Inflammation is now getting top billing as the latest health concern you should be worrying about. From avoiding so-called inflammatory foods to eating anti-inflammatory foods to treat and even cure inflammation, is there no disease that cannot be explained by our understanding of inflammation? Far from something scary, inflammation is a natural process that helps your body heal and defend itself from harm. It is only when inflammation becomes chronic that the story changes. In this podcast, I’ll explain just what exactly inflammation is, what causes it, when it is good and when it is bad, and importantly: what role diet and lifestyle habits play in inflammation.
Links referred to in the podcast
Episode transcript
To access the full episode transcript, go to the following link and select the individual podcast episode and then click on the ‘Transcript’ tab https://thinkingnutrition.buzzsprout.com
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Twitter: CroweTim
Inflammation is now getting top billing as the latest health concern you should be worrying about. From avoiding so-called inflammatory foods to eating anti-inflammatory foods to treat and even cure inflammation, is there no disease that cannot be explained by our understanding of inflammation? Far from something scary, inflammation is a natural process that helps your body heal and defend itself from harm. It is only when inflammation becomes chronic that the story changes. In this podcast, I’ll explain just what exactly inflammation is, what causes it, when it is good and when it is bad, and importantly: what role diet and lifestyle habits play in inflammation.
Links referred to in the podcast
Episode transcript
To access the full episode transcript, go to the following link and select the individual podcast episode and then click on the ‘Transcript’ tab https://thinkingnutrition.buzzsprout.com
Connect with me
Instagram: doctimcrowe
Facebook: Thinking Nutrition
Twitter: CroweTim
Hi, Tim here. Every now and then I take the opportunity to have a mini-break from putting out new episodes. But it also presents a great opportunity to dip into my back catalogue of episodes to pull out some that got a lot of listening engagement, and which are also topics that I still get asked a lot about. And for this week, it is on inflammation where I’ll explain just what exactly it is, what causes it, when it is good and when it is bad, and importantly: what role diet and lifestyle habits play in inflammation.
Inflammation is now getting top billing as the latest health concern you should be worrying about. From avoiding so-called inflammatory foods to eating anti-inflammatory foods to treat and even cure inflammation, is there no disease that cannot be explained by our understanding of inflammation? Far from something scary, inflammation is a natural process that helps your body heal and defend itself from harm. It is only when inflammation becomes chronic that the story changes. In this podcast, I’ll explain just what exactly inflammation is, what causes it, when it is good and when it is bad, and importantly: what role diet and lifestyle habits play in inflammation.
What is inflammation?
Let’s start this podcast off by defining what exactly inflammation is. Inflammation is the body's normal response to protect against infection, injury or disease. It involves several components of our immune system from the activation of white blood cells to the release of chemical inflammatory mediators.
Inflammation gets a pretty poor showing in the ‘health and wellness’ world, and while some of the negative press is justified, you should be thankful that your body is capable of going into an inflammatory state. Without inflammation, wounds and infections would never heal – that’s because inflammation is part of the body’s defence system. But here, we’re talking about acute inflammation – that’s the good type of inflammation that you want – without it, you would struggle to fight off infections and recover from injury.
So, every time your cut or burn yourself, graze your knee or sprain your ankle, the pain, redness and swelling you see is all part of the body’s inflammatory response that starts off the healing process. You would also know that this type of inflammation dies down after a short time and long-term recovery and healing takes over.
The evil cousin of acute inflammation in chronic inflammation. That’s when inflammation sticks around at a low level or over a long period of time – having detrimental effects on our health. Think of it as friendly fire from your immune system reacting to something that it perceives as a threat.
And here is a key point: unlike acute inflammation which shows up as redness, swelling and pain that you can see and feel, chronic inflammation can be invisible. It is hard to detect chronic inflammation so we have proxy measures for it like a blood test for an inflammatory marker called CRP, or C-reactive protein.
Just why chronic inflammation is bad news for your health is from a multitude of problems including a progressive shift in the type of white blood cells present at the site of inflammation, particularly the presence of macrophages. Macrophages are specialised cells involved in the detection and destruction of bacteria and other harmful organisms. In addition, macrophages can also present antigens to immune T cells and initiate inflammation by releasing molecules known as cytokines that activate other cells.
Chronic inflammation also increases platelet activation and blood clotting, depletes intrinsic antioxidants, generates free radicals and amplifies oxidative stress, delays wound healing and tissue regeneration and promotes cell ageing and premature cell death.
So, it is not too much of a stretch to say that many chronic illnesses such as heart disease, T2D and even cancer have chronic inflammation at their core. You’ll also come across it in conditions just as inflammatory bowel disease and even depression.
Causes
So, the million-dollar question: what causes inflammation? It’s a long list made up of viruses, autoimmune diseases like RA, smoking and pollution, and pathogens that the body can’t effectively repel. Ageing itself is also linked to inflammation. So too is obesity, in particular, central adiposity which has more macrophages localised in fat and thus produces more inflammatory mediators
And fun fact: Lack of sleep, especially that seen with shift work, can disrupt our circadian rhythm and alter the gut microbiota and in that way, may promote chronic inflammation. Check out my previous podcast episode number 42 on the link between poor sleep and metabolic disease.
And to stay on theme for this podcast being mostly about nutrition – a pretty poor typical Western diet high in highly processed convenience foods and added sugar and low in minimally processed plant foods has also been implicated in inflammation.
Treating
That’s the bad news out of the way. Now for the good news. Diet and lifestyle choices go a long way to treating inflammation. And for diet, what is widely considered an ‘anti-inflammatory diet’ is one high in fruits, vegetables, healthy fats, legumes, and whole grains. A Mediterranean-style diet would be one such variation of this especially when you add in fish and olive oil. And I’ll link in the show notes to a recent review paper outlining the research around the Mediterranean diet and inflammation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400632
But it doesn’t stop there:
And that last point on fibre is a big one as it’s primo fuel for our gut microbiome which is a big player in chronic inflammation especially when you consider our gut is the home to most of our immune activity.
When certain beneficial bacteria ferment fibre, they produce butyric acid that helps mediate the immune response, lower circulating inflammatory markers and improve the integrity of the gut barrier. Beneficial microbes also help fight off more inflammatory, gut-damaging microbes directly by suppressing their growth.
In fact, a recent meta-analysis published only in 2020 looked at the effects of probiotics on inflammatory markers which I’ll link to in the show notes. And the finding? Probiotics could significantly reduce blood measures of inflammation including CRP and a bunch of cytokines linked to promoting the inflammatory response including TNF-alpha and several interleukins. Interleukins are a group of naturally occurring proteins that mediate communication between cells. Interleukins regulate cell growth, differentiation, and motility. They are particularly important in stimulating immune responses, such as inflammation. https://pubmed.ncbi.nlm.nih.gov/30854594
So because of the connection between the gut microbiome and inflammation, fibre is one of the best anti-inflammatory foods you can consume. Fibre helps shape the bacterial community into a healthier, more inflammation-protective one.
Dairy
Special mention here of probably one of the most vilified inflammatory foods I’ve come across and that’s poor old dairy. Is dairy really an inflammatory food that should be on the ‘avoid’ list for everyone? I’ve always wondered how it has come to be, that over my decades in medical nutrition research, my subscription to dozens of leading medical and nutrition journals and keeping up with almost all areas of nutrition research that I’ve missed this link?
And I don’t mean an isolated study or two that shows that dairy causes inflammation. You can put a case forward for any food or nutrient causing or preventing any disease you want if you dig deep enough in the literature. I mean a consistent narrative of demonstrating inflammation seen across animal, observational and intervention studies and which outweighs studies that don’t show it or the opposite.
Where the truth lies is the opposite, and this was the topic of a published systematic review of the clinical evidence from 52 trials looking at dairy consumption and inflammation. And I’ll link to the review in the show notes. And the result? Dairy actually has a significant anti-inflammatory action which is bang on what I would expect considering the range of bioactive compounds in it linked to this and especially when you broaden it to fermented dairy foods. And no, the study was not funded by the dairy industry. https://www.tandfonline.com/doi/full/10.1080/10408398.2014.967385
It is only in people with dairy allergies (intolerances are not allergies) that you see inflammation and which should be surprising to no one. Peanuts, shellfish, eggs and so the list goes on are all ‘inflammatory’ if you have an allergy – that’s what an allergic reaction is after all. Yet just because some people have allergic reactions to peanuts, eggs or shellfish, we don’t label these as ‘inflammatory’ foods that the whole population needs to avoid.
If you don’t like milk-based foods, have ethical issues with it, or even have some tolerance issues with it – don’t eat or drink it – simple. Lots of other delicious foods to eat in the world. But don’t cut it from your diet just because of popularist woo pushed by ‘wellness’ bloggers telling you that dairy is inflammatory.
And to extend from this, you’ll come across lots of advice online about eating or avoiding certain foods because of their pro and anti-inflammatory effect. But the science is nowhere yet solid enough to really blame or hero any food as being a key inflammatory or anti-inflammatory agent. Sure, plenty of foods have been found to reduce inflammation such as turmeric, blueberries, ginger, tea, various vegetables, dark chocolate and fish – but most of the research though is from laboratory experiments as opposed to in people.
Where the research best points is into dietary patterns or themes that are linked to more or less inflammation such as a typical Western diet being in column A and a Mediterranean-style diet in column B. But all diets exist in countless variations. So it’s not that you shouldn’t believe that certain foods may be beneficial, but it’s better to focus on a whole diet and lifestyle when it comes to inflammation not just ‘hacking’ your way into it by gulping down turmeric lattes and thinking job done.
So that’s it for today’s show. You can find the show notes either in the app you’re listening to this podcast on if it supports it, or else head over to my webpage www.thinkingnutrition.com.au and click on the podcast section to find this episode to read the show notes.
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I’m Tim Crowe and you’ve been listening to Thinking Nutrition.