Chronic inflammation

Although an inflammatory response is an important part of a healthy immunity, persistent low-grade increased chronic inflammation is associated with symptoms such as fatigue, lack of motivation, joint pains, prostatitis, breast pain, abdominal bloating and wind consistent with irritable bowel disease. Over the long term chronic inflammation in the body is associated with an increased increase risk of early death and a large number of age-related diseases including:

• Dementia
• Arthritis
• Cancer
• Macular degeneration (poor vision)
• Heart disease & stroke
• Type two diabetes

 

Why do our bodies develop a state of chronic inflammation?

Our bodies think it is under constant attack from chemicals in our diet and our environment. In addition, a typical western type diet is low in the essential micronutrients to building a healthy immunity. Coupled with other lifestyle factors such as obesity and lack of exercise, excess stress is put on our immune pathways and it starts to dysfunction. This ailing immune system, tries to maintain immunosenescence by increasing NF-kappa B signalling which in turn increases inflammatory markers such as Interleukin (IL)-2,  C reactive protein, Tumour Necrosis Factor (TNF), IL-6 and cox-2. These cytokines and acute phase proteins  increase concentrations of NK cells and T cells which try to reject these environmental compounds. Unfortunately, these chemicals also regulate more than 150 genes involved in mechanisms of cell survival, inflammation and cancer development.

 

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What can we do to reduce chronic inflammation in our body?

Several self help lifestyle factors have been shown, with time and persistence, to reduce inflammation

[see references]. Here is a summary of the most important factors:

1. Reduce exposure to harmful chemicals:

Smoking: It almost goes without saying, that smoking is one of the most sure-fire ways to ingest hundreds of harmful chemicals into our bodies. Some have direct carcinogenic properties other trigger an inappropriate inflammatory response – See tips to quit smoking

Cosmetics and gels: Some cosmetics, gels, deodorants and soaps contain potential harmful chemicals. These include the pro-oestrogenic parabens and aluminium compounds. Although each item contains only small amounts, they are often taken frequently and over long periods – more about xenoestrogens

Diet: There are hundreds of potential carcinogens in our diet. The most common ones are acrylamides (AA) generated through high temperature cooking of carbohydrates. Polycyclic or aromatic hydrocarbons from smoked, burnt, grilled or barbecued foods. Allylaldehyde (acrolein), butyric acid, nitropyrene, benzpyrene nitrobenzene and other nitrosamines, from heated fats and oils. Polychlorinated biphenyls PCB’s, Polycarbonate plastic bottles including babies bottles, food containers and plastic film. Try to avoid regular consumption of heavily processed foods, containing high concentrations of artificial colourings and favourings. General tips include:

• Avoid reheating fats and oils.
• Avoid super heated snacks such crisps, chips and roasted or baked bars.
• Reduce aromatic hydrocarbons exposure by avoiding smoked, barbequed or burnt foods.
• Limit foods with high AA concentrations to small amounts.
• Try eating as much raw (healthy) food as feasible.
• Try eating more organic foods

 

2. Regular exercise:

Exercise is known to enhance natural killer cell activity and increase T-cell production reducing the need for the immune system to compensate by increasing circulating inflammatory biomarkers.  Studies  involving overweight and normal sized people found that leisure-time physical activity was inversely associated with lower prostaglandin-2 concentrations. Overweight individuals (BMI >25 kg/m2) also had increased mucosal concentrations but most importantly, an increase in activity level was associated with a 28% decrease in mucosal PGE2 even before weight loss. This was confirmed in another study from Italy subjects with type 2 diabetes and the metabolic syndrome, which showed that the anti-inflammatory effects of exercise were independent to achieving weight loss.

3. Reduce processed sugar intake:

There are several laboratory studies, which show that processed sugar and carbohydrates have a high glycaemic index foods and promote chronic inflammation. This was eloquently highlighted by an experiment where half a group of mice were fed sucrose with their usual meal at comparable levels of Western diets and the other half a normal diet. The western diet led to increased expression of inflammatory markers including 12-lipoxygenase (12-LOX) and its arachidonate metabolites. Fruit although containing fructose in small amounts is very healthy. Processed sugar is particularly harmful on an empty stomach such as in the morning so its important to have a completely processed sugar free breakfast. Sugary drinks also increase the glycaemic index rapidly and pile on the calories –  tips to reduce processed sugar intake.

 

4. Increase heathy probiotic bacteria intake:

We live in harmony with millions of healthy probiotic bacteria within our bodies, particularly in our gut which help with digestion and immunity (What are probiotic bacteria?). Occasionally the balance between these friendly bacteria and harmful bacteria is upset – a good quality, multi strain probiotic supplements can help to restore this balance. Abnormal gut bacterial growth can be caused by a poor diet, recent illness, antibiotics, chemotherapy, radiotherapy and simply traveling abroad. This can lead to gut problems such as bloating, wind, colicky pains, intermittent diarrhoea and constipation typical of irritable bowel syndrome.  There are also numerous trial linking an unhealthy gut with symptoms remote from the guts such as fatigue, lack of motivation and well as chronic conditions many of the chronic inflammatory conditions listed above.

 

5. Increase phytochemical intake:

Some phytochemicals,particularly the polyphenol group have direct anti-inflammatory properties. The green tea polyphenol, epigallocatechin-3-gallate (EGCG), and quercetin found in onions have been shown to suppress activation of the NF-kappaB family of transcription factors mentioned above. Laboratory studies have shown that animals fed a broccoli rich diet had reduced also had a reduction in the activation and production of inflammatory cytokines. A study led by the School of Biological Sciences and Norwich Medical School, found that cruciferus vegetable extracts also blocked histone deacetylase (HDAC) inhibitor which improve the epigenetic expression of the genes we have been born with. Many dark green vegetables and herbs such as ginger and turmeric contain natural salicylates, which block both COX-1 and 2 reducing the inappropriate production of prostaglandins. Making a fresh ginger and turmeric tea everyday is a tasty option.The Pomi-t trial showed that a purified whole food capsule reduced markers of prostate cancer progression and its ingredients (green tea, broccoli, pomegranate and turmeric) are known to have anti-inflammatory properties – read more.

 

6. Ensure an adequate plant and fish oil intake:

Omega 3, found in oily fish, seaweed, krill and some grass fed meats, is felt to have anti-inflammatory properties but taking extra amounts, in supplement form, in clinical trials has not, universally, been shown to have significant benefits. For example, fish oil supplements did not show any benefits for osteoarthritis but did for rheumatoid arthritis.  Nevertheless, it is well known from serum tests that many people in the UK are deficient in omega 3 and increasing oily fish intake to at least three times a week is certainly recommended. It may be worth measuring your blood levels with a micronutrient test. Omega 6, such as linoleic acid (LA), found in healthy nuts and vegetable oils,  is said to promote inflammation as it is a precursor for arachidonic acid.  In fact, the data indicates that high LA in the diet or circulation is not associated with higher in vivo or ex vivo pro-inflammatory responses its only low level of omega 3 which matter – read more.

7. Identify any intolerances or allergies

Food sensitivity symptoms are usually chronic and affect about 20% percent of the population. They are also sometimes referred to as delayed food allergies, and are also mediated by immune responses which increase chronic inflammation. Usually food intolerances cause bloating, wind and intermittent diarrhoea and constipation. They can also cause symptoms outside the gut such as fatigue, lack of motivation, depression and reduced brain power. They have also been linked to dementia nd parkinson’s disease. If you suspect you may have an intolerance, try to figure out causing your symptoms, start a food diary.  Record what you eat, and when symptoms occur. Then, after a week or so, look for correlations that may suggest causation. It can be up to 72 hours before a reaction occurs, so you can’t just look for an immediate reaction.
Then start a basic elimination diet by cutting out all of the foods that you think may be causing problems. the usual culprits or gluten and lactose in milk. Often you can re-introduce these foods later at lower amounts especially if you take a good probiotic supplement 

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Summary:

• If you smoke stop >tips to quit
• Cut out processed sugars – especially on an empty stomach such as in the morning >Tips to reduce intake
• Avoid dietary carcinogens such as burnt meats, processed snacks >more
• Increase intake of fresh fruit, nuts, berries and pulses >Healthy meal options
• Increase intake of healthy bacteria rich food and consider a healthy probiotic bacteria supplement >more
• Increase intake of healthy polyphenols and consider a healthy whole food purified supplement >more
• Avoid sedentary behaviour and perform a moderate exercise programme at least 3 hours a week >more

 

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References

1. Yang J et al. 2015 Sucrose-Enriched Diet Promotes 12-Lipoxygenase (inflammatory) pathway. Cancer Res; 76(1); 24–29.
2. Cooper R et al . 2005 Medicinal benefits of green tea: Review of non-cancer health benefits. J Altern Com Med;11:521–528.
3. Traka M et al 2009. Glucosinolates, isothiocyanates and human health. Phytochemistry Reviews 2009 (8), 269-282.
4. Thomas R et al 2015 Phytochemicals in cancer prevention and management BJMP 2015 (8) 2, 34-38.
5. Thomas et al. 2017 Exercise-induced biochemical changes: a scientific review.  British Journal of Sports Medicine. 10.1136/bjsports-2016-096343
6. Khansari N, et al 2009.Chronic inflammation & oxidative stress – a major cause of age-related diseases & cancer. Recent Pat Inflamm Allergy Drug Discov 3: 73-80.
7. Wolpin BM (2013) Hyperglycemia, insulin resistance, impaired pancreatic β-Cell function, and risk of pancreatic cancer. Natl Cancer Inst 105: 1027-1035.
8. Stark JR et al. (2009) Circulating prediagnostic interleukin 6 and Creactive protein and prostate cancer incidence and mortality. Int J Cancer 124: 2683-2689.
9. Ismail HA, et al (2004) Expression of NF-kappaB in prostate cancer lymph node metastases. Prostate 58: 308-313.
10. Hotamisligil GS (2006) Inflammation and metabolic disorders. Nature 444: 860-867.
11. Franceschi C et al (1995) The immunology of exceptional individuals the lesson of centenarians. Immunol Today 16: 12-16.
12. Rukavina D, Laskarin G, Rubesa G, Strbo N, Bedenicki I, et al. (1998) Age-related decline in human cytotoxic T lymphocytes and natural killer cells. Blood 92: 2410-2420.
13. Salminen A,  (2012) Phytochemicals sup- press nuclear factor-κB signaling impact on health span and the aging process. Curr Opin Clin Nutr Metab Care 15: 23-28.