Inflammation is our body’s response to stress. Any time it’s injured, or suffers any kind of stress or injury, inflammation flairs up. It’s a healing process.
Even though a bruise is painful, the swelling is there for a reason. It’s mitigating the damage. Things would be a whole lot worse if the body simply took the damage without complaint.
So, if inflammation is so good, why am I suggesting it causes heart disease?
The answer lies in the distinction. It’s systemic inflammation that causes heart disease, (otherwise known as chronic inflammation).
A swollen ankle is a response to the damage of a torn ligament. It’s acute inflammation. Systemic inflammation is the response to another type of damage. One that occurs gradually, and all over the body.
Personal trainers and physiotherapists can help you prevent and heal acute injuries.
If you want to protect yourself against systemic inflammation, however, you can come to people like me.
The things that cause systemic inflammation are things that we willingly consume, and which have a toxic effect on the body. This effect is mild, but cumulative, meaning that while one burger won’t hurt you, make them a regular part of your routine and your body will have to keep working harder and harder to protect itself against the growing threat.
Inflammation Makes Cholesterol Look Guilty
Systemic inflammation causes a type of swelling of your blood vessels. This makes the vessel wall stiffer, and the space in the vessel narrower.
While it’s clear how this would increase the risk of the vessels clogging up, the damage doesn’t stop there. It’s when plaque builds up in these little vessels that blockages can occur.
We’ve all heard of plaque, of how it clogs up the arteries with cholesterol and causes heart attacks and stroke. While this is true enough, it’s only half the story. Cholesterol is being framed for a crime it doesn’t commit.
Your body needs cholesterol for a wide manner of processes, from cell membrane structure to hormone production to strengthening memories. While every cell can produce it’s own cholesterol, they often need a little more than they can supply themselves. This is where the liver comes in, sending little packets of cholesterol out in proteins called LDLs.
These LDLs are pumped round the body, expecting to be snatched up through the blood vessel walls when it’s reached a place where it’s needed. An inflamed blood vessel, however, is somewhat desensitized to LDL, and instead of taking it out of the blood where it’s needed, it lets it pass right on by. Our little LDL particle remains in the blood for much longer than it expected, and it starts being bothered by free-radicals and other oxidative agents, (products of inflammation). If it had emotions, it would start getting anxious when it’s own antioxidant defenses start getting used up. It can only resist for so long, and when a free-radical finally get through and oxidizes our brave little LDL, it morphs into something horrible. When oxidized, anything is dangerous, and LDLs are no different. In order to protect the body from this maddened molecule, immune cells imbedded in the blood vessel wall grab hold of it and engulf it in a waxy prison.
Arterial plaque is full of cholesterol, but not at all caused by it. The liver has to get that cholesterol to the cells that need it. The problem is on the other side of the delivery system.
This is why drugs that lower cholesterol by forcing the body to stop producing as much of it can lower the incidence of heart disease, but at the cost of depriving the body of cholesterol it desperately needs.
If you’re currently on statins or another cholesterol lowering drug, consider using your food to improve your blood lipid profile for the longer term. We’ll talk about how in a moment. Of course, talk to your doctor before changing your medication routine, but it’s hard to argue that statins could be better for your long-term health than a clean, nourishing diet. Since it has no side effects (besides feeling awesome), a clean diet can be done alongside statins or any similar drug, so don’t be put off if your doctor insists you keep taking them for now.
Drugs should never be the default option, long term. They’re great at short-term effects like killing bacterial infections or keeping you unconscious during surgery, but they can’t compare to an optimized body for long-term health.
The 6 Biggest Causes of Inflammation
Let’s understand the system we’re working with, and fix it.
First, we need to stop damaging our bodies. Remember, inflammation is a healthy response to damage. We would be a lot worse for wear if our body didn’t get inflamed at all. It’s like the plaque, which protects the body from those dangerous little oxidised LDL proteins. The cost of this protection is delayed illness. It’s solving an urgent problem, and although it might cause another problem later on, it’s worth it. It can keep us going for long enough to get educated on how to solve the problem once and for all.
So what causes inflammation?
1. Grain Toxins
We’ll start with refined carbohydrates. Foods that make use of grains like wheat or corn provide our body with a platter of damaging toxins. Gluten is the most damaging, and I’m sure you’ve heard of people being allergic to gluten. Maybe you’re allergic to it yourself. If you are, you’re quite lucky. Your body has a no-tolerance policy for this particular toxin, and since you react so strongly to it, you won’t have a chance to accumulate subtle yet fatal damage over many years, like the rest of us.
There are other toxins found in grains, namely phytates and lectins. Phytates are found in large amounts in peanuts, although they’re not a grain, and this might contribute to some people’s highly allergic reaction to them.
For those of us who don’t notice when we inject these molecules, they’re likely to eventually damage the intestines anyway, perhaps causing leakygut syndrome where the contents of the intestine leak into the bloodstream, half digested, and you can imagine how much inflammation that would cause!
2. Sugar Spikes
Another cause of inflammation is the spikes and dips in blood sugar when you consume high-glycemic foods like bread or table sugar. The glycemic index refers to how quickly glucose gets from the food, through your intestinal lining, and into your bloodstream. It may come as a surprise, but white-flour bread has the same glycemic index as whole wheat bread.
The phrase “heart healthy whole grains” is a myth, and a marketing tactic. Get your carbohydrate from vegetables if you want to be truly heart-healthy.
3. Processed Fats
Regular readers will know why I recommend eating a diet high in healthy fats, and that unhealthy fats are a very different thing. Fats in their natural form are rarely unhealthy, so a safe bet is to go as unprocessed as possible.
“Processed” can mean a few things. Whenever you do anything to a food, you’re technically processing it. Butter is traditionally made by scooping the cream off the top of milk and squeezing it through fabric until you’re left with only the condensed milk fat at the end. Of course when we talk about “processed fats” or “processed foods” we’re not talking about safe and benign methods like that.
Instead we’re referring to the industrial and chemical processing that tend to transform food on a chemical level.
Hydrogenation is a particular type of transformation we should avoid. In fear of saturated fat as the cause of our disease, intelligent folk took it upon themselves to turn “healthier” fats (vegetable oil) into something more like butter. At the processing plant, hydrogen gas is bubbled up through liquid vegetable oil at high temperatures. The hydrogen molecules stick to the molecules of the oil and saturates them, giving them similar properties to butter. In the process, however, some of the atomic bonds change configuration into something that the body can’t deal with very well, leading once again to inflammation.
Nowadays, it’s widely accepted that trans-fats and hydrogenation are bad, but we still buy margarine that claims to have been made without these processes. It seems the pervasive belief that saturated fat is bad and should be avoided at all costs will continue to lead well meaning people into the unreliable hands of the food processing industry.
Further reading about vegetable oils, polyunsaturated fats, and omega-3 oils.
Smoking is an issue where the mainstream understanding matches up with what the science says. Some people used to believe it was healthy not too long ago, but the scientific evidence against it kept building until it was too compelling to deny. It’s heartening that even against something as profitable as cigarettes, the truth can still win out eventually.
We’ve found that when someone stops smoking, inflammation drops almost immediately. While smoking doesn’t contribute anything to your fat intake, it still increases your risk of atherosclerotic plaque building up in blood vessels.
Now you know why: It’s not down to the intake or production of fat, but rather the sensitivity of the blood vessels to LDLs, the cholesterol-transporting proteins.
5. Stress (and belief that stress is bad)
Stress is another well-known inducer of heart attacks. At some point we’ve all seen an actor in a fine suit, rushing around with a serious expression, suddenly clutch his chest and fall to the floor in the middle of a crowded office scene.
Stress can be a difficult thing to change. Smoking is addicting, but at least it’s near impossible to justify. When you’re working a demanding job and/or putting everything you have into raising kids, however, it’s a different conversation. Your family’s future relies on you working as hard as you can. So what can we do? We can’t just stop working!
Fortunately for achievers, new research suggests that simply believing that stress is good for you can immediately reduce the inflammatory response it otherwise induces.
It sounds a little woo-woo, perhaps, but considering that stress itself originates from the brain, is it so crazy to think that a shift in perspective could take the sting out of it?
See this TEDtalk (15 mins) if you want the whole story.
However, studies do consistently show that the dangers of stress are very real, and it’s probably a good idea, whether you believe stress is good or bad, to keep stressful things under control, and to be mindful of your relaxation.
6. Sleep Deprivation
Research has finally uncovered a physiological reason why we sleep. It seems that thinking produces waste products called “metabolites”. All cells in the body are constantly metabolising and producing waste products, and in most of the body these waste products are taken away by the lymphatic system.
The brain doesn’t have the same hook up, and so every once in a while it needs to be cleaned out. Something about sleep seems to make this possible, although we don’t yet know the exact mechanisms.
Risk of heart disease is increased if you deprive yourself of sleep, thanks to a triggering of that infamous inflammation. Cortisol and other stress hormones also increase their baseline, meaning they’re always there, in the background, at higher levels than they normally would be.
Research has shown high correlations between bad sleep and chronic illness. Health researcher and fitness coach Robb Wolf goes so far as to say, “If someone sleeps poorly it’s hard to keep them alive. If someone sleeps well, it’s hard to kill them.”
We don’t know much about sleep, but getting plentiful, high-quality sleep is clearly one of the best things we can do for our health.
Oxidative Stress Does The Dirty Work
Oxidation was so named as the reaction that occurs when something comes into contact with oxygen. You take a bit out of an apple, and the inner flesh turns brown as it’s oxidized by the surrounding oxygen. Oxidation is also what’s happening when iron rusts or copper turns green.
Soon, though, we learned that what was happening in an oxidation reaction that caused the change was the loss of electrons. The thing that was doing the oxidizing (the “oxidant”) which often contained oxygen along with other atoms, was stealing electrons from the hapless substance it comes into contact with. That loss of electrons causes an imbalance, and makes the substance unstable. It causes things to putrefy, when they’re outside the body, and when they’re inside, they cause dangerous reactive molecules.
Oxidation happens all the time in the body. In fact, our mitochondria, the little machines that pump out the majority of our energy, found a way to exploit this natural tendency for oxidants to take electrons from other molecules, and have packaged it and controlled it as a way to produce useful energy. Think of the dangerous reaction that a car’s engine is utilizing. Outside of an engine, the same reaction would be a destructive oil fire.
Oxidation is likewise a rouge reaction that our biology has tamed to metabolize carbohydrates and fats for energy. But when it gets out of control, that’s when “oxidative stress” can happen.
Free-radicals are what we like to call the “oxidants” that get loose in the body, and start stealing electrons from anything they can find, such as from DNA or cellular proteins, which then in turn steal electrons from the surrounding molecules to stabilize themselves, and what occurs can be a very nasty chain reaction of oxidation and instability that can destroy cells from the inside.
Luckily, unlike the combustion engine, our bodies evolved ways to clamp down on these escaped energy products called free-radicals. They do this special keepers-of-the-peace we’ve called “antioxidants”.
Antioxidants designed to be able to hand an electron to a free-radical (which calms it down), without becoming unstable itself.
Oxidative stress occurs when the free-radicals in our body start to overwhelm the our ability to keep them under control.
One of the potential repercussions of this free-radical overwhelm is the oxidation of LDL, the cholesterol transporter we came across earlier. If you remember, LDLs contain their own antioxidants, stashed away as a defense against free-radicals. If inflamed blood vessels keep LDLs in the blood stream for long enough, though, and eventually an LDL will exhaust its store of antioxidants, and a free-radical will oxidise it, and turn it into a monster – and you know the rest of the story.
Defeating Heart Disease: What Works
In my experience, reducing our risk of heart disease is as clear-cut as it is measurable. We know what works, and we know why.
When I see a patient with the symptoms of chronic inflammation, we first get their blood work done, to see what their lipid profile can tell us. A high number of LDLs in the blood suggests they’re not getting enough cholesterol to the cells that need them, and that the LDLs are at risk of oxidation (which leads to plaque and a risk of heart disease).
There are three critical steps that we then take to reduce this risk factor, as well as any others, (such as CRP levels):
1. Reduce inflammatory factors
In the diet, these usually take the form of refined carbohydrates and processed fats.
Throwing away the vegetable oils and margarine is easy enough once we understand why grass-fed butter is good for us.
Refined carbohydrates are a little harder to get rid of. Kicking carb cravings is a topic unto itself, and one that is crucial to read up on if you want to good chance of bringing down inflammation in the body.
Carbohydrate and fat often go together in processed and unhealthy forms. If you’ve swapped your cooking oil for butter, but haven’t thrown out the refined carbs, you’ll still be giving your body a whole heap of PUFAs that have been processed into trans-fats.
Carbohydrate masks fat. You’d never eat a stick of butter on its own for example, your natural instincts will let you know that it’s too much. However, throw it in with white flour and sugar, and soon you have a cake that can disappear at an alarming speed. The treats you buy at the store have a lot worse than butter in them, but you’ll never know when the sugary coating is working it’s magic.
2. Supplement with Omega 3
Omega-3 supplements are an easy way of helping the body to deal with its own inflammation, especially if your diet consists of a lot of high omega-6 PUFAs. I’ll often advise a patient to supplement with omega-3 fish oil capsules, at least while we’re still working on the diet.
The goal is to develop a lifestyle that effortlessly protects us against all the illnesses of inflammation (of which heart disease is only one), and there are multiple stages to get there. Supplements might not be ideal as a long-term solution, but they can work very well as a short-term crutch.
3. Boost the body’s defenses
With less processed food in your diet, you’ll finally have the space to fill your plate with nourishing whole-foods that will boost your body’s immune system, and calm inflamed tissues.
Antioxidants that exist in food are available for us to borrow and use in our own defenses against free-radicals. Many of these beneficial substances are what give colorful foods their unique look. Natural food is literally color-coded!
Nutritional deficiency is more common than most of us realise. Many people are deficient in vitamin D, while many more don’t have enough iron or vitamin B12. It’s very hard to tell without getting tested, and it could be working to compromise your bodily systems behind the scenes.
By filling your plate with nutrient-dense vegetables, lean meats, and healthy fats, you’ll be providing your body with everything it needs to heal and optimize itself, without any of the toxins that it’s usually having to deal with after every meal.
Where to Go From Here
Inflammation is something we choose. You can’t catch it from a sneeze. We all have the power to live in bodies that are optimized for leanness, vitality, and robust health, and a critical place to start building such a life is in our eating habits.
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