Instalment 1: The nitty-gritty

Note to the reader: most of the footnotes are references to articles in the scientific literature. These footnotes contain hyperlinks (the number at the end of each reference) to the abstracts for those articles as published in PubMed.

First, what is inflammation? Its manifestations, using the Latin terminology we learned in med school, are:

dolor (pain);

calor (heat);

turgor (swelling);

rubor (redness).

And there’s also functio laesa (loss of function).

Whether it’s an infection, a cut or scrape, or a pulled muscle, inflammation is the normal response of the body to injury, infection, or irritation, and helps keep injury from getting worse, or infection from spreading; it’s part of the healing process. This is called acute inflammation.

But too much inflammation, or for too long, or inflammation when it’s not called for, is a huge problem for some. We can call this chronic inflammation. For example, the inflammation due to autoimmune disorders like rheumatoid arthritis or ankylosing spondylitis can result in joint deformities, while other autoimmune conditions such as SLE (systemic lupus erythematosus) cause pain, fatigue, and issues with internal organs. Some are life-threatening!1

In addition, many experts believe that chronic inflammation is the cause of other important disorders such as cancer, dementia, and type 2 diabetes. And possibly depression and anxiety! So keeping inflammation under control is vital for feeling good and for staying healthy!

What causes inflammation?

We won’t discuss acute inflammation, as that is normal and self-limiting. So from here on in, we will talk only about chronic inflammation, which typically lasts for months or years. An important cause is autoimmune disorders, of which there are at least 80. These likely have a genetic component, but may be triggered by infection or something in the environment. According to Wikipedia, “Some common diseases that are generally considered autoimmune include celiac disease, diabetes mellitus type 1, Graves’ disease, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus”.

Allergic reactions, which are excessive inflammatory responses to otherwise harmless substances in the environment, can also be chronic if the environment exposure is longterm. For example, asthma, eczema, and allergies to some foods such as milk-protein allergy. Again, genetics may be important.

Then there are chronic infections, such as hepatitis C, HIV/AIDS, Lyme disease, or periodontal disease.

And let’s not forget chronic irritation. Normal joints have cartilage and synovial fluid for lubrication and move painlessly, but joints damaged from overuse (as in osteoarthritis) cause irritation when moved; this irritation results in chronic inflammation (ie, pain, swelling, and loss of function).

Bottom line: chronic inflammation has many possible causes, and can cause serious dis-ease. So, reducing and controlling inflammation can improve our lives, often in marked fashion!

Do-it-yourself approaches to controlling inflammation

If a specific cause for chronic inflammation can be identified and if there is a way to reduce or eliminate the cause, go for it! But finding the cause is often difficult. When there is no specific treatment, doctors may suggest nonspecific anti-inflammatory medication, including steroids and a variety of NSAIDs (Non-Steroidal Anti-Inflammatory Drug) such as ibuprofen, aspirin, or naproxen. Unfortunately, medications have side effects, and are often only partially effective.

Are there other ways to keep inflammation under control? For those of us who are committed do-it-yourselfers, I will offer some tips that I know will help because they are based on good science. As they involve our diet, our behaviour, and to some extent our environment, these tips are by and large easy and inexpensive to implement.

And because there are lots of people and companies out there offering treatments and remedies, generally because they hope to get your money, I will also offer some suggestions on how to evaluate those treatments and remedies, again based on good science.

How to identify strategies that reduce inflammation

How do I go about finding strategies to reduce inflammation? It’s relatively straightforward, and I believe you can use the same approach yourself.

Let’s first discuss the role of insulin and its less-well-known cousin, IGF-1 (Insulin-like Growth Factor one). Insulin is supremely important for our very existence. Children with type 1 diabetes, whose pancreases produce no insulin, will lose weight and starve to death unless treated with insulin, no matter how much food they consume.

So, insulin and IGF-1 are essential for us to grow up, put on weight, and be able to have children.

On the other hand, there’s good reason to believe that insulin stimulates cancer, dementia, obesity, heart disease, type 2 diabetes, and… inflammation!2

How is that possible? How can insulin be necessary AND deadly at the same time? It’s all in the timing. What’s good for us when we’re young, becomes “bad” when we’re old for us as individuals. But evolution doesn’t care about us as individuals; it’s all about the genome. And evolution wants older people to get out of the way so that the youngest generation (with the fittest genome) can better survive. So evolution came up with using insulin as a way to knock older animals off, by having insulin stimulate all the conditions of aging such as cancer, dementia, cataracts, arthritis, and so on. All inflammatory conditions! Because in the wild, developing any of these conditions means getting eaten!

Why insulin, though? Because insulin is stimulated by diet. Having plenty to eat means appreciable amounts of insulin, but when food is scarce, insulin levels drop. And under these conditions, animals will be healthier and live longer. Because evolution wants those animals to survive and wait out the bad times, and put off reproducing until food again becomes plentiful.

So, in order to keep inflammation under control, we need to keep insulin levels low. When we are successful at doing that, we are also reducing our risk of cancer, dementia, obesity, heart disease, type 2 diabetes, … Whoah, I think I’m repeating myself!

So, I can simply search the biomedical science (pubmed is your friend) to identify foods, drinks, medications, or behaviours which lower insulin and/or IGF-1 levels. Useful starting points in such a search are interventions effective against overweight or type 2 diabetes, including traditional or folk medicine approaches. Furthermore, looking at the diets and behaviours of cultures or groups which experience low levels of cancer, dementia, obesity, type 2 diabetes, etc. may give us further strategies. Finally, because insulin and IGF-1 promote conditions of aging, the diets and behaviours of populations with high proportions of centenarians, eg the so-called “blue zones” are also likely to reduce insulin/IGF-1. And, probably most fruitful of all, laboratory studies of ways to increase healthy longevity.

Please read instalment 2 to learn about what I’ve found!

  1. Some other common diseases that are generally considered autoimmune include celiac disease, diabetes mellitus type 1, Graves’ disease, inflammatory bowel disease, multiple sclerosis, and psoriasis.
  2. Garcia-Leme J, Fortes ZB, Sannomiya P, Farsky SP. Insulin, glucocorticoids and the control of inflammatory responses. Agents Actions Suppl. 1992;36:99-118. PMID 1609656

2 thoughts on “Instalment 1: The nitty-gritty

  1. Pingback: DIY: Inflammation –

  2. Lynda Cherry

    Hi Henry

    I have to ‘fess up I have only started to read your installments and may take some time to get through. So my first question relates to limiting fruit. Given what you wrote in Instalment 1 is the elimination of fruit related to the sugar content and thus stimulation of insulin? Also, you may have comments in subsequent postings but where are your thoughts on intermittent fasting?

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