Inflammation - Insidious Killer, or Nah?
Main points:
Inflammation is necessary for survival. It is a key defense mechanism your body uses to protect against bacteria, pathogens and other foreign invaders.
Acute inflammation is a short term condition characterized by redness, swelling, bruising, and pain. This is a healthy inflammatory response that resolves after the threat is gone – usually within a week or two.
Chronic inflammation is a long term condition where inflammation is still present even when there is no threat. This lingering inflammation can cause collateral damage to healthy tissues and organs. It can last for weeks, months, and even years.
Damage from chronic inflammation can play a significant role in the development of cardiovascular disease, cancer, diabetes, Alzheimer’s disease, kidney, liver, and autoimmune diseases. These diseases account for over 50% of deaths worldwide.
Factors that can cause chronic inflammation include:
➡️ Exposure to toxins, chemicals, and pollutants
➡️ Smoking tobacco
➡️ Excessive alcohol consumption
➡️ Diet containing mostly processed foods
➡️ Sedentary lifestyle
➡️ Poor sleep patterns
➡️ Excessive psychological stress
High body fat, especially the visceral fat located deep within the abdomen, is a major contributor to chronic inflammation.
You can measure your levels of inflammation by taking a CRP test, which measures C-reactive protein in your blood. Unfortunately it can’t tell you the cause of the inflammation, nor can it tell you if the inflammation is acute or chronic. Consult with your doctor when interpreting your test results.
You can lower and prevent chronic inflammation with these lifestyle habits:
➡️ Lose weight in a healthy manner
➡️ Quit smoking
➡️ Limit your alcohol
➡️ Eat nutritious, minimally processed, whole foods
➡️ Exercise regularly, with proper recovery
➡️ Sleep more (7-9 hours per night)
➡️ Manage your stress
Why I had to write about this
You’ve seen it.
You’ve heard about it.
Inflammation.
“Don’t eat this because it increases inflammation!”…or… “Eat these anti-inflammatory foods!” To regular folks, this roughly translates to “inflammation=bad…even though no one told me what it is!”
Count me in as one of the regular folk. For the longest time, I thought inflammation was what happened after injuries. You trip, fall, and get a nasty red and purple bump that hurts like hell for a couple days. That’s obvious enough.
But food causing inflammation? Stress causing it? And I’m sure you’ve heard people online talking about inflammation being this insidious and invisible specter that will destroy everything you love. Very similar to the discourse around cortisol, as I wrote in my previous article.
So all of this made me really curious: what the heck is inflammation, why does it occur, and will it eventually kill me?
If inflammation is so bad, why does your body have it?
Despite all the bad press about inflammation, it’s actually vital to your survival. Inflammation is a key defense mechanism against foreign agents and harmful stimuli, such as bacteria and pathogens.
It helps neutralize threats, remove damaged cells, and allow healing and repair to occur. Inflammation is an inextricable component of the immune system, serving as a first line of defense – you and I need it to stay alive!
Let’s go back to our previous example of tripping and falling, and see what the general process of inflammation looks like beneath the surface:
1️⃣ Receptors in your body detect the physical trauma of the fall, along with any foreign substances that enter your scrapes and cuts.
2️⃣ Upon detection, inflammatory pathways are activated, sending a wave of different inflammatory cells to the affected locations. These cells include the following:
White blood cells (leukocytes) – These are the immune system cells that do all the dirty work. They attack the foreign and harmful stimuli, and then clean up the remaining debris from the battlefield.
A whole slew of these leukocytes are recruited during the inflammatory process: neutrophils, macrophages, dendritic cells, T cells, B cells, natural killer cells, and more.
Cytokines – Small cell-signaling proteins secreted from leukocytes that help regulate the inflammatory response.
They can ramp up inflammation (pro-inflammatory) by signaling for more inflammatory cells to arrive at the affected sites. They can also dial down inflammation (anti-inflammatory), especially when the threat has been resolved.
3️⃣ As these cells trap, attack, and remove pathogens and damaged cells, you’ll experience increased blood flow in the affected areas, resulting in swelling, bruising, redness, and pain.
4️⃣ Pathogens, bacteria, and foreign agents are all destroyed. Damage is cleaned up. Healing and recovery are initiated. Inflammation is resolved, and the associated cells are cleared out.
This process is referred to as acute inflammation. It is a healthy response to a threat that then subsides after the threat is gone. Usually this is a short term affair, lasting no longer than one or two weeks. Common examples of acute inflammation are:
Bruises from physical injuries and trauma
Soreness after a tough workout
Swelling of the sinuses and sore throat during a cold or illness
Red itchy bumps from insect bites
Rashes or itchiness from allergic reactions
You’ve experienced all of the above before, and it was nothing life threatening right? Life sucked for a little bit, but you were back up and running in no time…all thanks to your body’s ingenious defense and recovery mechanisms.
The dark side of inflammation
Everything is hunky dory so far…but things start to go wrong if inflammation sticks around, even after the threat is gone. You’ve still got an excess of cytokines and leukocytes floating around in your tissues and organs, which under normal circumstances would have been cleared out already.
Without an enemy to defeat, these inflammatory cells start to cause collateral damage to its surroundings. This friendly fire can prolong inflammation, as the very same process that mistakenly did the damage, is also recruited to fix it!
Over time, the amount of collateral damage outweighs the amount of healing, resulting in more dysfunctional tissues and organs. This long lasting process is referred to as chronic inflammation.
It is typically low-grade in nature. There aren’t obvious symptoms (like the red, bumpy, painful ones you’d experience with acute inflammation), allowing this state to continue unnoticed.
Chronic inflammation can last for multiple weeks, months, or even years! Eventually symptoms will arise, such as:
❌ Body aches, headaches, joint pain
❌ Chronic fatigue
❌ Insomnia
❌ Mood disorders, depression, anxiety
❌ Fever
❌ Infections
❌ Gastrointestinal issues
❌ Skin rashes
It’s a wide ranging set of symptoms…many of which you and I have had multiple times in the past…and can be attributed to other causes too. Not exactly the most helpful list huh?
No wonder chronic inflammation can go under the radar for so long! So what happens if you miss these symptoms, and permit chronic inflammation to keep doing its thing?
One of the leading causes of death…worldwide
Here’s something crazy I discovered during my research that left my jaw on the ground: Over 50% of deaths worldwide are from diseases that are associated with chronic inflammation!
Unfortunately, this number is projected to increase in the decades to come. Here are some of the diseases that can arise from years of accumulated damage from inflammation:
Cardiovascular disease:
Heart attacks, strokes, and coronary artery disease are all leading causes of death in the US and worldwide.
Heart issues typically occur from a buildup of fatty, cholesterol-rich plaques inside blood vessels that disrupt and eventually stop blood flow – a condition called atherosclerosis.
Inflammation facilitates the progression of atherosclerosis, and can even lead to the breakage of these plaques, forming blood clots that can immediately trigger a heart attack or stroke.
Cancer:
Chronic inflammation not only damages healthy cells, but it can also cause mutations within these cells.
As a result, they can grow and divide abnormally, setting up the stage for tumor growth. It’s estimated that about 15% of cancers are associated with chronic inflammation.
Diabetes:
Chronic inflammation can reduce insulin sensitivity, reducing the amount of blood sugar uptake by the liver and muscles. This leaves excess sugar in the bloodstream…
…and high blood sugar is also a trigger for inflammation. Unfortunately, this seems to create a feedback loop that can potentially play a role in the development of diabetes.
Alzheimer’s Disease:
Dementia and cognitive decline is linked to chronic inflammation. Amyloid plaques are a core pathology of Alzheimer’s, which trigger an inflammatory response.
Prolonged exposure to inflammatory cells can damage healthy neurons, speeding up the progression of this disease.
Kidney, Liver, and Autoimmune Diseases:
Accumulated damage from inflammation can lead to decreased function of organs. Kidney disease and non-alcoholic fatty liver disease are linked to chronic inflammation.
Autoimmune diseases can potentially arise due to the over activity of the immune system in a chronically inflamed state.
Yikes! Fortunately,
These diseases can take years and decades to develop, and a large portion of what causes chronic inflammation are lifestyle based. You’re in control, to a large degree, in avoiding the habits and behaviors that contribute to these complications.
What lifestyle habits cause chronic inflammation?
Many of these are going to seem obvious. Generally, an unhealthy lifestyle will set the stage for chronic inflammation, and both you and I have had experience being unhealthy at some point, right? So let’s discuss some of these, and how they play a role in inflammation:
Exposure to Toxins, Chemicals, Pollutants:
These foreign materials can cause inflammation. It can become chronic if you are consistently in an environment where these harmful materials are present.
Smoking Tobacco:
Smoking damages airways, blood vessels, and almost every other organ in your body. Needless to say, this activates the body’s inflammatory response, which becomes chronic if you continue to smoke.
Excessive Alcohol Consumption:
Alcohol metabolizes into harmful compounds, causing inflammation in the gut that can later infiltrate the liver. Not only that, but alcohol may increase intestinal permeability, allowing for bacterial overgrowth that leads to even more inflammation.
Diet Containing Mostly Processed Foods:
An excess of refined carbs, sweets, saturated fats, trans fats, and processed meats have been linked to inflammation. Eating too many processed foods increases the likelihood of excess calories and weight gain – another factor that promotes inflammation.
Sedentary Lifestyle:
Low levels of inflammation appear to be associated with sedentary behaviors. Physical inactivity can also contribute to weight gain and increased body fat, which are both pro-inflammatory factors.
Poor Sleep Patterns:
Sleep is a crucial time for the body to clean out waste. Cutting back on this time can allow the waste to pile up, which can trigger inflammation to get rid of it.
Excessive Psychological Stress:
Normally, stress hormones such as cortisol have anti-inflammatory properties. Profound ongoing stress overexposes these hormones to the body, and resistance can develop.
Gradually the anti-inflammatory effects of these hormones get stripped away. Chronic stress keeps blood sugar elevated, increasing the risk of insulin resistance, which is a contributing factor to inflammation.
I mentioned weight gain and increased fat mass to be pro-inflammatory a couple times throughout this section. It’s actually quite a large risk factor for chronic inflammation! It’s pretty fascinating, and it’s deserving of its own section.
Excess body fat and its effect on chronic inflammation
Adipose (fat) tissue has the ability to produce its own inflammatory cytokines, called adipokines. The degree of inflammation adipose tissue produces is influenced by the amount of leukocytes (particularly macrophages) present in the tissue.
The more macrophages, the more intense the inflammation. In a normal healthy environment, adipose tissue contains about 5-10% macrophages. In an overweight or obese environment, that number can go up to 60%. This can be problematic because:
🔷 Body fat can make up a sizable chunk of the body
🔷 Body fat is spread out in multiple areas
🔷 Body fat can grow in size, and
🔷 All of this body fat produces inflammation!
In other words: more body fat, more inflammation. In addition, adipocytes (fat cells) become more and more dysregulated as total fat mass increases. They receive less oxygen due to scarcer blood flow. There’s only a fixed amount of blood vessels supplying a growing amount of adipose tissue.
To make things worse, some adipocytes will simply get crushed by the sheer amount of mass packed into a confined space. The lack of oxygen and the dead crushed fat cells both trigger inflammation.
So not only is adipose tissue inherently pro-inflammatory due to its macrophage content, but the dysregulation that occurs with fat accumulation is also pro-inflammatory. Double yikes!
However, it looks like one type of fat produces a disproportionate share of the inflammation: deep internal abdominal fat, also referred to as visceral fat. Visceral fat contains more macrophages than subcutaneous fat (the “surface level” fat that resides just underneath the skin).
The risk of cardiovascular, metabolic, autoimmune, and neurodegenerative disease all increase with excess visceral adiposity. All right I think you get the point by now: excess body fat (especially visceral fat) and chronic inflammation seem to go hand in hand. And chronic inflammation = not cool.
Measuring inflammation in your body
Unfortunately, there is no highly effective way for assessing whether you have chronic inflammation or not. However, measuring C-reactive protein (CRP) in your blood is a widely used and accessible approach to see your levels of inflammation at the time of measurement.
CRP is released by the liver when inflammation, acute or chronic, is present in the body. A CRP test can’t distinguish the type of inflammation, nor the cause of it. You and your doctor can keep an eye on the patterns of CRP in your body to draw conclusions of what may be happening. Here are the different test results that can emerge:
Normal
<0.3 milligrams per deciliter (mg/dL)
CRP is usually very low under normal healthy circumstances.
Minor Elevation
0.3 – 1.0 mg/dL
This level is seen in cases of low grade inflammation, such as obesity, common cold, sedentary lifestyle, smoking, and diabetes.
Moderate Elevation
1.0 – 10 mg/dL
This level is seen in diseased states, such as autoimmune disease, cardiovascular disease, and cancer.
Marked Elevation
10 – 50 mg/dL
This level is seen in an infection or in the presence of major physical trauma.
Severe Elevation
>50 mg/dL
This level is seen almost always in a case of a major infection.
How to lower and prevent chronic inflammation
Okay finally! Enough scary talk. Enough confusing science words. Let’s get down to business, and take some action. This section is pretty much the opposite of the section above that listed out the lifestyle causes of chronic inflammation. So let’s dive right in and go through each one:
Lose weight in a healthy manner:
This applies if you have a lot of excess body fat, especially if it’s the visceral kind that resides deep within your belly and waist. The good news is that visceral fat is the first to go when you embark on a healthy weight loss journey.
Don’t worry too much about how much weight to lose. Instead, focus on keeping off the weight that you do lose, no matter how small it may be. It appears that the duration of your weight loss has a significant impact on lowering chronic inflammation. Losing weight and regaining it shortly afterward kinda defeats the purpose!
All of the associated behaviors required for healthy weight loss also do a wonderful job at reducing chronic inflammation. These include reducing overall calories (especially from sugary and fatty processed foods), getting in consistent physical activity, and sleeping properly.
Focus on turning these behaviors into habits, and over time your excess body fat will begin to shrink, and you will gradually settle into a healthier body weight.
Quit smoking:
Much like weight loss, this is easier said than done. Quitting smoking can be a long journey too. There are many resources you can turn to. Experiment with different tools and strategies. Seek help if the habit seems to be intractable.
Limit your alcohol:
My insights about smoking apply here too. I think a good place to begin is to get an idea of how many drinks you’re having per week, and where they tend to occur.
From there, you can determine which drinks seem extraneous that you can whittle down on. Again, experiment and see what works. And if you need help, there are many resources you can recruit to your side.
Eat nutritious, minimally processed, whole foods:
Start by increasing the amount of vegetables and fruits currently in your diet. Spend more time at the produce section of your local grocery market. Try a new one each week. Integrate the ones you like into your regular meals.
Once you’ve got a handle on the vegetables and fruits, try branching out to other food categories: fresh cuts of meat and fish, eggs and egg whites, low fat dairy, beans, legumes, whole grains, nuts, and many more.
Slowly build up your new repertoire of nutritious foods. Getting a variety of these minimally processed, whole foods will provide your body with antioxidants, polyphenols, and fiber, all of which will reduce levels of chronic inflammation.
You can also try taking a multivitamin daily, along with a fish oil supplement high in omega 3 fatty acids (these have great anti-inflammatory properties), to help fill in any gaps in your nutrition.
Exercise regularly, with proper recovery:
Find a form of physical activity that you enjoy, and perform it at a frequency and intensity that works for your current fitness level. Be reasonable! What matters here is consistency.
It’s admirable to push your body’s limits from time to time, as long as it doesn’t come at the cost of consistency. Brutal workouts tend to be unsustainable. Ensure that you have proper recovery because that’s when the body builds itself back up and gets stronger.
Sleep more (7-9 hours per night):
Decide on appropriate bed and wake times. Experiment with them. You can rigidly abide by these times everyday of the week. Or you can just focus on waking up at a certain time on most days of the week, and going to bed when you feel tired.
Figure out what works for you. Setting up the right environment for sleep is very important as well. A dark, quiet, and slightly cool room is optimal. Try a wind down routine at night that relaxes you mentally and physically to prepare you for sleep.
Manage your stress:
Identify your stressors, and see if you can either eliminate or reduce them. Figure out if there are people, tools, and any other resources that can help shoulder the burden.
You can also carve out time to do things that you truly enjoy that replenish you. Engage in calm, mindful activities: meditation, walking in nature, writing, a gratitude practice, etc.
Come up with a mantra that can help ground you in challenging times: “This too shall pass” , “Life will go on” , “I will grow and adapt as I always do”. Work with a friend, family member, or a mental health professional to figure out potential solutions. You’ve got this!
Wrap it Up, B!
Inflammation is a complex process that is fascinating when it works normally. You and I have these microscopic armies protecting and healing us all day everyday! However, like all things, inflammation becomes problematic when it is out of balance.
The great news is that you’re in control. You can prevent the negative outcomes with the same old general healthy lifestyle habits that your mom probably nagged you about when you were younger.
This article only scratches the surface of inflammation. This was a challenging one to write, because of the broad nature of this topic, the enormous amount of intimidating scientific research published on this, and the level of unfamiliarity I had with inflammation prior to writing this article.
I’m absolutely sure there are things I’ve written here that aren’t 100% accurate. So if you have any contributions that you’d feel can improve this article, please share them with me: newton@newtonkwong.net. Thanks for reading all the way until the end, and I hope you learned something new!
Whoa you made it to the end!! Thanks for reading 🙂
If you found this article helpful, please check out my other ones!
Also, if you need help with any of the following:
⭐️ Losing weight ⭐️
⭐️ Gaining muscle ⭐️
⭐️ Managing your stress ⭐️
⭐️ Improving your nutrition ⭐️
⭐️ Increasing your daily energy levels ⭐️