Jan/Feb 2008

feature article

A little-understood health risk: long term, low-level inflammation causes disease and premature death. But there is much you can do to reduce it.

By Chris O'Brien

Scraped knees, bee stings, bruises, cuts and even the unsightly pimple are all commonly associated with inflammation: some sort of visible injury that is probably red and swollen. Yet inflammation is more complicated than that. It is happening all the time inside our bodies, a critical part of our immune response that fights off infection and disease. Long-term, low-level chronic inflammation from poor lifestyle, illness and other factors actually cause disease. In this way, inflammation wields a double-edged sword on our health, one essential, the other potentially disastrous. Which makes it important for everyone to understand.

The medical lingo that describes inflammation talks of cytokines, leukotrienes, macrophages, tumor necrosis factor and a whole host of immune cells and activities that take place at the molecular level. Without a medical dictionary and a spare long weekend, understanding inflammation is a tough task.

So let’s say for the sake of this article that inflammation is a physical immune response to a perceived threat that results in swelling, heat and blood flow to the area of the threat. For example, you’re strolling along your deck and, “ouch!,” a splinter of cedar jabs into your foot. Almost instantly, in addition to pain, you start to see swelling, and soon you’ll begin to feel soreness and see redness from the blood flow and the heat. That’s the inflammation response.

Take that same scenario and imagine instead of a splinter a piece of plaque lodging in the wall of an artery, undigested
food creating an infection in your gut, pieces of cartilage leading to swelling in your joints or white blood cells fighting off bacteria in your swollen throat. It’s a different trigger, with more or less the same end result.

The point is, inflammation happens all the time and for thousands of reasons in the body. Most of the time, the reasons are necessary immune responses that protect the body. Sometimes they’re not. In the case of rheumatoid arthritis, an autoimmune disorder, the body essentially attacks itself, mistaking its own joint fluid for a threat and creating a painful and chronic condition of joint inflammation and deterioration. These conditions are usually genetic or congenital—that is, they came with your body --and need to be treated medically. Other conditions, however, can be managed or even treated with non-medical interventions, and sometimes by simply a change in lifestyle.

Fire That Bad Diet
Some of the biggest risks to our health come when we artificially create chronic inflammation. This happens when we construct a threat in our bodies through poor diet, unhealthy lifestyle, exposure to toxins, or physical injury and stress.

You’ve seen the list of inflammation culprits: smoking, drinking, fatty foods, refined carbohydrates and sugars, pollution, pharmaceutical byproducts, lack of exercise and a stressed out mind and body. There’s no debate on any of these; they’ve all been indicted. Here’s what happens:

Meats, eggs, poultry and shellfish are all high in arachadonic acid, a compound which leads to inflammation by—here’s the technical stuff--metabolizing into prostaglandin 2 series compounds which cause an inflammation response. In layman’s terms, eat meat and eggs and you will have some inflammation occurring in your body. In the long run, high consumption of these foods, say, an Egg McMuffin in the morning, a burger and fries for lunch and a steak dinner will create a case of low-level chronic inflammation.

That particular state of low-level chronic inflammation has been connected to the causes of many diseases and serious conditions, including heart disease, cancer, diabetes, osteoporosis, Alzheimer’s, even depression and mood disorders.

Now, considering our diet above, let’s put a little mayo and some cheese on the burger and you’ve added a hearty dose of trans fats, which also induce inflammation. Trans fats increase levels of low-density lipoproteins (LDL, or “bad” cholesterol), the stuff that causes blood clots, lodges on the walls of veins and arteries, triggers inflammation and an overactive immune system, and is implicated in heart disease and a handful of other chronic conditions.

But wait, we haven’t even had dessert yet. Let’s say you top it off with some white flour heavily laced with sugar—dubious delicacies that cause inflammation as well. Wheat packs a few punches. First, it’s hard to digest and can irritate and inflame the gut. The gluten in wheat can trigger a mild allergic reaction and lead to more inflammation. Celiac Disease, otherwise known as gluten intolerance, is characterized by acute inflammation and irritation of the small intestine in response to gluten. Refined wheat also converts quickly into sugar, which in combination with the other sugars in the icing on your cake, forces your body to dump insulin into the blood stream. This rapid insulin response becomes a vicious circle: much research has found that inflammation leads to insulin resistance while excess insulin leads to inflammation. Basically, dessert is a precursor of type II diabetes.

While were at it, why not have a couple of glasses of wine or a few beers with that steak. Sure, there’s the “French Paradox” and the lower risk of heart disease from moderate consumption of certain wines, but the medical facts are that alcohol causes inflammation of the stomach, pancreas and intestines. This interferes with digestion and the absorption of nutrients--not to mention that the body will metabolize alcohol first before digesting food. So the steak, cheese and bread is basically rotting in your stomach while you’re having another Merlot.

But let’s not be too dramatic. In the average healthy person, a little bit of wine and some cheese is okay--unless, of course, you decide to have a smoke after dinner, which is tantamount to pouring gas on the inflammation fire. It’s easy to see how “the average American diet” is really a recipe for chronic inflammation and possibly if not probably disease.

Cool Inflammation With Healthy Foods
A healthier dinner would include a piece of walnut-encrusted salmon, which contains two foods rich in omega- 3 fatty acids. Omega -3s counteract the metabolism of arachidonic acid into prostaglandins, thereby reducing the inflammation response. Sauté it in olive oil with garlic and onions, and you’ve added three more natural anti-inflammatories. Or maybe poach it in ginger, a natural cox-2 inhibitor. And put some veggies on that plate. Spinach, kale and other leafy greens are rich in carotenoids, which help fight inflammation. Squash, carrots, sweet potatoes and other deep orange vegetables also contain inflammation-reducing antioxidants.

But what about dessert? How about some mango slices (rich in anti-inflammatory carotenoids), blueberries (loaded with proanthocyanidins, a potent antioxidant that fights oxidative stress and inflammation) and rice milk instead of cream or ice cream. Add a little honey, another natural anti-inflammatory, and a very small serving of extra-dark organic chocolate (rich in inflammation-fighting polyphenols), and you’re looking at an amazing—and amazingly healthy—meal.

If you’re eating right, a sip of wine won’t kill you, but clean, slightly chilled still or sparkling water is always the body-supportive beverage of choice. And as for that after-dinner smoke, go for a walk instead. Take in a little fresh air and get some exercise.

Exercise and Stress
Speaking of exercise, the lack of it has been firmly connected to inflammation, obesity, heart disease and many other conditions. Moderate exercise, on the other hand, is linked to lower inflammation and better health. In fact, some studies have associated exercise with lower levels of C-reactive protein, a biomarker of inflammation in the body that’s also associated with heart disease and type II diabetes.

Physical and psychological stress is also a huge cause of inflammation. Unfortunately, some of those folks not exercising are sometimes the same ones feasting on burgers and shakes too often. Let’s say they’re also always on the go, rushing through traffic and breathing in toxic fumes on the way to a crowded office complete with new carpet that’s outgassing formaldehyde. Environmental toxins have also been loosely associated with inflammation. Meanwhile, throughout this routine, let’s say they’re stressing: worrying about money, jobs, relationships, physical appearance, terrorism, religion, whatever. Stress has been associated with inflammation in the body. And stress often triggers other behaviors such as eating junk food and smoking and drinking which, in turn, lead to inflammation.

If you’re identifying with any of this, consider making some small changes in your daily routine. Bike to work if you can, take the bus and listen on headphones to a meditation CD on the way, or share a ride (and some good laughs) with a fun-to-be-with friend. Pack a healthy lunch and take a vigorous walk mid-day. Get to the gym after work to exercise or take a yoga class. And set aside ample time for friends and self-care. The combination of lowering stress and getting exercise will not only reduce or prevent inflammation, it will probably improve your mood, sense of self and quality of life.

So the answer to managing or avoiding low-level chronic inflammation isn’t found in the mysteries of corticotrophin-releasing factor and the hypothalamus. It’s really just a common sense approach to good health: a nourishing diet, giving up smoking, avoiding toxins and pollutants, getting ample exercise and lowering your levels of stress. You can help yourself get healthier now, and avoid chronic low-level inflammation and possible future physical challenges.