The Underlying Cause of Chronic Disease
The New Paradigm in Heath Maintenance and Disease Progression
Part III: Treatments for Chronic Inflammation
Treatments for Chronic Inflammation
I will divide our conversation today into five categories to create clear and actionable information:
- Food & Water
Anti-Inflammatory Food & Water
The average American eats almost 2,000 pounds of food a year, not including fluids. Food and drink intake is the largest single exposure to either inflammatory or anti-inflammatory substances. In a lifetime that can be over 60 tons of food consumption alone! The average American drinks only 58 gallons of water a year. On average, that is only 2.5 cups of water a day. If they were to drink the recommended 8 glasses a day that would add up to 185 gallons a year. As you can see, a small toxin exposure or chemical exposure in your food or drink can over time add up to an enormous amount of exposure either for the benefit or detriment of your health. So, the once a week fast food exposure or the daily exposure to chemicals in your drinking water can easily add up.
A recent study from the Harvard School for Public Health found that the drinking water of over 6 million Americans contained the industrial chemicals polyfluoroalkyl and perfluoroalkyl substance (PFASs), and these were above the accepted safety limit of 70 ng/l. This is in addition to typical amounts of chlorine and fluoride and traces chemicals found in drinking water.
Food and drink intake is the largest single exposure to either inflammatory or anti-inflammatory substances.
What can be done?
The Environmental Working Group has been testing food pesticide and chemical levels for years and has shown significant levels of pesticides, fungicides and related chemicals on many fresh foods. You can review their info at www.ewg.com This site has a nice little app you can download on your phone and use while grocery shopping to see which foods need to be organic and which do not.
Drink Better Water
Consider drinking filtered, non-bottled water. Nearly a quarter of bottled water comes from local municipalities and is no better than your own tap water. Better filters can be purchased easily online. I personally use a British Berkefeld Gravity carbon impregnated ceramic system. They are a little expensive but each cartridge is good for 2000 gallons of water, so it pays for itself in just a year (verses bottled water). Also, purchase a good quality stainless steel or glass water bottle to fill up from your filtered water. In the long run this will save you money.
Eat Better Food
Next, begin eating clean, anti-inflammatory foods. A full meal plan detailing an anti-inflammatory diet is available on our website. This plan explains how food can be medicinal and help your body with inflammation as well as naturally clean out toxins that have accumulated over time.
A short list of anti-inflammatory foods includes the following:
- Omega 3 rich foods (salmon)
- Monounsaturated oils with polyphenols (olive oil)
- Dark leafy greens (spinach, kale, chard, collards, broccoli)
- Phytonutrient rich foods (beets, berries, carrots, squash)
- Omega 3 rich nuts (almonds, walnuts, pecans)
- Immune modulating foods (mushrooms)
- Green & herbal teas
- Alliums (garlic, onions, asparagus)
The food suite above has a seven-day meal planning menu plus a nice one page sheet with a listing of all approved foods, to help you while grocery shopping.
Spices are often forgotten but are extremely important in their immune modulating and anti-inflammatory effects. One of my mentors mentioned to me a study of indigenous Indians off the coast of Honduras who drank daily a cocoa-based drink rich in polyphenols (plant based antioxidants). There was no high blood pressure or heart disease in this group of people. Most of the adult males who moved to the country capital and stopped drinking this beverage, within one year developed hypertension. Similarly, in India, where the average adult uses 5 teaspoons of turmeric a day, the elderly have a 4–6-fold decreased incidence of Alzheimer’s Disease. Curcumin (found in turmeric) alone has 83 different chemical pathways that it modulates to help regulate inflammation. Using more spices in your cooking allows you to ‘upgrade’ the anti-inflammatory effects of your food without changing the foods you eat or adding a single calorie.
The most important of these spices includes:
- Celery seeds
- Black pepper
- Holy basil
This may be the most difficult change to start because it is totally counter cultural to the contemporary American lifestyle. For example, exercising 30 minutes a day increases Serotonin levels (a brain neurotransmitter) more than the best anti-depressants on the market. It also will lower your risk for cardiovascular disease over 30% and significantly decrease your risk for neurodegenerative diseases (Alzheimer’s and Parkinson’s Disease). Meditation has been shown to lengthen telomeres (the protective caps on DNA that correlate to genetic age) as well and Tai Chi yet these practices are unknown or unpracticed by most Americans. Toxic or inflammatory relationships have been shown to disrupt sleep, elevate cortisol levels and suppress your Th1 immune cells (this concept was discussed in Part I) yet we rarely evaluate and remove ourselves from stressful jobs, stressful environments or relationships. ???Busy’ is a badge of honor we wear and refuse to give up—even to our own detriment. We get more ‘involved’ and keep ourselves super-busy all the time. A full discussion of this is not possible here, but suffice it to say this is a huge area of inflammation in most Americans lives.
Here are some ideas to address your inflammatory lifestyle:
- Deep breathing
- Meditation (focused awareness)
- Mindfulness Practices
- Biofeedback — Neurobiofeedback, HeartMath, MUSE
- Sunshine exposure for 20 minutes daily
- Sleep (ideally 8 hours at night, but if not then at least 7)
Removal of Triggers
There are many things that can trigger inflammation. We have already mentioned mechanical stress and trauma, the Standard American Diet (SAD), and environmental toxins in food and water.
Other things that can trigger or mediate inflammation include:
- Prescription drugs
- Over the Counter medications
- NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
- Fungal/bacterial/viral infections
- Lack of sleep and exercise
- Preexisting medical conditions (diabetes, hypertension or coronary artery disease)
Some of these can be easily address while others can be difficult or near impossible. It is best to start with the low hanging fruit: clean diet, daily exercise, adequate sleep, clean water and air. For many of my patients this has been all they have needed to do. I usually focus on diet first, as it is the most critical and the one most people identify with. Some of the others will require working with a Functional Medicine Practitioner.
I put this section last for a reason. Most people jump to supplements because they are thought of as a quick fix. Supplements, however, are meant to—well—supplement. Supplement all the above: diet, lifestyle, food, everything. So, when you reach for your supplement, ask yourself if you have addressed the above or have a plan to do so.
All the supplements below can be purchased through a health care professional or through FullScipts on our website.
- Curcumin: This is probably the most highly researched supplement currently and the best known. It helps decrease inflammation and modulate the immune system through 83 different biochemical pathways. Typical dosing is 100mg up to 500mg but safety data shows it is safe up to 10,000mg daily. The literature shows it being used for heart related issues and neurologic issues at doses of 1000mg to 5000mg. There are many different products out there but I use Meriva 500SF by Thorne in my clinic. It is a liposomal form using sunflower lecithin that improves its absorption, in some cases the blood levels are 20+ times that of the non-liposomal oral forms.
- Resveratrol: This polyphenol was very popular several years ago, Pterostilbene is a methylated form of resveratrol that some prefer. A well-known source of resveratrol is grapes and wine, though the amount in these is small (maybe 5-10mg). It is typically used for its anti-inflammatory effects in cardiovascular health as well as brain health. I usually recommend Resveratrol Supreme by Designs for Health. It has a decent dose of 200mg of the active trans-Resveratrol in a single capsule. Dosing for this suppliment ranges from 100mg to 400mg.
- Bowsellia Serrata: Also, known as Indian Frankincense, has been prized for it medicinal uses for millennia and was one of the herbs of great value the Wise Men brought from the East. It is used both topically and ingested, indications include arthritis, asthma as well as inflammatory bowel disease. Boswellic acids are the active constituent and act via their effect on migrating neutrophil blood cells as well as the complement system. Boswelllia Phytosome by Thorne delivers a phospholipid form at 350mg that is highly bioactive. Dosing ranges from 100mg to 500mg.
- Others: alpha lipoic acid, Pycnogenol, white willow bark, EPA/DHA fatty acids from fish oil, N-acetyl cysteine, probiotics, vitamin c, vitamin e (ideally with mixed tocopherols and tocotrienols)
Where to go from here
The information above is a lot to digest. I usually recommend starting with a few key areas and working out from there. Trying to tackle it all at once can be overwhelming. If you are having difficulty, you can reach out to your local Functional Medicine Practitioner (which can be found on the Institute for Functional Medicine’s website). Other resources include books listed on our website that have been written by Integrative and Functional Medicine Practitioners. Topics in these books ranges from thyroid disease, to brain health, neurodegeneration, gut health, IBS, adrenal fatigue and Chronic Lyme Disease.
I recommend starting with one item from each of the categories above and then expanding from there. Base how you are doing on how you feel. You can use Medical Symptoms Questionnaire as a starting point to assess your current situation and then rescore yourself in 4–6 weeks to see how you are doing and in which areas you are improving or need more help.
As always, you can as well work with your local Functional Medicine Practitioner.