Edited by the Doctr Simone Marata
The anti-inflammatory diet
The consumption of fruit and vegetables has been linked with the reduction of morbidity and mortality due to chronic degenerative diseases. It is not yet clear how the constituents of the diet are responsible for this association, but it appears that antioxidants play a greater role in carrying out this protective effect [1].
[1] Pellegrini N., Serafini M, Colombi B., et al. "Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays". J Nutr. 2003, 133: 2812-2819.
[2] La Vecchia, C., Altieri, A. & Tavani, A. "Vegetables, fruit, antioxidants and cancer: a review of Italian studies". Eur. J. Nutr. 40: 261-267.
[3] Pellegrini N., Serafini M, Colombi B., et al. "Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays". J Nutr. 2003, 133: 2812-2819.
[4] Brighenti F, Valtuena S, Pellegrini N, et al. "Total antioxidant capacity of the diet is inversely and independently related to plasma concentration of high-sensitivity C-reactive protein in adult Italian subjects." Br J Nutr 2005; 93: 619-25.
L "Inflammation
By inflammation or phlogosis we mean the set of changes that occur in a district of the organism affected by damage of such intensity as not to affect the vitality of all the cells in that district. This damage can be caused by physical agents ( trauma, heat, etc.), from chemical agents (toxic compounds, acids, etc.) and biological agents (bacteria, viruses, etc.). The response to damage, inflammation, is given by the cells that have survived the " action of it and therefore it is mainly a local reaction that medical terminology indicates by adding the suffix -ite to the name of the organ concerned (for example the terms tendonitis, hepatitis indicate an inflammation, respectively, of a tendon and liver). it is called a predominantly local reaction and not exclusively local as different molecules that are synthesized and released by the cells that participate in the phenomenon of inflammation pass into the blood and act on organs room, particularly on the liver, stimulating the liver cells to release other substances that are responsible for the acute phase response to inflammation. The onset of fever and leukocytosis (increase in the number of leukocytes circulating in the blood) represent other systemic manifestations of inflammation. In itself, inflammation is a useful process for the organism, as it allows to neutralize (if present) the agent that caused the damage, and to restore the normal condition pre-existing to the harmful event. In the case of a muscle injury, for example, the resulting inflammatory process will be necessary above all to activate a repartition process of the damage itself (in this case the agent that caused the damage will be a physical agent, eg a trauma, and there will therefore be no need to eliminate the agent that caused the damage, as is the case in other cases). The best known symptoms of inflammation are the increase in local temperature, swelling, redness, soreness and functional impairment. The phenomena that cause these symptoms are mainly due to events involving the microcirculation of the blood. A very rapid initial vasoconstriction will be followed by the relaxation of the smooth muscle cells present on the walls of the terminal arterioles, with consequent vasodilation and increased blood flow in the area of the trauma (hence the appearance of the local temperature increase and redness). Subsequently, the greatest affl flow of blood "stagnates" in the area of the trauma, thus increasing the viscosity of the blood (due to the aggregation of red blood cells and the exit towards the intracellular junctions of the "liquid" part of the blood); leukocytes will also begin to flow out of the blood to the extravascular compartment where they are recalled by particular cytokines. In this way the exudate is formed, the cause of the swelling in the area of the trauma, consisting of a liquid part and a part of cells suspended in it. Finally, the process of cell damage will begin.
The whole of the processes just described is mediated by numerous molecules that trigger, maintain and even limit the modifications of the microcirculation. These molecules are called chemical mediators of inflammation, and can have different origins and different destinies. They are histamine, serotonin. , the metabolites of arachidonic acid (prostaglandins, leukotrienes and thromboxanes), lysosomal enzymes, cytokines (type 1 and type 2), nitric oxide, the quinine system and the complement system. Instead, the cells involved in inflammatory processes are made up of mast cells, basophilic granulocytes, neutrophils and eosinophils, monocytes / macrophages, Natural Killer cells, platelets, lymphocytes, plasma cells, endotheliocytes and fibroblasts. Inflammation is therefore a temporary process of regeneration and restoration of the normal condition following damage; however, if the agents that cause the damage persist or there is a preferential production of type 1 cytokines, it can become chronic. In this case there is first a progressive reduction of the processes described above in the microcirculation - as occurs in healing -, while at the same time the cell infiltrate is progressively constituted by macrophages and lymphocytes which frequently arrange themselves around the vascular wall like a sleeve that induces the compression. As a consequence of this a state of tissue suffering takes place determined both by the presence of the infiltrate and by the reduction of the blood supply caused by the vascular compromise. Subsequently the fibroblasts can be stimulated to proliferate with the consequence that many chronic inflammation culminate in an excessive formation of connective tissue which constitutes the so-called fibrosis or sclerosis. For example, this is the case of cellulite, an aesthetic imperfection that affects many women, caused by the "increase in the volume of fat cells in certain parts of the body (thighs, buttock, etc.) c on lack of drainage of liquids and local inflammation processes that can lead, in the most advanced stages, to fibrosis and sclerosis with the formation of micronodules that give the skin the classic "orange peel" appearance.
Oxidative Stress
Free radicals are molecules or fragments of molecules characterized by the presence of one or more unpaired electrons and with independent existence; they have strong oxidizing or reducing power and are very unstable, as such they give rise to a series of redox effects with a clear prevalence of oxidative ones. The formation of free radicals is a process that occurs in many cellular biochemical reactions - for example they can be formed during the respiratory chain - but also due to the physical action exerted by the radiant energy on our organism; among the best known free radicals, the superoxide anion and hydrogen peroxide deserve mention.
Oxidative stress is linked to an imbalance between the production of reactive species (free radicals) and antioxidant defenses. In practice, oxidative stress can be defined as a disturbance in the relationship between pro-oxidant molecules and antioxidant molecules, capable of causing potential cell damage. Oxidative stress is in fact involved in the "etiology of many chronic-degenerative disorders, such as cardiovascular diseases, diabetes, cancer and neurodegenerative processes (eg. Alzheimer [1]). In" intense physical activity, oxidative stress is a factor which can affect athletic performance. Intense physical exercise is known to cause an increase in biochemical reactions related to the need to produce the energy necessary to perform muscle work and this consequently also causes an increase in the production of oxygen free radicals, which can contribute to direct damage. to the muscle and the onset of post-workout muscle soreness symptoms.
[1] FrlichI, Riederer P "Free radical mechanisms in dementia of Alzheimer type and the potential forantioxidative treatment." Drug Res 45: 443-449.
Composition of the anti-inflammatory diet
We said at the beginning of this short article that the quantity of a single antioxidant (eg vitamin E or tocopherol, vitamin C or ascorbic acid etc.) contained in a food does not necessarily reflect its total antioxidant capacity (TAC total antioxidant capacity) [1], but that this depends instead on the synergy and the redox interactions between the different molecules present in the food [2]. as in vivo antioxidant compounds act with different mechanisms, therefore a single method cannot be used to evaluate the TAC of a food [3]. The three tools proposed by the aforementioned study are: Trolox equivalent antioxidant capacity (TEAC) [4], total radical-trapping antioxidant parameter (TRAP) [5] and ferric reducing-antioxidant power (FRAP) [6]. [7] therefore worked on determining these three parameters for the main plant foods, fruits, drinks and oils consumed in Italy, thus creating a database from which it is possible to draw on for the drafting of the anti-inflammatory diet. Other studies worldwide have also carried out these determinations, and among the many it is worth mentioning the study entitled "The total antioxidant content of more than 3100 fodds, beverages, spices, herbs and supplements used worlwide" which appeared in the Nutrition Journal in 2010 [8]. In drafting the anti-inflammatory diet it must be taken into account that it will not be a single food that will be effective, as it will never be a Food Supplement - but rather it will be the synergy between foods that provide different antioxidant molecules - to counteract the inflammatory processes that occur, for example. , after a muscle injury, or to counteract the action of free radicals. Therefore, an example of an anti-inflammatory food plan should include:
- 5 portions of fruit and vegetables with high antioxidant power (eg berries, red plums, spinach, broccoli etc.);
- 2 servings of hot drinks such as coffee, tea and chocolate;
- 1 serving of 200 ml of a drink such as orange juice, mix of juices (orange, carrot, lemon) etc .;
- 1-2 glasses of red wine;
- Extra virgin olive oil.
Such a diet has been shown to be able to reduce a systemic marker of inflammation such as Reactive Protein C [9].
[1] La Vecchia, C., Altieri, A. & Tavani, A. "Vegetables, fruit, antioxidants and cancer: a review of Italian studies." Eur. J. Nutr. 40: 261-267.
[2] Pellegrini N., Serafini M, Colombi B., et al. "Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays." J Nutr. 2003, 133: 2812-2819.
[3] Pellegrini N., Serafini M, Colombi B., et al. "Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays." J Nutr. 2003, 133: 2812-2819.
[4] Pellegrini, N., Re, R., Yang, M. & Rice-Evans, CA "Screening of dietary carotenoids and carotenoid-rich fruit extracts for antioxidant activities applying the 2, 2_-azobis (3-ethylenebenzothiazoline-6 -sulfonic) acid radical cation decolorization assay. " Methods Enzymol. 299: 379-389.
[5] 13. Ghiselli, A., Serafini, M., Maiani, G., Azzini, E. & Ferro-Luzzi, A. "A fluorescence-based method for measuring total plasma antioxidant capability". Free Radic. Biol. Med. 18: 29-36.
[6] Benzie, I.F.F. & Strain, J. J. "Ferric reducing antioxidant power assay: direct measure of total antioxidant activity of biological fluids and modified version for simultaneous measurement of total antioxidant power and ascorbic acid concentration." Methods Enzymol. 299: 15-27.
[7] Pellegrini N., Serafini M, Colombi B., et al. "Total Antioxidant Capacity of Plant Foods, Beverages and Oils Consumed in Italy Assessed by Three Different In Vitro Assays." J Nutr. 2003, 133: 2812-2819.
[8] Carlsen et al. "The total antioxidant contento f more than 3100 fodds, beverages, spices, herbs and supplements used worldwide". J Nutr 2010, 9: 3.
[9] Valtuena S, Pellegrini N, Franzini L, et al. "Food selection based on total antioxidant capacity can modify antioxidant intake, systemic inflammation, and liver function without altering markers of oxidative stress". Am J Clin Nutr 2008; 87: 1290-7.
Anti-inflammatory Diet in Sport
During muscle exercise, high levels of ROS (reactive oxygen species) are produced, the so-called oxygen free radicals, which are associated with an increase in muscle damage with loss of muscle function. For this reason, over the years a lot of emphasis has been given to the possibility of supporting the antioxidant defense system with exogenous substances, in order to prevent muscle injuries and improve athletic performance. There are many articles published on this topic, and the consistent result is that antioxidant supplementation attenuates exercise-induced oxidative stress. Conversely, there is a growing body of evidence pointing to the detrimental effects of antioxidant supplementation over the health and performance benefits of exercise. A recent review [1] on the "topic concluded that" more research is needed. for the production of evidence-based guidelines regarding the use of antioxidant supplements during exercise. An adequate intake of vitamins and minerals through a varied and balanced diet is recommended, as this remains the best method to maintain optimal state of antioxidants in individuals who play sports. "
[1] Peterlenj TT, Coombes JS "Antioxidant supplementation during exercise training: beneficial or detrimental?" Sports Med. 2011; 41: 1043-69.
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