By Spondylitis Association of America
Chloe is an Accredited Practicing Dietitian and Sports Dietitian who specializes in nutrition for arthritis and inflammatory joint disease, food intolerance, and sports nutrition. Chloe loves cooking and creating recipes, writing, and helping others improve their health.
Elin Aslanyan (EA): Thank you, Chloe, for speaking with us. Would you tell us a bit about your background, what you specialize in, and what inspired you to write this cookbook?
Chloe McLeod (CM): Thank you so much for having me! I am an Australian Accredited Practicing Dietitian, and have been working specifically with people with inflammatory joint diseases for the past four years. Prior to this I have had roles in community health as well as hospital based roles.
The book came about because the resource we get asked for most often is recipes. So, we thought it was time to put together a collection of quick, easy, and most importantly, tasty meal and snack ideas that aim to reduce the inflammation burden within the body.
EA: Who is this cookbook geared to? Who can it benefit?
CM: While the book came about as a result of working specifically with people with inflammatory conditions, the great thing is that nearly everyone will benefit from following this style of eating, which is very ‘Mediterranean Diet’ based. If you are interested in following a mostly plant-based, wholefood diet aiming for long-term good health, and/or you suffer from one of the many forms of arthritis - including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, spondylitis, or any other health issue that may result in or from inflammation - this diet can benefit you.
Note: The article “Insights Into The Microbiome”, found in the Summer 2016 issue of Spondylitis Plus, offers a scientific basis to the theory that adopting a mostly plant-based diet may have a positive impact on reducing inflammation.
EA: The book features anti-inflammatory foods; what are some general categories of anti-inflammatory ingredients? Are there also pro-inflammatory foods or substances to avoid? What are some examples?
CM: We have chosen to split the book up into five sections: Vegetables & Fruit, Grains & Legumes, Fish & Seafood, Nuts & Seeds, and Herbs & Spices. Current evidence-based research indicates that many of these foods and spices provide key anti-inflammatory compounds. Apart from reducing inflammation, these foods help the whole body and its systems function better, and there is the benefit of prevention of elevated cholesterol, blood pressure and blood sugar levels. The result is better health, and for you to feel great! Examples include different colored vegetables, such as broccoli, spinach, pumpkin or cabbage; legumes, such as chickpeas or kidney beans; nuts, such as almonds and walnuts; fish, such as salmon or sardines, and herbs and spices, such as turmeric or parsley.
While the book is not vegetarian (or pescatarian, if being particular,) we have included only a small selection of meat based dishes. We have avoided including any refined sugar, and recommend avoiding processed, packaged options with artificial preservatives or sweeteners as much as possible. We prefer to focus on all the delicious things that CAN be included, rather than what should be avoided, as we feel that this makes it easier for clients to change; if you are focusing on ‘don’t have processed food,’ as opposed to ‘include more delicious vegetables,’ it is likely you will choose what you have been focusing on.
EA: What specific dietary recommendations are there for people living with forms of spondyloarthritis, such as ankylosing spondylitis and psoriatic arthritis?
CM: For psoriatic arthritis, achieving or maintaining a healthy weight range is recommended, as obesity is a common problem in this condition, resulting in an increased risk of cardiovascular disease. Otherwise, nutritional recommendations for people with psoriatic arthritis and ankylosing spondylitis are very similar to those for rheumatoid arthritis. In particular, higher quality research supports use of fish oil supplements and inclusion of fish, and following a mostly plant based diet. Vitamin D levels also need to be taken into account. There is emerging evidence of the role that turmeric plays in managing inflammation in this population; although further research is required, it is still often something I recommend.
For spondyloarthritis in general, following a mostly plant-based diet again is recommended; plenty of vegetables, fruit, whole grains and healthy fats from nuts, seeds, avocado, and fish. Again, I will often recommend avoiding highly processed foods, particularly those high in saturated fats, sugar or salt. Given the potential role of bacteria in the gut influencing these conditions, ensuring optimal gut health is also required. Including foods which promote growth of healthy bacteria, known as probiotic foods is something I also focus on with clients. This includes sauerkraut, kimchi, yoghurt, onion, garlic, asparagus and watermelon.
For this patient group it is a good idea to speak with your doctor about alcohol, and if this should be avoided. From a nutritional perspective, limiting intake is recommended.
EA: What about avoiding complex starches or gluten as a way to reduce inflammation? Is there evidence to support this, and is it something you suggest to your clients with inflammatory arthritis? Do you include low-starch or gluten-free recipes in your book?
CM: There is limited evidence to support this. The way I like to handle this with my clients is to recommend the higher level of evidence approach first. If this is not getting the results that we are after, a gluten free or low starch diet may be recommended. Many clients have read about these diets on forums or social media, and while the evidence is anecdotal, given there currently is not a lot else out there in relation to improvement of symptoms following these types of diets (other than a few papers in the area which show only a modest improvement, if at all,) if an individual wants to try it, I don’t see any harm. I actually believe it is better that this be done under supervision of a suitably experienced dietitian so we can ensure that other aspects of the diet aren’t falling down, and that whole food groups aren’t being cut out unnecessarily. Given the amount of chatter online regarding the benefits, I would love to see some more research in the area so there is higher level evidence either way, so we can better help those with inflammatory arthritis.
EA: Would you share your favorite recipe from this book? What makes it your favorite?
CM: Oh this is a toughie! I love the Orange and Fennel Ocean Trout. It is such an easy recipe, and so delicious; this is on high rotation at my house. I am also a fan of the Green Granola; it’s nice and crunchy and so yummy sprinkled on yoghurt and eaten with fresh berries. And the Tofu and Herb Salad is so lovely and colorful, you can’t help but feel healthy just looking at it!
Sharing the Trout recipe below for your readers.
Works well with Roast Vegetables with Basil and Garlic (page 90 of e-book), or with the Pomegranate Salad (page 27 of e-book).
The e-Book, Anti-Inflammatory Eating: Recipes from Your Dietitian’s Kitchen, is sold for $9.99 and can now be purchased from SAA’s online store, with $1 from each sale being donated to SAA!
Please note that SAA does not endorse or recommend any specific medications, diets, or products for spondylitis and always advises that you seek the counsel of your physician before initiating treatment.
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