Control Inflammation, Live Better!

As an Osteopath and Naturopath in Dubai, I often see patients who struggle with ongoing or chronic inflammation. Whether we are experiencing joint pain, recovering from an injury, trying to lose weight, or overcome chronic disease, controlling levels of inflammation throughout the body is one of the most, if not the most important consideration. Chronic inflammation is running rampant in modern society, and conditions such as heart disease, cancer,  autoimmune conditions and type 2 diabetes  are constantly rising. In addition, over the last 2 years we have seen the greatest increase in deaths from all causes since the 2^nd world war.

Our waning health has been a ticking time bomb for many years. For example, research suggests that between 1990 and 2015  global deaths related to poor metabolic health increased by 28.3%. Most recently, the global burden of metabolic disease, obesity and chronic inflammation has fuelled the fire of the pandemic, which exposed people to a much greater risk of hospitalisation and death. In addition, the impact of the ‘protective’ interventions imposed upon, such as lockdowns and novel medical interventions, are contributing to unprecedented levels of poor health, iatrogenic injuries, and death.

Our diet, lifestyle, and over dependence on pharmaceutical medications are creating a perfect storm of chronic inflammation and subsequent ill health. Diet alone is reported to be responsible for more disease than tobacco, alcohol and lack of physical activity combined. During the height of the pandemic, I wrote about the necessity for us to improve our resistance to disease through simple health behaviours. Even though the severity of the virus has now reduced significantly, statistics are showing us that our health is getting worse, and that our response was worse than the virus itself!

Life span may have increased dramatically over the last 70 years, but the gap between lifespan and health span ( number of years lived, free from illness)  is increasing. This is because we are living more of our lifespan with inflammatory chronic diseases. Research suggests that, on average, we will spend one-fifth of our lives with illness.

Fortunately, we have the power to resolve the silent epidemic of chronic inflammation that is driving our demise. By arming ourselves with widely available knowledge, and making better choices, we can reverse disease, build strong defences and significantly improve the way we feel and function.

Acute Inflammation

Acute inflammation is our body’s natural healing response to injury, infection and disease. It is our immune system’s immediate adaptive response that promotes protection, repair and recovery. A controlled inflammatory response to injury and infection is generally beneficial. The 5 fundamental signs of acute inflammation are:

• Heat
• Redness
• Swelling
• Pain
• Loss of function

Chronic Inflammation

When inflammation goes unresolved and continues for prolonged periods, it can become harmful. Chronic inflammation can result from a variety of factors including failure to eliminate the cause of acute inflammation, autoimmune conditions, and defects in cells responsible for controlling inflammation. The good news is that most of the risk factors for chronic inflammation can be improved through our behaviours. Fat loss, which is well within our control, is regarded as the most effective strategy to reduce inflammation.

Risk factors that promote ongoing inflammation include:

• Ageing
• Excess body fat
• A poor diet
• Smoking
• Reduction in sex hormones
• Poor sleep & high stress

 Common signs and symptoms of chronic inflammation include:

• Joint, muscle and body pain
• Chronic fatigue and poor sleep
• Depression & Anxiety
• Digestive issues such as constipation, diarrhea and acid reflux
• Increased weight
• Frequent infections

 Simple ways to reduce chronic inflammation

 Calorie Restriction

Fat loss is regarded as the most effective strategy to reduce low-grade chronic inflammation. To date, calorie restriction has been the most successful intervention in increasing healthy years of life, in any species ever studied. Sustainable calorie restriction is achieved by eating the right balance of protein, fibre and healthy fats to keep us satiated and satisfied. Eating around 30g of quality protein with EVERY meal will not only help to keep us satisfied, but also maintain our muscle mass, which is vitality important in weight loss, menopause and ageing.

Control Blood Glucose

Inflammation and high levels of blood glucose (hyperglycemia), are interrelated and have a causative effect on each other. Hyperglycemia is a sign of Metabolic Syndrome which afflicts 20-30% of adults globally and has been regarded as a pandemic for a number of years.

Our over consumption of processed foods, particularly refined carbohydrate, is one of the greatest contributors to hyperglycemia and subsequent metabolic disease. The main culprits are white flour, white bread, pastries, white rice, soda, pasta, breakfast cereals, and added sugars.  The most suitable carbohydrates to eat on an anti-inflammatory diet have a low glycemic load, such as non-starchy vegetables (table below), and berries.

Other simple solutions to control our blood sugar include:

• Meal Sequencing: Eating the fibre in our meals first and carbs last, has been shown to significantly reduce blood sugar levels.

• Break your fast with a high protein meal, : Most breakfast cereals cause large spikes in blood glucose due their refined wheat, corn and sugar content. Eating a savoury breakfast high in protein, fibre and healthy fats will keep us satiated for longer and regulate our blood sugar levels.

• Walk after a meal : After a meal, our blood sugar levels peak around 30-60 minutes By going for a gentle 15 min walk as soon as possible after a meal, we can supress blood sugar and insulin levels.

• Add vinegar to your diet: Consuming a tablespoon of acetic acid diluted in water, prior to, or with, meals will reduce blood glucose spikes by slowing down the release of glucose and helping our muscles soak up glucose out of the bloodstream quicker.

For more details on the above and other simple ways to improve your blood glucose levels, read ‘Glucose Revolution’ by Jessie Inchauspe.

Have an oil change

The type of fats we eat will also influence levels of inflammation. The typical western diet contains significantly more pro-inflammatory (omega 6) fats, than anti-inflammatory (omega 3) fats. Research suggests that the human diet evolved on a diet with equal amounts of omega 6 and 3 fatty acids. The typical western diet is now reported to contain an omega 6 to 3 ratio of around 16:1.

The balanced ratio of omega 6 and 3 fatty acids is critical for prevention and management of chronic disease. Avoidance of foods that are high in linoleic acid such as vegetable oils, will help reduce the production of the hormones (eicosanoids) responsible for promoting inflammation. Controlling our blood sugar and insulin levels will also help to inhibit this process.

It is important to note that a small amount of omega-6 fatty acids are essential for our health; however, it is available in many foods, and deficiency is rare. Most of the omega-6 fatty acids we consume, come from linoleic acid, and more specifically highly processed vegetable oils. Our consumption of vegetable oil is reported to have increased 20 fold over the course of the 20^th century.

A strong recommendation for reducing intake of linoleic acid, is to avoid consuming the oils below, and the processed foods that contain them.

• Sunflower oil
• Canola oil
• Peanut oil
• Canola/Rapeseed oil
• Safflower oil
• Soybean oil
• Grapeseed oil
• Cotton seed oil
• Corn oil

Partially hydrogenated oils known as trans-fats should also be avoided. Many processed, baked and fried fast foods contain trans-fats. A more detailed list of foods containing trans-fats can be seen HERE, and other pro-inflammatory foods to avoid can be seen HERE.

 Optimise your stress response

The duration and intensity of stress we experience can both reduce and increase inflammation. Evidence suggests that stress can activate inflammation in the brain as well as around the body. In general, acute stress can enhance the immune system, intense stress can over-activate the immune system, and persistent stress can suppress the immune system. The over activation of the immune system and sympathetic nervous system can lead to an imbalance of inflammation and anti-inflammation. This has been strongly implicated in conditions such as Heart Disease, Diabetes, Autoimmune conditions,  Depression, Alzheimer’s, and Parkinson’s Disease. Stress also plays a significant role in gastrointestinal conditions such as Irritable Bowel Syndrome, Inflammatory Bowel Disease and Intestinal Permeability.

A well-functioning immune system will initiate and resolve an appropriate amount of inflammation to protect us from infection, injury and disease. Autoimmune conditions such as Rheumatoid Arthritis, Hashimoto’s Thyroiditis, Psoriasis and Inflammatory Bowel Diseases, demonstrate how our immune systems can become overactive and begin to attack our own cells, rather than heal them.

Building resilience to stress should start with a focus on our perception of stress. The majority of stress we experience is psychological and always subjective. Our perception of an experience will govern the impact it has on our health. By simply perceiving a situation as a challenge rather than a threat, we can improve both our physiological and psychological responses. This requires us to consciously and deliberately appraise challenging situations as they arise. Asking ourselves the following 3 questions may help create a different perspective during a challenging experience:

• Does this situation represent a threat to my life?
• Do I have the resources to deal with the situation at hand?
• What can I learn from this experience?

An experience perceived as a threat is associated with:

• Attentional bias towards threat-related information, such as angry faces and emotionally negative words.
• Anticipation of physical harm
• Increased inflammation
• Reduced circulation around body
• Increased levels of stress hormone cortisol
• Increased levels of anxiety
• Poorer performance
• Avoidance of harm, expectation of damage/defeat
• Feelings of fear, anger, self-doubt and shame

An experience perceived as a challenge is associated with:

• Increased energy levels for enhanced physical performance
• Improved circulation around body
• Improved cognitive performance
• Hormonal responses related to growth and improved learning
• lower levels of anxiety
• Greater resilience to future experiences
• Feelings of excitement, enthusiasm, and confidence.

Protect your sleep

Both poor quality and a reduction in sleep contribute to pro-inflammatory responses. Poor sleep is associated with an increase in systemic pro inflammatory markers. Research suggests that the impact is stronger in women, and even one night of disrupted sleep can negatively affect the immune system. One of the main contributing factors to sleep related inflammation is insulin resistance, which can develop after just 3 nights of disrupted sleep. A lack of sleep contributes to unhealthy eating habits and subsequent insulin spikes, however, even with no increase in insulin release, insulin resistance can still develop as a result of poor quality sleep.

In my experience sleep improvement can be one of the hardest pillars of health to optimise. That said there are many simple and highly effective interventions that can rapidly improve sleep duration and quality. As part of my 5 Pillar Health Transformation Programme I guide clients through a personalised process to create a sleep routine that suits their lifestyle and individual preferences. For more information, get in touch HERE

Common tests for inflammation

A common blood test for systemic inflammation is a C-reactive protein (CRP) test. CRP is a substance produced by the liver in response to inflammation. High levels of CRP in the blood can be represent high levels of inflammation, however it is a non-specific blood tests and doesn’t identify where the inflammation is. CRP levels can be elevated in many conditions.

Interleukin 6 (IL-6) is a protein that helps regulate our immune response, and can be elevated in the presence of inflammation. IL-6 is not normally detected in the blood, or present in very low levels. This blood test is not as common as the CRP test but may be done in conjunction, if an inflammatory condition is suspected.

A Haemoglobin (HbA1c) blood test is not a test for inflammation but is used to detect average blood sugar levels during the previous 2-3 months. As mentioned earlier, chronic inflammation and high blood glucose create a vicious circle that up-regulate each other. HbA1c is a common test that can identify poor blood sugar regulation, which is associated with high CRP levels and chronic inflammation.

 Summary

In light of the recent rise in mortality and chronic disease, the quality of food we are eating should now be a top priority. It is time to acknowledge that our biology is at odds with our modern environments and lifestyles.  This mismatch is fuelling the smouldering fire of chronic inflammation that underlies most disease. Being chronically inflamed, overweight and medicated is quickly becoming the default state for adults, and more and more of us are sleepwalking towards a life of both physical and psychological misery. Like the analogy of the boiling frog-  our deterioration is happening so slowly and insidiously, that we continue to gradually and unknowingly compound the damage with our day to day choices, until our allostatic load ( accumulative burden of chronic stress on the body) pushes us into chronic disease.

It is easy to lay blame at the door of the behemoths such as the food, pharmaceutical and tech industries. who are over-succeeding in their quest for lifelong customers, addicted to poor quality food, pharmaceutical medications and social media.  However, we still have the autonomy and available knowledge to make informed choices that protect our health, and if we begin to make better choices, market forces may begin to make our modern environments less hazardous to navigate. For example- every food you buy in a store is a vote for more of the same.

Chronic inflammation lies at the root of all chronic disease, which is, for the most part, a consequence of our modern lifestyles. A lack of physical exertion, relentless stress, excessive use of pharmaceutical drugs, and poor quality food are hallmarks of modern life, and also the antithesis of a robust and healthy life!  To thrive in today’s world, we must firstly become aware of, and far more vigilant towards the toxic environments in which we now live. We must then value ourselves enough to apply the simple  evolutionary wisdom that has helped us thrive for time immemorial.

If we want to rid ourselves of chronic inflammation and its ensuing disease, we must start by reinforcing our own self-discipline and self-worth. By establishing a healthy and sustainable balance amongst key pillars of our health (diet, exercise, resistance to stress, mindset and recovery)- we can protect ourselves, dramatically improve our quality of life and influence the forces that are happily facilitating our demise. To make these improvements as easy, enjoyable and effective as possible, teaming up with an experienced Health Coach is an intelligent investment. A good Health Coach will show you how easy it is to live a life of balance, and robust health, whilst enjoying all the indulgences that a full life offers. For more information on how to build your fortress of health, get in touch HERE,

Take care