How Low-Grade Inflammation Wreaks Havoc
by Buffy Owens
Inflammation has been on mind. Why? Because recently I had a ‘Lyme flare-up’ that kicked in at the start of a nearly month-long travel adventure. Now, if I’m honest, the flare-up didn't come out of the blue. There were several subtle signals that I was kicking up a bit of low-grade inflammation in the weeks before I hit the road.
A FEW OF MY TELL-TELL SIGNS
Joint & Muscle Stiffness
Digestive Issues (especially bloating)
I have to admit, I had a draft of this post sitting around for months before my departure. Perhaps if I’d taken a bit of time to read it (and publish it), I would have shifted my behavior and taken some steps to decrease the inflammation.
I’m sure you’ve heard of low-grade inflammation before. Most likely in the context of diabetes, heart disease, and/or chronic pain. The truths is these diseases are on the rise worldwide. They’re serious chronic (long-term) conditions that share some commonalities.
What does that have to do with a Lyme flare-up? Well, Lyme is smart bug. When the inflammation it’s a bit like a neon light flashing for Lyme to come out and play. Basically — and you’ll get this if you have an autoimmune disease — my risk bucket is filling up.
What are the commonalities?
For one thing, diabetes and heart disease are both considered “lifestyle” diseases. Lifestyle diseases tend to occur in people with certain lifestyle habits (i.e., not-so-awesome nutrition and exercise habits, etc.). And chronic pain is linked to both of these “lifestyle” diseases. For example, the Australia Institute of Health and Welfare published a report that showed that 64.5% of people with chronic back problems also report another chronic condition. The most common chronic conditions stated were cardiovascular disease, diabetes, and chronic obstructive pulmonary disease.
While there are several links and risk factors for chronic disease and persistent pain, we’re going to focus on inflammation. We'll start by defining inflammation, and then I’ll give you some tips on how to tap into some of your lifestyle habits to shift your inflammation for the better. In fact, I used all of the strategies listed here plus intermittent fasting to reduce my inflammation while on the road.
NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.
What Is Inflammation?
Inflammation gets a lot of bad press, but it’s not always a bad thing. As in most areas of health, it’s the balance that’s important.
Inflammation is a natural process that our body uses to protect against infections, irritants, and damage. Inflammation helps our bodies eliminate damaged cells and tissues and helps them to repair. It also helps to reduce the cause of the damage, for example, by fighting the infection.
The word inflammation comes from the Latin word “inflammo,” meaning “I set alight, I ignite.”
Inflammation is a natural process to protect and heal our bodies. However, it can become self-perpetuating and stick around way longer than necessary. This long-term (chronic) inflammation is often associated with several health conditions and persistent pain.
Acute vs. Chronic Inflammation
When inflammation happens in a big way, for a short time, this is known as “acute” inflammation. Signs of acute inflammation include redness, heat, swelling, pain, and loss of function.
These short durations of active inflammation can help the body to heal injuries and infections.
When the injury heals, or the infection goes away, inflammation typically goes away too. However, sometimes, your immune system gets turned on and stays on after the "crisis" has passed.
Over time, this can damage healthy cells and organs and cause constant pain in muscles, tissues, and joints. It’s this type of inflammation linked to conditions like diabetes, heart disease, and persistent pain. It’s also linked with many other concerns related to the body, brain, and even mental health concerns.
Testing For Inflammation
Inflammation stems from the immune system’s response and also involves our blood vessels (arteries and veins) and other molecules.
One of these molecules is the infamous “free radical.” These highly reactive molecules (oxidants) help to fight infectious agents and also help cells to communicate. But, when they are in overdrive, and they aren’t counteracted with many antioxidants, they can tip the balance and cause damage to healthy cells.
There are several other inflammatory molecules, one of which can be measured with a blood test. This is C-reactive protein (CRP). CRP is considered one of the “markers” of inflammation. This “inflammatory marker,” when found in a blood test at high levels, indicate that there is inflammation in the body.
High blood levels of inflammatory markers like CRP are associated with increased risk of diabetes and heart disease. Some researchers believe that levels of inflammatory markers in the blood can actually predict whether someone is going to develop diabetes or heart disease eventually.
As I mentioned, there are several inflammatory molecules. And a lot of inflammation is not easy to detect. Some of the molecules (markers) stay localized to specific tissues and systems. Unfortunately, the more localized inflammatory markers are only detectable with complicated, expensive, invasive testing. But even then, biology is messy, and the tests are not always super reliable. Even people with severe inflammatory diseases do not always get an accurate result.
5 Tell-Tell Signs That You Have Chronic Inflammation:
Body pain, especially in the joints
Constantly feeling tired & fatigue, despite sufficient sleep
Skin rashes, such as eczema or psoriasis
Excessive mucus production (i.e., always needing to clear your throat or blow your nose)
Ongoing digestive issues: including bloating, abdominal pain, constipation, and loose stool
Chronic Inflammation & Diabetes
Diabetes is a complex condition of metabolism where our bodies don’t manage blood sugar levels very well.
Blood sugar levels naturally go up and down throughout the day. Up after we eat; and down when we’re hungry. In a person with optimal blood sugar control, when blood sugar levels get high, insulin is released. This tells our cells to absorb sugar out of the blood to level it out.
But when the control of the blood sugar levels isn’t as good, for example, when it stays too high for too long (i.e. because of insulin issues), this can lead to diabetes. And having diabetes can have many long-term health consequences like amputation, blindness, and kidney disease.
About 95% of diabetes is type 2 diabetes (T2DM), formerly known as “adult-onset” diabetes. This is because there are a whole host of nutrition and lifestyle habits, when done for years and decades, contribute to this diagnosis.
These nutrition and lifestyle habits can promote excess body fat and inflammation, and lead to an imbalance between insulin need and insulin production.
Inflammation is thought to be a key factor when it comes to diabetes. It can negatively affect insulin-producing cells. It’s also one of the causes of insulin resistance. In fact, some researchers argue that virtually all of the factors that promote diabetes are linked with inflammation.
Chronic Inflammation & Heart Disease
Heart disease is a major cause of death in countries such as Australia, the US, Canada, and the European Union.
The link between inflammation and heart disease was discovered back in 2006. The first stage of heart disease is called “atherosclerosis.” Complications of heart disease include things like heart attacks. Inflammation is a key issue linked with both atherosclerosis and heart attacks.
Atherosclerosis (hardening of the arteries) starts when there are too many “free radicals” inside the blood vessels. This can be from high blood sugar, high levels of oxidized fats in the blood (from too many free radicals), low levels of homocysteine (an anti-inflammatory molecule), etc.. These lead to damage of the inside surfaces of the blood vessels allowing buildup of plaque (including immune system cells) which increases chronic inflammation. This plaque narrows the inside of the blood vessels and can lead to complications like heart attacks. And after a heart attack, inflammation rises to even higher levels.
Research is underway specifically targeting inflammation to try to reduce heart and blood vessel injury, reduce the worsening of heart disease, and to promote healing.
Inflammation & Chronic Pain
Chronic or persistent pain is complicated and very dynamic. When it comes to inflammation, keep in mind that multiple cells are involved in the release of inflammatory mediators. The release of these mediators is part of the cell-to-cell communication that can generate pain.
Let’s take a quick look at one way chronic inflammation can contribute to persistent pain.
Specialized nerve cells play an essential role in the inflammatory process and tissue homeostasis — think muscles, tendons, ligaments, and fascia. Pain researchers describe one group of specialized neurons, the IV afferent neurons, as having the ability to “taste” the local tissue chemistry. When they taste inflammation, they are activated. When the flavor is anti-inflammatory, these neurons are inhibited or modulated.
What’s fascinating is that cells can release both pro-inflammatory and anti-inflammatory mediators and in doing so, determine the “flavor” of the tissue chemistry that is “tasted” by these specialized neurons. And nutrition can be a determining factor that generates the tissue “flavor” of inflammation.
Inflammation & Body Fat
There are different types of fat in the body, and various places fat tends to occur. Two types of fat are in the body, brown fat and white fat. The brown fat is highly vascularized, is found in the neck and shoulder regions in adults, and tends to burn energy as well as help in body temperature regulation. There is also an indication that this type of fat helps control the body’s triglycerides and cholesterol, and may reduce atherosclerosis. The most common fat in the body is the white fat, this is the stuff in the belly and is the majority of the “flab” we have.
Excess body fat, especially the white fat in the abdomen and around the internal organs, is linked with both diabetes and heart disease. In fact, excess body fat also increases the body’s need for insulin, and negatively affects insulin-producing cells.
But that’s not all.
Body fat itself can promote the activation of immune cells. The fat tissue can even produce its own inflammatory markers. This is particularly true for internal fat around the belly, liver, and heart. Plus excess body fat can change the biomechanical loading of a joint, which may accelerate degenerative joint diseases such as osteoarthritis.
But it’s the inflammation aspect of increased body fat that might explain why high levels of body fat are associated with osteoarthritis in non-weight bearing joints such as hands, where biomechanical loading isn’t weight related as it is in the knee.
Losing weight (i.e., excess body fat) reduces inflammation in belly fat as well as the rest of the body, and can help you to change the way that you move.
A Lifestyle Approach To Inflammation
There is a lot of evidence that improving nutrition and lifestyle can help many factors associated with chronic diseases, including reducing inflammation.
In fact, according to the NIH:
“People with insulin resistance and prediabetes can decrease their risk for diabetes by eating a healthy diet and reaching and maintaining a healthy weight, increasing physical activity, not smoking, and taking medication.”
“The main treatment for atherosclerosis is lifestyle changes.”
Here are several ways you can upgrade your nutrition and lifestyle.
A nutritious diet promotes health, reduces the risk of many chronic diseases, and can reduce inflammation.
Some areas that are being researched now are anti-inflammatory diets and foods.
One diet has a lot of science supporting its health promoting, emotional well-being improving, and life-extending properties. This is the Mediterranean diet. The Mediterranean diet includes a lot of vegetables, fruits, and legumes; some fish, whole grains, tree nuts, and dairy; and small amounts of olive oil, tea, cocoa, red wine, herbs, and spices. It also has low levels of red meat and salt, and a low glycemic index (it doesn’t raise blood sugar very high).
The Mediterranean diet can lower the risk of diabetes and adverse effects of obesity, even without weight loss. One of the reasons why it is thought to be because of its anti-inflammatory properties.
Foods that are often consumed in the Mediterranean diet contain substances that are both anti-inflammatory and antioxidant. Substances like polyphenols, flavonoids, pigments, unsaturated fats (including omega-3s), and anti-inflammatory vitamins and minerals like vitamin E and selenium. These foods may also help to improve insulin sensitivity, quality of blood lipids, and the gut microbiota.
Many anti-inflammatory effects of these foods have been demonstrated in a laboratory or with animals. Extra-virgin olive oil, tree nuts, and cocoa have been associated with anti-inflammatory effects, like reducing blood levels of CRP, in people.
Even when we look at individual components in a food, we should keep in mind that it’s the whole diet, with all foods and lifestyle components that help to promote health. One or two individual aspects don’t have the same effect as a holistic approach to improving overall nutrition and lifestyle.
Inflammation - Sugar & Starch
Excess sugars and starches put stress on our blood sugar levels and increase our risk of chronic diseases. They also promote inflammation in the body.
Animals who eat sweets and white bread, and drink a lot of sugar-sweetened beverages have higher levels of inflammatory markers like CRP. Studies in people also show that diets low in sugar and starch have lower than average levels of CRP.
One possible reason is that more sugar and starch may increase the production of inflammatory molecules and free radicals by giving immune cells more fuel and increase their activity.
You can upgrade your nutrition in this area by eating fewer sugars (especially “added” sugars) and starches (especially “refined” carbohydrates).
Inflammation - Dietary Fat
Some lab and animal studies show that increased levels of saturated fats can increase the production of inflammatory markers and free radicals. Meals with unsaturated fats seem to reduce the inflammatory response after the meal.
Unsaturated fats like omega-3’s from fish seem to be particularly healthful. People who eat more fish tend to have lower levels of atherosclerosis and heart disease. Why? Fish-based omega-3 unsaturated fats reduce the source of inflammation and increase the number of anti-inflammatory molecules.
Tree nuts are another excellent source of unsaturated fats and anti-inflammatory polyphenols. While nuts do contain a fair amount of fat, many studies show that people who regularly eat nuts do not tend to have a higher BMI (body mass index) or more body fat. Even adding nuts to the diet doesn’t seem to promote weight gain compared to the number of calories they contain. And that is if there is any weight gain at all, because many studies show no weight gain after adding nuts to the diet.
Why don’t fat-containing nuts promote weight gain? Several studies show an increase in the resting metabolic rate in people who eat nuts - they seem to burn more calories even when they’re not active. This may be because of the type of fat (unsaturated), protein, fiber, and/or the polyphenol content in the nuts.
You can upgrade your dietary fats by eating more fish and nuts. Fish and nuts contain unsaturated fats that have anti-inflammatory effects. They can also enhance insulin sensitivity and even improve the health of insulin-producing cells.
When it comes to fish oil supplements, many studies show a reduction in risk factors for heart disease by improving the way our bodies metabolize fats and its ability to “thin” the blood. However, fish oil supplements have mixed reviews when it comes to reducing inflammation. They can be helpful for some, but I recommend eating the fish itself.
Inflammation - Dietary Fiber
People who eat more fiber tend to have lower risks of diabetes and heart disease. There are a few ways this is thought to work, one is from reduced inflammation. This is because people who eat more fiber, fruits, and vegetables tend to have lower levels of CRP.
In fact, animal studies show that eating fiber reduces the levels of inflammatory markers and also reduces excess body fat.
This effect can be because fiber slows down the absorption of food from the body, reducing blood sugar spikes. It can also be because of its interaction with the friendly microbes in our gut.
Foods that are high in fiber include whole grains, legumes (i.e., beans and lentils), cocoa, seeds (e.g., sesame), tree nuts (e.g., almonds), avocados, raspberries, and squash.
Inflammation - Moderate Exercise
Regular exercise helps with many chronic diseases, as well as helping to reduce inflammation.
Just 20 minutes of moderate exercise (like fast walking) can stimulate the immune system in a way that creates a chain reaction of anti-inflammatory effects. In fact, regular moderate exercise tends to lower markers of systemic inflammation. In fact, one study showed that just 20 minutes of moderate exercise a day decreased inflammation markers by 12%. So remember, your workout session doesn't actually have to be intense to have anti-inflammatory effects.
The 5-Point Rating Scale of Perceived Exertion "Talk Test" by Bergland
Very Easy: You could sing a song (40 to 50 percent maximum heart rate).
Easy: You could carry on a regular conversation (50 to 60 percent).
Moderate: You could speak four- to six-word sentences (60 to 80 percent).
Hard: You could express short two- or three-word thoughts (80 to 85 percent)
Very Hard: You could grunt and use sign language (85 to 100 percent)
Like a little more oomph in your movement? People who exercise at a higher intensity tend to have even lower levels of CRP. So if your system can tolerate more intensive training, then weaving it into your lifestyle could help you to lower your CRP markers. However, if your bucket is already full, then intense training may not be for you.
Inflammation - Sleep
Both acute and chronic sleep deprivation can cause an increase in inflammatory markers in the blood.
Sleep, immune function, and inflammation share a common regulator. Our sleep is regulated by circadian rhythms, which drive hormones and other physiological changes that cause us to move back and forth along a continuum of sleep and wakefulness throughout the 24-hour day. When circadian rhythms are out of sync, so is sleep.
That said, the circadian rhythms regulate more than just our sleep patterns. They also impact our immune system, and with it, our levels of inflammation. When circadian rhythms are disrupted, so is normal immune function.
Too little & too much sleep triggers inflammation.
There is a robust body of research showing that lack of sleep raises levels of inflammation in the body. Laboratory studies have found that an acute and prolonged — 24 hours or more — sleep loss increases inflammation activity in the body. The chronic and insufficient sleep that so many people experience in their daily lives can also elevate inflammation.
But lack of sleep isn’t the only contributing sleepy factor in inflammation. It might surprise you to learn that sleeping too much can also trigger unhealthful inflammation. A 2016 study reviewed more than 70 scientific investigations into the relationship between inflammation and sleep. It found that in addition to short sleep’s adverse effects on the immune system’s inflammatory response, sleeping excessively also raised levels of key inflammatory markers, including C-reactive protein.
I encourage you to upgrade your sleep. For most adults, that’s between 7-9 hours a night. Consistently getting the right amount of sleep might help you to avoid low-grade, systemic inflammation that’s associated with aging and chronic disease.
Inflammation can be healthy if it is fighting an infection or healing a wound, but chronic inflammation is associated with many serious conditions.
There are a lot of nutrition and lifestyle issues that can contribute to chronic diseases & persistent pain. There are several ways they can do this; inflammation is just one of them.
The good news is that there are several nutrition and lifestyle factors you can utilize to reduce inflammation. These include eating fewer sugars and starches, eating more fish, nuts and dietary fiber, and getting regular exercise and quality sleep.
NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.