Introduction

A silent plague is sweeping America, and the vast majority of us are at risk. It has taken the form of a statistically significant and incalculably devastating series of epidemics -- an "epidemic of epidemics."

I believe this plague is largely preventable, and yet we are doing little to stop its spread. On the contrary, we're actually encouraging a tidal wave of disease. At best, these illnesses compromise our quality of life; at worst, they can be painful, debilitating, and fatal.

Consider the following:

· Seventy million Americans suffer from arthritis -- or one in every three adults. That's twice as many arthritis sufferers as there were two decades ago.

· More than 20 million Americans have asthma today. It is the sixth most common chronic human disease.

· More than 50 million Americans suffer every year from allergies, a number that has doubled in the past twenty years. There has been a 100 percent increase in the prevalence of hay fever in developed countries in each of the last three decades. Allergic dermatitis affects us at triple the rate in 1960. Ten percent of our young children are affected by allergic dermatitis.

· There were 18.2 million people in the United States with diabetes in 2002, a 49 percent increase from ten years ago. This debilitating disease contributes to about two hundred thousand deaths in the United States each year.

· Cardiovascular disease is the number one killer of Americans. Almost 64 million Americans have it in some form, and it killed almost a million people in 2001.

· Eczema is the most common skin condition in children under eleven; an estimated 15 million people in the United States suffer from the symptoms of this disease.

· One million Americans have inflammatory bowel disease.

Anyone would agree that these numbers are overwhelming. But they're even more devastating when you realize that this isn't just a random laundry list of conditions. In fact, these diseases all share a single underlying cause.

What's the common denominator linking these seemingly disparate diseases, and other serious ones, including lupus, Crohn's disease, and psoriasis? The answer comes from a surprising quarter: the body's own self-defense system. These are all inflammatory diseases, diseases that occur when the body's own defense system turns against itself.

And our bodies are turning against themselves in record numbers. Each one of these diseases, taken individually, represents a serious health problem in this country. Taken together, as a category of diseases, this can only be seen as a pandemic. It is true that some of these diseases overlap, like allergies and asthma, which makes it difficult to make an accurate estimate of the full scope of the inflammatory disease problem in this country. But even with that overlap, I don't think I'm overstating the problem when I say that inflammatory diseases affect as many as half of the people in this country.

The Inflammatory Cluster

You're probably familiar, from the news and movies like Erin Brockovich, with the phenomenon called the "cancer cluster," when people in a community or a profession develop related types of cancer in disproportionately high percentages. It's an absolutely terrifying occurrence.

When a cluster is identified, researchers immediately look for a proximate cause, a cancer-inducing agent to which every one of the patients has been exposed. When that proximate cause is uncovered (a factory dumping toxic chemicals into the groundwater, for example), the rest of us thank our lucky stars that it didn't happen in our neighborhood.

When I began my research into the connection between diet and inflammatory disease, I was simply searching for something to help people who suffered from advanced and chronic inflammatory disease. I wanted to find a natural, dietary solution that would alleviate symptoms in people who had otherwise exhausted their options. But I came to realize, as I hope you will over the course of this book, that the problem of inflammatory disease was much, much bigger than I had thought -- and the stakes much higher as a result.

In fact, the soaring rise in inflammatory disease in this country is nothing less than a cluster in its own right. It's a nationwide cluster, a cluster without walls, unbounded by the typical limits of geography or demographics. You can't breathe a sigh of relief that you live outside the radius of the toxic-waste spill, because there is no "outside." There is no localized danger zone, no limited area that can be cordoned off and sanitized.

It is when we begin to look for the proximate cause of this tremendous, nationwide epidemic that the terrible gravity of the situation hits home: the answer may in fact be right on our dinner plates. I believe that a major component driving these diseases is our diet, and the "toxic-waste spill," to continue the metaphor, is our very food supply. There is no safe house, no place to hide, unless we fundamentally change the way we eat, in the ways prescribed in this book.

This disaster has sneaked up on us, but not overnight: the circumstances leading up to it have been brewing for a century or more. The staggering number of Americans suffering from these painful and debilitating diseases are, horribly, acting as the canaries in the coal mine. Their agony is sending a message, loud and clear, to those of us who have so far managed to dodge the bullet. This book isn't about the division between people who have inflammatory disease and people who don't. It's not about "who has it" and "who doesn't"; instead it's about "who doesn't" and "who will?" Every single one of us has pulled a chair up to this contaminated trough -- which means that every single one of us is at risk.

"Why Haven't I Heard About This?"

You're probably wondering: if out-of-control inflammation is a silent plague threatening all of us, and not just a rare and exotic condition that affects the unfortunate few, why don't I know about it?

In fact, you know more about inflammation than you think. Like oxygen, inflammation is essential to our continued survival. When the inflammation system goes off course, we quickly turn to medication; I'd bet that there isn't a soul among us who doesn't have a bottle of aspirin in the medicine cabinet. This wonder drug quiets pain, soothes fever, and reduces swelling, like several of the other very effective anti-inflammatory drugs on the market.

Sometimes, however, our system becomes chronically inflamed. Why this happens is a puzzle. But we've been gathering the pieces of this puzzle for a while. Pharmaceutical companies have played an important role in uncovering the mysteries of how the inflammation system works. In fact, I like to refer to the inflammatory pathway that is the subject of this book as "the billion-dollar pathway," because it has absorbed more time and research -- and research dollars -- than almost any other area of medicine in the last thirty years. Soon, you will know it by another name: the AA Pathway (more about this later). The ability to block the AA Pathway is the magic behindblockbuster drugs like Celebrex and Singulair, as well as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). The AA Pathway is also the magic behind the Chilton Program, a whole new all-natural way of thinking about inflammation.

Why the Stakes Are So High Right Now

The shockingly high number of people who have been diagnosed with inflammatory disease is one reason that we must come to terms with this plague. The fact that every single one of us is potentially in the line of fire is another. But out-of-control inflammation looms large as a public health issue for a variety of other reasons as well:

· Inflammatory diseases are debilitating and, in many cases, fatal. And there is no cure for these diseases. Although in most cases, we've gotten better at treating their symptoms, treatment often means expensive, long-term medications with side effects that can be as damaging as the diseases themselves, and even the best medications don't work all the time, or for everybody.

· More diseases have inflammation at their root than we think. Inflammation, it turns out, is the culprit behind many of the life-threatening conditions we thought were closed cases. For instance, ten years ago, cardiologists thought elevated blood lipids like cholesterol and triglycerides were the primary cause of heart disease, so we categorized atherosclerosis as a lipid-storage disease. Now we believe that heart disease, the leading killer of Americans, actually has inflammation at its root. And new research shows that underlying inflammation may be linked to other major killers, like Alzheimer's and certain types of cancer.

· Other human conditions have a significant inflammatory component. Even conditions that aren't strictly categorized as inflammatory diseases frequently have a significant inflammatory component, which is often the root of chronic pain and deforming tissue damage. For example, inflammation is a major driving force behind type 2 diabetes and dementia. In fact, inflammation may play a major role in the category of ailments and diseases we have previously called "aging." Consequently, treating and preventing inflammation can mean a tremendous boon for all of us, often resulting in an enormous increase in function and great relief from pain.

· Inflammation isn't the only burgeoning epidemic. Approximately 64 percent of Americans are overweight or obese. Not only does being overweight exacerbate an existing inflammatory disease, but fat cells play a major role in the creation of the messengers that cause inflammatory disease.

· More and more people are affected every year. Today's inflammatory disease statistics are alarming. Tomorrow's numbers will be worse. The number of people suffering from these diseases -- and dying from them -- continues to grow. Our medical systems, medicines, and technologies have never been better or more accessible to many people, and yet these diseases flourish as if we lived in the Dark Ages.

If we hope to see any meaningful relief from this pandemic, we must begin to address its underlying cause; and, to do that, we must investigate why these diseases are happening to us in such disproportionately high numbers, and what we're doing that's causing those numbers to rise.

Tammy's Story: A Personal Crusade

Vital journeys in life often start with the intense desire to help someone whom you love. If almost 50 percent of Americans have an inflammatory disease, then certainly every American's life has been touched by this epidemic, and I am no exception. It was my own personal experience with inflammatory diseases in people whom I cared about that motivated me to dedicate my life to this research.

My sister Tammy was diagnosed with juvenile rheumatoid arthritis (RA) at the age of thirteen. I truly believe that if Satan were to design a disease, it would be this one -- an opinion that's shared by those who live with RA, and the doctors who treat it. It's truly a monstrous affliction: an incurable disease characterized by excruciating pain and gradual debilitation.

Tammy is one of the bravest people I've ever met. Although she's been suffering from this demon of a disease since childhood, I don't think I've ever heard her complain -- but the physical evidence of her disease is written all over her body. By the age of thirty, her hands were so grotesquely deformed that it hurt just to look at them, and her knees were enormously swollen with bony protuberances, places where the chronic inflammation had affected so much tissue that the shape of the joint was permanently damaged.

To control her disease, Tammy had progressively moved up to more and more serious medications. By the fall of 1997, she was taking a medication called methotrexate, originally designed as an anti-cancer drug. It is very powerful and toxic. The immediate side effects included mouth sores, diarrhea, and a loss of appetite, but there was also a long-term threat: taken in high enough concentrations for long periods of time, methotrexate can eventually threaten every major organ system in the body.

The medication was expensive, the side effects made her very uncomfortable, and, as the mother of three small children, she was worried about its effects on her future health. But like many RA patients, Tammy simply didn't have a choice. This drug was her only hope. The worst part was that the methotrexate wasn't even all that effective. Despite this heavy-duty medication, Tammy still couldn't walk up a flight of stairs or tie her own shoes. And no matter what she did, her disease continued to worsen.

After two full knee replacements and five surgeries to rehabilitate and replace the joints in her hands, Tammy was at the end of her rope. She had heard in RA sufferer support groups an excited buzz about "alternative therapies" promising increased function and pain reduction. The possibility of help was tantalizing, but inaccessible -- there was absolutely no consensus about what worked! Some sufferers were claiming terrific results from diets that contained supposedly anti-inflammatory foods, and from taking huge doses of antioxidant vitamins and fatty-acid supplements. Dosages varied wildly, depending on whom you asked, and nobody seemed to be all that concerned about science or safety.

Understandably overwhelmed by the contradictory information whizzing back and forth, Tammy called me. At the time, I was a faculty member at the prestigious Johns Hopkins Asthma and Allergy Center and an internationally recognized expert in asthma.

"I need to try something else," she said. "My doctor is telling me I've exhausted my options, but what I'm doing clearly isn't working, and I can't go on like this. Isn't there anything else I can do?"

"I have no idea," I said. "But don't you dare take anything until I do."

That night, I spent the evening at our medical library examining the claims behind these alternative medicines. Tammy had been right: there was a whole culture of people with inflammatory diseases of all kinds, clamoring for help. In almost all cases, their diseases were chronic and progressive. The prescription medications they were taking often had unacceptable side effects, and they were legitimately afraid of the effects these medications might have on their long-term health. Traditional medicine was not providing acceptable solutions for these people, and they were desperate for answers from other quarters.

But if there was help to be found, it wasn't going to be from natural-product companies, which seemed to prey on the hopes and fears of despairing sufferers, trading in great promises that could only end up in profound disappointment. I was appalled by the misinformation about diet and supplements I was reading in the materials I found. At best, the information was useless, the "prescriptions" not much better than snake oil. At worst, the recommendations were downright dangerous -- combinations of supplements at dosage levels that could have potentially fatal results, like platelet stickiness and heart attack.

At the same time, I couldn't dismiss everything I found as quackery. As silly as some of the scientific claims were, I could also see the gleam of real treasure there. Sure that I wasn't the only scientist to make these inquiries, I went to Medline, a list of about 11 million references from medical journals, to see what the medical community had to offer. I looked for clinical trials designed to test alternative therapies for inflammatory disease.

Unfortunately, what I found there wasn't much more conclusive. There weren't a lot of studies, and, for the most part, the ones I did find lacked real scientific vigor. Many of them hadn't used a placebo control group, which meant that there wasn't a real standard against which to compare their results. Most of them hadn't taken place in a major medical center setting, where the researchers could ensure strict compliance. And in some cases, there was a question about how the outcomes had been measured. From a scientific perspective, the research was inadequate, to say the least.

But again, there was just enough possibility to intrigue me. There was a large body of evidence indicating a connection between inflammatory disease and diet -- specifically, the fatty acids in our diet, which happened to be my own primary area of expertise.

I sat up for several long and sleepless nights thinking about Tammy's options, and my own. At the time, I had two major grants funded by the National Institutes of Health, and I was consulting for three major pharmaceutical companies. In other words, I had a lot of research money at my disposal. I was a world-recognized scientist, specializing in the way that fatty acids are metabolized in the body on a cellular level, and it was very clear from the research I'd found that there was overlap between my field of expertise and inflammation.

As the sun came up on my last sleepless night, I realized I had an opportunity to help my sister, and millions of people like her. Wasn't it time that I started looking at the forest, instead of so closely focusing on the trees?

And so it was that with my colleagues at Johns Hopkins (and building on the work of countless scientists and researchers before me), I began my quest to develop safe, effective, scientifically based, natural approaches to preventing and treating inflammatory disease through diet.

Now I believe I know a major reason why America and other first-world nations are falling prey to the epidemic rise in these diseases despite our unprecedented medical advances. And with that answer in hand, I was able to devise a program -- a simple, easy-to-follow diet solution that I believe will help stop, reverse, and even prevent the debilitating effects of an immune system that has been set permanently on overdrive.

Although the program was not designed to supplant medication, it did in some of the patients who were a part of the six clinical trials that tested the foundations of these diet plans. People suffering from inflammatory disease often saw a conspicuous difference in the markers of inflammation within just seven to ten days.

After following the rules of my dietary program for a month, a woman with chronic pulmonary disease was able to sleep without oxygen for the first time in a decade. A lifelong asthmatic and amateur cyclist achieved a new personal best in cycling, two months after he'd been convinced he'd have to park his bike for good. My oldest son, Josh, who used to gauge how well he was controlling his asthma by the number of football practices and games he missed, hasn't missed one in over a year. And, after six months on the diet, my own sister opened and closed her hand completely, for the first time since she was fourteen years old.

How to Use This Book

I have written this book because I believe that we can -- safely and naturally -- attack this "epidemic of epidemics" where it stands. I believe we can limit and indeed, in some cases, even reverse the damage it has already done in the lives of so many Americans. I believe that every one of us is at risk of developing inflammatory disease unless we bring these fatty acids back into balance. And I know that people who suffer from inflammatory disease can see measurable, and in many cases life-changing, improvement in their disease, simply by changing what they eat. This, obviously, makes for a tremendous improvement in their quality of life.

I've designed this book with that end in mind. In the first half of this book, we'll discuss this silent epidemic. You'll learn how the standard American diet has led to this crisis of truly enormous proportion.

In the second half of the book, I'll give you the tools you need to fight back. We'll determine your "Inflammatory Quotient" -- your inflammatory risk profile, which will, in turn, determine how you proceed through the rest of the program. If you have already been diagnosed with an inflammatory disease, or have a strong genetic predisposition in that direction, you'll follow the Inflammation Solution Diet. This program is not intended to supplant the treatment plan your doctor has put in place, but to complement it, and I know that both you and your doctor will be thrilled to note how quickly you see improvement using this plan.

Even if you don't suffer from one of these diseases, you are nevertheless at significant risk, in part due to your diet. Thus, the other tier of the Chilton Program, the Inflammation Prevention Diet, is designed to benefit people who want to do all they can to resist or hold inflammatory disease at bay for themselves and their families.

The Good News

While the Chilton Program represents a radical new way to control inflammation, it doesn't require a radical adjustment in your ability to enjoy food. The foods you'll find in this program are ordinary and delicious American table foods. I've provided you with four weeks of meal plans for the Solution Program, and four weeks of meal plans for the Prevention Program, so that you can see how easy it is to choose the healthiest and least-inflammatory foods. After that month is over, I believe that you'll look and feel significantly better.

And in this book, you'll find all the tools you'll need to incorporate your new anti-inflammatory eating habits into the rest of your life, long after you've eaten your way through the meal plans. You'll find all the information you need to follow the Chilton Program in easy-to-understand indexes and a new anti-inflammatory nutritional pyramid, so that you can choose delicious, healthy, anti-inflammatory foods at a glance.

The Chilton Program is simple in part because I've designed a new index system that assigns an inflammatory potential value to the most common foods in our food supply. I have called this the Inflammatory Index. These values will enable you, for the first time, to take control of your overactive inflammation by eating foods low on the Inflammation Index. The innovative and easy-to-understand Inflammation Index in this book ensures that anti-inflammatory choices are never farther away than your fingertips.

My research has also indicated that you can't affect inflammation by fatty acids alone: you must also pay close attention to the amount, and types, of carbohydrates you consume. Consequently, reducing the amount of carbohydrates you eat is another cornerstone of the Chilton Program. It's also one of the reasons that following the prescriptive weight-loss portion of this program can help you lose weight (as other lower-carbohydrate diets like Atkins and South Beach have done), if that's something you need to do. However, there's one enormous difference: the other low-carb diets do not take inflammation into account.

I have nothing but respect for these diets because they have successfully tackled some of America's biggest misconceptions about food. But I am concerned that many of their recommendations may be worsening our epidemic of inflammatory disease.

The Glycemic Index is the gold standard for measuring how different foods affect blood sugar, and it is used extensively by nutritionists. You'll find a ranking that takes that index into account in this book so you can ensure that your carbohydrate intake isn't sabotaging the work you're doing to suppress inflammation on the fatty-acid side.

The Promise

With Inflammation Nation, you're really getting two books in one: an explanation of an epidemic, and a very specific dietary takeaway that will help you prevent, treat, and reverse inflammatory disease in your own life and in the lives of those you care about.

Too many Americans suffer from these painful, debilitating diseases. Too many Americans like me have helplessly watched their loved ones fight the uphill battle against them. And every single one of us is at great risk unless we start right now, by changing what we eat and what we feed our families.

Keep reading. You will learn how inflammation, a natural and vital process, works against you; how you can take the first steps to prevent your body's natural defense system from turning against itself; how you can incorporate a more healthful, anti-inflammatory way of eating into your life; and how, in so doing, you can take part in beating back this epidemic of very destructive diseases.

Copyright © 2005 by Chilton Health Technologies, LLC