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Fighting Inflammation with Food Synergy

One of the reasons some studies haven’t shown more impressive results tying disease reduction to the quantity of fruit and vegetable consumption (see EPIC Study) may be because of quality of fruit and vegetable consumption. People are more likely to eat bananas than blueberries; cucumbers instead of kale. Berries are the healthiest fruits (see Best Berries) and greens are The Healthiest Vegetables.

Variety is also important. We know, for example, spinach is healthier than lettuce (see #1 Anticancer Vegetable for a comparison of salad greens), and a big salad is better than small, but is it better to get the spring greens mesclun mix than even the straight spinach? Is it healthier to eat one apple and one orange than it is to eat three apples or three oranges? Though there are generic plant compounds like vitamin C that are found scattered throughout the plant kingdom, there are also specific phytonutrients produced by specific plants to perform specific functions—both in their organs and ours. We miss out on these if we’re stuck in a fruit and vegetable rut, even if we’re eating many servings a day.

There are tens of thousands of these phytonutrients (see my 2-min. Phytochemicals: The Nutrition Facts Missing From the Label), but they’re not evenly distributed throughout the plant kingdom. Those wonderful glucosinolates I discuss in The Best Detox, Broccoli Versus Breast Cancer Stem Cells, and Lung Cancer Metastases and Broccoli, for example, are found almost exclusively in the cabbage family. Likewise, you won’t get lemonoids like lemonin and limonol or tangeretin in apples. Comparing apples and oranges is like, well, comparing apples and oranges.

At the same time, all fruits are just fruits, whereas vegetables can be any other part of the plant. As I lay out in my 2-min. video Apples and Oranges: Dietary Diversity, roots harbor different nutrients than shoots. Carrots are roots, celery and rhubarb are stems, dark green leafies are leaves of course, peas are pods, and cauliflower is true to it’s name as a collection of flower buds, but all fruits are just fruits. The available evidence suggests it may be most important to get in a variety of vegetables so you can benefit from all the different parts of the plant.

We know that whole foods are better than eating individual nutrients, for example a carrot is better than a beta carotene pill, because of what’s been called nutrient synergy where the whole is greater than the sum of its parts, as many of the nutrients interact, work together, and complement one another. The same can be said of various food combinations. For example, I’ve talked about the wonders of the spice turmeric (Oxalates in Cinnamon), but the key component has very poor bioavailability. Just a tiny bit gets into your bloodstream after eating a nice curry—unless, you add some black pepper. The phytonutrient in black pepper boosts the absorption of the turmeric phytonutrient 2000%! That’s why dietary diversity is so important.

In Garden Variety Anti-Inflammation I detail some recent studies that looked at disease risk and the variety of fruit and vegetable consumption. Researchers found no difference in inflammation between those eating 6 servings of vegetables a day and those eating 2 servings, but those eating the more variety—even if they didn’t necessarily eat greater overall quantities—ended up with significantly less inflammation in their bodies. This supports the American Heart Association’s latest dietary guidelines, which, for the first time, added a recommendation for also eating a variety of fruits and vegetables.

For more on the anti-inflammatory nature of plant foods, see my 1 min. video Anti-Inflammatory Antioxidants and 2 min. Aspirin Levels in Plant Foods.

-Michael Greger, M.D.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

149 responses to “Fighting Inflammation with Food Synergy

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  1. I am glad you wrote this post – it is a really important message. It is very unfortunate that people like Timothy Key, one of the lead researchers in the EPIC diet and cancer study, has been writing commentaries saying that fruit and vegetables don’t protect against cancer. That kind of message hits the general media headlines and the general public thinks “OK, so why bother with the broccoli then”. Dominique Boivin and Richard Beliveau did a study pointing out that the most cancer protective vegetables (the cabbage/kale and onion/leek families) make up only a tiny proportion of the average person’s vegetable intake – reinforcing the point you make the beginning of the post about quality of fruit and veg being important, as well as variety. 

  2. Also, eating organic fruit/veggies is better than conventional. I’ve read studies/articles (maybe yours?) that show a big difference in nutrient content. Also with organic, there’s no pesticide/herbicide residue or GMOS for bodies to have to detox, which takes away from the benefits of good wholesome vegan food!

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  4.  Message *:
    I went on a close to vegan diet after reading stuff from
    Dr. Mercola, Dr. McDougal, Dr Ornish and Dr Campbell. The change in my
    lipid panel was amazing. For example my triglycerides went from 190 to
    60. I am retired now and want to join in helping people understand
    nutrition. The purpose of this message is to ask advice on how to pursue
    an education on this subject. I live in Boise, Idaho.
    I will make a contribution but first need to significantly improve my nutrition knowledge.
    Rick Kartes

  5. Going Vegan was the best decision I have ever made. I just found out I need a low oxalate diet to avoid more kidney stones. I will need to avoid some vegetables. Any low oxalate diet tips?

    1. Oxalic acid occurs naturally in many plant foods. Spinach, rhubarb,
      Swiss chard, cocoa powder, chocolate, beets, beet greens, peppers,
      strawberries, tea (both black and green), okra, peanuts, pecans and
      wheat germ and bran contain sufficient oxalic acid to increase urinary
      oxalate excretion. Increased oxalic acid in the urine raises the TSI and
      presumably increases the risk of calcium oxalate-rich kidney stones.
      One study showed that most of the above mentioned oxalic acid-containing
      foods do significantly increase urinary oxalate excretion. It seems
      reasonable to limit the intake of these oxalic acid rich foods [Spinach,
      rhubarb, Swiss chard, cocoa powder, chocolate, beets, beet greens,
      peppers, strawberries, tea (both black and green), okra, peanuts, pecans
      and wheat germ and bran] in people with recurrent calcium
      oxalate kidney stones. Calcium oxalate is poorly absorbed so foods with
      as much or more calcium as oxalic acid would probably have little impact
      on urinary oxalate excretion. However, plant foods are not the only
      source of urinary oxalic acid so even if all plant foods are avoided
      calcium oxalate stones may still form. Oxalic acid can be derived from
      the breakdown of dietary protein as well as from high doses of vitamin
      C.Table 2 below lists foods with the most oxalic acid and high ratios of oxalic acid to calcium. If
      calcium rich foods are consumed with these foods it is likely that the
      absorption of oxalic acid from the gut would be reduced.Table 2. Foods to Avoid for People with Recurring Kidney StonesFoodBeet greens, cookedRhubarb, stewed, no sugarSpinach, cookedBeets, cookedSwiss Chard, cookedSpinach, frozenCocoa, dryOkra, cookedSweet potatoes, cookedPeanutsTeaPecans, halvesWheat germ

    2. @Lee, I had a co-worker who was advised to stop all consumption of SOFT drinks to help his kidney stone situation. Just gently offering this; you CAN be vegan but also drink junk like soft drinks, after all. Not sure this is your situation, though. 

  6. Fast Food Nutrition Facts Fighting Inflammation With Food Synergy | | Fast Food Nutrition Facts says:

    […] Fighting Inflammation With Food Synergy | This entry was posted in Uncategorized and tagged EPIC, nutrition, Nutrition Facts, quantity, […]

  7. Would love for you to do a video about maca. Supposed to be good for regulating hormones, gives an energy boost, and increases libido as well… curious what the research says though.

  8. It is my understanding that plants make antinutrients as part of their evolutionary defense mechanism. How should we include this factor in choosing which plants to eat. The dramatic case of the Bok Choy coma being an example. Comas aside, at what level does the bad stuff in Bok Choy set an upper bound for optimal health?

    1. Many antinutrients such as lectins, phytic acid, trypsin and α-amylase inhibitors.are deactivated with cooking. And most foods we eat (such as grains and beans) that contain these antinutrients must be cooked anyway before consuming.

  9. As dental hygienist and a recent convert to plant-based eating, I am very interested exploring any effects this may have on periodontal disease.  I have seen organizational websites attributing plant-based diets as contributory or causative to the development of PD.  If there is an overall reduction in inflammatory issues including heart disease, diabetes, etc., how does that play out in PD?  I am also a grad student looking for a thesis topic – this is very intriguing.  Would really appreciate your opinion/position on this topic!

  10. What is your opinion of carrageenan? It’s in everything and I see lots of posts/studies that it causes inflammation, allergies, etc. And is there a difference between degraded and undegraded? Thanks!

        1. I did a brief pub med search and at this point it seems like the jury is out. I would use the precautionary approach and avoid or use it in a limited fashion. I and I’m sure you are looking forward to Dr. Greger’s upcoming video… so stay tuned.


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