Brian Hig­gins

The book­stores are heav­ing with ‘anti-in­flam­ma­tory ‘ di­ets. But what ex­actly are we talk­ing about when we talk about in­flam­ma­tion, and can what we eat have any im­pact? GP takes a closer look

Irish Independent - Health & Living - - YOUR BODY -

IN 2017 a study was pro­duced show­ing that pa­tients with a higher blood lev­els of the in­flam­ma­tory marker C Re­ac­tive Pro­tein (CRP) were more likely to die from car­dio­vas­cu­lar dis­ease. The fit­ness and food com­mu­nity quickly caught on and the idea of anti-in­flam­ma­tory di­ets spread like wild­fire. Now we are all talk­ing about it, but do we re­ally know what in­flam­ma­tion is? De­spite pop­u­lar mis­con­cep­tion, in­flam­ma­tion is gen­er­ally not a neg­a­tive thing. It’s the body’s amaz­ing response to a stress. When dam­age such as an in­fec­tion, burn, bone frac­ture or skin lac­er­a­tion oc­curs, the body re­sponds by be­com­ing in­flamed. This makes the area painful so that we avoid fur­ther dam­age — and it in­creases lo­cal blood flow caus­ing red­ness, swelling and heat. But the in­creased blood flow brings nu­tri­ents and im­mune cells to the site that be­gin a heal­ing process. This is known as acute in­flam­ma­tion.

In some cases, this in­flam­ma­tory response can be­come pro­longed, or chronic, and the very same response which was help­ful in the short-term re­sults in pain and cel­lu­lar dam­age in the long-term. Com­mon recognisable ex­am­ples of this in­clude the pain and swelling of os­teoarthri­tis and gout. In­ap­pro­pri­ate in­flam­ma­tion is also the un­der­ly­ing cause of other con­di­tions, such as al­lergy, coeliac dis­ease, au­toim­mune dis­ease and many can­cers. An au­toim­mune dis­ease is any con­di­tion where the body causes in­flam­ma­tion in er­ror af­fect­ing how or­gans work, caus­ing ill­ness.

Many en­vi­ron­men­tal fac­tors that cause chronic in­flam­ma­tion can lead to ill health. Smok­ing is the most com­mon fac­tor with which I as a GP deal on a daily ba­sis. The stress caused by in­haled cig­a­rette smoke within the lung, re­sults in in­flam­ma­tion that over time hard­ens the lung tis­sue, re­sult­ing in chronic ob­struc­tive air­ways dis­ease. The in­flam­ma­tion from cig­a­rette smoke also al­ters the lung cell DNA. If an un­for­tu­nate se­ries of DNA al­ter­ations oc­curs, then cancer de­vel­ops when these dam­aged cells be­gin to over­grow and in­vade lo­cal tis­sues and even­tu­ally spread, or metas­ta­sise, through­out the body.

An­other com­mon en­vi­ron­men­tal cause is UV ra­di­a­tion. UV ra­di­a­tion pen­e­trates the der­mis (deep skin layer) and the in­flam­ma­tory response causes melanin cells to darken to pre­vent fur­ther burn­ing. Over time, chronic sun ex­po­sure will cause pre­ma­ture age­ing and may re­sult in skin can­cers know as, squa­mous cell and basal cell car­ci­no­mas. Acute se­vere burns, es­pe­cially in child­hood, can also cause per­ma­nent DNA dam­age that can lead to melanoma later in life.

There are many other in­flam­ma­tory con­di­tions with un­der­ly­ing en­vi­ron­men­tal fac­tors that we do not fully un­der­stand in­clud­ing, coeliac dis­ease, di­a­betes, rheuma­toid arthri­tis, lu­pus and mul­ti­ple scle­ro­sis

A broad range of med­i­ca­tions have been de­vel­oped to help treat in­flam­ma­tory dis­ease. These “anti-in­flam­ma­tory” med­i­ca­tions work in dif­fer­ent ways to dampen our body’s in­nate response to stress. The most read­ily avail­able is ibupro­fen but there are many oth­ers such as cor­ti­cos­teroids, an­ti­his­tamines and even tar­geted bi­o­log­i­cal ther­a­pies.

As well as med­i­ca­tions, there are nat­u­rally oc­cur­ring sub­stances in the en­vi­ron­ment which help re­duce in­flam­ma­tion. Some of these have been used for cen­turies to treat many ail­ments. White wil­low bark is one of the best known and we have pu­ri­fied the chem­i­cal into a med­i­ca­tion called sal­i­cylic acid that is used in many med­i­cated skin creams. Many other foods have been found to have anti-in­flam­ma­tory prop­er­ties in­clud­ing, turmeric, blue­ber­ries, gin­ger, green tea and cer­tain root veg­eta­bles to name a few.

How­ever, it’s cru­cial is to be mind­ful that when a sub­stance has been found to have prop­er­ties in a lab­o­ra­tory, it is not un­der­stood how well these trans­late to day-to-day life. Many blogs, diet books and public fig­ures make state­ments about

Many foods have been found to have anti-in­flam­ma­tory

prop­er­ties in­clud­ing turmeric, blue­ber­ries, gin­ger

and green tea

these food sources with­out suf­fi­cient sup­port­ive ev­i­dence.

Turmeric is a com­pound that has been stud­ied ex­ten­sively and a good ex­am­ple of this. It ab­so­lutely has anti-in­flam­ma­tory and anti-ox­i­dant prop­er­ties. It can re­duce symp­toms in arthri­tis and im­prove choles­terol lev­els when com­pared to a placebo. How­ever, it has not been shown to be su­pe­rior to pre­scrip­tion med­i­ca­tion or to have long-term ben­e­fits. Turmeric is now pro­moted as a type of su­per­food, used in many recipes and sold as a food sup­ple­ment. What is not made clear in these pro­mo­tions is that this chem­i­cal is poorly ab­sorbed. So when taken on its own, is of very lit­tle ben­e­fit. Although it should be noted that taken with piper­ine, the ma­jor com­po­nent of black pep­per, the body’s abil­ity to ab­sorb turmeric in­creases by 2000pc.

Anti-ox­i­dants are dif­fer­ent to anti-in­flam­ma­to­ries in their prop­er­ties, but are equally if not more rel­e­vant when dis­cussing healthy di­ets. How­ever, while they are gen­er­ally ac­cepted as be­ing healthy, it is not known how much of these foods, what dose, and fre­quency are needed in a diet to have a long-term health ef­fect. I am scep­ti­cal of the se­lec­tion-box ap­proach to med­i­cal re­search that is be­com­ing more and more com­mon in fit­ness and life­style lit­er­a­ture and me­dia. Med­i­cal re­search is of­ten taken out of con­text as head­lines like “a glass of wine a day is good for you” are in­ter­est­ing to read, but aren’t nec­es­sar­ily an hon­est rep­re­sen­ta­tion of the truth. If you look at the com­mon healthy di­ets be they pa­leo, anti-in­flam­ma­tory or anti-ox­i­dant di­ets, they all have a sim­i­lar un­der­ly­ing struc­ture of lim­it­ing sat­u­rated fats and pro­cessed food while in­creas­ing healthy fats, fruits and veg­eta­bles. My ad­vice when it comes to anti-in­flam­ma­tory di­ets and anti-ox­i­dant di­ets is en­tirely sup­port­ive. I am happy to see my pa­tients eat­ing lots of fresh fruit, root veg­eta­bles and oily fish, while avoid­ing calo­rie dense pro­cessed foods and smok­ing. I am not sup­port­ive be­cause I truly be­lieve that is due to a re­duc­tion in “in­flam­ma­tion” but be­cause these di­ets ad­vise sen­si­ble por­tions of well-bal­anced meals that are sim­ply are good fuel. The body is a ma­chine and like any ma­chine, run­ning it on good fuel yields good re­sults.

Cer­tain foods have been found to have anti-in­flam­ma­tory prop­er­ties

Turmeric: is it a su­per­food?

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