Inflammation – More Isn’t Always Better

By: Alicia Jerome MS, RDN

Have we been thinking about inflammation in a too narrow interpretation? We expect a skin wound to heal from the inflammatory process. We appreciate how our body restores homeostasis. But what happens when inflammation lasts longer than it takes to heal a wound?

Traditionally, our definition of inflammation was limited in scope to a disruption of structural integrity – think a laceration or gingivitis. Ruslan Medzhitov, PhD, Sterling Professor of Immunobiology at Yale School of Medicine suggests, “Rather than simply a defense mechanism against tissue perturbation, inflammation, is a response that’s engaged whenever something is ‘off’ in the body.”¹ Within this larger paradigm, medical professionals can categorize inflammation as acute or chronic.

Acute inflammation is a response to a “sudden body damage.”² The “body sends inflammatory cells to the injury” to activate healing.² Symptoms may include redness, swelling, heat, and pain. Typically, this is a short and welcomed process. Inflammatory heroes are sent, and they save the day!

Chronic inflammation, on the other hand, involves a continuous cycle of sending inflammatory cells but no or limited healing occurs. Chronic inflammation is associated with different cardiovascular diseases, obesity, Alzheimer’s, Crohn’s, and arthritis, just to name a few conditions.³ Unfortunately, symptoms of chronic inflammation may go unnoticed until the disease is well established.

When the inflammation cycle is prolonged and restoration of homeostasis is not achieved, this once-welcomed response system becomes a burden to the entire body. ³ One particular burden of chronic inflammation occurs when inflammatory cells see neighboring cells or organs and attack, believing them to also be a threat.

The relationship between chronic inflammation and disease is complicated. Dr. Robert H. Shmerling, medical editor of Understanding Inflammation from Harvard Health Publishing and an associate professor of medicine at Harvard Medical School says, “It's a chicken-and-egg scenario. Does chronic inflammation increase the risk of these ailments, or is it a byproduct? It is not always clear." ³

Let’s put this into practical terms. With obesity, “Excess of macronutrients in the adipose tissues stimulates them to release inflammatory mediators …, reduces productions of adiponectin, predisposing to a pro-inflammatory state and oxidative stress.”⁴ These mediators then encourage the liver to release C-reactive protein (a marker of total body inflammation) which in turn is associated with such diseases as depression, cancer, and renal diseases.⁴ Reduction in adiponectin is also “associated with impaired fasting glucose, which can lead to type 2 diabetes, metabolic abnormalities, coronary artery calcification, and stroke.”⁴ The inflammation cycle can quickly become a downward spiral.

Naturally, the next question is “how do you treat or prevent inflammation?” This can be divided into two categories: factors to decrease and factors to increase in one’s lifestyle.

Decreasing alcohol intake, excess body weight/fat, chronic stress, smoking, and pro-inflammatory foods can make significant reductions in overall systemic inflammation.² A pro-inflammatory food or diet is one the includes large amounts of red, processed, or organ meat, refined carbohydrates like sweets, white bread and rice, most salty snacks, fried foods, trans fats, and sugar sweetened beverages. ⁵ One study of over 200,000 men and women found that those that consumed the most pro-inflammatory foods had a 38% higher risk of developing cardiovascular disease when compared to those who consumed the most anti-inflammatory foods.⁶

Increasing exercise or active movement, stress-relieving events and social interactions, quality sleep, and anti-inflammatory foods can make a positive impact on reducing inflammation.² Anti-inflammatory foods include green leafy vegetables, dark yellow vegetables, whole grains, beans and nuts, fruit, some spices, mono-unsaturated fats, and depending on which study you read, coffee and wine.⁵ One such diet that encompasses many of these anti-inflammatory foods is the Mediterranean Diet.

Practically, here are a few ways to increase the number of anti-inflammatory foods one consumes in a day:

• For breakfast, include more whole grain cereals or oatmeal with flaxseed or walnuts and dark berries. Add in more fruits and vegetables by trying a smoothie with berries, banana, spinach, flaxseeds, and protein powder.

• For lunch and dinner, make half your plate vegetables like kale, spinach, or broccoli. Drizzle with olive oil instead of butter. Incorporate more beans and legumes to boost fiber and find recipes the help you explore spices like turmeric, curcumin, garlic, and ginger.

• For snacks, choose veggies and hummus or nuts and berries.

• For beverages, choose non-caloric, unsweetened beverages, with wine being the exception instead of the norm. 

Inflammation is like fire – necessary and beneficial in small amounts but destructive and harmful when out of control. We are fortunate to live in a day where we can make lifestyle and food choices that will keep our inflammation fires small and manageable. After all, more isn’t always better.

References:

1. Backman, I. (2021, December 21). Inflammation is a fundamental part of physiology: New approaches by Yale immunobiologist. Yale School of Medicine. https://medicine.yale.edu/news-article/inflammation-is-a-fundamental-part-of-physiology-new-approaches-by-yale-immunobiologist/
2. Cleveland Clinic. (2021, July 28). Inflammation: What is it, causes, symptoms & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/21660-inflammation
3. Foods that fight inflammation. Harvard Health. (2021a, November 16). https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
4. Ellulu, M. S., Patimah, I., Khaza’ai, H., Rahmat, A., & Abed, Y. (2017, June). Obesity and inflammation: The linking mechanism and the complications. Archives of medical science : AMS. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507106/
5. McManus, K. D. (2020, December 23). Do pro-inflammatory diets harm our health? and can anti-inflammatory diets help?. Harvard Health. https://www.health.harvard.edu/blog/do-pro-inflammatory-diets-harm-our-health-and-can-anti-inflammatory-diets-help-2020122321624
6. Li, J., Lee, D. H., Hu, J., Tabung, F. K., Li, Y., Bhupathiraju, S. N., Rimm, E. B., Rexrode, K. M., Manson, J. E., Willett, W. C., Giovannucci, E. L., & Hu, F. B. (2020). Dietary Inflammatory Potential and Risk of Cardiovascular Disease Among Men and Women in the U.S. Journal of the American College of Cardiology, 76(19), 2181–2193. https://doi.org/10.1016/j.jacc.2020.09.535