Base Knowledge: Inflammation
The good and bad of this important immune response--and what to do about it.
Inflammation may get a lot of bad press, but contrary to popular perception, this vital immune system function can actually be a good thing. It’s only problematic when it gets out of control.
Yet, it’s become a universal catchphrase for feeling bad. If you’re not sure what’s wrong, you can always blame inflammation, the same way folks used to fret over non-descript, olde-timey conditions like “the vapors.”
Unlike the vapors, inflammation won’t pass after a moment of repose on the settee and some smelling salts. (Actually, that’s not true. Low-grade inflammation can sometimes be caused by too much stress, so resting on the couch might be just the ticket, but I maintain that snorting ammonia probably won’t help.)
Now that I’ve tortured a few Victorian era references and offended any Charlotte Brontë fans out there, let’s learn a little more about inflammation.
The good and bad sides of inflammation.
Inflammation is a normal immune response. At its most basic, it’s a swelling caused by white blood cells gathering at an injury or infection to help fix it. Think of it like a bunch of EMTs, fire-people, and police gathering at the scene of a car accident. In some instances, like a sprained ankle, inflammation also immobilizes the injury, which can be pretty useful.
You hear the word “cytokines” thrown around a lot when inflammation is discussed. These are the little proteins that regulate inflammation—think of them as the dispatchers in our emergency services simile.
When this swelling happens for a short period of time, it’s a good thing and it’s called acute inflammation. It occurs in situations ranging from a paper cut to pneumonia and can last anywhere from minutes to a few weeks.
It can also occur during exercise. When you push your muscles, you damage them with little microtears. Immune cells arrive on the scene and repair those tears. This “exercise-induced inflammation” actually fortifies those damaged muscles to be tougher. This is why continued exercise makes you stronger, faster, or just more fit in general.
However, there’s a dark side to inflammation. Sometimes, the immune response gets triggered by something that doesn’t go away—so inflammation doesn’t stop. This is called chronic inflammation. It can spread, becoming systemic.
What causes chronic inflammation?
Even a little swelling from a pimple can become infected and turn into full-blown body-wide inflammation. This is called sepsis, and it’s one important reason to thoroughly clean little cuts (and zits).
Other times, people experience chronic inflammation due to autoimmune diseases like multiple sclerosis, rheumatoid arthritis, or lupus. In these instances, the body becomes confused and views its own tissues as foreign objects. The immune system kicks in and your body attacks itself, resulting in a destructive cycle of chronic inflammation.
Allergies and intolerances can also play a role in inflammation. In these situations, your immune system mistakes an otherwise benign substance—anything from pollen to pet dander to peanuts—for something dangerous and attacks it as it works its way through your system.
I’m not going to address managing these issues today. That said, if you have an autoimmune disease or an allergy and you’d like more information about the intersection of nutrition, exercise, and your condition, drop me a line. I’ll track down an expert—a really good one, not just some rando with initials after theirname—and feature an interview, just because you asked so nicely.
Luckily(ish), there’s a whole world of inflammation caused by factors that you can semi-control. Here are a few:
Smoking is obvious. You’re introducing all kinds of immune system-worthy toxins into your system. Alcohol is a little more controversial, but it’s safe to say that regular, excessive use can also cause inflammation.
Diet-related inflammation is typically linked to excess consumption of saturated fat, trans-fat, and added sugar.
Stress-related chronic inflammation is interesting (in my opinion, at least). At its core, stress response—called allostasis—is the fight-or-flight instinct in action—and that instinct is tough on the body. It activates all kinds of hormones and increases heart rate and blood pressure. The toll it takes requires repair—thus, inflammation.
This is fine if you’re running from a sabretooth tiger, pushing through a 24-hour mountain bike race, or pulling a kitten off a railroad track seconds before a steam engine barrels by. Once the source of stress passes, you can rest and the inflammation will pass—provided you didn’t get eaten, fall off a cliff, or become a locomotive’s hood ornament.
But the chronic stress of modern life never seems to stop—and that generates chronic inflammation.
A lack of sleep may cause inflammation. Sleep is, in a way, anti-inflammatory. When you don’t sleep, you’re not getting that benefit. You also stress your body. (See “stress” above.)
Aging can play a role in chronic inflammation. (Some wise-ass scientist dubbed it “inflammaging.” Haha.) A lot of other factors can somewhat help stave off inflammaging, so don’t lose the aforementioned sleep over it.
Obesity also plays factor in chronic inflammation because excess body fat can trigger the release of the “inflammatory mediator” white blood cells we discussed earlier. Visceral fat, or “belly fat,” is especially inflammatory. Science isn’t clear as to why this is the case.
Potential impacts of chronic inflammation.
Chronic inflammation is linked to a number of diseases, including cardiovascular and metabolic complications, various forms of arthritis, some cancers, and kidney disease. You may recognize that these are also obesity-related issues. In fact, complications associated with obesity are thought to be caused by inflammation, not the fat itself.
What to do about chronic inflammation.
Remember that there’s a difference between acute and chronic inflammation. One bad night’s sleep or one cheesecake bender isn’t going to do you in. Yes, you’ll have an inflammatory response, but it’ll pass as long as you get some rest and/or lay off the pastries for a beat.
However, if potentially damaging activities and substances occur in your life on a continued basis, that can be no bueno.
Stress and exercise.
While exercise is technically a stressor, it has a complex, Goldilocks-like relationship with inflammation.
The Baby Bear Soft Bed: Exercising just once (or on rare occasion) will cause an inflammatory response. It won’t feel good and your body probably won’t adapt. Not much good will come of it, so save yourself the 45 minutes and just run into a brick wall. You’ll feel the same afterwards either way.
The Papa Bear Hard Bed: Exercising too much, or “overtraining,” also causes an inflammatory response—and because you’re not giving yourself enough time to heal, this can lead to chronic inflammation. If you feel sore all the time, your fitness isn’t progressing, or you take a week off and experience massive gains, these are signs that you are overdoing it.
The Mama Bear Just Right Bed: Exercise on a regular basis (without overtraining) will, again, cause an inflammatory response. But it will also eventually fortify your immune system and have an anti-inflammatory effect.
To be clear, regular exercise will not suppress your healthy immune response. However, it can help control the chronic inflammation that leads to things like cardiovascular issues and type 2 diabetes.
A Harvard study from November suggests that regular exercise mobilizes “inflammation countering” immune cells called T-cells, which play a big role in muscle recovery and may also play a role in reducing chronic inflammation.
In other words, Mama Bear crushes it.
Countering chronic inflammation with food.
The foods below have pretty hefty research behind them. That said, it’s difficult to completely counter inflammatory habits by putting things in your mouth. You can eat all the leafy greens you want—but smoking can still give you cancer. You can gulp down jars of omega-3 fatty pills—but overtraining can still lead to injury.
So, absolutely, eat these foods—they will benefit you—but you need to pair that with other smart choices.
Fresh fruits and veggies are a great source of polyphenols, plant-based substances that act as antioxidants to combat oxidative stress—and thus inflammation. (If that all read like Latin to you, the links will clear things up.) Make sure that leafy greens and berries are on your shopping list.
Coffee, tea, and dark chocolate are also good sources of polyphenols. However, as much as a boy can dream, they can’t replace fruits and veggies.
Whole grains contain fiber. Last year, a Columbia study linked cereal fiber to reduced inflammation and lowered risk of cardiovascular disease.
Fatty fish contain omega-3 fatty acids. There are about a zillion studies linking omega-3s to reduced inflammation. If you’re not a big seafood fan, omega-3s are easy to supplement.
Nuts! Almonds and walnuts, in particular, seem to counter inflammation. This is probably due to the fiber, polyphenols, and unsaturated fats, as well as antioxidant minerals like magnesium and selenium.
There are other foods to consider—and I’d love for you to respond with some of your inflammation-countering faves—but at the end of the day, focus on these buzz-worthy buzzwords: polyphenols, antioxidants, fiber, and omega-3 fatty acids.
And limit saturated fat, trans-fat, and added sugar.
For many of us, chronic inflammation is simply a symptom brought on by bad choices. With a few lifestyle adjustments, we can get it under control.
But, again, don’t do it with smelling salts. That stuff is bad news.
Since introducing fruits and leafy greens into my diet, the effect they've had on the repetitive intense training – and weight – is incredible. I sometimes get worried about going back [to what I was doing before] but the results from the anti-inflammatory sources are too astonishing to even consider returning to the nutrition I once had.