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When inflammation is bad for your health

Inflammation is an essential part of our body’s defence system - our immune system - in response to threats such as injuries and infections. Inflammation which follows detection of tissue injury or an invading pathogen is an acute reaction which typically involves redness, swelling, soreness, pain and temporary lack of function - this is normal and required for healing. There are, however, cases in which inflammation is problematic: overreaction of the immune system; failure of immune system to switch off once threat subsides;  misfiring of the immune system (as in allergic reactions and autoimmune diseases); and, chronic inflammation - constant triggering of the immune system.

Chronic low-grade inflammation typically causes no symptoms and is strongly linked to numerous diseases including atherosclerotic cardiovascular disease (heart attacks and strokes), cancer, metabolic diseases and neurodegenerative diseases. Numerous studies have consistently shown that individuals with chronically elevated inflammatory markers are at a significantly increased risk of dying from these diseases as well as all-cause mortality (death from any cause).

Chronic inflammation is one of the cellular hallmarks of ageing. However, this type of silent, persistent inflammation is very much related to lifestyle and predisposing factors include: obesity, poor diet, lack of exercise, chronic stress, poor sleep, social isolation, dysbiosis and chronic infection.

Obesity and inflammation go hand in hand which is why there is such a clear association between obesity and chronic disease. Obese people have excess adipose tissue which is stored beneath the skin - subcutaneous fat - and deep within the abdomen - visceral fat. Visceral fat is not simply a store but hormonally active, producing pro-inflammatory substances which alert our immune system causing constant low-grade inflammation. The more visceral fat the more inflammation.

A poor diet - typical Western diets high in refined sugar, saturated fats, ultra processed foods and low in fibre - are associated with pro-inflammatory chemical production. From a dietary stand-point the greatest concern is overconsumption of calories - consuming more calories than we use which leads to obesity. Although certain food types, such as refined sugar and trans and saturated fats are likely to increase inflammation directly, the greatest problem is their over consumption which is most problematic. Individuals who eat diets high in refined sugar generally eat more calories and those who consume a high amount of saturated fat tend to have minimal fibre in their diet. As discussed previously fibre is an essential part of a healthy diet as it maintains a healthy gut microbiome. Disruption to this microbiome causes an imbalance in the gut which leads to gut wall dysfunctioning as an effective barrier between our internal and external environment, leading to inflammation.

We should aim for overall healthy dietary patterns rather than focussing on specific foods or food groups. Focus on a variety of fruit, vegetables, wholegrains, fish, lean protein, healthy fats, and limit refined sugars and high fat foods.

Having a sedentary lifestyle is thought to have a direct effect on inflammation that is apart from physical inactivity contributing to increased obesity. On the other getting regular exercise reduces  chronic inflammation through various mechanisms including production of anti-inflammatory molecules by our muscles. Sleep also seems to have a direct effect on systemic chronic inflammation. Even a single night of poor sleep increases inflammatory markers. Doing this regularly will out you in a state of chronic low-grade inflammation, predisposing you to a myriad of chronic diseases.

Chronic stress and social isolation are also associated with increased inflammation and both are known risk factors for the chronic diseases of ageing. Like inflammation, stress is useful in acute situations, however it becomes unhealthy when it persists in the long-term. When chronically stressed your body becomes used to having raised cortisol (stress hormone) in the blood which opens the door for increased and persistent inflammation. Additionally, chronic stress also reduces the ability of your immune system to fight off infection.

Smoking and excessive alcohol consumption are perhaps more obvious contributors to chronic stress. Beyond smoking’s causal role in a wide range of diseases, it is also a known accelerator of inflammation. Heavy alcohol drinking leads to systemic inflammation both through disruption of the gut microbiome, as discussed above, as well as by damaging cells and tissue throughout the body. Additionally, alcohol consumption tends to lead to poorer food choices over and above the excess calories in alcohol.

Repeated infection may also cause systemic inflammation when the body cannot eliminate a pathogen. A noteworthy contributor to chronic inflammation due to persistent infection is gum disease. Poor dental hygiene is linked to systemic inflammation and is known to increase risk of developing various chronic diseases including Alzheimer’s Disease and cardiovascular disease.

So how do we go about identifying whether you have low-grade chronic inflammation if there are no clear symptoms yet can have such devastating effects? There are various biomarkers one can look at to determine whether or not inflammation is present, the most common ones being high sensitivity C-Reactive Protein (hsCRP), erythrocyte sedimentation rate (ESR), ferritin and fibrinogen.

Preventing low-grade inflammation mainly comes down to lifestyle changes: avoiding excessive calorie consumption; having a diet high in fibre and low in refined sugars and saturated fats; being physically active; having good dental hygiene; getting enough, good quality sleep; managing your stress effectively; and, having positive social connections. Practising these consistently throughout our lives is key, as opposed to aiming for perfection. Being persistent with your efforts and timely monitoring (under your doctors guidance??) help create habits which help stave off the development of this chronic inflammation and the numerous chronic conditions it is associated with.

If you would like to test your personal risk factors for developing chronic diseases of ageing, and find out if you have high markers of inflammation find out more about the Longevity Annual health check and download the longevity doctor guide to healthy living.


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