Health Matters: Chronic inflammation endangers health

Conway McLean, DPM, Journal columnist

Inflammation has gotten a bad rap. It gets trounced in the media, with arthritis sufferers nodding in agreement. Advertising presents inflammation as a terrible thing, causing pain and problems all over the body. Wherever you have pain, there must be inflammation. It should not be surprising when it is offered up as the cause of some illness, even when there is no definitive diagnosis.

Is inflammation always a bad thing? Why does it occur if it’s harmful? In truth, inflammation is an essential part of healing. It is your body’s protective response to injury or damage. It helps your natural healing and repair processes. Inflammation is the only identified mechanism for restoration of tissue after injury. Inflammation includes a long chain of molecular reactions and cellular activity, which are designed to restore all manner of tissue injury, from a simple cut to the tissue repair required after giving birth.

These are essential functions. Without inflammation, that first injury, the skinned knee as an infant, might never heal. Our bodies are programmed to go through a chemical cascade of events called inflammation. When it proceeds in an appropriate and timely fashion, it leads to healing. But, to be accurate, we should refer to it as ‘acute inflammation’.

We all know the usual signs of inflammation. A good example would be after a bee sting. The area becomes red, hot, swollen and painful. These are considered the cardinal signs of inflammation, the classics. But again, we are talking about ‘acute’ inflammation, that essential component of the healing process.

Chronic inflammation is a very different sort of animal. Problems tend to occur when the body is experiencing high levels of inflammatory markers on a long term basis. The critical differentiating factor between acute and chronic is the chemistry of the affected area. This in turn affects the cells of the tissue.

The reasons this condition of chronic inflammation may develop are numerous. Many modern stressors, from pollution, to obesity, can lead to it. An infection that is not resolved in a timely fashion is another reason chronic inflammation develops. Trauma or persistent foreign bodies can lead to it. Chronic diseases like diabetes, gout, rheumatoid arthritis, obesity, or cancer, can as well. Other known causes include chemical agents which cannot be broken down (like asbestos exposure) to recurrent acute inflammation. Even harmful lifestyle habits, especially an unhealthy diet, can lead to it.

One area of research is into the consequences of processed foods, especially trans fats. These are a group of substances used in these foods that are completely synthetic and not found in nature. These seem to result in high levels of inflammation in the blood stream, on a lasting, ‘chronic’ basis.

Chronic inflammation can have several consequences on how our bodies function, leading to an increased risk of chronic diseases and disorders. Inflammation is a major factor in the progression and worsening of various chronic diseases, including some of those just mentioned, like diabetes and cardiovascular disease, as well as the autoimmune diseases.

Numerous pharmaceuticals have been developed to reduce inflammation. Unfortunately, as is the case with nearly all drugs, there can be complications. The cardio-vascular side effects of the non-steroidal anti-inflammatory drugs (ibuprofen, etc) were uncovered after years of use. Cortisone, prednisone, and the many other steroids, all cause significant problems if taken long enough or inappropriately.

You don’t have to accept chronic inflammation as a part of modern life; there are choices to make that can reduce its development….or encourage it. Dietary decisions, often made haphazardly and without care, can go a long way to reducing the risks. Obviously, one’s lifestyle is a tremendously important factor. So is a person’s genetic composition (although we have no control of that).

There are many different herbs and foods that can help you reduce inflammation in your body. Alpha-lipoic acid has been recognized as a particularly beneficial one. This is a fatty acid made by your body which plays a key role in metabolism and energy production. It also functions as an antioxidant, protecting your cells from damage and helping restore levels of other antioxidants, like vitamins C and E. ALA, as it is referred to, also reduces inflammation, especially the kind linked to insulin resistance, cancer, heart disease and other disorders. A reduction of several inflammatory markers in the blood has been well documented with ALA administration. Many sources recommend a dosage of 300-600 mg per day.

Another supplement receiving noticeable attention by the media would be the spice, turmeric, which contains the substance curcumin. This apparently provides several impressive health benefits. Curcumin seems to decrease inflammation in diabetes, heart disease, inflammatory bowel disease and cancer, but is also helpful in improving symptoms of osteoarthritis and rheumatoid arthritis. Curcumin, and therefore turmeric, is helpful because of its effect on systemic levels of inflammation. Curcumin is poorly absorbed from the intestines, although that can be improved tremendously by taking with black pepper. The recommended dosage is 100-500 mg daily (when taken with pepper).

Omega-3 fatty acids are vital to health and found in large quantities in fish oil. They can decrease the inflammation associated with diabetes, heart disease, cancer and many other conditions. Americans are consuming far too much Omega-6’s in their diet. These are found in many oils when derived from animal sources. These seem to promote chronically high levels of inflammation in the blood stream, as opposed to those sourced from plants (further evidence that a plant-based diet is healthier).

Many different types of Omega-3’s are found in nature, although the two best defined as health-inducing are EPA and DHA. In particular, the latter has been shown to have anti-inflammatory effects that promote gut health. DHA also lowers the levels of certain chemical messengers in the body, especially those which promote chronic inflammation. It may also decrease the muscle damage that can occur after exercise. The recommended dosage is thought to be about 1 gram of omega-3s from EPA and DHA per day.

As should be expected, and has been hinted at here, some foods seem to encourage high systemic inflammatory levels. Try to avoid or limit these foods as much as possible. These include highly processed and refined carbohydrates, such as white bread and pastries. Fried foods, the staple of too many American diets, appear to promote chronic inflammation, as does soda and other sugar-sweetened beverages. Processed meat, such as hot dogs and sausage, have been clearly implicated in stimulating the development of chronic inflammation. So does red meat. The same is true for margarine, shortening, and lard.

We don’t know enough about diet and nutrition, and the subtle but significant relationship between them and our health. Look down any city street in America for evidence the “wrong” foods can hasten the evolution of various illnesses, especially obesity and its associated pathologies. Supplements have little to no downside, other than expense, and help to ensure your body has the nutrients for health and well-being. But buy supplements from a reputable manufacturer; how a supplement is produced, and from what, do have an effect on what it will do for you.

Once again, the adage still rings true: the foods you consume today become the muscle and skin you grow tomorrow. Avoid chronic systemic inflammation by making informed choices. Too many debilitating diseases can result from making the wrong ones. Essential nutrients, especially those with high levels of antioxidants (the most well-known examples being vitamins C and E), appear to protect against inflammation and tissue damage. In the case of chronic inflammation, supplements can help bring things back into balance.

Inflammation has become a vital topic in the study of human illness. We do not know enough about nutrition and health, but we know what we put into our bodies can support well-being, or lead to disease. Good health can be encouraged, wellness optimized, with proper nutrition. Get exercise, live smart, eat well. Your health and quality of life will be the beneficiary.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.


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