- By Rita Rubin
Inflammation, the body's means of defending itself against infection, is by nature a good thing. But when it persists it can be a key symptom of chronic illness.
The trouble arises when your immune system can't turn off its routine reaction even after the battle against an infection has been won — and you might not even realize the flame continues to burn.
Constant, unchecked inflammation has been linked to an increased risk of cardiovascular and neurological disease, cancer, diabetes and rheumatoid arthritis. There is even a theory that a type of inflammation in young children may be a cause of autism.
Are You at Risk?
People with inflammatory conditions, like rheumatoid arthritis or Crohn’s disease, are at elevated risk of persistent swelling elsewhere, says Russell Tracy, director of the clinical biochemistry research lab at the University of Vermont. Gum disease can also spread inflammation.
"It shouldn’t be a surprise that inflammation in your gut, lungs or liver can have an effect on the inflammation response in your coronary arteries," he says. "It’s all connected."
The best current measure is a simple blood test for C-reactive protein, or CRP, which is produced by the liver. An elevated CRP level is a sign of inflammation somewhere in the body, although the test doesn’t pinpoint the exact location.
A separate blood test, called a high-sensitivity CRP test (or hsCRP), can better assess your specific risk of heart disease from inflammation. The federal Centers for Disease Control and Prevention and the American Heart Association both advise hsCRP screening for anyone with other risk factors for coronary heart disease, like smoking, obesity or high cholesterol.
Smoking and a high-fat diet are dangerous because they prevent inflammation from easing, which can lead to chronic problems. Fat cells, specifically, can spur production of cells called cytokines, promoting inflammation. Refined sugar also promotes cytokine production and inflammation. A number of studies have found that losing weight (and eliminating fatty foods and refined sugar from your diet) can lower one's CRP levels.
If your physician determines that such risk factors or your family medical history increase the possibility of coronary heart disease, he or she could advise you to get your hsCRP checked. "If you’re testing to try and identify inflammation in the blood vessels, a little bit of irritation in the walls of the arteries, then you need that high-sensitivity test," says cardiologist and Harvard Medical School professor Christopher Cannon, co-author of The Complete Idiot’s Guide to the Anti-Inflammation Diet (2006).
A large-scale 2008 study of more than 17,000 men and women, known as the Jupiter trial, suggests hsCRP testing might also be useful for people in their 50s and 60s who don’t initially appear to have an elevated risk of coronary heart disease. The study found that those with normal levels of LDL, or "bad" cholesterol, but high hsCRP levels, cut their odds of a heart attack and stroke by almost half over five years by taking a cholesterol-lowering statin drug.
Another pair of expansive clinical trials recently launched with the goal of determining how effectively anti-inflammation treatments can cut the risk of heart attack or stroke. "If you could find a way to dramatically reduce the incidence of heart attacks by blocking inflammation, that would change the practice of medicine," cardiologist Mark Fishman, president of the Novartis Institutes for BioMedical Research, which is involved in one of the trials, recently told The Wall Street Journal.
Eat Right and Limit Inflammation
Maintaining a healthy diet, avoiding cigarettes, minimizing stress and exercising regularly can improve your odds of avoiding this chronic problem. "Whatever your grandmother told you to do prevents inflammation," says Bharat Aggarwal, chief of the cytokine research laboratory at the M.D. Anderson Cancer Center in Houston.
Aggarwal is one of a growing number of physicians who believe that our food choices can have a potent anti-inflammatory effect. In a paper published earlier this year in the journal Preventive Medicine, he said such spices as black cumin, ginger, clove and cinnamon contain compounds that can limit or prevent chronic inflammation.
Recent research also found that arthritis symptoms might be relieved by circumin, the chemical that gives the spice turmeric its yellow color. Participants in two studies took a circumin-based supplement. More comprehensive testing with a control group is still necessary, but circumin has long been used as an anti-inflammatory treatment in India.
Aggarwal maintains a website about the health benefits of certain spices and teaches a cooking class to cancer survivors at the medical center. Some patients, he says, are skeptical about incorporating these natural ingredients into their meals. "They think it is going to be hot," he says, "but it’s not hot at all. Everything is aroma."
Just adding spice to your cheeseburger or fried chicken isn’t going to cut it, though. If fatty, fried foods are among your staples, you may need to overhaul your eating habits. "The Mediterranean diet is probably the best thing," says Cannon, who recommends more whole-grain foods, nuts, fruits and vegetables as well as unsaturated fats, poultry, eggs, low-fat dairy products and fish high in omega-3 fatty acids, like salmon. He also advises limiting red meat, butter, sweets and white starches like pasta, potatoes and white rice.
“We’re sort of circling back to mom and apple pie," Cannon says. "Well, more like mom and apples.”