The right chemistry: avoiding chronic inflammation

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Oh! You stubbed your toe. It swells quickly, heats up, becomes red and sore. You may curse, but you are actually experiencing the beginning of the healing process. “Inflammation” is the body’s attempt to correct ailments caused by physical injury, infection, or exposure to toxins. Thanks to the “acute” inflammation, you will soon be kicking again without pain. Long-term or “chronic” inflammation, however, is a different story. That can make you kick the bucket.

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As early as the 1st century AD, the Roman encyclopedist Aulus Cornelius Celsus produced a comprehensive medical work, De Medicina, in which he described the use of opiates to counteract pain, explained that fever was the body’s attempt to restore health, and introduced the tetrad of “flush (redness),” “heat (heat),” “tumor (swelling)” and “pain (pain)” as the cardinal signs of a condition we now call inflammation. Of course, the knowledge of physiology at the time was too rudimentary to offer an explanation for what was happening, but it was clear that inflammation was the prelude to healing.

Today, we know that redness is caused by the dilation of the blood vessels in the area of ​​the injury as a result of increased blood flow that can also be felt as heat because the blood is warm. The blood releases white blood cells (neutrophils) to cleanse cellular debris caused by injury, antibodies to destroy bacteria and viruses, and clotting factors that prevent the spread of infectious agents through the body. Chemical mediators of inflammation, such as histamine and cytokines, change the permeability of blood vessel walls to allow white blood cells to diffuse from the bloodstream into injured tissues. Prostaglandins rush to the scene to raise the temperature and impair microbial activity. As the fluid that carries the white blood cells enters the injured tissue in the bloodstream, it causes swelling, which in turn causes pain.

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Finally, after the white blood cells managed to devour the remains of the injured tissues and the antibodies neutralized the microbes, the healthy cells begin to multiply. The pain goes away, the swelling goes away, and the memory of the acute inflammation fades.

Now for a more disturbing scenario. Inflammation is an essential response to cope with various forms of aggression to the body, but it is not always perfectly controlled. Cholesterol deposits in the arteries, foreign substances like silica dust, and some infectious organisms can resist the body’s attempts to remove them and precipitate a continual attack by white blood cells. The immune system can also make a mistake and launch an inflammatory attack against a normal component of the body resulting in an “autoimmune disease” such as rheumatoid arthritis, multiple sclerosis, celiac disease, or type 1 diabetes. Even some specific foods or components can look like an enemy to neutralize. The result is chronic low-grade inflammation that is associated with cardiovascular disease, diabetes, and some cancers.

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Obviously, chronic inflammation is undesirable, but how do we know when it is present and what can we do about it? The inflammatory activity of white blood cells is associated with the release of chemicals into the bloodstream that can serve as inflammation markers, the main ones being interleukin 6 (IL-6), a highly sensitive C-reactive protein (hs-CRP). , fibrinogen, homocysteine, and tumor necrosis factor alpha (TNF-alpha). These markers increase with obesity, smoking, inactivity, lack of sleep, and poor diet.

The diet connection has received a lot of attention because it is an easily modifiable lifestyle factor. Based on an extensive literature search of cell culture studies, animal experiments with specific nutrients, and human epidemiological studies in which the relationship between inflammation markers and diet was determined, researchers have developed a “dietary inflammatory index (DII) “. Through a complex formula, numerical values ​​are assigned to various foods and 45 specific nutrients based on how they affect inflammatory markers. Sugar, trans fats, refined carbohydrates, omega-6 fats, red and processed meats are classified as inflammatory, while fiber, vitamin E, vitamin C, beta-carotene, magnesium and moderate intake of alcohol are anti-inflammatory. A food frequency questionnaire can then be used to calculate the anti-inflammatory effect of a specific diet.

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Not surprisingly, the typical “western” diet with its high content of red meat, whole dairy, refined cereals, and low consumption of fruits and vegetables is associated with higher levels of CRP, IL-6, and fibrinogen. In contrast, the “Mediterranean diet,” which includes whole grains, fruits, vegetables, fish, olive oil, moderate alcohol consumption, and little butter or red meat, is associated with lower levels of inflammation.

When DII scores were calculated in a study of about 5,000 adults, those who ranked in the top quarter, meaning they ate the most inflammatory foods, had much higher CRP levels than those in the bottom quartile. This indicates that a DII score can predict whether a specific diet is linked to inflammation. Even more significantly, the meta-analyzes, essentially the combination of relevant studies, found an association between a low DII score and protection against cancer and cardiovascular disease.

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Does this mean that we should all test our blood for inflammatory markers to see if we are at risk for low-grade chronic inflammation? No, unless a doctor suspects, based on the symptoms, that there may be some pathological process. Otherwise, what you would do in response to elevated scores is what we should all be doing anyway. Exercise, watch our weight, minimize highly processed foods, and emphasize whole grains, fruits, vegetables, beans, lentils, nuts, fish, and olive oil. As for the plethora of dietary supplements flooding the market with “reduce inflammation” claims, the only documented reduction will be in your bank account.

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Joe Schwarcz is Director of the Office of Science and Society at McGill University (mcgill.ca/oss). Presents The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3-4pm