Acute and chronic inflammation
Author Paul Hollinrake, Researcher & Trainer in Public Health/14 March 2019
Acute and chronic inflammation. Whilst most people often discuss inflammation in a negative light, acute inflammation is a normal short-lived response. In fact, it’s a way your body protects itself from injury, trauma, surgery, infection, chemicals and allergies. The external signs of acute inflammation which can be felt or seen include heat, pain and swelling. In contrast, chronic low-grade inflammation cannot be seen as it occurs at the cellular level. This can be difficult to notice. It is this that is associated with various conditions such as diabetes, fatty liver, heart disease and some cancers. Chronic inflammation, which can last weeks, months or even years is your body’s failure to maintain homeostasis (natural balance). This can include factors such as a viral infection, the environment, poor nutrition, smoking, stress, sedentary lifestyle or obesity.
The progression of chronic inflammation which leads to ill health involves complex biological pathways which will eventually prevent normal cell function. Inflammation markers that can be tested in your blood can include C-reactive protein (CRP), homocysteine, TNF alpha and IL6, IL8.
For those of you who wish to reduce chronic inflammation through your diet, then it makes sense to eat fewer inflammatory foods and more anti-inflammatory foods. Free radicals are a result of natural metabolism but can cause issues if left unchecked. Antioxidants play a key role in regulating free radicals and keeping them under control. The goal here is to avoid processed foods and consume a diet that is rich in antioxidants. All dietary approaches should include a healthy balance of the key nutrients. These include protein, fats and carbohydrates whilst also meeting the body`s needs for vitamins, minerals, fibre and water.
Studies of the Mediterranean diet have promoted it as a healthy, anti-inflammatory diet. These studies have shown a reduction in inflammatory markers such as CRP and IL6/8. Low carbohydrate research has also had positive outcomes for reductions in inflammation in those who are obese or have metabolic syndrome.
You should consider reducing or omitting the following pro-inflammatory foods:
1. Fruit juices and drinks with added sugar
2. Processed oils, e.g. vegetable and seed oils. Trans fats: hydrogenated foods
3. Processed meat e.g. sausage, burgers, hot dogs
4. Refined carbohydrate: pasta, bread etc.
5. Desserts: ice cream, cakes
6. Alcohol: excessive consumption
7. Snacks: crisps, crackers, biscuits etc.
Anti-inflammatory nutrients and foods
Try to include more of these foods:
1. Vegetables: especially cruciferous varieties e.g. broccoli, Brussels, cabbage, cauliflower & kale. Peppers e.g. red, yellow, red and chilli
2. Fruit: the darker, deeper varieties e.g. berries, cherries
3. Healthy fats: extra virgin olive oil, avocados, olives (Antioxidants)
4. Omega-rich fatty fish e.g. salmon, mackerel, sardines, herring
5. Nuts: Natural nut butter, almonds, walnuts
6. Dark chocolate: ideally 85%
7. Green teas (EGCG)
8. Spices added to recipes: turmeric, fenugreek, cinnamon
Other lifestyle considerations
Although the main focus here has been diet related, there are other areas of your lifestyle which can have an impact on inflammation. Taking up regular exercise has shown to decrease inflammatory markers. Aim for 30 minutes per day on most days of the week and try to include at least two days of resistance training. For more information see our other blog exercise & weight loss.
Getting good quality and enough sleep is also very important. Studies have shown that a poor night of sleep increases inflammation. For more information on sleep and how to improve it please see our blog on sleep.
The immune-inflammatory system is a key response between stress and illness. It has been suggested that stress is a risk factor in many diseases. This activates inflammation in the whole body. Long term psychological stress could also have a negative influence on a person’s nutritional choices. This could lead to overeating, eventually causing excess weight issues. For overweight and obesity, the recruitment of immune cells to adipose tissue can cause inflammation. This is thought to contribute to insulin resistance. Therefore adipose tissue itself can contribute to diabetes and cardiovascular disease.
Take home message
An anti-inflammatory diet along with other lifestyle factors such as good quality sleep, exercise and stress reduction can provide many benefits such as a reduction in obesity, diabetes, heart disease and cancer. The Mediterranean and low carb diets can assist in the reduction of chronic inflammatory markers. Incorporating anti-inflammatory foods into your meal plans will lower your risk of developing a disease and improve your quality of life.
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*Flavonoids: Anthocyanins a group of phenolics which have anti-inflammatory and antioxidant properties. Others include epigallocatechin (EGCG), curcumin and quercetin.
** EPA and DHA: lipid mediators that are derived from EPA/DHA such as E and D series resolvins, protectins and maresins. They have strong anti-inflammatory actions and have important roles in resolving inflammation.