Dr Aidin Rawshani

Reduce and prevent chronic inflammation in your body


How to avoid and fight chronic inflammation

Chronic inflammation resembles a persistent low-grade infection

Inflammation is a condition that occurs when the body defends itself against damaging factors. Inflammation is a complex biological reaction that begins when the body’s various tissues are damaged, the tissue that takes damage releases substances to recruit the immune system that activates and migrates to the damaged tissue through the blood vessels.

The damage in various tissues can come from foreign organisms (such as viruses, bacteria, parasites) that penetrate the tissue. Inflammation occurs even with mechanical damage to tissues, for example, pinching injuries, when a person clamped his finger in the door, muscles, tendons and other tissues are compressed and injured. Damage can also occur inside the cells or when exposed to irritants to which the tissues of the body react.

Inflammation is the system that intends to remove the damaging factors, and also initiate the healing process. Inflammation is often confused with infection that actually involves a condition where pathogens such as bacteria, viruses or parasites colonize an organism, but most often an inflammatory process occurs in the tissue that is infected.

Inflammation is characterized by the following five characteristic

  • Redness
  • Swelling
  • Pain
  • Heat
  • Loss of function in the affected area

Acute and chronic inflammation

Inflammation is divided into two different reactions. Acute inflammation involves a short-term and specific reaction of the immune system, which is usually a good thing and part of the body’s natural healing process. Chronic inflammation is completely different and anything but favorable for the body. Unlike acute inflammation, chronic inflammation can be seen as a chronic low-grade infection that constantly activates the immune system. The low-grade inflammation can cause serious complications over time such as stroke, heart attack, cancer, reduced insulin sensitivity, obesity, high blood pressure and much more. The condition also leads to damage to the kidneys and nerves.

Low-grade inflammation is often seen as the major culprit of diabetes-related complications. Inflammation is not a specific condition but an underlying process that occurs in several different conditions. Many people with diabetes at the same time have other diseases such as high blood pressure, obesity, lipid disorder and elevated blood sugar levels. One hypothesis among researchers and doctors is that several cardiovascular risk factors together potentiate the low-grade inflammation and that it contributes to that people with multiple risk factors or poor risk factor control also have a higher risk of developing complications.

In the future, people with chronic diseases or low-grade inflammation are likely to be treated with diet, medications and physical activity designed to suppress inflammation in the body, in addition to medicines for high blood sugar, blood pressure and lipids. A randomized clinical trial was published two years ago in a scientific journal where, for the first time ever, it noted that inflammation-reducing drugs could reduce the risk of myocardial infarction and other cardiovascular complications (reference: Ridker P et al. Antiinflammatory Therapy with Canakinumab of Atherosclerotic Disease. N Engl J med 2017; 377:1119 -1131). We will also be able to identify individuals with varying degrees of inflammation to better tailor the treatment and offer individuals with pronounced inflammation more aggressive treatment.

Unlike acute inflammation, chronic inflammation usually does not cause symptoms. Most often, blood tests and other biomarkers are required to establish that a person has a low-grade inflammation in the body, these samples are not routinely examined in clinical practice. Scientists argue that we do not need to check these samples because few studies have shown that these inflammatory biomarkers (substances that increase in the body in inflammation) predict future development of diabetes, in addition, today there is no effective treatment beyond weight loss that is the only proven effective treatment.

An interesting aspect is that inflammation in the body increases with age, scientists have theories that low-grade inflammation is the cause of several of our major age-related diseases. Doctors believe that low-grade inflammation causes damage to our DNA, which in turn increases the risk of cancer development.

Obesity and inflammation

Research shows that excess body fat is associated with chronic inflammation, especially in individuals with abdominal obesity. There are various explanations for the connection between obesity, diabetes and reduced insulin sensitivity. One explanation is that inflammatory markers (TNF-alpha, IL-6 and CRP) released from the abdominal fat have reached the liver early via the blood system and the inflammation in the liver becomes more pronounced than in other organs.

The liver is an essential organ for sugar metabolism and inflammation interferes with the regulation of blood sugar, which in turn affects other organs. Scientists and doctors believe that a diet consisting of vegetables, whole grains, healthy fats, fruits and nuts can help reduce inflammation in the body. One should also reduce sugar intake and saturated fats.

Physical inactivity

Studies show that regular exercise has anti-inflammatory effects. During a workout, your muscles release anti-inflammatory substances into the bloodstream, at the same time the production of inflammatory substances is reduced, the combination contributes to the reduction of inflammation. That’s not all, the anti-inflammatory substances have continued positive effects even after the workout and help improve sugar metabolism for a longer period.

Increased exercise also leads to less abdominal obesity, which in turn reduces inflammation. Several forms of exercise are good for inflammation, obesity, diabetes and cardiovascular disease. All individuals should exercise 150 minutes or more per week with moderate to intense physical activity (fast walking, cycling or eg tennis). Spread out the workouts for at least three days and do not walk more than two days in a row without any kind of physical activity.

The connection between depression and inflammation

A significant proportion of individuals with type 2 diabetes develop a depression that is severe enough to affect blood sugar levels at some point in their lives. People with depressed mood or depression find it more difficult to cope with their illness. Inflammation of the brain can be the cause of severe depressions. Scientists have shown that inflammatory markers occur to a greater extent in the spinal fluid in individuals with depression than those without. Even individuals attempting to commit suicide have elevated levels of these markers.

The very highest levels are found in patients who have made violent suicide attempts, the level of inflammatory substances is linked to the severity of the depressive symptoms according to some studies. It is difficult to determine what is the cause and effect, but there is a lot of evidence that inflammation leads to depression and not the other way around. Experiments in rats show that if you inject inflammatory substances into the brain, they exhibit depressive behaviour. The brain itself can release inflammatory substances.

Anti-inflammatory diet

Anti-inflammatory diets have become popular in recent years. The recommended diets are similar to the Mediterranean diet, which includes a lot of fish, fresh fruits, vegetables, healthy fats, nuts, moderately with red wine and very little red meat. Anti-inflammatory food components such as omega-3 fats possibly protect the body from any damage caused by inflammation.

Saturated trans fats, sweet foods and refined carbohydrates such as white rice and bread contribute to inflammation. Several dietary supplements are said to have anti-inflammatory properties, such as turmeric and willow bark, but the effect is not sufficient to support the use of these products for inflammatory conditions.

Currently, there are no prescription drugs that specifically target chronic inflammation, however, there are plenty of drugs to treat acute, short-term inflammation. The most common medications are non-steroidal anti-inflammatory drugs (NSAIDs). Corticosteroids such as cortisone and prednisolone may be prescribed for inflammatory conditions. They can help suppress the inflammation but these powerful drugs also have a risk of side effects.

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