The Invisible Health Condition Behind Everything From Heart Disease To Erectile Dysfunction
Scan the obits and you’ll see the usual suspects listed as causes of death—heart disease, cancer, stroke, and complications from diabetes and Alzheimer’s disease.
What you won’t read about is chronic inflammation, a deep-body immune response that medical researchers are beginning to recognize as the underlying reason we develop these deadly conditions. “Most major diseases seem to have a chronic inflammatory component,” says integrative medicine expert James Dillard, M.D.
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“Evidence shows that arthritis, certain allergies, and asthma are increasing at alarming rates,” says Ski Chilton, Ph.D., a professor of physiology and pharmacology at Wake Forest Baptist Medical Center and the author of Inflammation Nation.
The dramatic upswing in these milder conditions suggests that chronic inflammation is also on the rise and that it will increasingly fuel serious diseases as well.
While the medical establishment is still trying to better understand chronic inflammation, a growing body of research is casting light on the poorly understood process and pointing us toward ways to fight it.
What the Heck Is Inflammation?
Chances are you’re already familiar with acute inflammation. This is the redness, heat, and swelling of a gum infection or a hammer-meets-thumb injury.
These reactions are triggered by the flood of white blood cells summoned by your body to surround and protect the wound.
Acute inflammation also occurs internally when you get an infection, such as pneumonia. In that event, those same white blood cells take aim at the bacteria in your tissues and bloodstream. In both cases, the heat and swelling of acute inflammation are all part of your body’s battle against the invaders that cause infection—they help speed the healing process.
Chronic inflammation is different. It happens when the white blood cells produced by your body to fight off infection don’t retreat.
Instead they attack healthy tissues and organs.
“Our own defenses literally bombard us with friendly fire,” says Peter Libby, M.D., a cardiovascular specialist at Harvard Medical School who studies inflammation.
Maybe not so friendly. When chronic inflammation runs high, you’ll start to see problems wherever you’re genetically weakest.
If that’s your arteries, you get heart disease; your joints, arthritis; your brain, Alzheimer’s disease; and so on.
“But the same process is driving all of this,” says Brent Bauer, M.D., director of complementary and integrative medicine at the Mayo Clinic.
You can stop chronic inflammation, and when you do, you’ll have a better chance of avoiding the most common causes of early death.
How Chronic Inflammation Affects Your Body
Let’s look at the impact of inflammation on heart disease, which is responsible for one in four deaths in the United States. White blood cells are constantly being produced inside your bone marrow and stored in your blood and lymphatic tissues.
These cells come in six main varieties: neutrophils, eosinophils, basophils, bands, monocytes, and lymphocytes.
When bad LDL cholesterol begins building up in your blood vessels, your immune system reacts by deploying macrophages, which are formed from monocytes.
If you suffer from chronic inflammation, however, your body over reacts, sending more white blood cells than necessary.
These hyperactive cells then literally attempt to suck up the cholesterol particles—to swallow and digest them in their acidic bellies. Soon the white blood cells become so loaded with fat that they simply die, leaving a puddle of fatty debris—but not before sending out distress flares, messenger proteins called cytokines that call in more microphages.
This insidious process happens quietly over years. “One of the most dangerous things about chronic inflammation is that you can’t feel it happening,” says Dr. Dillard.
Slowly and silently, the white blood cells that are killed in active duty help form plaque that begins to line your previously smooth arterial walls. Your blood vessels, in turn, go from soft and pliable to overloaded with fatty substances such as cholesterol—a condition called atherosclerosis.
At this point a blood clot, often protruding from a crack in the plaque, can stop the bloodflow to your heart or brain, causing a heart attack or stroke. Or the debris from one of those plaque adhesions can break free and lodge downstream, clogging the flow of blood through the artery.
“Heart disease and stroke that result from this kind of plaque buildup are a leading cause of death and disability worldwide,” says Dr. Libby.
So while the obituary may read “heart attack,” it should read, “Died from complications of chronic inflammation.”
Inflammation doesn’t just hurt your heart, of course. It also impacts your:
Brain: Mounting research indicates that inflammation in the brain contributes to depression and cognitive decline.
Joints: Chronic inflammation can lead to rheumatoid arthritis by causing joint swelling, which damages cartilage and bone.
Belly: Visceral fat, the kind that gives you a beer gut, secretes chemicals that lead to inflammation.
Why Is Inflammation Becoming More Common?
The question scientists are trying to answer now is why this immune response is becoming more common. So far, the work suggests that our modern lifestyle and diet are overwhelming our primordial immune system.
The advent of antibiotics and vaccines has us outliving the infections that used to kill us, says Dr. Libby
But living longer means more opportunities for age, genetics, and bad habits to affect our organs and arteries.
Your body interprets these stressors as trouble and calls out the cavalry of white blood cells, setting in motion a cascade of chemical reactions that can destroy healthy tissue.
“The body has a limited tool kit for responding to danger,” explains Dr. Bauer. “The immune system responds the same way, with the same white blood cells, whether it’s combating a parasite, a toxin, or a cholesterol-packed artery.”
Here’s an example. A person who eats a lot of processed and fried foods can become overweight, and the visceral fat cells—which become stockpiled in the belly and around the organs, particularly in men—start pumping out chemicals that goad the body’s immune system into action. The fat that accumulates in your abdomen is metabolically very dangerous,” says Dr. Libby. It pumps out chemicals with evil-sounding names like interleukin-6 and tumor necrosis factor, which stimulate the chemical reactions that spur inflammation.
This means you can roughly assess your risk of chronic inflammation by looking at two obvious factors: the size of your belly and the food in your diet.
If you can’t see your feet and you eat out of grease-stained paper bags and drink through straws, there’s a good chance chronic inflammation is wreaking havoc on your body right now.
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Can Reducing Inflammation Protect You From Getting Sick?
Much is still unknown, but physicians and researchers do believe it’s preventable and reversible.
“People who are less inflamed over a long period of time have far less incidence of illness,” says Dr. Dillard.
You can assess your own situation with a quick blood test that measures a liver chemical, C-reactive protein (CRP), which rises in response to inflammation.
This test, available for as little as $35, can help assess your risk of heart attack, especially if you’re younger than 60 and have a family history of heart disease.
Your doctor will explain your results, but CRP levels between 1 and 3 milligrams per liter of blood signal chronic, low-grade inflammation with an intermediate risk of heart disease. Levels above 3 milligrams indicate a high risk.
If your CRP level is above normal, your doctor might suggest that you start taking statins, such as atorvastatin (Lipitor), says Dr. Libby.
How to Fight Inflammation
Although some doctors recommend fighting inflammation with over-the-counter drugs like aspirin and ibuprofen, those drugs have not been proven effective for preventing first-time heart attacks, says Dr. Libby.
Statins, however, reduce both inflammatory markers and the risk of heart attack or stroke.
If you’re overweight, you can lower your inflammation risk by dropping a few pounds.
One study found that even a small dip in body weight reduced inflammation. Obese people who lost 3 percent of their weight showed a 10 percent reduction of MCP-1, a protein associated with inflammation.
For a 113kg man, 3 percent is a mere 4kg. “It’s best to exercise at intermediate intensity, but the good news is that you don’t have to do it for very long,” says Chilton.
He recommends that you aim to hit 65 to 80 percent of your maximum heart rate—you should be breathing hard and sweating—for a minimum of 20 minutes each day. While you’re trimming bad fat from your belly, add more good fat to your diet. Fish and olive oil deliver omega-3 and omega-9 fats, which inhibit your body’s inflammatory signals.
The Mediterranean diet delivers both of these foods, plus complex carbohydrates from vegetables and whole grains.
“There’s no anti-inflammatory eating plan that’s better tested in all of science,” says Chilton.
Cutting back on simple sugars and sweeteners like high-fructose corn syrup is another critical step in the battle against inflammation.
In one small study, men who drank 20 ounces of a sweetened beverage every day for three weeks saw their CRP levels jump by as much as 109 percent.
For your sweet-food fix, choose fruit, which contains antioxidants called polyphenols that can reduce inflammation and may make blood vessels more flexible.
In a study review published in the Journal of Agricultural and Food Chemistry, berries (which are especially rich in polyphenols, as are cherries and plums) were shown to reduce biomarkers of inflammation.
Coffee is also a good source of polyphenols.
Researchers aren’t sure why, but studies have suggested that moderate coffee consumption (one to five cups a day) may help enhance insulin sensitivity, and drinking three or more cups a day is associated with lower levels of enzymes that indicate liver damage and inflammation.
Oh, and don’t forget to brush your teeth. There seems to be a link between gum disease and heart problems, arthritis, and erectile dysfunction. If flossing makes your gums bleed, you probably have inflammation too.
Reacquaint yourself with your dentist, and practice good oral hygiene to kill the bacteria that causes gum inflammation.