's a really good balance. That seems to get... And that was arrived at empirically by our ancient forebearers, really. They knew some of this just by observing what they were eating, I suppose. So that kind of balance that we see in the Mediterranean diet, and there's very good evidence, as you know. So the Mediterranean diet, and that's defined by things like nuts and legumes and herbs, there's been really good studies on that. Big study. It lowered CRP, the biomarker of inflammation, the Mediterranean diet. You know, so there you have some of the evidence then that these diets actually do something that's measurable that we know is inflammatory. You know, now you can show it's working then, you know?

Jonathan: One of the things that I hear our scientists and others talk a lot more about is polyphenols in plants, and they talk about that in relationship often to the microbiome.

Luke: Yep.

Jonathan: Does that link into inflammation in any way?

Luke: It does. It's very interesting. They're antioxidants, remember. Now, as I said earlier, you get these oxygen radicals, they're called, coming off food that can be very damaging. Loads of literature on this, like tens of thousands of papers. Now, these are natural antioxidants. They lower the bleach that you're making. And you're, I mean, it's a strange analogy, but you are making bits of bleach. You're making in your immune system, by the way, to kill all known germs dead. That's Domestos. You make a natural bleach. I bet you never knew that.

Jonathan: No, I didn't.

Luke: Yeah. There's cells called neutrophils that make bleach to squirt on the bacteria. So we make our own bleach.

Jonathan: I can see that'd be dangerous if it got out of hand.

Luke: Now we're talking. So you can see now if you make too much bleach, that begins to bleach your own tissues and causes the injury. You know there's evidence for this. What are these antioxidants? They're chemicals, natural chemicals, that mop up the oxygen radicals and detoxify your body of these things. And again, we see loads of them in plants. Plants are very rich in them. That's one reason we ate plants probably. They get into your gut and certain bugs love them. Again, getting back to the idea of certain species of bacteria, they eat them and they really like them when they start dividing, you know? So it looks as if polyphenols can also help the microbiome. But they're not as important by a country mile as fiber. That's your key microbiome feed. Or as you might know, fiber in your diet. The main benefit from fiber is to get the right balance of bacteria in you. Got loads of evidence for this. A high-fiber diet's beneficial because it works with the microbiome. Now, by the way, the plants with the polyphenols are full of fiber anyway.

Jonathan: And so if I increase the fiber, like we know that overall that's very good for my health- Yeah ... and it's good for my microbiome, does it have any impact on my inflammation?

Luke: Well, it will do through the bacteria. See, you're allowing the good guys to grow. They're making chemicals, natural chemicals, that suppress inflammation. So it's indirect, if you like. There's some evidence of some fiber breakdown products being anti-inflammatory themselves. So you never know. You might get two for the price of one. The bugs are growing, and they're suppressing inflammation, and meanwhile, you're making interesting things off the fiber that also might repress inflammation.

Jonathan: What about supplements? Because there must be millions of supplements on the market that, you know, claim to be anti-inflammatory. Are these worth spending your money on?

Luke: I'm always slightly skeptical. Let's start with that. Because you should get it from a balanced diet. You shouldn't have to take vitamins either, by the way, because the balanced diet will be full of them. Now, if you have certain diseases where your nutrients are problematic and you can't metabolize things properly, you might have anemia, there's various things, vitamin D deficiency, then you take a supplement. But generally, if you're reasonably healthy, there's no need to take these supplements because the balanced diet will provide it, provide you with the things that you need.

Jonathan: Final question. If someone is listening to this podcast and suddenly thinking, "Oh, wow, actually I think I am living with this chronic inflammation," what's the one thing that they could start doing today?

Luke: It's always good to get expert advice on these things. So the number one advice is try to get reassured, try to get some mirth, good balanced diet, exercise, sunshine in the morning. Did you know, John, the first hour of sunshine is more beneficial than sunshine at dusk? There's a circadian aspect to inflammation. You know? It's worse at certain times of the day, you know? If your clock is off kilter, jet lag exacerbates arthritis. Did you know that? Because your body clock is off kilter. Get the clock regularized by sunshine in the morning, you know.

Jonathan: Well, Luke, there are so many topics you've just opened up there at the end. I definitely wanna have you come back and cover them. Unfortunately, we're over time, so what I would like to do is just try and do a little wrap-up. I'm gonna try and summarize. So the first thing this brings to mind is this analogy that my immune system is sort of like this vacuum cleaner going around cleaning up the damage. But unfortunately, in our modern world, like this vacuum cleaner is massively overheating. The vacuum cleaner can't cope. It's burning up. And then it starts to create all of these problems. And you describe the way that, like, my inflammation system makes basically like bleach inside my body to clean things up. Good for killing bugs, bad if it's out of control. And as a result of this low-grade long-term inflammation, you are saying that's what causes heart disease. That's what causes Parkinson's. That's what causes Alzheimer's. But even aging itself, it seems, may be largely driven by this inflammation, this inflammaging idea. Which also means if you can reduce the inflammation, you know, we can live longer, healthier, happier lives. So that's really exciting. On the flip side, if you are living with this chronic inflammation. Actually it leads to sort of sickness behavior. And so you said fatigue is one of the key features. Then we talked about specifically like what's the foods that we're eating and how does this affect it? We all know that having lots of sugar isn't very good for us and having a diet where you're constantly having these blood sugar spikes is bad. But interestingly, your own research has shown that if you do have this inflammation, then actually high levels of blood sugar make it particularly bad because you get these sort of fumes that come off it that then make inflammation even higher. And fructose is even worse. So if you've got this ultra-processed food that often has this fructose thing, it's a problem. However, if I eat an apple, you said it's totally fine because it's sort of wrapped up in the fiber and actually that's gonna be healthy for me. So it's not that fruit is bad, it's what happens when you take the sugar off it. We then talked about meat, and what you said is like we're evolved to eat meat. If we're eating meat in moderation, you shouldn't worry about it. But when you're eating meat, it is actually causing this oxygen damage. If you're eating all these vegetables with it, then they're sort of the antioxidant fire brigade to put it out. So you need to balance that out. We then talked about some of the foods that people are very worried about being inflammatory, like gluten and dairy. And what you said is like there are specific tests and if you're worried, you should go to your doctor, have those tests. Something like celiac is a really serious disease, but if you don't, you shouldn't feel like gluten is just an inflammatory food for everybody. Like, the vast majority of people can digest that just fine. And then finally we talked about like what should you do? Your microbiome is this huge support, so if you can eat the diet that really feeds it, then it creates all of these anti-inflammatory products. And so, you know, polyphenols are one thing in the food which is exciting, but the biggest thing is just all this diversity of fiber because then it's going to support you. And we shouldn't be shocked because you said like plants were the original anti-inflammatory medicines and you were saying like willow bark, which became aspirin, like people used this for thousands of years. And the final thing I think I wouldn't want to leave without is remember Dr. Mirth for your long-term health. You know, like we talk about all the things with food and all the rest of it, but actually having pleasure and fun is really helpful and can lower your inflammation. So, you know, don't get so caught up in all this wellness and stuff that you lose the ability to actually enjoy your life.

Luke: Okay. You could work for me. You've captured it all perfectly.