🔑Key Points
Inflammation is part of the body’s own response to protect itself against damage.
If sustained for prolonged periods of time, inflammation can be damaging to the body.
Bad inflammation can be harmful to the tissues and is linked to a number of health problems including cancer, cardiovascular disease, musculoskeletal disorders, metabolic disorders, pain, and neurodegenerative disease.
A simple three step plan can help you reduce inflammation.
If you have underlying conditions or any disorders that may run in the family you’ll need to see your PCP and they will help you come up with a plan. Don’t wait.
📰In this Issue
In this post I discuss what inflammation is and why sometimes its considered a bad thing. I also discuss a three part solution on how to reduce inflammation and I give you additional resources for you to further educated yourself.
What is Inflammation?
Inflammation is a Defense Mechanism
Although inflammation is often perceived as a negative process, inflammation is actually a crucial part of the body's natural defense mechanism. It is basically a biological response triggered by the body with the objective of protecting itself from harmful stimuli. These stimuli can include things like:
Pathogens (bacteria, fungi, and viruses): For example, when you get a skin infection at the gym, the area gets inflamed.
Damaged cells/tissue from an injury: For example, if you take an elbow to the face, the area gets inflamed.
Irritants in the environment: For example, pepper spray and smoke cause inflammation of the airways.
The Role in Healing and Protection
When a harmful stimulus is detected - say an infection or an acute injury, the body's immune system responds by increasing blood flow to the area to allow for more oxygen, nutrients, waste removal, and by releasing cytokines to instruct immune cells to arrive and accumulate at the front lines, assess the damage, and start the healing process.
This response is typically characterized by redness, heat, and swelling - from increased blood flow and increased metabolic activity at the injury site, and in most cases, pain – the nerve terminals in local tissue get stretched, compressed, and pick up biochemical signals from all these local changes and activity. Together, we perceive this processes as inflammation.
☑️Acute vs. ☠️Chronic Inflammation
Before we continue, it's important to differentiate between two types of inflammation: acute and chronic.
☑️Acute inflammation is the immediate, short-term response to an injury or pathogenic process. This is what causes the redness and swelling we were just talking about - maybe due to a small cut, blunt trauma, or maybe the soreness in your throat during a cold. This type of inflammation is beneficial and is actually very necessary to start the healing process. When the problem has been addressed, the body deploys anti-inflammatory mechanisms that make inflammation go away and return things to normal.
☠️chronic inflammation, on the other hand, is a prolonged inflammatory response that can last for months or even years. Chronic inflammation occurs when either anti-inflammatory mechanism fail to activate and function properly, or when the body continues to receive harmful stimuli and therefore continues to activate pro-inflammatory pathways constantly and continuously. If you think of your immune system as the police force or military protecting your body against pathogens and injuries, you can think of chronic inflammation as an overly aggressive police force that starts mistreating the citizens, or a military presence that starts to linger for a little bit too long for comfort and starts causing trouble.
Why is Chronic Inflammation Considered Bad?
Unlike acute inflammation, chronic inflammation can be harmful to the tissues and cells of the body, and in fact has been linked to a number of health problems including cancer, cardiovascular disease, musculoskeletal disorders, metabolic disorders, pain, and neurodegenerative disease.
This is definitively a very complex topic, but since we are not trying to train immunologists with this post, understanding the distinction between acute and chronic inflammation is a very good starting point. The main idea here is that while inflammation is a vital part of the body's healing process, it's not always a positive phenomenon. The difference lies in the duration and context of the inflammatory response. Chronic inflammation, unlike the very necessary acute type, can be detrimental to our health and must be addressed.
Chronic Inflammation: A Silent Threat
Chronic inflammation often goes unnoticed because its symptoms can be subtle and not as immediately apparent as those of acute inflammation. This stealthy nature makes it a significant risk factor for various health conditions, emphasizing the need for awareness and preventive measures.
Chronic inflammation is characterized by a low-grade, long-term inflammatory response that can persist for months or even years. It arises when the immune system continuously sends inflammatory cells - even in the absence of an immediate threat or injury, or when anti-inflammatory mechanisms fail to kick in. This prolonged state of alert can slowly start damaging healthy cells, tissues, and organs.
Here are some examples of continuous harmful stimuli that can cause chronic inflammation in an otherwise normal immune system:
You have two surgeries on your knee and almost no cartilage but you ignore the pain and continue to train for decades until you develop arthritis on that knee (me).
Your roommate smokes inside the house and you are chronically exposed to second and third hard smoking until you develop lung cancer.
You drink alcohol like a maniac and your poor liver takes the hit every time and cleans up your mess - after all, that’s what good livers do… Until inflammation overwhelms it and you develop chronic hepatitis.
You live on fast food and soda. Sugar turns your gut microbiome upside down leading to chronically high insulin levels, diabetes, and turning your arteries into ticking time bombs ready to give you an infarction or a stroke at any time.
Your home is old AF, mold creeping up inside the walls and air ducts, turning it into a spore fest that constantly triggers your allergies in your lungs and airways.
You work a 9 to 5 and are glued to your desk, barely moving, accumulating belly fat (proinflammatory) and turning your weak body into a breeding ground for chronic pain and inflammation.
Weekends mean party till dawn and sleep all day. You mess up your circadian rhythm once a week and turn your sleep cycle into a chaotic mess that fuels chronic inflammation.
Your cortisol is chronically elevated because you are a 'yes' person, taking on every task, stress piling up, and turning your mind into a battleground for chronic stress-induced inflammation.
Here are some reasons why anti-inflammatory mechanism may fail to kick in:
Genetic Factors: Certain genetic predispositions can impair anti-inflammatory responses. For example, mutations or polymorphisms in genes coding for cytokines, their receptors, or signaling proteins can alter the body's ability to mount an effective anti-inflammatory response.
Nutritional Deficiencies: Certain nutrients, like omega-3 fatty acids, are precursors to anti-inflammatory mediators. Deficiencies in these nutrients can impair the body’s ability to resolve inflammation.
Medication Effects: Certain medications, especially prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, can disrupt the body's natural inflammatory balance and impair healing processes.
Comorbidities: The presence of other chronic conditions, like obesity, diabetes, or cardiovascular disease, can create a systemic environment that favors inflammation and hinders the anti-inflammatory response
Aging: Aging is associated with a phenomenon known as 'inflammaging,' where there is a chronic, low-grade inflammation due to the immune system's declining ability to regulate the inflammatory response effectively
Poor Gut Microbiome: A healthy microbiome promotes a balanced immune system, while dysbiosis (an imbalance in gut microbial communities) can lead to increased intestinal permeability ('leaky gut') and systemic inflammation. Dysbiosis can result from poor diet, antibiotic use, or infections. When the gut barrier is compromised, bacterial products can enter the bloodstream, triggering an immune response and systemic inflammation. This chronic low-grade inflammation can impair the body's anti-inflammatory mechanisms.
Lack of Exercise: Regular physical activity is known to have anti-inflammatory effects because after the acute pro-inflammatory response triggered by exercise, the body must engage anti-inflammatory mechanisms. Exercise stimulates the production of anti-inflammatory cytokines and helps in the regulation of the immune system. Think of it like a training regimen for the anti-inflammatory arm of the immune system.
3 Steps to Stop Inflammation
Lifestyle factors often contribute to chronic inflammation. Poor diet, lack of exercise, smoking, and prolonged stress are common culprits. These factors can alter the body’s natural defense mechanisms, turning a protective response into a harmful one.
1. Fix your diet - Top Foods that Reduce Inflammation
When fixing your diet you need to keep three objectives in mind:
Provide adequate nutrients to establish and maintain a healthy gut microbiome. These include a high fiber diet and highly fermented foods like kimchi, kombucha, yogurt, and kefir. Here is a short clip on the topic.
Avoid pro-inflammatory foods. Both sugar and starch have pro-inflammatory properties. Other pro-inflammatory foods include margarine, soda, gluten, and many additives and preservatives used in highly processed items. For a more complete list you can check out the following clip:
Lose weight: Obesity causes inflammation, particularly belly fat. You are not going to outwork a poor diet in the gym. Remember, the three pillars of a healthy nutrition are:
Timing
Food Quality
Food Quantity
You should control all three of them at all times.
2. Exercise
It is very important to exercise for a number of reasons:
Exercise directly activates anti-inflammatory mechanisms: Every time you hit the gym and work out your body will undergo a brief pro-inflammatory phase followed by a natural anti-inflammatory response to turn it off. For this reason, it turns out that daily exercise not only trains your muscles but also but trains your anti-inflammatory system by deploying it daily.
Chronic stress is pro-inflammatory: Exercise has been proven by many studies to reduce stress and improve sleep.
Belly fat is pro-inflammatory. Exercising consistently will help you get your body weight under control. No mystery here. See this post on exercise for details:
3. Take the Right Supplements
The main idea here is to supplement your nutrition with compounds that directly affect inflammation and with compounds that support exercise and enhance sleep to have a compounding effect. Here are a few ideas:
Probiotics: The gut microbiome consists of trillions of microorganisms, including bacteria, that play a crucial role in digestion, metabolism, and immune function. Probiotics strengthen the gut barrier, compete with pathogenic microorganisms, produce short chain fatty acids - which are necessary for anti-inflammatory mechanism, and interact directly with gut cells enhancing their response to pathogens.
Fiber: Fiber is basically food that helps optimize the gut microbiome because it feeds and helps select the right type of organisms.
Curcumin: Curcumin, the active compound found in the spice turmeric that has potent anti-inflammatory properties. It inhibits the production of pro-inflammatory cytokines, enhances antibodies, and has antioxidant properties.
Omega-3 fatty acids: Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are well-known for their anti-inflammatory properties. Omega-3 fatty acids are involved in the synthesis of specialized pro-resolving mediators (SPMs) like resolvins and protectins. They also inhibit the NF-κB pathway, thereby reducing the expression of various pro-inflammatory cytokines and mediators, and finally, Omega-3 fatty acids can influence macrophage function - a type of immune cell, encouraging a shift from a pro-inflammatory phenotype (M1) to an anti-inflammatory phenotype (M2).
Vitamin D: Vitamin D has a profound effect on various cells of the immune system. It can modulate the activity of T cells, B cells, and dendritic cells, and is particularly known for its action on T regulatory cells (Tregs). Tregs play a crucial role in maintaining immune tolerance and preventing autoimmune responses. Vitamin D promotes the development of these cells, which helps in reducing unnecessary inflammatory responses.
What if I Still Feel Like Crap?
Besides these easy to implement approaches, it also Important to identify any underlying pro-inflammatory conditions you may have or that run in your family - such as allergies and autoimmune disorders. See your PCP about these conditions. They will be able to help you come up with a plan and point you in the right direction in case you need to see a specialist.