The Race Against Inflammation
Posted On Jul 23, 2014
Inflammation increases our risk for many health problems, and affects how we age. can we quell this killer?
BY Catherine Winters | ILLUSTRATIONS by Bryan Christie
Who hasn’t been affected by inflammation? The skinned knee that turns red. The ankle that balloons upon suffering a sprain. The nasty case of bronchitis that seems to last forever. The pimple that erupts on your chin the day of your important job interview.
These episodes may not be fun to endure, but this type of inflammation is actually a good thing. “It’s one of the most important aspects of our body’s ability to heal,” says Tieraona Low Dog, MD, of the Arizona Center for Integrative Medicine in Tucson. According to the doctor, acute inflammation (quick, with symptoms that are typically present for just a few days), occurs when the immune system senses an outside invader and mounts a two-pronged attack. Extra blood travels to the injured area to help with healing while white blood cells leap into action to fight off infection.
Like Dr. Jekyll, however, inflammation has a dark side. That alter ego comes in the form of chronic, low-grade inflammation. Research shows that this second type of inflammation is associated with many health problems, including cardiovascular disease, gum disease, eczema, osteoporosis, dry eye, various cancers, type 2 diabetes, Alzheimer’s disease, and osteoarthritis. Even obesity is a disease of inflammation. “Visceral fat in the abdomen generates a lot of free fatty acids, which trigger an inflammatory response,” says Robert M. Carey, MD, of UVA’s School of Medicine. Carey is a former president of the Endocrine Society.
Such simmering inflammation also drives many autoimmune diseases such as rheumatoid arthritis, Graves disease, lupus, and celiac disease. In these instances, the body mounts an inflammatory response against itself.
The Roots of Inflammation
Acute inflammation is caused by germs (such as a virus or bacteria), an injury, or an environmental trigger. Meanwhile, chronic inflammation can come from the foods we eat and the water we drink, a sedentary lifestyle, or exposure to toxins. “The modern lifestyle has led many to have chronic inflammation in the body,” says Dr. Low Dog.
One major dietary culprit is an imbalance of omega-6 and omega-3 fatty acids. Omega-6 fatty acids found in vegetable oils (corn, soy, safflower, cottonseed, and sunflower) and in livestock trigger inflammation. Omega-3 fatty acids (fish, marine oil, walnuts, and flax seed) fight inflammation.
The ideal ratio of omega-6s to omega-3s is 1 to 1—a balance that keeps the risk of chronic inflammation from developing. However, modern-day food processing has caused our diet to become jam-packed with omega-6 fatty acids. Our ratio of omega-6s to 3s is oftentimes as high as 20 to 1. That’s a sure-fire recipe for inflammation, and an invitation for a host of health repercussions.
One study found that people who ingest the highest amounts of vegetable fat have more than a two-fold increased risk for advanced age-related macular degeneration—the leading cause of blindness in older adults. Another study, published in The Journal of Clinical Oncology, reported that breast-cancer survivors who get higher levels of omega-3s compared to omega-6s have less inflammation and fatigue. People who suffer from, or who are at risk for, metabolic syndrome (a cluster of inflammatory conditions that raise heart disease risk), may lower levels of inflammation by eating a diet rich in omega-3s, according to one review. The list goes on.
All of us are fair game for health problems caused by undetected inflammation. Atherosclerosis, or hardening of the arteries, is caused by low-grade inflammation. So are many cancers. “Chronic inflammation at a site in the body can lead to cancer in that area,” says Dr. William J. Meggs, chief of toxicology at East Carolina University’s Brody School of Medicine in Greenville, North Carolina.
Persistent inflammation can worsen a pre-existing condition, or trigger inflammation in another area of the body. Such is the case when a person with asthma gets the flu. “Inflammatory cells fighting the flu excite inflammatory cells in the lungs of the patient with asthma,” explains Dr. Meggs. “Similarly, people with rheumatoid arthritis are more susceptible to blockages in heart arteries than those without RA.”
For people with a genetic predisposition for a particular disease, inflammation can increase the odds of developing it. “The interplay between environment, lifestyle, and genes determines exactly who gets what disease and at what time in their life,” Dr. Meggs says.
Chronic inflammation may also cause seemingly unrelated problems. One group of researchers has found that women with inflammatory conditions—psoriasis, rheumatoid arthritis, inflammatory bowel disease, or lupus—have a two-to–five-fold increased risk of entering menopause before age 45 and for premature ovarian failure.
Despite these effects on health, doctors don’t routinely screen patients for inflammation. Yet knowing if it’s present in our body makes good preventive health sense, say experts in functional, preventive, and anti-aging medicine. “My goal is to find disease before it happens,” says Amy Myers, MD. Myers is the medical director of Austin UltraHealth in Texas, specializing in functional medicine.
Dr. Myers routinely conducts a comprehensive blood panel on new patients, measuring levels of an inflammatory marker called C-Reactive Protein, or CRP. Levels climb when there’s inflammation in the body. Even if a patient has normal levels, Dr. Myers repeats the test annually so she can take preemptive action, should inflammatory markers spike.
There is one catch: The CRP test doesn’t tell you what’s causing inflammation—only that it’s present. CRP levels could be high because you have heart disease, cancer, lupus, or an ingrown toenail. “It might be some little insignificant inflammation going on somewhere,” says Dr. Meggs.
Dr. Myers recommends seeing a doctor who specializes in functional, anti-aging, or integrative medicine to measure your CRP levels. Or consider visiting a walk-in lab or using an online lab, such as Directlabs.com, Labtestsonline.com, or Biophysicalcorp.com. Armed with information about your inflammatory levels, you can work with a physician to zero in on the trigger and lower them if they’re high, or take steps to keep them from rising.
Research on the subject of inflammation goes on every day, all the time. The advances made by science are dramatic. Still, there are no guarantees in life. The best anyone can do is be proactive. “The most careful and diligent person still has some risk for disease,” Dr. Meggs notes. While we can’t escape inflammation indefinitely, there are things we can all do to delay its deleterious effects. “We can reduce our risk of getting disease earlier, and live a longer, healthier life.”
10 Tactics to Reduce or Prevent Inflammation
1. Avoid cigarette smoke.
According to the United States Surgeon General, chemicals in cigarette smoke can inflame not only the linings of the lungs but also the blood vessels.
2. Watch the alcohol.
A study published in The European Heart Journal found that consuming moderate amounts of
wine or beer is associated with lower levels of several markers of inflammation.
3. Minimize pollutants.
“Exposure to any product of combustion can increase the risk of heart attack,” says Dr. Meggs, noting that even the tiniest of particles in vehicle exhaust are capable of causing inflammation of the arteries. Dr. Myers notes there’s lots you can do at home, such as running a HEPA air purifier to reduce indoor air pollutants and removing contaminants from the water you shower in and drink, using
shower and water filters.
4. Mind the gluten.
A protein found in rye, barley, and wheat, gluten can cause a “leaky gut.” This occurs when tight junctions in the intestinal lining break apart and particles of undigested food, toxins, and more slip into the bloodstream. “Our body perceives these particles as foreigners and attacks,” says Dr. Amy Myers. That can trigger inflammatory responses such as irritable bowel syndrome (an autoimmune disease), depression, acne, or eczema.
5. Eat “Mediterranean.”
There’s a reason people in Mediterranean countries have lower rates of heart disease. The diet emphasizes a daily intake of fruits, vegetables, whole grains, beans, nuts, or seeds; fish and seafood; olive oil as a prime fat source; low to moderate amounts of cheese and yogurt; and wine in moderation. One recent study found that people who closely followed such a diet had, on average, 20 percent lower levels of CRP and 17 percent lower levels of another main marker (IL-6) for inflammation.
6. Stay active.
“The benefits of exercise are phenomenal,” says Dr. Meggs. A pilot study published in the journal Circulation found that the more fit middle-aged women were, the lower their CRP levels. Resistance or strength training is also known to tame inflammation. Researchers from Texas Christian University found that 12 weeks of such training lowered levels of CRP by 33 percent in obese women, ages 60 to 70, who had not exercised regularly during the previous six months.
Lonely seniors are at greater risk for cardiovascular disease and Alzheimer’s disease—associated with inflammation—which may lead to earlier death. Mindfulness-based meditation may be the antidote. Researchers at Carnegie Mellon University in Pittsburgh solicited people, 55 to 85, to attend eight weekly two-hour meditation sessions and to practice 30 minutes a day. They were less lonely and had lower levels of CRP.
8. Slim down.
In one study, overweight and obese post-menopausal women who lost weight reduced levels of three key markers of inflammation related to cancer. Women either cut calories to 1,200 to 2,000 per day or did 225 minutes of moderate to vigorous physical activity per week. Another group did a combination of the two. After a year, dieters who lost at least five percent of their body weight lowered CRP levels by 36 percent. The diet-plus exercise group lowered theirs by 42 percent.
9. Get more fiber.
Fiber is associated with less inflammation. Women need 25 grams per day; men need 38 grams per day.
10. Don’t skimp on sleep.
People who average six or fewer hours of sleep per night have higher levels of three markers of inflammation, including CRP, according to researchers at Emory University School of Medicine in Atlanta, Georgia. The average CRP levels are approximately
25 percent higher in people who get fewer than six hours of sleep than in people who get six to nine hours per night.
Over-the-counter, prescription and natural remedies can help lower inflammation levels. (Before you try them, get your doctor’s OK.)
Biologic drugs. Prescription medications ease inflammation and minimize symptoms associated with autoimmune disease. The medication a person should take depends upon his or her disease.
Non-steroidal anti-inflammatories reduce the inflammation associated with musculoskeletal conditions, such as arthritis and lupus. These drugs are available over-the-counter or by prescription. Side effects may include stomach bleeding, allergic reaction, or kidney
or heart problems.
These good bacteria not only ease inflammation in the gut but also keep the immune system healthy. “Seventy percent of your immune system is in your gut,” says Dr. Low Dog. Editor’s pick: Great DigestWorks, a proprietary blend of probiotic strains combined with a prebiotic to encourage the growth of beneficial bacteria in the digestive tract.
People who don’t eat enough fish should consider omega-3’s. Ask your doctor for dosage guidance. Exceeding three grams per day may affect blood’s ability to clot. Editor’s pick: Omega XL green-lipped mussel oil, from the waters of New Zealand. One study showed that Omega XL was more effective at reducing inflammation than traditional fish oils, and effectively promotes the omega-6/omega-3 balance.
This eases the presence of inflammation in the respiratory tract and intestines. University of Michigan researchers found that ginger supplements reduce markers of colon inflammation, which may lead to cancer. Take two to four grams (four 500 mg capsules) per day of dried ginger.
Johns Hopkins University researchers found that a pill containing turmeric and onions reduced the size and number of precancerous polyps in the intestines of people with a specific genetic condition, lowering the risk of colon cancer. Dr. Low Dog recommends taking 1,000 mg per day. To lower inflammation elsewhere in the body, look for turmeric containing piperine, an alkaloid found in black pepper. Exceeding 10 mg of piperine a day could interfere with prescription drugs.
A South African herb, this is safe and effective for pain, especially back pain, says Dr. Low Dog. “One of the principle ways to ease pain is to reduce inflammation,” she says. She recommends 1,200 to 2,400 mg of Devil’s Claw, daily. Make sure the supplement provides 50 to 100 mg of harpagoside. Avoid using during pregnancy.
“This is a potent anti-inflammatory, especially for the stomach and small intestine, says Dr. Low Dog. Licorice can potentially raise blood pressure, so choose well. Deglycyrrhizinated licorice (DGL) is a compound in which pressure has been removed.
An amino acid, glutamine is good for the immune system and repairs gut lining, says Dr. Myers.
Try 3 to 5 grams per day.