You can do a lot to fight inflammation.
Your patients may not pay much attention to inflammation, but you should. It’s linked to chronic conditions as diverse as cancer, Alzheimer’s, obesity, congestive heart failure, and diabetes.
“Silent inflammation” is literally a stealth bomber, reducing your odds of living a long and disease-free life just as effectively (and as silently) as if you were breathing an invisible, odorless poison gas.
Why should you care?
If you’ve ever stubbed your toe, banged your head against a beam, or gotten a splinter or an abscess, you know what acute inflammation is. White blood cells—also known as leukocytes— mobilize to the injury site, surrounding it like an army blocking off an invading force. Specialized white blood cells called macrophages (Latin for “big eaters”) look and act like little PacMen, initiating defense mechanisms and literally swallowing up and immobilizing any invading pathogens.
These activities are collectively known as “inflammation.” And the body needs inflammatory chemicals, because the ability to mobilize them effectively is an integral part of the natural healing response.
But for most people, the inflammatory army is in overdrive while the anti-inflammatory army is underfunded.
People need inflammation to heal— it’s vital to have those white blood cells rushing to the site of an injury. But the body also needs anti-inflammatory compounds to act as correctives when there’s too much inflammation.
Inflammation and anti-inflammation forces need to be in balance, otherwise there’s trouble.
The slow killer
“Classic (acute) inflammation hurts,” says Barry Sears, PhD. “Silent (chronic) inflammation slowly kills.” In the latter case, instead of being a transient event, the inflammatory response persists over time, “like an ornery child who can’t resist picking at a scab” writes science reporter Christine Gorman.
Eventually, chronic inflammation can and will destroy tissue. Little wonder Time presciently titled a cover article in 2004, Inflammation: The Silent Killer.
Some foods, like sugar and excess vegetable oils, have the effect of turbo- charging the inflammatory production pathways, while other foods (like wild salmon with its rich content of omega 3s, and the antioxidant astaxanthin found in certain marine plants and animals) have precisely the opposite effect. This is where things get interesting from a clinical perspective.
The body makes inflammatory and anti-inflammatory compounds called eicosanoids from one source only: fat. The type of fat one consumes has a profound effect on the eicosanoid production factory. Omega-6 fatty acids, the kind found in vegetable oils like corn, safflower, soybean, and canola oil are pro-inflammatory— they’re the precursors for the inflammatory chemicals manufactured in the body. Omega-3 fatty acids, the kind found in fish, fish oil, flaxseed, chia seed, and hempseed are the exact opposite. They’re precursors for the body’s anti-inflammatory compounds.
Most researchers agree that the ideal relationship of omega-6 fatty acids to omega-3 fatty acids is about 1-to-1, the same ratio found in the diet of hunter- gatherer societies. This ratio keeps the eicosanoid production factories in harmony, with the body producing a nice balance of inflammatory and anti- inflammatory chemicals as needed.
But the ratio of pro-inflammatory fats to anti-inflammatory fats in the typical Western diet is far from ideal. It’s usually between 15- and 20-to-1.
Steps toward wellness
Fortunately, a great deal of inflammation is controllable. If patients can put out the fire within, or at least stop it from spreading, they’ll be well ahead of the game. And it all starts with food.
The plant kingdom is loaded with natural anti-inflammatories. (One example is quercetin, found in onions and apples.) Some of the anti-inflam- matory superstars that should be part of any anti-inflammatory diet are the following:
- leafy greens (e.g., spinach, chard, and kale)
- bell peppers
- Brassica vegetables (e.g., Brussels sprouts, cabbage, broccoli, and cauliflower)
- beans (all types)
- nuts and seeds
- spices (ginger, turmeric, cinnamon, cloves)
- herbs (parsley, rosemary, thyme, oregano, mint, tarragon, dill)
- tea (all types)
- red wine
- cocoa and chocolate (if low in sugar)
- flaxseed and flax oil
And wild salmon, which isn’t a member of the plant kingdom but is a great source of the two most important omega-3s found in food, as well the superstar antioxidant astaxanthin. Grass- fed beef also has omega-3 fats, as do sardines, mackerel, herring, and tuna.
Inflammation is likely to emerge as the health concern of the decade, but the good news is that you can do a great deal to combat it. Healthy whole foods, plenty of omega-3 fats, and a minimum of sugar are a great place to start.
Many supplements can help lower inflammation. Here’s a short guide to the most important ones.
Omega-3. Omega-3s are among the most anti-inflammatory substances known and should be part of everyone’s supplement program. Given the variety available in the market, it’s clear that most consumers are sold on them.
Omega-7. Omega-7 is a fatty acid found in cold-water fish as well as macadamia nuts and sea buckthorn berries. It has beneficial effects on metabolic syndrome, diabetes, weight, triglycerides, and insulin resistance. A study at the Cleveland Clinic found that omega-7s lower C-reactive protein—a marker for systemic inflammation—by 44 percent.2
Curcumin. This extract from the Indian spice turmeric has multiple benefits and is highly anti-inflammatory, while being easy to supplement. Research has demonstrated its anti-inflammatory, anti-oxidant, anti-thrombotic, and cardiovascular protective effects.3 It also reduces oxidized LDL (bad) cholesterol.4
Magnesium. Magnesium supplements are a must for those who want to protect their heart. Magnesium lowers blood pressure, helps control blood sugar, and relaxes the lining of blood vessels. And almost all dietary surveys show that Americans aren’t getting nearly enough. Because blood pressure can contribute to inflammatory lesions in vascular walls, it’s a good idea to include it in an anti-inflammatory supplement program.
Resveratrol. Resveratrol is the ingredient in red wine that’s best known for its anti-aging properties. It helps protect the arteries, improves their elasticity, inhibits blood clots, and lowers both oxidized LDL and blood pressure.5 It’s both a strong antioxidant and an anti-inflammatory, inhibiting a number of inflammatory enzymes that can contribute to heart disease.6 The recommended dose is 200 mg a day of trans-resveratrol, the active component of resveratrol.
Methyl sulfonyl-methane (MSM). This is a natural anti-inflammatory that blocks the transmission of pain signals in nerve fibers. It’s known as being great for joint health and reducing the pain of arthritis. The biochemical precursor to MSM—dimethyl sulfoxide—has been studied extensively for pain and inflammation.
Cocoa flavanols. Plant chemicals in cocoa known as flavanols help the body synthesize nitric oxide, which is critical for healthy blood flow and blood pressure. Nitric oxide also makes the lining of the arteries less attractive for white blood cell attachment.
Researchers in Germany found that those who ate the greatest amount of flavanol-rich dark chocolate had lower blood pressure and a nearly 40 percent lower risk of heart attack or stroke compared to those who ate little or no chocolate.
Boswellia. Boswellia is well-known for its ability to lower inflammation. A dose of 150 mg three times a day is recommended for two to three months. It has been used effectively in combination with ginger, turmeric, and ashwaganda, and proven beneficial for inflammation and pain associated with osteoarthritis and rheumatoid arthritis. BosPure is an extract that is standardized to contain more than 10 percent natural AKBA (acetyl-11-keto- β-boswellic acid), the most powerful form, and can be found in some commercial products.
Gamma-linolenic acid (GLA). This is an anti-inflammatory omega-6 fatty acid and the active ingredient in evening primrose oil, borage oil, and black currant oil.9,10 GLA seems to have a synergistic effect with the long-chain fatty acid EPA (eicosapentaenoic acid) and should be given together with omega-3 fish oil. About 1000 mg a day of GLA is recommended.
Lowering inflammation may be one of the most important things you can do for your overall health and the health of your patients. Fortunately, most of the effective tools are at your disposal.
Jonny Bowden, PhD, CNS, is a nationally known board-certified nutritionist and expert on diet and weight loss. His latest book, Smart Fat: Eat More Fat, Lose More Weight, Get More Healthy, co-written with award- winning patient educator Steven Masley, MD, will be published by Harper Collins in early 2016. He can be contacted at @jonnybowden, or through jonnybowden.com.
1 Gorman C, Park A, Dell K. “Health: The Fires Within.” Time. http://content.time.com/ time/magazine/article/0,9171,993419,00.html. Published Feb. 2004. Accessed Dec. 2015.
2 Experimental Animal Laboratory. Final report for study onCCO Technologies Oil (CCO-Oil) on the development of atherosclerosis. Department of Cardiovascular Medicine, Cleveland Clinic; 2008.
3 Wongcharoen W, Phrommintikul A. The protective role of curcumin in cardiovascular diseases. Int J Cardiol. 2009;133(2):145-51. 4 Houston M. (2002). What Your Doctor May Not Tell You About Heart Disease. New York: Grand Central Life and Style.
6 Carluccio MA, et al. Olive Oil and Red Wine Antioxidant Polyphenols Inhibit Endothelial Activation. Arterioscler Thromb Vasc Biol.
7 European Society of Cardiology. “Study shows chocolate reduces blood pressure and risk of heart disease.” http://www.eurekalert.org/ pub_releases/2010-03/esoc-ssc032910.php.
Published Mar. 2010. Accessed Dec. 2015.
8 Bowden J. (2008). The most effective natural cures on earth. Beverly, MA: Fairwinds Press.
9 Kapoor R, Huang YS. Gamma linolenic acid: an antiinflammatory omega-6 fatty acid. Curr Pharm Biotechnol. 2006;7(6):531-4.
10 Tate G1, Mandell BF, Laposata M, et al. Suppression of acute and chronic inflammation by dietary gamma linolenic acid. J Rheumatol. 1989;16(6):729-34.