The Key to Longevity & Prevention of Disease

Inflammation, The Common Denominator

By Tieraona Low Dog, M.D.

For millennia, medical observers have marveled at inflammation. Aulus Celsus (30 BC – 45 AD), Roman author of De Medicina, described the four principal signs of inflammation as redness, warmth, swelling and pain. Galen (129 – 220 AD), physician to emperor Marcus Aurelius, noted a fifth sign: loss of function in the affected tissue.¹

Those characterizations are just as true today, but more recently, researchers have come to a new, more far-reaching realization. This local, temporary, and ultimately beneficial process that optimizes healing at, say, a wound site, sometimes becomes widespread and chronic.

In this state, the serum markers that characterize inflammation increase throughout the body for years or even decades. Inflammation is associated with health conditions once thought quite disparate, including metabolic syndrome, non-alcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease.²

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As one research group put it, “The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear.”²

Whole-body, chronic inflammation is so important, that, as a physician, I’m tempted to say that understanding its causes and treatments should be one of our central tasks.

So How Do We Lower Inflammation?

One challenge facing inflammation researchers, and physicians trying to leverage their insights, is determining precisely which serum markers best indicate pathological inflammation. While C-reactive protein is commonly used as a single proxy for inflammation, it may not be a comprehensive measure.3 Other markers include TNF-alpha, IL-6, IL-8, MCP-1, E-selectin, I- CAM and PAI.4 Not knowing the most effective way to measure inflammation also makes it difficult to assess, treat and then monitor the efficacy of the treatment.

Having said that, however, there are a number of lifestyle recommendations that can be made that have a beneficial impact on inflammatory markers and benefit overall health, in general. A diet very low in carbohydrates is one effective strategy. A study of overweight men and women with atherogenic dyslipidemia found that, compared to a diet low in fat, the low carbohydrate diet was associated with greater decreases in several serum markers.

Researchers concluded “a very low carbohydrate diet resulted in profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet.”4

This is a vital conclusion. One of the biggest mistakes ever made in nutrition science was to demonize dietary fat. Far worse for our health is a diet filled with dietary sugars and high glycemic-load carbohydrates. Diets that frequently spike insulin and insulin growth factors are profoundly inflammatory.4

Other studies have found lowered serum markers associated with:

  • Increased fruit and vegetable intake5
  • Higher serum vitamin D6
  • Higher omega-3 fatty acid intake (from cod liver oil)7
  • Intake of supplemental curcumin, a component of turmeric7
  • Intake of supplemental magnesium8

This list could be far longer, as virtually any human activity – even certain mental states achieved in meditation – seems to influence inflammation levels.9

Cooling the Fire Within

It’s vital to realize that the causality of chronic inflammation appears to be reciprocal. For example, eating inflammatory foods often leads to fat accumulation, and the resulting body fat is itself inflammatory.10

The solution, then, is what I call an anti-inflammatory lifestyle. At minimum, it should consist of:

  • Maintenance of ideal weight through a program that includes regular exercise
  • A low glycemic-load diet rich in nutrient-dense foods

Also useful are:

  • Supplemental turmeric and magnesium
  • Mindfulness-based meditation
  • Regular green tea consumption11
  • Probiotic supplements12
  • Active social engagement13
  • Sleep hygiene to improve sleep13

As physicians, our responsibility is to present these options to our patients, and through open, respectful dialogue, determine which of these is most necessary, and most likely to be pursued.

I cannot overestimate the importance of understanding and moderating inflammation. Nothing is more likely to foster long term, robust health in our patients – and ourselves! – than crafting and following an anti-inflammatory lifestyle.

 

References:

  1. Granger ND, Senchenkova E. Inflammation and the Microcirculation. San Rafael, CA: Morgan & Claypool; 2010.
  2. Minihane AM, Vinoy S, Russell WR, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. British Journal of Nutrition. 2015;114(07):999-1012. doi:10.1017/s0007114515002093.
  3. Aguiar FJ, Ferreira-Júnior M, Sales MM, et al. C-reactive protein: clinical applications and proposals for a rational use. Revista da Associação Médica Brasileira (English Edition). 2013;59(1):85-92. doi:10.1016/s2255-4823(13)70434-x.
  4. Forsythe CE, Phinney SD, Fernandez ML, et al. Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation. Lipids. 2007;43(1):65-77. doi:10.1007/s11745-007-3132-7.
  5. Bhupathiraju SN, Tucker KL. Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults. The American Journal of Clinical Nutrition. 2010;93(1):37-46. doi:10.3945/ajcn.2010.29913.
  6. Fornari R, Francomano D, Greco EA, et al. Lean mass in obese adult subjects correlates with higher levels of vitamin D, insulin sensitivity and lower inflammation. Journal of Endocrinological Investigation. 2014;38(3):367-372. doi:10.1007/s40618-014-0189-z.
  7. Reddy P, Lokesh BR. Studies on Anti-Inflammatory Activity of Spice Principles and Dietary n-3 Polyunsaturated Fatty Acids on Carrageenan-lnduced Inflammation in Rats. Annals of Nutrition and Metabolism. 1994;38(6):349-358. doi:10.1159/000177833.
  8. Moslehi N, Vafa M, Rahimi-Foroushani A, Golestan B. Effects of oral magnesium supplementation on inflammatory markers in middle-aged overweight women. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences. 2012;17(7):607-614.
  9. Kloet ERD, Andela C, Meijer O. Faculty of 1000 evaluation for A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. F1000 – Post-publication peer review of the biomedical literature. 2013. doi:10.3410/f.718142865.793485315.
  10. Perry CD, Alekel DL, Ritland LM, et al. Centrally located body fat is related to inflammatory markers in healthy postmenopausal women. Menopause. 2008;15(4):619- 627. doi:10.1097/gme.0b013e318159f1a2.
  11. Bhattacharya S, Chandra S, Chatterjee P, Dey P. Evaluation of anti-inflammatory effects of green tea and black tea: A comparative in vitro study. Journal of Advanced Pharmaceutical Technology & Research. 2012;3(2):136. doi:10.4103/2231-4040.97298.
  12. Plaza-Díaz J, Ruiz-Ojeda F, Vilchez-Padial L, Gil A. Evidence of the Anti-Inflammatory Effects of Probiotics and Synbiotics in Intestinal Chronic Diseases. Nutrients. 2017;9(6):555. doi:10.3390/nu9060555.
  13. Friedman EM. Sleep quality, social well-being, gender, and inflammation: an integrative analysis in a national sample. Annals of the New York Academy of Sciences. 2011;1231(1):23-34. doi:10.1111/j.1749-6632.2011.06040.x.

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