Chronic Inflammation May Be Making You Sick

Inflammation and Disease

by Dr. Zach, 2019

1. What is inflammation?  Good or bad?
2. What are autoimmune disorders?
3. What is chronic inflammation?
4. What conditions has chronic inflammation been linked to?
5. How is inflammation found?  Are there signs, symptoms, tests?
6. What can we do about chronic inflammation?  Medications? How much exercise? What foods?

We recently discussed how modern medicine is recognizing infectious microorganisms as the cause for diseases like ulcers, which were previously thought to be from other causes.  Another area of great new interest is how chronic inflammation is related to disease.  

What is inflammation? It is the body’s way of signaling the immune system to heal and repair damaged tissue, as well as defend itself against foreign invaders, such as viruses and bacteria.  Inflammation is a vital part of the immune system’s response to injury and infection.  

However, in some diseases, like arthritis, the body’s defense system — the immune system — triggers an inflammatory response when there are no foreign invaders to fight off. In these diseases, called autoimmune diseases, the body’s normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal.

Autoimmune diseases include rheumatoid arthritis, Lupus, Multiple Sclerosis, and Inflammatory Bowel Disease (Crohn’s disease and Ulcerative Colitis), among others.  These diseases are treated with therapies aimed at the damage done and also at suppressing the inappropriate inflammation with antiinflammatory medications.

While inappropriate inflammation has been recognized as a cause of disease for many years, it is only recently that other ailments are being linked with chronic inflammation.  Unlike the inflammation that follows a sudden infection or injury, the chronic kind produces a steady, low level of inflammation within the body that can contribute to the development of disease. Low levels of inflammation can get triggered in the body even when there’s no disease to fight or injury to heal, and sometimes the system can’t shut itself off. Arteries and organs break down under the pressure, leading to other diseases, including heart disease, stroke, diabetes, cancer, and Alzheimer’s disease.  

Chronic inflammation is largely asymptomatic.  There are some blood tests which doctors use to measure inflammation in the body.  People with higher levels of these markers, including CRP (c-reactive protein) and ESR (erythrocyte sedimentation rate) are at higher risk for such diseases, probably due to the damage done to the organs by chronic inflammation.

The question is what can be done about chronic inflammation.  While there are antiinflammatory medications available, such as ibuprofen and naproxen, it is not a good idea to take these for more than a short period of time because of the potentially harmful effects they have on the stomach and kidneys.  Other antiinflammatory medications, such as prednisone, are similarly harmful if taken for long periods of time. In addition, while antiinflammatory medications can treat an acute episode of inflammation, they do not treat or reverse the underlying cause of the inflammation.

At this time the best treatments we have to combat chronic inflammation are those we know to help decrease the risk of cardiovascular disease — diet and exercise.  It is well-established that losing weight can significantly decrease inflammation. But the benefits of diet and exercise on inflammation go beyond the benefits resulting from weight loss.  

What foods should we not eat?

We know that certain foods increase inflammation, including refined carbohydrates, such as white bread and pastries, french fries and other fried foods, soda and other sugar-sweetened beverages, red meat (burgers, steaks) and processed meat (hot dogs, sausage), and margarine, shortening, and lard.  We should include less of these in out diet.

What foods should we eat to decrease inflammation?

Foods that have antiinflammatory effects include tomatoes, olive oil, green leafy vegetables, such as spinach, kale, and collards, nuts like almonds and walnuts, fatty fish like salmon, mackerel, tuna, and sardines, and fruits such as strawberries, blueberries, cherries, and oranges.  We should include more of these in our diet.

Other things we can do to decrease inflammation are to get plenty of sleep, lower stress levels, and seeking out treatment for conditions known to be associated with inflammation, such as gum disease (see your dentist) and high cholesterol levels (see your doctor). Avoid contact with heavy metals such as mercury, found in high levels in some large fish, and limit exposure to substances, such as diesel exhaust and cigarette smoke, that can set off the immune system. 

Inflammation is an essential element of a healthy body, but like many healthy things it is possible to have too much of a good thing.  Inflammation can be harmful if it affects an organ that is healthy, and it can cause long-term damage if it simmers chronically. Doctors are studying the effects of chronic inflammation looking for better ways to detect it and to treat it.  Right now the best things we can do to combat chronic inflammation are to eat well (avoid pro-inflammatory foods and eat more antiinflammatory foods), exercise, take care of our mouths, and not smoke. See your doctor for more information.

In terms of how much exercise, and what kind, recommendations are as follows:

1. At least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. The exercise should be spread out over the week, and doing more than that will lead to greater benefits  . Even small amounts of physical activity are helpful. Being active for short periods of time throughout the day can add up to provide health benefit

2. People should do strength training exercises for all major muscle groups at least two times a week. They should aim to do a single set of each exercise, using a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.

Moderate aerobic exercise includes activities such as brisk walking, swimming and mowing the lawn. Vigorous aerobic exercise includes activities such as running and aerobic dancing. 

Strength training can include use of weight machines, one’s own body weight, resistance tubing or resistance paddles in the water, or activities such as rock climbing.

In general people should aim for 30 minutes of moderate physical activity every day. 

Reducing sitting time is important, too. The more hours you sit each day, the higher your risk of metabolic problems. Sitting too much can negatively impact your health and longevity, even if you get the recommended amount of daily physical activity.

Even brief bouts of activity offer benefits. For instance, if you can’t fit in one 30-minute walk during the day, try a few five-minute walks instead. Any activity is better than none at all. What’s most important is making regular physical activity part of your lifestyle.