Most Americans know that health risks such as high blood cholesterol and blood sugar are important to monitor, but a growing number of researchers believe that other major factors with far-ranging effects on heart disease and cancer should be getting more attention.
One of these "big" factors is inflammation, and it's easy to look past it as we focus on smaller health targets. Basic healthy lifestyle choices are the key to fight inflammation, but we need to beat the epidemic of excess abdominal obesity to take the most powerful anti-inflammation step of all.
A recent study in the Journal of the American Medical Association showed that among 500 adults with diabetes, medical treatment reduced blood sugars to near normal levels, but markers of inflammation, present in all subjects, were not reduced.
Researchers suggest that this may help explain why several large studies of heart disease among patients with type 2 diabetes did not show any lower risk of heart disease despite intensive blood sugar control. Reducing high blood sugar is crucial to limit small blood vessel damage in the kidney and eye caused by diabetes, but it does not appear to be enough to stop the heart disease-diabetes link.
Our body's ability to respond to infections and injury with inflammation is an immediate response crucial to health. But chronic, low-grade inflammation seems to damage body tissues in ways that lead to and accelerate development of chronic health problems linked with age.
Scientists now consider atherosclerosis ("hardening of the arteries") an inflammatory process, and inflammatory cells have been found in the fatty plaque that builds up in blood vessels. Inflammation may also promote cancer development by damaging our genes, increasing cell turnover and increasing development of blood vessels that allow cancer cells to grow and spread.
A variety of lifestyle changes can reduce or prevent this chronic, low-grade inflammation. Studies show lower levels of markers of inflammation in those who don't smoke and those who exercise regularly. One recent study showed that several inflammation markers dropped within weeks among women in a smoking cessation program. Good dental care that prevents the gum inflammation known as gingivitis may even help to reduce overall body inflammation. Moderate exercise like walking seems to directly reduce signs of inflammation, even after adjusting for its impact on weight control.
A plant-based diet with plenty of vegetables, fruits and beans also seems to decrease inflammation. Studies link a more "Mediterranean-style" diet with lower levels of an inflammation marker called CRP.
Scientists emphasize that it is the impact of the overall diet and whole foods that supplies interacting antioxidant and anti-inflammatory phytochemicals (like carotenoids and flavonoids) with vitamins like vitamin C that provide protection, rather than just a single compound. A Mediterranean-style diet is traditionally higher than the typical American diet in omega-3 fat, found especially in fish. A healthy balance between omega-3 and other fats reduces production of hormone-like substances that stimulate inflammation.
While all these lifestyle choices impact inflammation, research suggests that obesity may be the single largest influence on inflammation. Fat cells secrete certain proteins (such as interleukin-6 and tumor necrosis factor) that stimulate inflammation throughout the body. Fortunately, even a modest seven to ten percent weight loss as part of a healthy lifestyle is enough to reduce markers of inflammation.
Chronic underlying inflammation can be measured by blood tests such as "high-specificity C-reactive protein" (hs-CRP), which is produced by the liver, and IL-6 and TNF-alpha, secreted by other cells. But since these tests can't identify where the inflammation is or which of many potential causes is responsible, for now it may be best to simply recognize that making changes to improve health habits and weight will have far-reaching, positive health effects.