‘Inflammation’ is a commonly cited, yet poorly understood, condition that is often used as a “catch-all” diagnosis by both the wellness and medical community to explain non-specific symptoms like aches, pain, fatigue, and stress. In addition, inflammation seems to be linked to an increasing number of diseases, ranging from metabolic syndrome to type 2 diabetes. But what exactly is inflammation? Can you test for it? And, most importantly, are there natural ways to neutralize the impact of inflammation? In this blog post, I’m taking a detailed look at the process of inflammation, it’s link to chronic disease, and the simple ways in which you can fight it.
A Closer Look at Inflammation
Inflammation was first described by Aulus Cornelius Celsus, a Roman encyclopedist who lived from 25 BC to 50 AD, as redness, swelling, warmth, and pain (1). This type of inflammation – termed acute inflammation – occurs when you cut yourself or bang your knee; it’s the body’s innate or inborn response to injury and is designed to heal and repair. In some instances, this type of inflammation may become chronic, with tissue death or scarring occurring as a result.
In recent years, a new type of inflammation has been recognized that doesn’t occur in response to tissue injury or infection, but rather to environment, disease, diet, and lifestyle factors. This inflammation – termed “low grade inflammation” – may affect as many as 30% of the U.S. adult population (2) and is evidenced by a subtle rise in inflammatory markers (1).
Low-grade inflammation is an active area of research given its involvement in a host of chronic diseases where it is not only an outcome of the disease itself, but often a promoter as well. For example, in heart disease, the build-up of cholesterol-rich plaque in the walls of the arteries triggers the immune system and leads to the recruitment of white blood cells. The presence of these white blood cells exaggerates the inflammatory response and results in an even greater build-up of plaque that can eventually rupture, causing the artery to become cut off from its blood supply (3). Other diseases and illnesses linked to low-grade inflammation include cancer, diabetes, cognitive illnesses like Alzheimer’s and dementia, neurological diseases, autoimmune diseases, and arthritis (4).
Can Inflammation be Diagnosed?
The most common test for inflammation is C-reactive protein (CRP or highly sensitive (hs)- CRP). This protein is produced by the liver and rises within 4-6 hours in the bloodstream following exposure to an inflammatory trigger. Due to its stability, reliability, and cost-effectiveness, it is the most practical approach for monitoring inflammation (5).
A second test that may be performed to detect inflammation is called an ‘erythrocyte sedimentation rate’ (ESR) test. This test measures the amount of time it takes for the red blood cells (the erythrocytes) to seperate from the liquid (plasma) part of the blood in a test tube. Inflammation can make this process occur more quickly and is indicative of inflammation (6).
What dietary factors lead to inflammation?
Excess calorie intake
Consistently consuming a greater number of calories than what is needed for your body can lead to weight gain and an increase in adipose (fat cell) tissue that is responsible for stimulating pro-inflammatory markers (7).
If you are at a higher weight, you may wish to speak with your doctor about screening for CRP. If low-grade inflammation is present, losing a small amount of weight (e.g. 5-10%) may be enough to resolve the inflammatory process.
To set-up your cronometer.com account for weight loss, click on your “Profile” and select your desired weight goal (a recommended, sustainable target is ½ to 1 lb per week; which will lower your maintenance calorie needs by 250-500 calories per day, respectively).
High glycemic index (GI) foods
As discussed in my previous blog, the consumption of high GI foods (e.g. white rice, white potato, white bread) results in a quick and dramatic rise in blood sugar compared to foods that are lower GI (i.e. sour dough bread, sweet potato, oat bran). Research suggests that the frequent consumption of high GI foods among those with inflammatory conditions may lead to poor clinical outcomes (9).
Saturated and Trans Fat
The link between trans fat and heart disease is well-documented and it’s been suggested that inflammation may be an underlying factor mediating this relationship (7). In contrast, the link between saturated fat and heart disease is less clear in human trails, although in vitro and animal-based studies have shown an association between saturated fat and inflammation (7).
You can track both saturated and trans fat in your cronometer.com account – aim to keep trans fat as close to 0% as possible and saturated fat to less than 10% (although a lower target may be even more beneficial (8).
Omega 6 fats
Omega 6 fats are a type of polyunsaturated fat possessing both anti and pro-inflammatory properties. Over the last several decades, there has been an increase in the consumption of omega 6 fats (through plant oils like safflower, sunflower, soybean, and corn) that has resulted in a ratio of omega 6 to 3 of 10-20:1 (an ideal ratio is considered 4-1:1; 7). This ratio has been associated with a rise in pro-inflammatory markers and may increase an individual’s risk of developing an inflammatory disease (10).
What foods fight inflammation?You can keep an eye on your ratio of omega 6 to omega 3 in the ‘Nutrient Balance’ box, found at the bottom of your diary page.
Omega 3 fats (EPA and DHA)
EPA and DHA are a type of fat found in algae and animals that consume algae (i.e. fish). These long-chain fats can also be made in very small amounts from ALA, which is found in flax, chia, hemp, soy, walnuts, and a few other plant-based foods. EPA and DHA have been shown to suppress the production of inflammatory products while simultaneously promoting those that help resolve inflammation (7).
Vitamin C is an essential nutrient that can mitigate inflammation by acting as an antioxidant. In the human body, free radicals are created as a result of a poor diet, alcohol, smoking, or exposure to environmental triggers (such as pollution). Free radicals are atoms with an unpaired electron that are very unstable and highly reactive, causing damage to DNA or other parts of the cell. Antioxidants, like vitamin C, neutralize free radicals by donating an electron, which stops damage to the human body. The best sources of vitamin C include peppers, guava, papaya, kiwi, orange, lychee, and strawberries (11).
Like vitamin C, vitamin E also works as an antioxidant in the body, scavenging for free radicals. The best dietary sources of vitamin E include almonds, sunflower seeds, wheat germ, spinach and hazelnuts (12). If you’re having a difficult time finding foods that meet your vitamin E needs, click on the “Oracle” and customize your preferences to see what food suggestions cronometer.com has.
Polyphenols are chemical components found in a variety of plants, such as fruits, vegetables, whole grains, chocolate, coffee, olive oil, and tea. Research suggests that polyphenols possess powerful anti-inflammatory properties by preventing free radical formation and decreasing the production of mediators that stimulate inflammation (7).
Pre and Probiotics
Prebiotics are the indigestible, nonabsorbable part of the plant that is fermented by the bacteria living in our gut. This fermentation process improves the healthfulness of the intestinal tract and promotes the growth of healthy bacteria. Prebiotics are naturally found in vegetables (asparagus, bananas, garlic, artichoke, leeks, onion, tomatoes), grains (barley, rye, whole grains), and roots (chicory, dandelion, elecampane), as well as fermented products (13).
Probiotics are living microorganisms (bacteria) that when consumed, exert health benefits (14). They are found in foods like yogurt and kefir, or supplements. Studies suggest that both pre and pro-biotics may have anti-inflammatory properties and they are often suggested for individuals suffering from gastrointestinal symptoms (7).
At the end of the day, it’s important to remember that inflammation is a necessary physiological process that helps our bodies to fight illness and infection. However, low-grade, uncontrolled inflammation can increase our risk for disease and lead to symptoms such as fatigue and pain. While diet plays an important role in managing inflammation, keep in mind that it is an overall dietary pattern that will have the greatest impact on our body’s inflammatory status.
Susan Macfarlane is a Registered Dietitian Nutritionist utilizing cronometer.com to help run a busy private practice in Ontario, Canada and blogs regularly for cronometer.com
- Antonelli M, Kushner I. It’s time to redefine inflammation. FASEB J. 2017 May;31(5):1787-1791. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/28179421
- Kushner, I., Rzewnicki, D., and Samols, D. (2006) What does minor elevation of C-reactive protein signify? Am J Med. 2006 Feb;119(2):166.e17-28. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/16443421
- Minihane AM, Vinoy S, Russell WR, Baka A, Roche HM, Tuohy KM, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015 Oct 14;114(7):999-1012. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/26228057
- Minihane A. Low grade inflammation [pdf]. n.d. Available from: http://ilsi.eu/wp-content/uploads/sites/3/2016/05/AM-Minihane.pdf
- Adelstein S, Baker, A, The Royal College of Pathologists of Australasia. Making sense of inflammatory markers. 2014 June. Available from: https://www.rcpa.edu.au/getattachment/7d8d8036-473e-4e15-8756-bf07e597de43/Making-Sense-of-Inflammatory-Markers.aspx
- Tidy C. Blood tests to detect inflammation. 2018 Jul. Available from: https://patient.info/health/blood-tests/blood-tests-to-detect-inflammation
- Franz M. Nutrition, Inflammation, and Disease. Today’s Dietitian. 2014 Feb;16(2):44. Available from: http://www.todaysdietitian.com/newarchives/020314p44.shtml
The American Heart Association. 2015 Aug. Available from: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations
- Buyken AE, Flood V, Empson M, et al. Carbohydrate nutrition and inflammatory disease mortality in older adults. Am J Clin Nutr. 2010;92(3):634-643. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/20573797
- Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated fatty acids. J Nutr Metab. 2012;2012:539426. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/22570770
- Dietitians of Canada. Food sources of vitamin C [pdf]. 2017. Available from: https://www.dietitians.ca/Downloads/Factsheets/Food-Sources-of-Vitamin-C.aspx
- Dietitians of Canada. Food sources of vitamin E [pdf]. 2017. Available from: https://www.dietitians.ca/getattachment/341815c0-a66a-4cdb-a6e7-33606b74d5fe/Factsheet-Food-Sources-of-Vitamin-E.pdf.aspx
- Unlock food. Prebiotics. 2018 Jan. Available from: http://www.unlockfood.ca/en/Articles/Digestion/Prebiotics.aspx
- National Center for Complementary and Integrative Health. Probiotics: In Depth. 2018 Jul. Abstract available from: https://nccih.nih.gov/health/probiotics/introduction.htm#hed2