 A Thumbs Down Book Review
Inflammation Nation: The First Clinically Proven Eating Plan to End Our Nation's Secret Epidemic
By Floyd H. Chilton, Ph.D.
Fireside, 2005
Review by Katherine Czapp
Asthma, rheumatoid arthritis, lupus and allergies are just a few of the debilitating conditions that have excessive inflammatory response as a marker of their condition. Many other chronic diseases of our age, such as diabetes, cancer, heart disease, Alzheimer's and obesity may also have their roots in deranged inflammatory response, suggests author Floyd H. Chilton. Considered as related diseases, they together create a vast net that includes half of the American population. Although Dr. Chilton, professor of physiology and pharmacology at Wake Forest University School of Medicine, has spent much of his career as a researcher and consultant for several major pharmaceutical companies, which included work on Pfizer's controversial arthritis pain drug Celebrex, in this book Dr. Chilton turns from drugs to diet in order to address the inflammation puzzle.
Dr. Chilton outlines the mechanics of inflammatory response in the body in both healthy and unhealthy situations. While noting that a healthy inflammatory reaction serves purposes of tissue isolation and protection from further injury so that the body can then heal, an inflammatory response that does not turn itself off clearly creates havoc in the body, with no opportunity for complete healing to occur. The book features schemata of battle scenes with what look like regiments of the Golden Horde, complete with charioteers and smoking encampments, to illustrate damage done to the body when inflammation cannot be regulated; and section headings such as "Shock and Awe" and numerous bristling military metaphors keep us properly frightened of the whole process.
The inflammatory messengers responsible for initiating a response and controlling its intensity are the prostaglandins and leukotrienes. These messengers are pictorially represented as hysterical figures with megaphones, and so the reader is conditioned to wince whenever they are mentioned. Here Dr. Chilton leaves out the part of the discussion that explains the several classes of prostaglandins and their cooperative, regulatory feedback responses. An elegant description of this fascinating and complexly detailed aspect of biology can be found in "Tripping Lightly Down the Prostaglandin Pathways," by Dr. Mary Enig and Sally Fallon, but in short, for the inflammatory response to work in a healthy fashion the three classes of prostaglandins must have their pathways "clear" for their normal production. This means access to healthy traditional fats supplied by a balanced diet and an avoidance of rancid, processed vegetable oils that disrupt the pathways, such as corn, canola and soy.
Dr. Chilton's take on the inflammatory messengers, however, is to note that since they are derived from the fatty acid arachidonic acid (AA), and the aim is to block their overproduction in cases of inflammatory disease, his route is to limit consumption of preformed AA in the diet--which means limiting the consumption of nutritious foods like butter, egg yolks and liver. He does not seem to understand that the body also makes anti-inflammatory prostaglandins from AA.
While noting that humans are not very efficient at converting other fatty acids into AA, numerous other species are, including fish, and Dr. Chilton gives a good explanation of how farmed fish, which are fed soy pellets high in omega-6 fatty acids have tissue fatty acid compositions much different from, and much less healthy than, their wild equivalents who eat foods high in omega-3 fatty acids. In fact, farmed salmon cannot be recommended at all, and especially not for those suffering from inflammatory disease; doctors who do not emphasize the difference when recommending fish to their patients are failing miserably in their service. Dr. Chilton goes on to rightly condemn factory-produced eggs for their terrible ratio of fatty acids, although he believes that it is impossible to produce an egg that would be "safe" to eat with supplementation of flax meal or other foodstuffs high in omega-3s.
This leads to the next two points of Dr. Chilton's anti-inflammatory strategy. Because AA requires the action of an enzyme to be converted into prostaglandins and leukotrienes, Dr. Chilton prescribes another fatty acid, gamma-linolenic acid (GLA), in the form of borage seed oil capsules. Inflammatory cells take up GLA, convert it to DGLA, which in turn is a potent inhibitor of AA conversion into inflammatory messengers. Because a high GLA intake can also cause production of AA in the liver, however, Dr. Chilton's diet prescribes frequent meals of wild fish high in eicosapentaenoic acid (EPA) which blocks that potentially counter-productive action of GLA. Finally, carbohydrates are limited on Dr. Chilton's diet to those considered low to moderate on the glycemic index, since blood sugar and insulin levels are intimately connected to fatty acid metabolism and need to be kept stable in order for healing to occur.
The modern American food supply gets much of the criticism it deserves as Dr. Chilton decries the products of factory farming and feedlot livestock management, including farmed fish, of course. Further, with our food cheap, plentiful, and routinely shipped coast to coast, Americans no longer eat locally or seasonally. "We are all feeding from a poisoned trough," declares Dr. Chilton, but unfortunately he wastes this apt and excellent metaphor when we finally arrive at the details of his "Solution" and "Prevention" diets.
The chapter "Getting Started" lays out the foundations of how we'll be eating on the Chilton Diets. Here we are prepped to understand that all margarines used are 70 percent vegetable oil, but with no trans fats. The only fats sanctioned besides margarine are "lite" mayonnaise, canola, cooking spray or "butter-flavored granules." Occasionally olive oil is allowed. Egg substitutes or egg whites, 2 percent milk cheeses and 1 percent milk are the typical dairy products allowed. All juices are unsweetened, or may be artificially sweetened. Artificially sweetened coffee, tea and diet sodas may be used as desired. Welcome back to the poisoned trough! Or as Dr. Chilton now calls it, "your anti-inflammatory arsenal." These are "ordinary American table foods. You don't have to learn to love some grain you've never heard of before…[or] mail order any bizarre ingredients." No, but you will be turning again and again to new-fangled factory concoctions that somehow have escaped Dr. Chilton's scrutiny as possible culprits in the cause of epidemic poor health in modern America.
Let's just take a brief look at some of the ingredients that regularly appear on the weekly menus. Trans-fat free margarine is hardly any better than the old variety; with oxidized vegetable oils (usually canola or soy) and the usual brew of chemical constituents. According to Joseph Mercola, these products may legally declare themselves "trans fat free" as long as each serving size contains less than 500 milligrams of trans fat, and since servings are purposely sized small, it's easy to end up consuming many servings per day. Water, high-fructose corn syrup, soy oil and more chemicals make up "no-cholesterol" mayonnaise. (By the way, don't be taken in by Spectrum's organic extra virgin olive oil mayonnaise--the first ingredient is soy oil.) In Dr. Chilton's book, there is no discussion about the effects of oxidized, rancid polyunsaturated vegetable fats and the cell damage they create, or the disruption they cause in healthy prostaglandin production and therefore their role in inflammatory disease.
Breakfasts on the weekly menus are all lowfat, except for the borage oil capsule that is always prescribed. Typical fare is a whole wheat waffle (packaged) with blueberries, margarine and non-fat yogurt; another morning one sits down to a cup of multi-grain Cheerios with a cup of 1 percent milk, 4 dried apricots halves and a half grapefruit, or a half-cup of liquid egg substitute is served with one ounce of Canadian bacon, two slices of whole wheat bread, margarine and tomato juice.
Lunches usually involve a fat-reduced meat (skinless chicken or 95 percent lean ground beef) cooked with no fat and salads dressed with "lowfat Ranch or Italian dressing"--more packaged oxidized oils.
Dinner often highlights the wild fish that is a cornerstone to the dietary strategy, but it is prepared with canola oil or cooking spray, and sometimes olive oil. Whole wheat pasta or dinner rolls usually appear, with margarine, of course.
Desserts are infrequent, but include horrors such as Sugar-Free Waldorf Gelatin Salad featuring aspartame-loaded, chemically flavored and colored gelatin.
Ignoring his earlier comments on locally available seasonal produce, one often finds asparagus and corn, peas and tomatoes, or blueberries and strawberries in the same meal, but by this point, it hardly matters.
Dr. Chilton claims that sufferers have seen positive results in as little as a week on his diet. I can only imagine this possible because of the frequent borage oil supplementation and the regular inclusion of wild fish, and especially fish roe, which he recommends but for which there are no recipes or menu selections. Otherwise, the diets seem to be a recipe for chronic nutrient deficiencies with their absolute exclusion of animal fats such as butter or cream, and downright dangerous because of the fake, fabricated fats and heavy chemical load, perhaps especially of aspartame. Dr. Chilton makes no mention of alternatives to the factory farmed animal products he condemns, even though the availability of grassfed animal products is growing steadily. This is likely because saturated fats remain the enemy, and especially as found in nutritious foods such as organ meats. For those whose inflammatory disease may be unknowingly accompanied or instigated by gluten sensitivity, these diets will only worsen their conditions with their heavy reliance on the new, "whole" grain (and therefore high-phytate) versions of everything from bagels to macaroni.
While diet can indeed often be the answer for many health problems, one that "prescribes" certain nutrients as though they were drugs without examining the context of the complete diet in relation to the individual is doomed to fail. "I'm not the healthiest eater in the world," admits Dr. Chilton, "and I don't think you have to be, either." Thanks, doc.
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This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2006.
About the Reviewer
 Katherine Czapp was raised on a three-generation, self-sufficient mixed family farm in rural Michigan. After studying Russian language and literature at the University of Michigan, she is gratified to discover that the skills and experiences of her anachronistic upbringing are useful tools in the 21st century. She works independently as a three-season organic gardener and WAPF staff editor. She and her husband Garrick live the slow life in Ann Arbor, Michigan. To learn more about authentic sourdough bread recipes and to obtain a live culture starter, visit www.realsourdoughbreadrecipe.com.
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