Inflammation: Western diet shifts immune cell balance

The immune cells of macaques fed a Western-like diet adopt a pro-inflammatory profile.
  1. Christina M Bergey  Is a corresponding author
  1. Department of Genetics, Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, United States

Our Palaeolithic ancestors would have never experienced anything like a cheeseburger, which has existed for only about 0.1% of human evolutionary history. But they would have loved the processed American cheese, the added bacon, the side of deep-fried potatoes and the 30-ounce soda. Such an energy-dense meal is now readily accessible in high-income countries for the first time in our evolution. Besides this caloric overabundance, numerous nutritional characteristics separate this so-called ‘Western’ diet from what our forebears used to eat. Refined sugars, cereals and vegetable oils, meat from domesticated animals, added sodium, and, in some groups, dairy foods, are now widespread components that would have been largely alien before the advent of farming, animal husbandry and industrialization (Cordain et al., 2005). In the United States, highly manipulated, ‘ultra-processed’ foods which often contain additives like sugar, salt, and fats could now account for two-thirds of the calories that young people consume (Wang et al., 2021).

The modern rise of conditions like obesity, type II diabetes, and cardiovascular disease has led many to posit that an ‘evolutionary mismatch’ is to blame: our physiology evolved in an environment that primarily offered a plant-based diet, and is therefore ill-suited to the modern nutritional landscape (Eaton et al., 1988). Human evolution did not stop with the transition to agriculture, of course, but ten millennia are not enough to fully adapt to such a wholesale dietary transformation. Supporting this conjecture, many chronic diseases are rarer among those who follow the Mediterranean diet, which is thought to be closer to the foods consumed by our ancestral hunter-gatherers due to its abundance of plant-based proteins and relative absence of meat and refined carbohydrates (Mackenbach, 2007). Yet exactly why the Western and Mediterranean diets are associated with such differing rates of disease is unknown.

Now, in eLife, Thomas Register, Noah Snyder-Mackler and colleagues from various institutions across the United States – including Corbin Johnson as first author – report testing a mechanism that may explain the health benefits of the Mediterranean diet over its Western counterpart (Johnson et al., 2021). Their research focused on monocytes, a group of white blood cells which, depending on their exact type, perform distinct immune functions. Based on the genes they express, these cells can either propagate inflammation or halt the process to repair and regenerate tissue (Orekhov et al., 2019).

A prior study, which did not directly investigate diet, found that the monocytes of people with obesity were more likely to be pro-inflammatory (Devêvre et al., 2015). Building on these results, Johnson et al. investigated how diet could influence monocyte activity by feeding macaques a Western- or Mediterranean-like diet.

The change in diet caused a staggering 40% of monocyte genes to be expressed in a different way, with the Western-like diet increasing the activity of genes that regulate pro-inflammatory processes (Figure 1). This result corroborates the findings of a similar study of more limited scope, in which the pro-inflammatory response of monocytes and related cells was dampened in elderly human volunteers who consumed a Mediterranean diet, compared to those on more Western-like foods (Camargo et al., 2012).

The Western diet shifts monocytes to be pro-inflammatory in a macaque model

Macaques were fed either Western or Mediterranean-like diets, and the gene expression of their monocytes was profiled. The proportion of pro-inflammatory genes being activated was then computed (shown in graph). This revealed that genes overexpressed in the Mediterranean-like diet (represented by the olive branch) were less likely than chance (marked as zero) to be pro-inflammatory (data shown in green). Genes that were highly expressed in the monocytes of monkeys fed a Western-like diet (represented by the piece of meat) were more likely than expected by chance to be pro-inflammatory (data shown in red). The gene classification was based on prior direct comparisons of pro-inflammatory and regulatory monocytes (Schmidl et al., 2014).

Image credit: Data adapted from Johnson et al., 2021 (CC BY 4.0).

Macaques are not a perfect analogue to people, but the approach by Johnson et al. bypasses limitations of human studies, which may be limited in time and hampered by participants’ poor recollection of what they had for lunch. Overall, this work bolsters the hypothesis that alterations in monocyte activity explain how the Western diet is associated with inflammation. In turn, these results shed new light on conditions such as cardiovascular disease and cancer, which are also associated with inflammation and cause an immense proportion of modern deaths (Furman et al., 2019).

Several outstanding questions remain: for example, what are the the specific components of the Mediterranean and Western diets that impact monocyte balance and associated diseases? A more nuanced classification of monocyte subtypes could provide additional insight, as would having a clearer idea of the roles human genetic and epigenetic variation play in determining diet response. In addition, genes – in particular those involved in immunity – are connected through delicate networks: could increased inflammation perturb these complex connections, and through this contribute to the evolutionary mismatch between our genomes and our diet? As the Western diet and ultra-processed foods strengthen their hold and now spread across the globe, studies that answer such questions and help to understand the health implications of modern diets are urgently needed.

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Author details

  1. Christina M Bergey

    Christina M Bergey is in the Department of Genetics, Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, United States

    For correspondence
    christina.bergey@rutgers.edu
    Competing interests
    No competing interests declared
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-8336-8078

Publication history

  1. Version of Record published: September 13, 2021 (version 1)

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© 2021, Bergey

This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.

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  1. Christina M Bergey
(2021)
Inflammation: Western diet shifts immune cell balance
eLife 10:e72787.
https://doi.org/10.7554/eLife.72787

Further reading

  1. Junk food causes continuous inflammation and bad behaviour in monkeys

    1. Epidemiology and Global Health
    Tina Bech Olesen, Henry Jensen ... Morten Rasmussen
    Research Article

    Background: Worldwide, most colorectal cancer screening programmes were paused at the start of the COVID-19 pandemic, whilst the Danish faecal immunochemical test (FIT)-based programme continued without pausing. We examined colorectal cancer screening participation and compliance with subsequent colonoscopy in Denmark throughout the pandemic.

    Methods: We used data from the Danish Colorectal Cancer Screening Database among individuals aged 50-74 years old invited to participate in colorectal cancer screening from 2018-2021 combined with population-wide registries. Using a generalised linear model, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) of colorectal cancer screening participation within 90 days since invitation and compliance with colonoscopy within 60 days since a positive FIT test during the pandemic in comparison with the previous years adjusting for age, month and year of invitation.

    Results: Altogether, 3,133,947 invitations were sent out to 1,928,725 individuals and there were 94,373 positive FIT tests (in 92,848 individuals) during the study period. Before the pandemic, 60.7% participated in screening within 90 days. A minor reduction in participation was observed at the start of the pandemic (PR=0.95; 95% CI: 0.94-0.96 in pre-lockdown and PR=0.85; 95% CI: 0.85-0.86 in 1st lockdown) corresponding to a participation rate of 54.9% during pre-lockdown and 53.0% during 1st lockdown. This was followed by a 5-10% increased participation in screening corresponding to a participation rate of up to 64.9%. The largest increase in participation was observed among 55-59 year olds and among immigrants. The compliance with colonoscopy within 60 days was 89.9% before the pandemic. A slight reduction was observed during 1st lockdown (PR=0.96; 95% CI: 0.93-0.98), where after it resumed to normal levels.

    Conclusions: Participation in the Danish FIT-based colorectal cancer screening programme and subsequent compliance to colonoscopy after a positive FIT result was only slightly affected by the COVID-19 pandemic.

    Funding: The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.