Inflammation may be the biggest threat to our health, greater than any other single factor. The reason? Inflammation is at the root of so many of the disturbances in our bodies, including diabetes, cardiovascular disease, neurologic disorders, neuromuscular diseases, and gastrointestinal issues, just to name a few. Chronic silent inflammation can disrupt the normal workings of all body systems. That is why eliminating causes of inflammation is so important, be it through our diet, our environmental exposures, and even our stress levels.
We do need an inflammatory response at times, such as when we have an infection and we need to fight back and heal. However, long-term inflammation is what can lead to metabolic and neurodegenerative issues. It is apparent that chronic inflammation can suppress the normal function of our mitochondria (those tiny powerhouse energy producers in our cells), and this has been linked to certain degenerative diseases in particular, and the aging process in general. I will get back to this in a bit.
There is growing evidence that, on a cellular level, it is an inflammatory process at work in such things as Alzheimer's, Parkinson's, Multiple Sclerosis, and possibly even schizophrenia and bipolar disorder. The brain is a fine-tuned instrument that can easily be disrupted, as it is less able to protect itself against inflammation than other parts of the body. There has been a lot of research on this subject (see Enzinger, et.al. Risk factors for progression of brain atrophy in aging: six-year follow-up of normal subjects. Neurology. 2005 May 24;64(10):1704-11; also Crane, et. al. Glucose Levels and Risk of Dementia. NEJM. August 8, 2013:369:540-548) , although no truly definitive study. That is why questions remain. What makes one person at risk and not another? And is inflammation the true cause or just part of the process, a manifestation of another problem? These are questions that will be answered over time as more definitive research is obtained. For now, we can at least focus on what we already know.
Next, a little medical lesson regarding the cascade of events in the inflammatory process: First, free radicals (reactive oxygen and nitrogen species) induce what is known as iNOS (nitric oxide synthase) and COX-2 (cyclooxygenase type 2) enzymes. These then convert arachidonic acid into the inflammatory prostaglandins that wreak havoc in our bodies. The reactive oxygen species are pro-inflammatory cytokines that actually bind to our cells to cause genetic mutations that allow for the release of the 2 enzymes. As these enzymes work to cause inflammation, there is a feedback loop that actually causes more cytokine production. This can overwhelm our anti-oxidant defense mechanisms, leading to a worsening of the problem. This imbalance between the free radicals and the anti-oxidants is called oxidative stress. More on this can be found in article by Wei in which this imbalance was shown to be responsible for the age-dependent process of mitochondrial decay (Wei, et. al. Oxidative damage and mutation to mitochondrial DNA and age-dependent decline of mitochondrial respiratory function. Ann N Y Acad Sci. 1998;854:155-170).
Oxidative stress leads to disruption in DNA and RNA synthesis, destruction of cellular enzymes, and disturbances in protein synthesis. When the DNA/RNA production is compromised, we cannot repair and replicate cells; when the enzymes are diminished, we cannot perform normal chemical processes; and when protein synthesis is disrupted, we lose the ability to produce cellular energy. This is called free radical damage, and is what happens to our mitochondria, especially as we age and the free radical damage takes its toll over many years. These processes basically lead to the signs we see in aging, as our cells break down and stop working properly.
So how can we stop inflammation? Well, taking over-the-counter anti-inflammatory drugs (such as ibuprofen and naproxen) is not the answer in the long-term, as these medications have a variety of risks of their own. Our best defense goes back to reducing the things that lead to oxidative stress, while also increasing those that produce anti-oxidants. As I touched upon in the beginning, this means establishing an anti-inflammatory diet, taking additional anti-oxidant supplements if needed, exercising, reducing alcohol intake, eliminating smoking, and reducing overall stress levels. This is just a basic outline, as a plan should be tailored to each individual's needs and lifestyle. A thorough discussion with your doctor is the next step....
