Inflammation Information

Very recently the word "inflammation" has shown up in popular media, medical literature, and health and lifestyle related websites across the globe. It's a hot topic right now in medicine and has linked many diseases and problems together to a common source of injury. However, there seems to be a lot of talking and explanation but the points have been severely missed by the public. In this post I hope to explain what inflammation is, what it is responsible for, what causes it, and what we can do about it. Read on....

Inflammation is the body's natural response to any injury, bacteria, virus, allergen, or anything deemed "foreign" that is in the body. The "foreign particle" concept is an important thing to understand as many structures in the body transform into a "foreign" structure once injured or degraded to a certain extent. What happens is the body attacks these foreign particles via the immune system until the particle is removed or controlled and released from the body somehow. Acute (short-term) inflammation is commonly associated with redness, heat, swelling, and pain. Remember when you sprained your ankle? Inflammation of the joint caused it to swell, get warm, and hurt. Basically inflammation causes a localized increase in bloodflow to the affected area allowing more white blood cells (immune system) and chemicals to aid in tissue repair and remodeling so you heal correctly. This only lasts for a relatively short period of time, so the long term effects on the body are minimal. Also this kind of inflammation is easily detectable, as you can feel the pain and see the swelling. However, inflammation isn't that black and white. Inflammation occurs deep within the body in organs, blood vessels, muscles, tendons, ligaments, and other internal structures. Tendonitis is inflammation, arthritis is inflammation, and so are many other common ailments. However it gets even worse. Inflammation that occurs in tissues such as the small intestine, blood vessels, heart, and other organs result in the same cascade of the immune system, however no pain is felt. Dr. Barry Sears, author of Enter the Zone and a leading researcher of inflammation, coined the term silent inflammation for inflammation that occurs within the body and can cause disease and poor health but doesn't provide any pain to let you know something is wrong. Acute inflammtion generally isn't a big problem, minus the pain and discomfort, however chronic inflammation (long term) is a real big deal and as many researchers and doctors have discovered is the root of many common diseases and health problems. So what can inflammation cause?

Inflammation is responsible for rheumatoid arthritis, tendonitis, Gout, Alzheimer's disease, type 2 diabetes, Parkinson's disease, Multiple Sclerosis, cataracts, autoimmune diseases, many types of cancer, heart disease, osteoarthrits, and other pathologies including shin splints! Wow, is there anything inflammation can't do? It is the opinion of this author that inflammation occurs in pretty much every disease and pain that we human encounter. Like I mentioned earlier, acute inflammation isn't the real problem. In fact, we need a healthy immune system for acute inflammation to protect against infections, repair damaged tissue, and to keep the body humming along nicely. However when inflammation persists for long periods of time, damage to the cells within the body occurs. Damage to the cells over extended periods of time (chronic inflammation) can cause dysfunction of the organ, tissue, joint, or even cell. Let's take Multiple Sclerosis, for example. Inflammation of the myelin sheath (tissue that surrounds nerve cells) causes neurodegeneration (nerve damage) which results in a slowing down or even stoppage of nerve impulse transmission via the nerves. The end result is a loss of function from the nerve and the resulting tissue that ther nerve innervates. Say hypothetically that an effected nerve innervated a foot extensor. Once the inflammation of that particular nerve got severe enough to disrupt function (transmission of electrical activity-nerve impulses) then the muscle would lose function and we could see musclular disfunction in this area. Obviously, widespread inflammation could affect more processes than this isolated example. What about cancer? Chronic inflammation, as said before, can damage cells. Damaging a cell can result in a few things, such as loss of the cell's response to growth controls, modification of cell DNA, cell death, and a host of other things. Cell death really isn't too big of a deal as other cells will usually pick up the slack, but a change in the cell's DNA and a loss of growth control can be the start of cancer. A cell that grows uncontrollably and doesn't respond to feedback from the body can be the genesis of a tumor. This is bad news obviously. The cancer-inflammation link is well documented and if you want information the internet is a great resource. Lastly, let's talk about arthritis. The literally means inflammation (-itis) of the joint (-athr). In general, athritis is an immune response misdirected to a joint. The immune system's response is often overzealous and causes pain, loss of function, and a build up of soft tissue deposits as a result of the inflammatory response. Consequently, the soft tissuse deposits that the immune system's response leaves behind are not the same as the original equipment your body came with and are easily damaged resulting in even more inflammation. And thus the cycle repeats. So what causes chronic inflammation?

Chronic inflammation can be caused by a number of things, poor biomechanics during exercise and daily activity, exposure to dietary and environmental allergens, excess body fat, persistent infections, and many more. Poor biomechanics during exercise and daily activity causes a continual injury to tissues, ligaments, and tendons. Constant microtrauma to these tissues causes the accumulation of inflammatory products in the muscle, joint, or surrounding bones and can cause tendonitis, bursitis, or athritis due to the continual improper remodeling of tissue, immune system byproducts, and the actual inflammatory response persisting over long periods of time. The continual swelling, accumulation of white blood cells, and deposition of proteins such as fibrin and immunoglobulin further prevents proper function of the injured tissue, resulting in even worse biomechanics and compensatory activity of other muscles. This can lead to strains, pain, and dysfunction, among other things. Dietary and environmental allergens are a very real problem. High blood sugar and high blood insulin levels seem to be some of the most important factors in chronic inflammation. Chronically high blood sugar as well as high blood insulin levels have a tendency to damage blood vessels, nerves, tissues, and cells with prolonged exposure. As a result inflammation occurs. In fact, food has a pretty dramatic effect on overall body inflammation. Inflammation tends to rise and fall based on the levels of certain hormones, especially eicasanoids (eye-cas-a-noids). Eiscasanoids are either pro-inflammatory (causing inflammation) or anti-inflammatory (preventing inflammation). Obviously the goal isn't to erradicate all inflammation, as then our immune system would crash, we wouldn't recover from exercise, and we'd likely go into sepsis from the first bacteria we encountered. The real goal is to keep these hormones relatively balanced while giving the edge to the anti-inflammatory eicasanoids (so more inflammation is prevented rather than caused). Pro inflammatory eicasanoids are formed when fatty acids enter a hormone pathway and get remodeled into arachadonic (a-rack-a-don-ick) acid (AA). AA is stored in fat cells as well, so the more body fat someone carries, the more inflamed they are. The catalyst for conversion to AA is insulin. The higher your insulin levels are, the more AA you produce. Conversely, the lower your insulin levels are the more anti-inflammatory eicasanoids you produce, and the less AA you produce. Obviously having more anti-inflammatory eicasanoids floating around would be beneficial to anyone, but especially those with arthritis, Alzheimer's disease, Parkinson's, cancer, MS, heart disease, or those interested in enhancing their wellness. So how do we lower insulin and prevent the conversion of fatty acids in the body to AA? Read on....

Insulin levels are controlled by what we eat, drink, and smell..yes SMELL! Ever heard the expression "I can just look at that _________(cookie, cake, pizza, etc) and gain weight!"? Turns out it may be true. Recent studies have linked simply smelling something appetizing with the pancreas releasing a bit of insulin. Insulin has a host of jobs to do, but it mainly is used for storing energy (fat) and catalyzing (speeding up) reactions in the body, for our purposes increasing the conversion of fatty acid molecules to pro-inflammatory eicasanoids. Well we can't control what we smell, and it's effect is rather small when we compare it to what we drink and eat. If you drink something with sugar, artificial sweetener, or any carbohydrate then insulin will be released at a fairly large rate. This is due to the nature of liquid food. The basic nutrients are already broken down and ready for use so the body doesn't have to process them to a very large extent. Henceforth, drinking a gatorade or soda causes a quicker and sharper insulin spike than eating a bowl or oatmeal or a potato. Remeber we want to keep insulin relatively low to avoid causing unnecessary inflammatory processes, so sugary (artificial or otherwsie) drinks should be avoided. Food-wise, civilization has been very unkind to us. Back in the 1900's the average sugar intake (from food, drink, etc) was around 4-10lbs per person a year. These days it's closer to 120-140lbs of sugar a year. Talk about a significant increase! Sugar is literally in everything. Cereal, bread, pasta, rice, etc. And those are just the refined sources. A medium sized regular potato has about 50g of glucose in it, which causes blood sugar to jump about 5x its normal level and causes a large rise in insulin levels. So instead of eating all this starch that makes up the current American diet, a shift to green leafy vegetables, nuts, seeds, lean meat, and moderate fruit intake would cause a marked lowering of blood insulin levels in most people. Fibrous carbohydrates such as those in temperate fruits and fresh vegetables cause little to no rise in insulin levels. Meats and other animal products actually tend to lower insulin levels as well as healthy fats from nuts and seeds. All of this sums up quite nicely to lower insulin and subsequently lower inflammation. Imagine being less dependent on modern medicine's medication and healthier by just choosing better food options! Also you can correct poor biomechanics and muscle activity by getting hooked up with a DFM trainer so that they can show you proper technique.

This post has gotten plenty long, and for that I apologize. However inflammation is running amok and causing serious harm to most of our community. Hopefully through the spread of knowledge and education on the subject we can start changing the lives of many. Until next time, keep working hard!

-Jordan Feigenbaum CSCS, ACSM-HFS
DFM Trainer