What do heart attack, stroke, cancer, diabetes, obesity, Alzheimer’s disease, Parkinson’s disease, autoimmune disease, gastritis, fibrosis, rhinitis, sinusitis, asthma, arthritis, dermatitis, depression, ADD, dyslexia, schizophrenia and an army of diseases ending in the suffix, “itis”, have in common?
We need inflammation to survive. It’s the body’s response to trauma and injury to help repair itself. Without inflammation, infections would go unchecked and wounds would never heal. It is however when inflammation does not resolve the problem that it becomes a longer term issue.
Acute inflammation occurs in response to an infection or injury. It is a life-saving process and generally short-lived and localised. It resolves when the body removes the damaged cells and replaces them with new cells.
“Chronic” comes from the Greek word “khronos” which means “lasting for a long time”. While acute inflammation is intense and often painful, chronic inflammation is long-lasting and can be silent. Chronic inflammation can damage your organs, for example, the pancreas (diabetes), the arteries (atherosclerosis), the joints (arthritis), the nerve cells (Alzheimer’s and dementia), depress your immune system and lead to many other diseases.
The longer the inflammatory process lasts, the more damage it does to your tissues.
Eicosanoids are local hormones that control cell behaviour and the entire inflammatory process. There are 3 different types - prostaglandins, thromboxanes or leukotrienes. The body uses dietary essential fatty acids Dihomo-Gamma-Linolenic Acid (DGLA), Arachidonic Acid (AA) and Eicosapentaenoic Acid (EPA) to produce eicosanoids.
Your health depends on the type of eicosanoids your cells produce. Eicosanoids derived from omega-6 fatty acids (AA) promote inflammation and tissue destruction. Those derived from omega-3 fatty acids (EPA) are anti-inflammatory and promote healing. Eicosanoids from DGLA promote both anti-inflammatory and pro-inflammatory eicosanoids.
We need both kinds of eicosanoids, in the correct balance, to be in a state of wellness.
Key players in the inflammatory process: cortisol & insulin
Cortisol is an anti-inflammatory steroid hormone produced in the adrenal glands. It is released in response to stress. It suppresses the immune system and therefore shuts down excess inflammation.
Chronic stress causes excess cortisol to be present in the blood. Cortisol inhibits muscle and fat cells from taking in glucose, preserving glucose in the blood. This increases the load on the pancreas, as it tries to churn out enough insulin to cope.
Excess insulin in turn increases the production of of pro-inflammatory eicosanoids. Excess insulin also increases the production of a pro-inflammatory cytokine called interleukin-6 (IL-6), which causes C-reactive protein (CRP), a marker of inflammation, to form.
Long-term, excess cortisol overtaxes the adrenal glands and can lead to adrenal exhaustion.
How do you measure inflammation?
There are no direct tests for silent inflammation in the body, but we can test for markers.
C-Reactive Protein (CRP) – A standard CRP test is normally used to test patients at risk of bacterial/viral infection, flare-ups of acute inflammatory diseases and how well an anti-inflammatory medication is working, rather than identifying silent inflammation. High sensitivity CRP test (hsCRP) is much more sensitive and is useful in predicting heart attack, stroke, sudden cardiac death and peripheral arterial disease, even when cholesterol levels are within an acceptable range.
Erythrocyte sedimentation rate (ESR) – it can measure non-specific, chronic inflammation in the body. The higher the ESR, the greater the inflammation. It’s normally used in conjunction with other blood tests and patient history to determine the cause of the problem. CRP is a better marker of inflammation, but many doctors still use ESR as an initial test for inflammation as it is easily performed.
Triclyceride/HDL ratio - A high TG/HDL ratio over time will drive the body to produce too much insulin, and excessive triglycerides can make it difficult for the liver to remove insulin from the blood. The elevated insulin will increase pro-inflammatory eicosanoids and silent inflammation.
AA/EPA ratio - is a common test for silent inflammation. An ideal ratio is between 1 and 3. You are no longer well if the ratio is greater than 10, and a ratio of 15 or over means the body is in silent inflammation mode.
Fasting insulin level - the higher the insulin level, the more inflammation in the body.
Some of the chronic diseases linked to silent inflammation are:
Diabetes – Inflammation plays a role in both type 1 and type 2 diabetes.
Obesity – Visceral fat is metabolically active (in contrast to subcutaneous fat, which is not) and produces inflammatory molecules. It is associated with high levels of CRP. Studies show that unless obese people take steps to reduce silent inflammation, it will be difficult for them to lose excess weight around the abdomen.
Cancer – Chronic inflammation has been linked to DNA damage. Inflammation produces cytokines that encourage cell proliferation and supresses cell death.
Alzheimer’s disease – There is growing scientific evidence that inflammation generates large quantities of free radicals that cause beta-amyloid plaques and neurofibrillary tangles to form in the brain. Asthma – Mast cells in the bronchial tubes overreact to a trigger and release pro-inflammatory substances including histamine and leukotrienes, causing the bronchial lining to swell and produce mucus.
Arthritis – All forms involve inflammation.
There are many other chronic diseases linked to silent inflammation, including Parkinson’s disease, dementia, fatty liver disease, sleep apnoea, osteoporosis, chronic kidney disease, neuropathy, autoimmune diseases and chronic obstructive pulmonary disease just to name a few.
- Fatty fish rich in EPA & DHA – promote anti-inflammatory eicosanoid production.
- Wild fish rather than farmed fish. Farmed fish have 2-3 times less omega 3 than wild fish, and have significant levels of antibiotics, PCBs, dioxin and hormones.
- Other omega 3 sources – flaxseed (whole, ground and oil), chia seeds, walnuts, hemp seeds, leafy greens. Note that the omega 3 in flaxseed has a limited conversion to EPA in healthy people of up to 8%.
- Cold pressed extra virgin olive oil – contains at least 2 dozen anti-inflammatory nutrients with antioxidant properties.
- Low GI foods – high GI foods result in excess sugar and insulin in the blood, triggering pro-inflammatory eicosanoid production from omega 6 fatty acids. Low GI keeps inflammation at bay.
- A wide range of different coloured fruits and vegetables – contain a host of anti-inflammatory phytonutrients, vitamins and minerals and antioxidants.
- Fibre – people with high-fibre diets have lower levels of CRP and inflammatory cytokines. Fibre helps to lower the GI of foods.
- Nuts & seeds – people who eat the most nuts and seeds have the lowest levels of inflammatory markers in the blood. The arginine in nuts may play a role in this, along with the healthy, plant monounsaturated fats.
- Legumes – highly anti-inflammatory through their phytonutrients & antioxidants. Low GI.
- Free range, organic, grass-fed meat, rather than mass produced – have higher omega 3 and lower omega 6, and are lower in fat and free from antibiotics, steroids and hormones.
- Other, specific anti-inflammatory foods – ginger, garlic, green tea, turmeric, cacao, cinnamon, wheatgrass, all fresh and dried herbs and spices
Foods that contribute to inflammation
- High GI carbohydrates
- Lectins, if there is a sensitivity
- Refined sugar
- Artificial sweeteners
- Dairy products
- Processed meat
- Mass produced/farmed meat
- Farmed fish
- Trans fatty acids
- Refined cooking oils
- Foods cooked at a high temperature – form advanced glycation end products (AGEs)
- Chemical additives
- Nightshade vegetables & fruits, if there is a sensitivity
- Foods that one is allergic or sensitive to
- EPA/DHA - fish oil
- GLA – evening primrose or borage oil
Antioxidants – oxidative stress can initiate inflammation and inflammation can initiate the production of free radicals. Free radicals can also “turn on” bad genes. There are hundreds of antioxidants, but there are 5 that work synergistically to quench free radicals that are a major cause of inflammation in the body:
- Vitamin C
- Vitamin E
- Lipoic acid
- Folic acid, vitamin B6 and vitamin B12
- Vitamin C – Works in the watery part of cell membrane to quench free radicals. Recycled by vitamin E, lipoic acid and glutathione.
- Vitamin E – Works in the oily part of cell membrane to quench free radicals. Recycled by vitamin C & coenzyme Q10. Reduces inflammation.
- Lipoic acid – Can mop up free radicals in both the watery and the oily parts of the cell membrane. It can activate good genes and suppress bad genes. Levels decline with age.
- Coenzyme Q10 – Found in cell membranes and mitochondria and mops up free radicals there. Levels decline with age, and statin use.
- Glutathione – The “master antioxidant” – all other antioxidants depend on glutathione to function. People with silent inflammation have low levels of glutathione. The body’s main detoxifier.
- Anti-inflammatory lifestyle changes
- 30 minutes or more of moderate exercise, most days of the week – supresses the inflammatory process, increases antioxidants, reduces levels of inflammatory markers.
- 7-9 hours sleep per night – encourages healing and reduces inflammation. Even a few hours of lost sleep can prompt the immune system to turn against healthy tissues.
- Reduce exposure to environmental toxins – dugs, cigarette smoke, industrial chemicals, heavy metals, pollutants, cleaning products, pesticides and chemical food additives can compromise the immune system and result in chronic inflammation.
- Reduce stress – stress induces an inflammatory state in the immune system by generating the production of pro-inflammatory cytokines.
Orange Immunity Booster Smoothie
- 250g Pureed Pumpkin
- 1 Banana (frozen)
- 2 grams Turmeric
- 1tsp cinnamon
- 1 tsp Ginger
- 7g Ground Flax Seed
- 180 ml Unsweetened Almond Milk
- 2 Navel Orange (peeled and sectioned)
- 20g Maple Syrup