“Inflammation is a HOT TOPIC in Medicine.  It appears connected to almost every known chronic disease” - Dr.  Mark Hyman

The foods we eat play an integral role in either preventing or creating inflammation in the body. I frequently explain to my patients that inflammation in the body  increases pain and promotes disease. Consuming a diet high in  inflammation-causing sugar, saturated fats, and simple carbohydrates will lead to more pain and disease while a diet high in foods that are anti-inflammatory will do the opposite.  

Medical diagnoses that are due to inflammation end in “itis".  Itis is Latin for inflammation.   Examples of acute inflammation in the body:

• Appendicitis – inflammation of the appendix
• Cellulitis – inflammation of skin (due to infection)
• Colitis – inflammation of colon, may be acute or chronic
• Cystitis – inflammation of the bladder by either a bacteria or food sensitivity
• Gingivitis – inflammation of the gums, may be acute or chronic
• Pericarditis  – inflammation of the sac surrounding the heart
• Mastitis  – inflammation of the breast 

In addition, scientists now believe that inflammation plays a role in some chronic conditions:

• Cardiovascular disease  – heart attacks and strokes
• Autoimmune diseases  – lupus, hypothyroid, rheumatoid arthritis for example
• Alzheimer’s disease  – inflammation of the brain is a common  contributor
• Arthritis – inflammation of a joint or muscle (fibromyalgia)
• Gastritis – inflammation of the stomach, can lead to ulcers
• Allergies – also known by doctors as allergic rhinitis

What is Inflammation?

Inflammation results when there is imbalance in the body—in a sense, the body is internally “on fire”. During times of stress, the body produces a steroid hormone called cortisol,  in excess.    When cortisol is elevated, the body makes a inflammation causing chemical called prostaglandin E2. Chronically elevated cortisol levels turn on inflammation-causing genes which make inflammation proteins (known as TNF alpha, NF-KB, IL-1, IL-6, COX-1 and COX-2).  The  COX-1 and COX-2 enzymes are reduced by anti-inflammatory pain medications such as ibuprofen, naproxen, celecoxib (Celebrex).

Stress and Inflammation

Many events occur in our daily lives that stress our bodies. Some we have control over while others, not so much. Many of us fail to find adequate time to relax. Chronic stress can overwhelm the body and create imbalance, or disease—it also causes oxidative damage to cells, which in turn results in inflammation. Chronic inflammation initiates damage to the brain, heart, blood vessels and bones which ultimately initiates premature aging.

Foods Which Cause Inflammation

There are plenty of commonly eaten foods that cause inflammation:

• Trans-fats – Food label will say “partially hydrogenated”. Common in baked goods, non-dairy creamers. Also a the ingredient in margarine.
• French Fries and other fried foods
• Fast foods
• Soda pop and other sugar-filled drinks
• Baked goods and pastries

Other Causes of Inflammation

Food is not the only cause of inflammation. Certain lifestyle choices can also have an effect:

• Tobacco use (smoking and chewing)
• Physical inactivity
• Poor sleep or sleep-related disorders, like untreated sleep apnea
• Leaky Gut Syndrome
• Emotional stress and being unforgiving in attitude
• Physical stress
• Environmental toxins
• Obesity

Scientists now believe that inflammation is also the main cause of heart attacks and strokes.   Contrary to popular belief, more than half the people who have a heart attack or stroke have normal blood pressure and normal cholesterol. While these are important risk factors,  there must be something else contributing—it's inflammation.

Cardiovascular disease, a term that includes heart disease and strokes is responsible for more than 17 million deaths per year worldwide.  Most of these can be prevented. The Center for Disease Control (CDC) reports that in the United States, more than 610,000 deaths occur each year from heart disease.  Eastern Europe and Central Asia have some of the highest rates of heart disease in the world according to a study in the International Journal of Cardiology.  Inflammation is the primary cause in all of those regions.

Measuring Inflammation

There are a variety of blood tests that can measure inflammation:

• C-Reactive Protein (CRP) – Produced by the liver, C-Reactive Protein becomes elevated if there is tissue injury, inflammation or an infection.  Optimal level < 1 mg/L, normal level is 1-3 mg/L, and elevated level > 3  mg/L

Elevated levels of CRP increase the risk of cancer and heart disease, according to a 2017 study in the Journal  of the American College of Nutrition.  In 2008, the Jupiter study  showed cholesterol-lowering statin drugs could reduce inflammation.

• Erythrocyte Sedimentation Rate – An older but still common blood test used by doctors to measure inflammation in the body.  This test calculates the rate that red blood cells settle to the bottom of a test tube.

• Ferritin – A test ordered by doctors to measure iron levels in the body. During times of illness, ferritin level can be elevated.

• TNF-alpha – A protein made by certain white blood cells in response to inflammation in the body.  TNF-alpha is elevated in those with rheumatoid arthritis, psoriasis, and inflammatory bowel disease. There are a few drugs on the market, including  etanercept (Enbrel) and infliximab (Remicade), that target this chemical.

• Interleukin-6 (IL-6) – This enzyme is made in response to inflammation in the body. Not frequently measured by doctors

Conventional Treatment

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) –  Can be helpful.  However, side effects may include kidney disease, heart attacks, strokes and stomach ulcers.
• Acetaminophen (paracetamol, Tylenol) – When taken in large amounts, it puts extra stress on the liver

Food: The First Pathway to Reduce Inflammation

Choosing the right food to consume is one of the most important ways to prevent and  lower inflammation.  A diet rich in fruits, vegetables, and beans is key, but a variety of foods can help:

• Nuts – unsalted brazil nuts, pine nuts, almonds, cashews and walnuts.  Nuts are rich in linoleic acid, a unique, healthy anti-inflammatory omega-6 fatty acid
• Seeds – unsalted pumpkin, chia and sunflower seeds
• Fruits – organic fresh fruits
• Dietary lignans – found in flaxseed, green tea and strawberries
• Leafy greens – collard greens, spinach and kale, to name a few
• Soy products – organic tofu, edamame, miso, tempeh
• Fish – eat wild (not farm-raised) fish, but no more than once per week due to possible mercury contamination (low mercury fish options include trout, whitefish, salmon, anchovies and many more).
• Red meat – eat only grass-fed and hormone-free meat
• Olive oil – pure and virgin are rich in oleic acid, an omega-9 fatty acid, only cook with olive oil at low and medium temperatures
• Coconut oil  – ideal for cooking at high temperatures and healthier than canola oil. 
• Light sesame oil – acceptable for cooking at high temperatures, has various health benefits

These dietary changes can also help:

• Reducing dairy consumption – milk, creamer and cheese
• Limiting sugar consumption
• Eating fewer refined grains such as breads, pastries and desserts
• Increase water consumption – use BPA-free reusable water bottles in place of disposable plastic water bottles

Supplements and Herbs That Reduce Inflammation

Taking all of the following supplements is not required to see changes in reducing inflammation. However, choosing three to five can be considered—in addition to diet and lifestyle changes.

Curcumin/Turmeric – Curcumin, the active ingredient in turmeric, is also a potent anti-inflammatory herb, which can be consumed as a spice in one’s diet or taken as supplement. Curcumin can help prevent oxidation and inflammation, according to a 2016 report in the journal Disease.  Curcumin lowers IL-6, TNF-a, and NFKb. Caution  if using NSAID anti-inflammatory drugs (ibuprofen, naproxen) as bleeding risk may be increased. Suggested Dose: turmeric or curcumin, 500 mg daily up to three times per day.   

Nigella Sativa (black cumin seed oil) – A medicinal herb shown to reduce inflammation in both rheumatoid arthritis and osteoarthritis. It does so by inhibiting inflammatory chemicals called IL-1, IL-6 and nuclear factor KB.  Suggested Dose: Black Cumin Seed Oil - 200 mg daily.

Boswellia – Ayurvedic herbal supplement can help and reduce pain and inflammation markers, like CRP in rheumatoid, and reduce pain in osteoarthritis.  The resins are used to make the essential oil frankincense. Suggested  dose: Boswellia  -50 mg per day minimum.

Omega 3 Fish Oil (EPA/DHA) – Studies show that essential fatty acids help improve pain and reduce use of NSAIDs. Studies also show a reduction of joint stiffness and blood pressure when fish oil is taken daily. Suggested  dose: Omega 3 Fish Oil - 500 mg - 2,000 mg per day.

Ginger - Ginger can help reduce inflammatory markers and pain in osteoarthritis. Ginger contains a chemical called kaempferol, a natural COX inhibitor, meaning it works similar to ibuprofen and naproxen to reduce pain and inflammation. Add it to your food or consider taking a supplement. Suggested  dose:  Ginger - 25 mg per day minimum.

The above five supplements can be taken separately or taken in a combination nutraceutical supplement. 

Krill Oil  -Inflammation protein increases one’s risk for heart disease and stroke. A 2007 study in the Journal of the American  College of Nutrition demonstrated that Krill Oil consumption reduced CRP levels, or inflammation,  by almost twenty percent.  Further, a 2016 study in Archives of Medical Science confirmed  the CRP lowering benefits of Krill Oil at a dose as low as 500 mg twice per day.  Suggest dose: 500 to 2,000 mg per day.

Resveratrol – Resveratrol has been shown to have many functions, and studies show it can lower lowers TNF-alpha and CRP levels. Resveratrol is a phytonutrient—a naturally occurring, plant-based antioxidant compound found in red wine, grapes, berries and nuts. Resveratrol may be associated with delayed aging (learn more).  Suggested  dose:  Resveratrol -100-200 mg per day

Vitamin D –Vitamin D has numerous health benefits. Studies have shown that those with  higher levels of vitamin D have less inflammation and lower CRP levels.  Suggested  dose:  Vitamin D - 1,000-5,000 IU daily.

Probiotics – Studies have shown that a leaky gut, or disruption in the diversity of intestinal bacteria, increases systemic inflammation. Use of antibiotics or acid reducers, in addition to a poor diet can negatively affect gut bacteria, resulting in increased CRP.  Suggested  dose:   Probiotic 5 billion to 60 billion units daily

Flaxseed – Flaxseed and related foods have health benefits related to the heart. A 2016 study in Nutrients showed flaxseed lowers CRP in those classified as obese when compared to non- obese people. Another 2016 study showed daily consumption of up to six grams did significantly reduce blood CRP levels and inflammation. Suggested  dose: Flaxseed 1,000-2,000 mg daily. Can also be consumed as a food item.

Pycnogenol – A potent antioxidant. A 2008 study showed a reduction in CRP blood levels when taken as a supplement. Suggested dose:   Pycnogenol - 50 mg up to three times daily.

Kudzu Root – This root is native to Asia, and its name is derived from Japanese, where kuzu means "plant". Studies show the anti-inflammatory properties of this root, including lowering of  CRP. Suggested dose:  Kudzu root 750 mg twice per day

Green Tea – Green tea is one of the most consumed adult beverages in the world, second only to water and coffee. Studies have shown numerous heart and brain health benefits, in addition to an anti-inflammatory effect and lowering of CRP. Consume as a tea or Green tea supplement.

Essential Oils – Certain oils reduce inflammation when applied topically, including tea tree oil,  chamomile, frankincense, oil of oregano and ginger.

You Can Fight Inflammation

Inflammation is a serious condition that increases risk for disease. An unhealthy diet and inactive lifestyle are significant reasons people develop excess inflammation. Lifestyle changes and a healthy diet can provide major benefit in the prevention of numerous conditions. For those who suffer from arthritis, fibromyalgia, chronic allergies, leaky gut, gastritis and other chronic inflammatory conditions, supplements should also be considered when diet and lifestyle changes are not enough.

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