What exactly is Inflammation?

Many people have probably heard the term ‘inflammation’, and often believe it is a bad thing. Well actually, this is sort-of true, but not completely.

On the positive side, you twist an ankle playing sports, moments later it is red, very painful and radiating heat. These are all signs of inflammation, the start of the healing process that makes your ankle better in a matter of just a few days.

Consequently, the inflammatory response is a vital defence mechanism that evolved in humans to protect us from infection and injury. There is little doubt that without inflammation humankind would not have survived through to the 21st century – therefore inflammation is not just good, it is a perfect adaptation to ensure survival.

Conversely, inflammation is also implicated in ageing degenerative diseases such as muscle wasting and frailty, painful arthritic conditions, neuro-degeneration including Alzheimer’s disease and diseases that can eventually kill us such as cardiovascular disease and cancer 1

So the question remains “in the 21st century, what makes inflammation dangerous to health? “

Low-grade chronic inflammation

An inflammatory response that lasts only a few days is acute inflammation. Its purpose is to localise and eliminate an injury or pathogen and to remove damaged tissue so that the healing process can begin. It is when, for various reasons (explored below), the inflammation is not resolved in the typical 4-7 days and healing is incomplete and the inflammatory response continues unabated, becomes ongoing and chronic.

Chronic inflammation may be thought of as a slowly simmering process that quietly damages cells, tissues and organs and can be present years, even decades. Chronic inflammation, when left unchecked is the precursor to the development of many diseases.

To prove that inflammation is ubiquitous, one only has to consider that sales of anti-inflammatory drugs are expected to reach $106.1 billion globally by 20202. Reducing inflammation is one of the primary therapeutic strategies in the management of pain, such as headaches, migraines and fibromyalgia, as well as chronic diseases such as rheumatoid arthritis, osteoarthritis, inflammatory bowel disease, psoriasis, asthma and much more.

Just some of the signs of chronic inflammation:

  • Ongoing, pain in the body, regular or constant joints or muscles that ache

  • Allergies or asthma (especially when they keep getting worse)

  • High blood pressure or blood sugar problems, insulin resistance

  • Ulcers and irritable bowel syndrome (IBS), regular constipation or diarrhoea

  • Constant fatigue or lethargy

  • Foggy thinking, issues with concentration and memory

  • Skin problems and red, bloodshot eyes

  • Sleeping problems, sleep apnea

  • Excess weight around the abdomen

Possible causes for unresolved low-grade inflammation

At Nutritional Immunology we aim to determine the reasons for the chronic activation of the immune response and find the cause (or in most cases the cause of the cause) to reduce inflammation and restore health and balance.

Examples of underlying reasons that can contribute to a chronically activated immune response:

  • Low nutrient diet consisting of processed foods and high carbohydrate consumption, leading to sub-optimal nutrient status

  • Continual eating, constant snacking with limited overnight fasting window

  • Unresolved infection, bacterial, viral or parasitic

  • Poor oral and gum health, with underlying infection

  • History of antibiotic use, particularly in early life

  • Disrupted circadian rhythm, irregular wake/sleep patterns

  • Overuse or abuse of drugs, including tobacco, alcohol, pain relief and recreational drugs

  • Little movement, sedentary lifestyle

  • Toxic exposure from pesticides, toxic metals, pollutants

  • No exposure to the great outdoors, natural elements such as heat or cold

  • Stress, physical and emotional, unable to relax

  • Unresolved traumatic experiences, particularly in early life

​​​​​​Foods that can contribute to or reduce chronic low-grade inflammation

  1. Foods containing gluten: If you read our article on this subject you will see that gluten has been implicated in leaky gut, and so a diet high in bread, pasta and other gluten-containing foods may be contributing to low-grade inflammation and sub-sequential disease3.

  2. Pro-inflammatory fats, specifically trans-fats and omega-6 fatty acids: Trans fats are dangerous chemicals hidden in hydrogenated oils which have been implicated in inflammatory conditions4. Although there has been a concerted effort by the government to reduce trans-fats in the food chain, they are still present in foods such as salad dressings, margarine and baked items such as doughnuts, cakes and biscuits

Many foods are fried in oils high in omega-6 fatty acids. While your body needs a balance of omega-3 and omega-6, the keyword is a balance. Typically, the omega-3 to omega-6 ratio should be approximately 1:1 or 1:2; however, in most Western diets it is about 1:15. Omega-6 fats at this high of a level in the human body are pro-inflammatory, which can lead to inflammation and chronic pain.

That is the bad news, now the good - there are also many delicious foods, which can contribute to an anti-inflammatory diet:

  1. Turmeric, containing curcumin: Perhaps the daddy of all the anti-inflammatory substances. Curcumin has been linked to improvement in symptoms in various diseases including major depression5, chronic fatigue6, arthritis, cardiovascular disease and even dementia7. Many people enjoy turmeric to spice up their foods, now you know it can also spice up your health.

  2. Cold water fish: It’s probably true to say that the majority of people interested in healthy eating will know about the importance of cold water fish such as salmon, mackerel and sardines. These fish are high in the omega-3 fatty acids, EPA and DHA. Omega-3 fatty acids play a vital role in reducing inflammation through their conversion into a variety of potent anti-inflammatory compounds, which counteract the pro-inflammatory response.

  3. Flaxseed: Another source of omega-3 fatty acids. Always use ground flaxseeds as we can find it difficult to digest the whole seed. Sprinkle on soups and salads or mix with your breakfast smoothie.

  4. Dark leafy greens: Greens such as spinach, kale, and Swiss chard are high in antioxidants, minerals and phytochemicals, all nutrients that fight oxidative stress and inflammation. Leafy greens create a state of alkalinity in your body, which helps to balance out acidity known to induce inflammation.

  5. Olive oil: One of the most striking constituents in the Mediterranean diet is the high consumption of extra-virgin olive oil. Olive oil consists of the mono-unsaturated fatty acid oleic acid and is particularly rich in phenolic antioxidants which have been shown to protect against colorectal cancer, coronary heart disease, and ageing8.

Although this is just a short list of wonderful anti-inflammatory foods, the takeaway message is that a nutrient-rich diet, high in a variety of fruits, vegetables, herbs, spices and beneficial fats is one of the best ways to reduce chronic inflammation and the risk of developing a debilitating chronic illness.

How We Work

The Gut and the Immune System

It may sound strange that gut health would affect immune health but it starts to become clear when we understand that approximately 80% of the immune system is located in the gut – it’s no surprise really that food can be a major source of invaders. It seems when gut health suffers so does the rest of the body and the result for most individuals is inflammation.

A common culprit in inflammatory symptoms is leaky gut, also known as intestinal hyperpermeability. Leaky gut is a condition in which the lining of the digestive tract becomes porous, allowing undigested foods, bacteria, yeasts and other toxins into the bloodstream. This triggers the immune system to do its job and launch an attack on these toxins which, if the gut remains leaky, can cause chronic low-grade inflammation throughout the body.

Exposure to the same food magnifies the response which can lead to symptoms of discomfort, abdominal pain, gas and bloating (IBS symptoms!) and, for many people, this happens every time they eat9. Leaky gut has been associated with food hypersensitivity and in fact, in one clinical study, the severity of symptoms was related to increased intestinal permeability10

There is also a very influential third party involved and that is our gut flora, often referred to as microbiota. The research on their impact on our health and their relationship with our immune system is growing exponentially. It seems they are in constant communication with our immune system and if they become disturbed so can our immune response11. Reasons for disturbed microbiota are varied; however, if you have ever been on a course of antibiotics then your flora would have been affected and the more antibiotic courses during your lifetime, the greater the potential effect.

Most importantly, food intolerance or sensitivities need to be addressed as quickly as possible. Continuing to eat foods that can potentially damage the gut and lead to leaky gut, could be the pre-cursor for serious disease12,13.

Functional tests for food sensitivities, intolerances and allergies, as well as intestinal permeability are available and may be suggested if signs of IBS, inflammation or allergic reactions are present.

How We Work

Scientific References:
1. Ostan, R. et al. Immunosenescence and immunogenetics of human longevity. Neuroimmunomodulation 15, 224–240 (2008).
2. Allied Market Research. Anti-inflammatory Therapeutics Market is Expected to Reach $106.1 Billion, Globally, by 2020 -. PR Newswire (2015). Available at: http://www.prnewswire.com/news-releases/anti-inflammatory-therapeutics-market-is-expected-to-reach-1061-billion-globally-by-2020---allied-market-research-528652061.html. (Accessed: 13th September 2016)
3. Fasano, A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol. Rev. 151–175 (2011). doi:10.1152/physrev.00003.2008.
4. Lopez-Garcia, E. et al. Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction. J. Nutr. 135, 562–6 (2005).
5. Lopresti, A. L., Hood, S. D. & Drummond, P. D. Multiple antidepressant potential modes of action of curcumin: a review of its anti-inflammatory, monoaminergic, antioxidant, immune-modulating and neuroprotective effects. J. Psychopharmacol. 26, 1512–24 (2012).
6. Brown, B. I. in Alternative therapies in health and medicine 20, (2014).
7. Lee, K.-H. et al. A curcumin derivative, 2,6-bis(2,5-dimethoxy benzylidene)-cyclohexanone (BDMC33) attenuates prostaglandin E2 synthesis via selective suppression of cyclooxygenase-2 in IFN-γ/LPS-stimulated macrophages. Molecules 16, 9728–38 (2011).
8. Owen, R. W. et al. The antioxidant/anticancer potential of phenolic compounds isolated from olive oil. Eur. J. Cancer 36, 1235–1247 (2000).
9. Shanahan, F. & J. Whorwell, P. IgG-Mediated Food Intolerance in Irritable Bowel Syndrome: A Real Phenomenon or an Epiphenomenom[quest]. Am J Gastroenterol 100, 1558–1559 (2005).
10. Ventura, M. T. et al. Intestinal permeability in patients with adverse reactions to food. Dig. Liver Dis. 38, 732–6 (2006).
11. Kau, A. L., Ahern, P. P., Griffin, N. W., Goodman, A. L. & Gordon, J. I. Human nutrition, the gut microbiome and the immune system. Nature 474, 327–36 (2011).
12. Fasano, A. Leaky gut and autoimmune diseases. Clin. Rev. Allergy Immunol. 42, 71–8 (2012).
13. Fasano, A. & Shea-Donohue, T. Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat. Clin. Pract. Gastroenterol. Hepatol. 2, 416–22 (2005).