Chronic Inflammation: The Slow Burn of Disease
Written by Nicole Crane. B.S., NTP
Ouch! You stub your toe on your bedpost for the hundredth time. Almost instantly, the redness, pain, swelling and heat wash over your toe. These four symptoms are the classic and predictable signs of acute inflammation, and they serve a very important purpose. When you stub your toe, cut your finger, or overwork yourself at the gym, the body responds with acute inflammation. This type of inflammation is a healthy, normal part of the healing process; itis how the body heals itself and it is essential to maintain your health.
Four Responses of Acute Inflammation
There are 4 predictable responses the body has when we develop acute inflammation - redness, heat, swelling and pain. Sometimes, if a muscle or joint is injured, a fifth sign – impairment of function of the injured body part – may also occur. All of these signs are normal and healthy, as acute inflammation allows the body to bring more blood to the injured site, which delivers nutrients, white blood cells and other aspects of the immune system in order to allow the body to remove damaged cells and begin the healing process. Acute inflammation is a short term response to an injury, and the body is able to resolve the inflammation and turn it off on its own. Redness and heat result from the increased blood flow to the site of injury. Swelling results from the accumulation of fluid at the injury site, which is a consequence of the increased blood flow. Finally, swelling can compress nerve endings near the injury, causing the characteristic pain associated with inflammation. Feeling pain is very important to make you aware of the tissue damage – if you are not feeling pain, you cannot tell if you are injured. Additionally, inflammation in the joint usually results in a fifth sign (impairment of function), which forces you to limit movement and rest the injured joint to aid in healing.
A well-controlled acute inflammatory response has several protective roles; It prevents the spread of infectious agents and damage to nearby tissues, it helps to remove damaged tissue and pathogens, and it assists the body’s repair processes. All of these roles are helpful for the body in removing cells that no longer function and replacing them with healthy cells so the body can continue to function normally. Acute inflammation plays little role in the process of chronic disease. However, what truly is at the root of nearly all disease processes is another type of inflammation, known as chronic inflammation. The body cannot maintain optimal health with inflammation that lasts for weeks, months or years.
Impact of Chronic Inflammation on the Body
This second type of inflammation, chronic inflammation, has a significant negative impact on our vitality and long-term health. Chronic inflammation affects our immune system, tissue function, biochemical reactions, and much more. We develop inflammation because of our food choices, medications, and lifestyle factors such as stress and alcohol use. Chronic inflammation is at the root of most disease processes in the body. In 2011, The CDC (Center for Disease Control) stated that 7 of the top 10 causes of mortality are directly attributed to inflammation1, which is the physical culprit when you have any of the “itis” diseases. For example, when you have an inflamed tendon, it is called tendonitis. Inflammation is not just pain; it can have serious health consequences. We cannot have a healthy heart and vascular system2, a healthy liver, or a functioning digestive system when active inflammation is present. Our hormones and our metabolism do not work optimally when we are inflamed, and this can lead to weight gain and poor blood sugar control.3 Even mood and cognitive disorders become significantly worse when the body is inflamed.
Differences between Acute and Chronic Inflammation
Chronic inflammation is different from acute inflammation in several significant ways. Firstly, chronic inflammation lasts months or years instead of days or weeks. Second, it continuously triggers and re-triggers the involvement of the immune system. This begins the cycle of increased inflammation, further damage, and more immune involvement, which causes the body to have trouble turning off the different proteins and other types of cells that trigger the “on and off” switch of inflammation. Inflammation gets stuck in “on mode,” and this begins the disease process in the body. Next time your doctor does lab work, request a test called CRP (C-reactive protein), which measures inflammation in the body. There are several natural therapies for inflammation, such as Omega-3 fatty acids and herbs like turmeric and boswellia that can be very effective inflammation modulators.
Healthy Nutrition for Healthy Inflammation
The vast majority of individuals in the US are eating a diet that is quite rich in the building blocks of what turns inflammation on, but consume very few foods that build up the inflammation resolvers. Once the flame has been lit, poor food choices, stress, and poor sleep patterns only fuel the fire. While we cannot always control stress or sleep quality, food choices and proper supplements for additional support are entirely in your hands. The type of fat, the amount of sugar, and the form of carbohydrates you eat are some of the main determining factors in whether you will suffer chronic inflammation or maintain overall wellness. The good news, though, is that nature has provided us with several powerful inflammation regulators, like Omega-3 fatty acids found in fish and krill oil, plus herbs like turmeric and boswellia. These work by producing the immune cells that resolve inflammation, so you can finally end the damaging cycle of chronic inflammation.
EPA and DHA
There are two families of fatty acids (EFAs) which are critical for many different aspects of our health. The term “essential” in biochemistry means that the body cannot make them; therefore, it is essential that we consume them through the diet. These essential fats are the Omega-3 family and the Omega-6 family. There are many fatty acids that are members of these EFAs, but some are much more important than others, especially when it comes to whether inflammation is kept in “on” mode or has the ability to naturally turn it off. Generally speaking, Omega-3 fatty acids, especially the ones we find in fish and krill oil, which are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), help create the eicosanoids that turn off localized inflammation. EPA and DHA are so important that nearly all other Omega-3 fats, like ALA found in flax and chia seeds, will be enzymatically converted into EPA and DHA. Most of us do not get nearly enough Omega-3 in our diet, and this is the first problem with chronic inflammation. EPA and DHA are essential to the production of prostaglandins that resolve inflammation. The second problem is Omega-6 fats, which produce the enzymes that turn and keep inflammation active and in “on” mode, are naturally widespread in many foods. As mentioned, inflammation is a delicate dance, and some inflammation is vital to acute inflammation and to the healing process. A healthy diet has an Omega 6:3 ratio that is 4:1 or less. There are many healthy foods that contain more Omega-6 fat than Omega-3 fat, and there is nothing wrong with this. The bigger problem is that all processed foods, and our food supply in general, is completely oversaturated with processed Omega-6 fats that have been isolated from foods. These are mostly refined foods containing corn oil, canola oil, soybean oil and other industrially-produced vegetable fats. Unfortunately, it is a huge challenge to find a packaged food in the average grocery store that does not contain these pro-inflammatory Omega-6 fats. A diet rich in fruits and vegetables, grass-fed beef, wild caught salmon, tuna, and other oily fish like sardines and anchovies, is a far cry from the “Standard American Diet”. As its acronym suggests, this diet is quite sad! While other cultures cook with herbs and spices that help regulate inflammation, the only seasoning universal in American cooking is processed salt.
The good news is that you can change your diet today! If you do not already read food labels, start looking for these inflammation producers in the food you buy. You can expect to find these processed Omega-6 oils in margarine, mayonnaise, sauces, most baked goods, and packaged foods in general. There is one place that Omega-6 fats hide that you might not expect, and that’s in grain and corn-fed beef. These days, that’s nearly all the beef produced in the US! We become inflamed when the Omega-6 to -3 ratio in our overall diet exceeds 4:1, so if you are a big meat eater, choose grass-fed beef. It could make a world of difference in your “itises” and inflammation! The other food to watch out for these oils in salad dressing, as 99% of bottled dressings are made with soybean or canola oil. Your best bet is to make your own salad dressing. If you want to gain the full benefits of those veggies in your salad, make your own dressing with olive oil or even flax oil, which is a good source of the Omega-3 fat called ALA (Alpha-Linolenic Acid).
As impressive as the health benefits of EPA are, DHA is the ultimate fatty acid that supports optimal health. DHA is not a substrate for prostaglandin production, and it tends to inhibit the enzymes that allow for prostaglandin synthesis if EPA and DHA are out if balance. However, DHA is the precursor of the docosanoids. Docasanoids are the precursors for resolvins and protectins, which are comparable to the eicosanoids and have potent inflammation modulation and immuno-regulatory actions. DHA is believed to have specific effects on gene transcription that regulate a number of proteins involved in making different fatty acids. It has been shown to have beneficial effects on inflammatory disorders of the intestinal tract, likely due to regulation of specific signaling proteins in cell membranes, and not prostaglandin activity. As EPA tends to improve inflammatory responses, DHA tends to improve nerve and neurological health as well as cell-to-cell communication. DHA is a major component of phospholipids, especially those in the cell membranes of brain synapses. DHA is also found in high concentration in the retina, where it is a major structural component of the photoreceptor outer segment membranes. DHA also binds strongly to specific sites on rhodopsin, the primary light receptor in the eye, supporting vision in a significant way. Although adequate amounts of DHA are especially important during pregnancy and infancy, this fatty acid plays a vital role in supporting brain function throughout life. Up to 45% of the fatty acids in synaptic membranes are composed of EPA and DHA. Adequate DHA intake is necessary for optimal nerve communication. DHA has also been shown to support healthy and normal mental health. Like EPA, DHA has impressive cardio-protective effects. It also reduces blood clotting, controls inflammation, supports healthy triglyceride levels, and promotes cell membrane health in the heart, thus supporting a normal heart rhythm. DHA can even support healthy lung function by decreasing the formation of pro-inflammatory leukotrienes made from the Omega-6 fat arachadonic acid that acts as a blood vessel constrictor, benefiting those with asthma.10 EPA and DHA have wonderful widespread benefits for the whole body.
There are some powerful, natural herbs that can make a significant difference in pain and the body’s inflammatory response. When it comes to herbal medicine and inflammation, the spice turmeric is the most powerful, most effective remedy for cooling inflammation. A close second is the Ayurveda herb Boswellia, otherwise known as frankincense. Seek a supplement that includes these herbs to help the body produce less of the proteins that have a pro-inflammatory action. Again, in the beautiful wisdom of Mother Nature, inflammation is not simply shut off like a light, which is the way NSAID drugs work. In this situation, the body is not allowed to self-regulate. Instead, these herbs act like a dimmer switch. They let the injury heal or the immune system get rid of the infection, but when that is completed they make sure inflammation is turned off. Otherwise, the body becomes stuck in a vicious cycle of inflammation that will not subside, leading to damage that perpetuates the inflammation. Turmeric/Curcumin supports immunity, and because of the essential role it plays in a healthy inflammatory response, it’s great for the brain, the heart, the GI tract, all of the joints and tendons, lungs, and muscles. 11, 12 If you have pain, inflammation, and disease in any part of your body, and if you have any form of “itis”, fish oil or krill oil would be a great addition to your nutrition protocol.
There is one more aspect of diet that is important to address. Sugar is all its many forms creates a huge amount of pro-inflammatory molecules, which turn on inflammation and pain. The best thing you can do to prevent inflammation and disease is to give up sugar and all refined carbs, but that’s much easier said than done. Try to limit soda, candy, bread, pasta, rice, cookies, cake, and all the other foods sugar hides in as much as you can – you will feel much better overall. Sugar, especially fructose and high-fructose corn syrup, creates something called advanced glycation end products, or AGEs, that are aptly named because they age our body at a very fast rate. AGEs are sugars that attach to the proteins in our body, causing damage and inflammation to structural proteins as in the eyes, skin, joints and tendons, and every other part of your body. This damage causes inflammation, and if the body does not have the right nutrition to turn it off, we tend to age more quickly by developing wrinkles, older-looking skin, stiff joints, and pain with movement. AGEs also damage proteins that make up the hormones and enzymes that drive all our biochemical processes, and this may have a variety of consequences including mood and brain issues, hormonal imbalances, low energy levels, sensitivity to stress and poor sleep patterns. Depending on what becomes damaged, for example nerves or hormone cells, diseases can develop and worsen over time.13 If you have chronic inflammation, do your best to cut sugar. I know it can be incredibly hard, but it is well worth giving up sugar for good. The modern American diet drives all the pathways that turn inflammation on, but we have very few sources that help to turn inflammation off. Inflammation is biochemical, and you can use food and supplements to maintain a healthy, balanced, and normal inflammatory response.
Inflammation is an issue that plagues many people, and years of damage and pain cannot be healed overnight. But by making some positive changes in your diet, eating and drinking less sugar, choosing high-quality meats, and cutting down on soda, sweets, and processed food, you can shift the balance and help the body create less of the proteins that turn inflammation on. By introducing a key supplements like Krill Oil, you can help your body make the proteins that turn inflammation off and bring the body back into balance and optimal health. It is possible to live without pain, inflammation and disease! Having optimal health is your right, and something you deserve. Change your diet, add some supplements, and cool down the slow burn of inflammation. Managing inflammation is the first and most important step in supporting your overall health for the entire length of your life.
- Challem, Jack, The Inflammation Syndrome, Hoboken, NJ; John Wiley and Sons Publishing, 2010
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