by Deb Brothers-Klezmer, BSN, RN-BC, CRRN, NCTMB & Wendy Midgley, MEd, RD, CDE
“To stay healthy it is necessary to reduce unnecessary inflammation.” –Mark Liponis MD, Medical Director Canyon Ranch, Lenox, MA–
“Chronic inflammation may be the engine that drives many of the most feared illnesses of middle and old age.” Diseases associated with chronic inflammation include: obesity, diabetes, gum disease, arthritis, auto-immune disorders, cardiovascular diseases, gastrointestinal disturbances, certain cancers, allergies, and more.
Inflammatory disease rates are on the rise. A lead article in the USA TODAY newspaper Friday October 22, 2010 stated: “Diabetes Cases May Double by 2050. And perhaps triple, with 1 in 3 having the disease.”
***A January 4, 2012 article in ScienceDaily.com discussed the emergence of inflammatory bowel disease as an ever increasing global disease, especially in Canada and European countries. Asian countries have lower rates but are catching up as they become more industrialized and eat more processed foods.***
Inflammation is such a key aspect in so many diseases—that the future of Medicine may even include a specialty called “Inflammology”.
WHAT is INFLAMMATION? Inflammation is a normal defensive reaction in our bodies that occurs with injury, tissue damage, infections, perceived toxic invasions (such as from chemicals, harmful bacteria, and viruses), food sensitivities and environmental allergens.
The inflammatory process entails a complex biological response that involves the vascular and immune systems and the body’s natural pharmacy of chemicals.
Inflammation can occur on outer tissue wounds that we see, as well as in internal processes that we cannot see. Typical external signs are heat, redness, swelling, pain, pus at a wound site. Typical inner signs of inflammation are chronic aches and pains, gastrointestinal disturbances, allergies, chronic rashes, fatigue.
In acute situations, inflammation saves our lives. But when inflammatory processes are in overdrive, they promote many diseases and accelerate aging.
Laboratory measures for Inflammation include: HS-CRP (high sensitivity C-reactive protein), ESR (erythrocyte sedimentation rate), white blood cell count, RF in Rheumatoid arthritis, and many more. HS-CRP is one of the most commonly studied markers. High HS-CRP levels are associated with higher risks of having a heart attack or developing type 2 diabetes.
Excessive abdominal fat is another strong indicator (marker) of inflammation. Increased waist circumference has a strong correlation to many chronic diseases (heart disease, asthma, breast cancer, and dementia) and even earlier death. Men should have a waist circumference no bigger than 40 inches. For women: no bigger than 35 inches.
Why is Inflammation “an epidemic” these days? Lifestyle habits of “modern life” are increasingly promoting body imbalances and feeding the fires of inflammation. The systems that naturally attempt to keep us healthy are being over-taxed and challenged to keep up with demands.
The Lifestyle habits in question include: poor nutrition, inadequate or excessive sleep, lack of relaxation, not enough physical activity, negative attitudes and thought processes, cigarette smoking, overindulgence in alcohol or other addictive substances, even the excessive use of prescription medications.
Are we stuck with chronic diseases and accelerated aging? Do we say: “it is simply in my genes and inevitable?” Or, can we do more about our health than we think?
Yes, we DO have a greater say in our health issues than we know. The relatively new science of EPI-GENETICS explains how factors like diet, perceived stress, physical activity, even how we talk to ourselves– can influence the expression of our genes and the DNA itself…and therefore the quality of our health. With some diseases we have a “choice aspect” —–as to whether or not we manifest them.
***YOU CAN HELP YOUR BODY FIGHT INFLAMMATION BY REDUCING STRESS, ELIMINATING SUGAR AND PROCESSED FOODS, GETTING ENOUGH SLEEP, GETTING ENOUGH SUNSHINE(but not too much), AND LAUGHING***
***According to the World Health Organization statistics: 80% of premature heart disease, stroke and type 2 diabetes is preventable; 40% of cancer is preventable.***
How can we: Choose Health, Counter inflammation, and Delete Inflammation from the Body? DO adhere to medical advice from your health care providers, but also follow these KEYS:
- If overweight or obese, lose weight and maintain a healthy weight.
2. Follow an anti-inflammatory way of eating.
According to Shereen Jegtvig (health and nutrition writer www.About.com , April 2012), some experts believe that we can decrease inflammation by choosing certain foods and avoiding others.
The advice is to: Eat fewer processed foods which are laden with chemicals, excess sodium (salt) and high fructose corn syrup. Rather: Choose more “whole, clean foods”. Eat a wide variety of colorful vegetables and fruits, and whole grains. For animal proteins: choose grass-fed beef and poultry from free-range chickens and turkeys.
Try to eat a diet that is at least 50% vegetable, to make your diet more alkaline vs acid. A high acid residue in the diet is associated with higher states of inflammation and disease processes.
- Choose a low glycemic load type, i.e., small frequent meals/snacks that combine proteins, unprocessed carbohydrates, fiber and healthy fats like olive oil. Eating this way also helps reduce insulin resistance which is associated with increased risk for type 2 Diabetes.
- Limit sugar, white flour products, processed grains, alcohol, caffeine, excessive meat and dairy. Avoid pro-inflammatory omega 6 fatty acids such as corn oil and sunflower oil. Avoid excess organ meats (for example: liver) which are high in inflammatory arachidonic acid.
- Incorporate more of Nature’s healing foods and herbs, e.g.: ginger, cinnamon, capsaicin (red-hot pepper), cilantro, rosemary, parsley, turmeric, marjoram, thyme, milk thistle tea, green tea.
- Choose healthy fats such as olive oil (extra virgin olive oil–“EVO”), which are high in monounsaturated fats.
- Include more Omega 3 fatty acids (essential fatty acids) , especially the EPA/DHA components of omega 3 supplements. Omega 3 deficiencies have been linked to immune, metabolic, cardiovascular, depression and behavioral problems. Fish such as salmon are high in omega 3’s. Flaxseed and flaxseed oil contain some omega 3’s. Natural algae supplements can provide DHA omega 3 fatty acids. Fish oil supplements provide the highest concentration of both EPA and DHA omega 3’s. Dr. Mark Hyman recommends taking 1000 mg of fish oil twice a day. He states: “the fish oil you take should contain a 300/200 ratio of EPA/DHA”.
NOTE: If you are taking medications, particularly blood thinners, check with your doctor first before starting fish oil.
3. Consider careful addition of Nutrition Supplements. Take a multivitamin/mineral that is food-based. Be careful w/excessive folic acid supplementation. Some recent studies are linking excessive folic acid intake to a rise in certain types of cancer.
- Check your VITAMIN D LEVEL. Many people are deficient in Vitamin D. Laboratory tests can determine your Vitamin D level. A PROPOSED OPTIMUM LEVEL is: 50-70 ng/mL (measured as “Total 25 OH Vitamin D”—which is the circulating form of Vitamin D in the body). (12) Some sources suggest even higher optimum Vitamin D levels.
Recommended safe supplemental levels are 1000-2000 IU Vitamin D3 per day. Many medical doctors recommend 4000 IU Vitamin D per day or higher, especially in winter months. The body manufactures some Vitamin D when the skin is exposed to sunlight. In northern climates, sun exposure is limited, so Vitamin D formation is low. The use of sun block formulas also blocks Vitamin D formation, In addition, the normal diet contains very low levels of Vitamin D.
Vitamin D levels should be monitored by periodic lab tests, if one is taking high levels of supplemental Vitamin D.
- Take a CoQ10 supplement if you are taking a statin type medication (like Lipitor or Crestor) for hypercholesterolemia. Statins DO lower “bad cholesterol” and act as an anti-inflammatory. However, they also inhibit the production of CoQ10. CoQ10 is a natural product made in our bodies. It helps muscle cells use oxygen, which is important for aerobic capacities and anti-oxidant action. The muscle fatigue and weakness (that some experience on statin medications) has a relationship to the disruption of CoQ10 production . Dr. Andrew Weil and Dr. Mehmet Oz have recommended 200 mg/day CoQ10 supplement—preferably in gel form for better absorption.
4. Heal your gut and encourage natural detoxification processes. Follow an anti-inflammatory diet as above. Eliminate food allergens and food sensitivities if present. Eat yogurt with live healthy bacteria cultures. Take probiotics if your gut is out of balance. For probiotics: It is recommended that one take a daily 6-10 billion CFUs* dosage for general health and a daily 20-40 billion CFU dosage for gastro-intestinal health issues. Even larger dosages are recommended for acute situations and to replace organisms lost in extended antibiotic treatments. *CFU= Colony Forming Units
NOTE: if you have a dairy sensitivity, make sure you purchase a probiotic that is dairy-free.
5. Improve Liver Function and Metabolism through healthy weight loss and more natural food choices. Consume fewer chemicals and medications whenever possible to decrease the liver’s work-load. Follow an anti-inflammatory diet as described above. Milk thistle tea is sometimes used as a natural herbal liver detoxifier.
6. Stay well hydrated. Eating a high intake of vegetables, raw veggie drinks, and fruits will help you stay hydrated. AVOID FRUIT JUICES which are high in sugar and high glycemic (tending to raise blood sugars quickly). In addition, drink 6-8 glasses pure water per day. Natural herbal teas and green tea also provide fluids.
7. Engage in regular physical activity. Regular exercise floods the body with “feel good” endorphins and reduces cortisol secretion. It also makes cells more sensitive to insulin and helps regulate blood sugar levels.
“Exercise regularly. It is a natural anti-inflammatory.”
Physical activity comes in many forms. Regular physical activity is recommended 5+ times per week for 30+ minutes per session.
8. RELAX and reduce stress hormone levels in the body. Possible methods to relax include: meditation, breath-work, yoga, Tai Chi, Chi gong, walking, music, sitting by the ocean, gazing from a mountain peak, losing oneself in the creative process. Set aside 15-20 minutes (or more) each day for some form of mindful relaxation.
9. GET QUALITY SLEEP. Most adults need~ 7-8 hours average per day. School age children and adolescents need 9 or more hours. TOO MUCH SLEEP has been associated with heart problems, sleep disorders, depression, stroke, weight gain, and other health problems.
In addition to the obvious physical and well-being benefits of high quality sleep, sleep also allows us to dream and nurture spiritual connectedness. (Integrative Sleep Medicine Expert Rubin Naiman, PhD)
A good night’s sleep is often interpreted by one as feeling fully rested, alert, and clear. It resets the body and brain. These feelings may be the result of the anti-inflammatory effects of sleep. A good night’s sleep can delay or prevent the inflammatory process.
***Repair of the body and immune function happen best during times of high quality sleep.***
Dr. Wendy Troxel and colleagues at the University of Pittsburgh have found that people with sleep problems such as difficulty falling asleep, fretful sleep, or loud snoring have a higher risk for chronic inflammation and putting the brain at risk for neurodegeneration.
A cascade of biochemical sequences and events happens during a good night’s sleep. Yale researchers have discovered that a specific immunity gene, TLR-9, functions best with a good night’s sleep–working in alignment with the body’s natural circadian rhythm (our “body clock.”) With high quality sleep– specific proteins called cytokines help fight inflammation and infection, and further regulate deepsleep.
To Improve Poor Sleep:
–Stay up during the day and avoid deep napping.
–Avoid evening liquids.
–Stay mellow in the evening, “wind down” for a good night’s sleep.
–Go to bed around the same time each night.
–Avoid caffeine and chocolate from late afternoon onward.
–Turn all sources of light away from you.
–Place cell phones and computers away from your head.
–Fall asleep to soothing melodies.
–Take slow, relaxing, steady breaths.
REFERENCE: Huffington Post 2/17/2012. Article: “Lack of Sleep Causes Body Clock to Alter Immune System” by Krysty Hazell
10. Don’t smoke cigarettes (nicotine). Only smoke marijuana if medically recommended.
11. Change how you talk to yourself and others. Our cells, and our DNA, like POSITIVE vs. negative WORDs and ATTITUDES.
12. Examine your BELIEFS and also be open to knowing your “hidden beliefs” about life. Modify the beliefs that no longer serve you. “Hidden beliefs can give rise to inflammatory disorders.”
13. Pay attention to your EMOTIONAL HEALTH. Anger, resentment, and burn-out are associated with the fires of inflammation. “Emotions can cause physical inflammation in a very direct sense” due to excess cortisol secretion. Those who release their emotions have may have lower inflammatory markers. In a report written by Jeanette Raymond, PhD, it was noted that Rheumatoid arthritis patients who disclosed their emotions had reduced levels of inflammation.
14. Nurture positive relationships with others.
15. Do work and service you enjoy.
16. Don’t go solo in the change process. Take classes or work with a buddy.
17. Work with Health Care Professionals, for example: nutritionists, body work specialists such as massage therapists, acupuncturists, chiropractors, physical therapists, cranial sacral therapists, personal fitness trainers. Also functional medicine practitioners, osteopaths, naturopaths, psychotherapists or lifestyle health coaches.
18. Be adventurous during the change process. Experience therapy or assessment modalities you haven’t tried before. For example: consider trying LLLT (low-level laser therapy) to treat the pain and inflammation of arthritis, neck pain, and joint disorders. Or consider infra-red (infrared radiant heat) saunas for ailments such as Rheumatoid arthritis. For anxiety and depression associated with inflammation, try using a 10,000-lux light box if you are unable to get 30 minutes of natural outdoor light each day. Although controversial, many people have experienced a reduction of inflammatory symptoms with these. (NOTE: Use of such therapies should be discussed with one’s physician).
19. Cultivate HUMOR and LAUGHTER in your daily life. Laughter releases “feel good hormones” and decreases stress levels. According to acclaimed humorist and stress expert, Loretta Laroche: we need to learn to “reframe” what we consider stress.
NOTE: IF you want to stop inflammation, get off the couch and fill at least 60% of your supermarket basket with foods from Mother Earth. And try not to stub your toe along the way!!! And:
Remember Loretta LaRoche’s famous quote from her book title:
“Life is not a stress rehearsal.”
Clear out inflammation and be vibrantly well!!!
The Wellness Shifter Ladies!!!
Wendy and Deb
- Melon with Minted Yogurt from The Inside Tract (book) by Mullin and Swift
This recipe provides Vitamin C, Vitamin A, beta-carotene, and fiber from melons; Protein, calcium and some Vitamin D from yogurt. Mint provides antioxidants and phytonutrients, as well as an anti-spasmodic gastrointestinal calming property.e
Prep Time: 5 minutes Cook Time: None Makes: 2 servings
Ingredients: 2 cups plain yogurt (cow, goat or sheep), 1/4 cup fresh mint leaves-chopped; 2 teaspoons honey, 1/2 a honeydew or cantaloupe melon–seeded and cut into chunks.
Directions: Mix the yogurt, mint, and honey. Pour over the melon chunks and enjoy.
Nutritional Composition per serving (2 total servings). Calories: 243 Carbohydrates: 38 grams Fiber: 2 grams Protein: 15 grams *Fat: 3 grams Sodium: 204 mg
*Fat content varies depending on what % fat yogurt is used. Figures here are with full fat yogurt
- Greek Salad from Ultrametabolism, book by Mark Hyman, MD
PREP TIME: 10 minutes COOK TIME: None
Ingredients: 1/2 cup crumbled feta cheese, 1 small pickling cucumber–peeled and diced, 1 plum tomato-chopped, 4 T. chopped green bell pepper, 4 T. chopped red onion, 4 black olives-pitted and halved; 2 teaspoons extra virgin olive oil; 4 tsp freshly squeezed lemon juice, 1 T. chopped fresh oregano or 1 teaspoon dried oregano
Dressing: 1/2 cup Greek yogurt, 1 T. finely chopped fresh spearmint, pinch sea salt, dash of freshly cracked black pepper
Directions: Place the cheese, cucumber, tomatoes, pepper, onion and olives in a medium bowl. Fold in the olive oil, lemon juice, and oregano. Set aside. In a small bowl, mix together the yogurt, mint, salt and pepper. MIX Salad ingredients and Dressing together. This salad can be eaten as a side salad as part of a Mediterranean meal, Or as a sandwich filling–using whole wheat pita pockets.
Nutrition Composition per salad serving (2 total servings; does not including bread)
Calories: 195; Carbohydrates: 11 grams; Fiber: 2 grams; Protein: 8 grams; Fat: 13 grams, Sodium: 420 mg
- http://www.rodale.com/reduce-inflammation Posted 5/17/10: Interview of Mark Liponis, MD by Jeff Rossman, PhD: “Mind Body Mood Advisor: Nine Strategies to Reduce Inflammation”
- C Gorman, A Park, K Dell: “The Fires Within”, TIME Magazine article,2/23/2004, Vol 163
- www.sciencedaily.com/releases/2012/01/120104135402.htm (Re: inflammatory bowel becoming more global disease)
- www.ultrawellness.com/blog/ultrawellness-key-3 Posted 7/8/09: Mark Hyman, MD: “Is Your Body Burning Up with Inflammation”
- Ridker, MacFayden, Nordestgaard et al. “Rosuvastatin for Primary Prevention among Individuals with Elevated HS-CRP and 5% to 10% to 20% 10 year risk: “Implications of the Justification for Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER TRIAL) for “Intermediate Risk.” 8/25/10: Circulation, Cardiovascular Quality and Outcomes (journal)
- B Jacques, ND. “C-Reactive Protein: Risk Factor for Cardiovascular Disease and Beyond.” January 2006: Naturopathy Digest
- http://www.cplpub.com/index.html?lang=en-us&target=d113.html (accessed 10/19/10 from American Heart Association quote from “Inflammation, Heart Disease, Stroke: The Role of C-Reactive Protein”
- E Jacobs, C Newton, Y Wang, et al: “Waist Circumference and All-Cause Mortality in a Large US Cohort,” Archives of Internal Medicine 8/9/10
- Lipton, Bruce, PhD. The Biology of Belief: Unleashing the Power of Consciousness, Matter and Miracles. (book, Hay House, 2008)
- www.drweil.com (Click on ‘Dr. Weil’s Food Pyramid’ for Anti-Inflammatory Diet and Pyramid)
- http://nutrition.about.com/od/dietsformedicaldisorders/a/antiinflammatoryfoods.htm See article by Shereen Jegtvig: “Anti-Inflammatory Foods”, April 2012
- Submitted by D.Mitchell: “Folate, Folic Acid May Raise Breast Cancer Risk in Some Women.” EmaxHealth. (accessed10/26/2010)
- www.ScienceDaily.com See Feb 13, 2012 article: “Motivation to Exercise Affects Your Behavior.”
- http://www.womentowomen.com/healthynutrition/vitamindtestingandtreatment.aspx#levels (Marcelle Pick, RN, NP, functional medicine website)
- B Hollis. Symposium. Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency. Feb. 2005, J of Nutrition 135: 317-322
- www.drweil.com (Click on ‘Supplements’, then ‘Vitamin Library’, then ‘Vitamin D’)
- http://healthybodydaily.com/dr-oz/dr-oz-dr-andrew-weil-antioxidant-cocktail-co-q10-benefits 7/12/10: “Dr Oz The 5 Supplements You Should be Taking Daily”
- G Mate, MD. “Inflaming Emotions” (article), accessed 11/1/10.. http://www.alive.com/print_version.php?chosen_topic_id=1943&site_id=5
- D Mandel, “Safe Solutions for Harmful Inflammation.” http://www.turnonyourinnerlight.com/Inflammation.html accessed11/1/10
- Jeannette Raymond, PhD. “Disclosing Emotions Reduces Inflammation in Rheumatoid Arthritis. 7/30/10. www.goodtherapy.org/blog/rheumatoid-arthritis/
- F G Oosterveld, JJ Rasker, et al. “Infrared Sauna in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effects.” Clin Rheumatology (journal) JAN: 28 (1), 2009
- www.esciencenews.com Go to article published Friday 3/30/2012. “Greater Traumatic Stress Linked with Elevated Inflammation in Heart Patients.”
- Mullin, Gerard, MD and Swift, Kathie, MS, RD. The Inside Tract: Your Good Gut Guide to Great Digestive Health (book) Heal your gut and counter inflammatory processes.
- Hyman, Mark, MD. Ultrametabolism (book). Also The Ultrametabolism Cookbook by Mark Hyman, and Ultraprevention (book–great description of inflammatory process and how to correct) by Mark Hyman, MD and Mark Liponis, MD