Diane Magazine - "The Heat Is On"
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By Karen Cicero
Photos By Bob Carey
Asthma appears nothing like arthritis. Heart disease seems far afield from heartburn. Yet researchers say these 4 conditions and at least 30 others are linked by a single factor that is taking medicine by storm. Discover what it is—and how you can stay out of its path.
What Mary Ann Provost and Dana Milburn have in common is far from obvious. Provost, 63, is raising her grandchild. Milburn, 28, is dating. Provost lives near Boston. Milburn lives near Philadelphia. Provost is a little overweight. Milburn is a size 6. Provost has diabetes. Milburn has psoriasis. “Their health problems seem unrelated to most people and even some doctors, but they’re actually closely linked,” says William Joel Meggs, MD, PhD, a medical researcher at East Carolina State University in Greenville, North Carolina, and author of The Inflammation Cure. The newly recognized insight: inflammation. “In diabetes, inflammation impairs the body’s blood. In psoriasis, inflammation causes the body to begin growing new blood vessels so more blood flows to the skin, making it red and flaky. There are two different results, but one common trigger.” Turns out, the bond between diabetes and psoriasis is just the tip of the iceberg. 
After all, doctors say, what’s asthma, but airway inflammation? Arthritis? Joint inflammation? Heartburn? An inflamed esophagus. Heart disease? Blood vessel inflammation. Crohn’s disease? An inflamed intestine. Lately physicians have been playing a massive game of connect the dots with more than three dozen seemingly far- flung conditions being tied to each other through the single common thread of inflammation. (See “Your Body Under Fire,” page 43.) “It’s like the Holy Grail of medicine,” says Dr. Meggs. “Inflammation holds the key to sickness and health.” Here, leading scientists explain how inflammation flares up—putting you at risk for a mind-boggling number of diseases—and, more importantly, how you can avoid it.
Fire Hazards
Scratch that; you don’t want to avoid inflammation entirely. “It’s your body’s self-defense mechanism to keep you healthy,” says Richard Becker, MD, professor of medicine at Duke University School of Medicine and a scientific advisor for the American Heart Association. Cut your finger or twist your ankle? Infection-fighting white blood cells rush to the area to clean up bacteria and other potentially hazardous microbes. Trademark signs of inflammation—like redness, swelling, heat, and pain—ensue. Once the infection fighters have cleaned up the mess, the immune system relaxes, the inflammation subsides, and your body goes back to business as usual.
At least, that’s how things are supposed to work. Problem is, for reasons scientists don’t fully understand, in some people the infection fighters become overzealous, sticking around long after their job is done. Or in some cases, there was never a real problem in the first place—a false alarm jump-started the immune system. “These cause chronic low-grade inflammation,” explains Barry Sears, MD, author of The Anti-Inflammation Zone. “Most people aren’t even aware that they have it until the levels of certain inflammatory chemicals are measured in their blood or until their doctor tells them the conditions they have are related to inflammation.”
In fact, doctors were in the dark about inflammation until not that long ago. “It’s really been in the last 10 years that this area of research has exploded,” says Dr. Becker. What has lit a fire under physicians: statistics that if a patient had one particular condition, she was at far greater risk of having another. Type 2 diabetes, it has been shown, triples the risk of heart disease in women. Lupus, a study found, raises the risk of heart disease 50-fold in 35- to 44-year-old women. “In the case of psoriasis, we picked up on the fact that patients tend to have a much higher risk of heart disease—and that’s when we asked what links them and pursued inflammation as the connection,” says Joel Gelfand, MD, medical director of the Department of Dermatology’s Clinical Studies Unit at the University of Pennsylvania. Doctors also noticed that taking a medication for one condition helped improve another. “They observed that arthritis sufferers have lower rates of Alzheimer’s disease and came to the conclusion that the anti-inflammatory medications used to treat arthritis provided the benefit,” says Dr. Sears. “In some studies, when patients were given medication to treat their arthritis, their diabetes disappeared,” adds Allison Goldfine, MD, assistant director of clinical research at the Joslin Diabetes Center in Boston.
Top 10 Firefighters
Once doctors discovered that inflammation had wide-reaching effects, they began to focus on how they could control it. Some of their tests, like one that Dr. Goldfine is coordinating, involve anti-inflammatory medications. But many others focus on how simple changes in what you eat and how much you exercise can help keep your immune system working exactly as it should. “Inflammation is at the root of a lot of diseases—that’s the bad news. But by reducing inflammation in your body, you can lower your risk of a lot of diseases all in one shot,” says Dr. Meggs. Here are proven ways to fight the flames.
FOODS THAT STEADY (NOT SPIKE) BLOOD SUGAR.
Scientists have developed the glycemic index (GI), a system that rates how foods affect blood sugar on a scale of 1 to 100. Sweets, white bread, and white potatoes have a very high glycemic index, causing your body’s blood sugar to spike after a meal. In a Harvard University study, researchers found that levels of C-reactive protein (CRP) were 32% greater in women with diabetes who ate the most high-GI foods compared with women who consumed the fewest. See “Eat This, Not That,” page 44, for a guide to low-GI alternatives. And you can check out the GI of any food at glycemicindex.com.
THE CATCH OF THE DAY.
You’ve probably heard that the omega-3 fatty acids found in low-mercury fatty fish like wild salmon and canned light tuna help lower the risk of heart disease, Alzheimer’s disease, rheumatoid arthritis, and a host of other conditions. “They help prevent these health problems or ease their symptoms because they have anti-inflammatory properties,” says Dr. Sears. If you’re not a seafood lover or don’t have the opportunity to enjoy it very often, he suggests talking with your doctor about taking a fish oil supplement. “I tell my patients that if you only have 30 seconds in your day to devote to reducing inflammation, take one of these supplements,” he says. If you don’t have any chronic conditions, he recommends 2 1/2 g daily (about one teaspoon or two or three capsules). If you do suffer from heart disease, diabetes, or another illness, he’d at least double that amount. For information on the best brands of fish oils (some manufacturers are, well, a little fishy), check out consumerlab.com, which has tested the freshness and confirmed the contents of more than 40 products.
Experts say that inflammation is a culprit
in the following diseases.
Acne
Allergies
Alzheimer’s disease
Asthma
Attention deficit disorder
Breast cancer
Bronchitis
Bursitis
Chronic fatigue syndrome
Colitis
Crohn’s disease
Depression
Diabetes
Fibromyalgia
Gastritis
Gum disease
Heart disease
Insomnia
Laryngitis
Lung cancer
Lupus
Migraines
Multiple sclerosis
Osteoporosis
Ovarian cancer
Parkinson’s disease
Psoriasis
Rheumatoid arthritis
Schizophrenia
Scleroderma
Sinusitis
Stroke
Tendonitis
Vaginitis
A SPINACH SALAD WITH BEANS.
When you toss in black or white beans, you’ll double the salad’s amount of magnesium, a mineral that researchers at Medical University of South Carolina in Charleston suggest helps reduce inflammation. In a study of men and women, the researchers found that those who consumed less than the government’s recommended amount of magnesium—320 mg daily for women over age 30—were twice as likely to have high levels of CRP in their blood, a big clue that inflammation is present. Two cups of raw spinach fork over 50 mg of the mineral. Just 1/2 cup white or black beans adds another 60 mg or more. Other magnesium powerhouses: nuts, fortified cereals, sunflower seeds, bananas, avocados, fish, and whole grains like brown rice and oats.
NOT TOO MUCH (OR TOO LITTLE) EXERCISE.
Researchers have known for years that exercise improves a person with diabetes’ chances of staying heart attack-free. But a soon-to-be-published study puts the finger on why: “Exercise has a bigger effect on inflammation than it does on blood pressure, cholesterol levels, and a host of other factors,” says the study’s author, Samia Mora, MD. “It’s mainly through inflammation that exercise lowers heart attack risk.” And even if you don’t have diabetes, exercise gives you an edge. Working out four times or more a month lowers the risk of having a high level of CRP and other signs of inflammation in healthy women ages 40 and over, according to a study by researchers at Emory University. (Just think of the benefits you’re getting from your three-times-a-week Curves workouts.) So how much exercise is enough? Paul Thompson, MD, director of cardiology at Hartford Hospital in Connecticut, recently published a review of all articles on exercise and inflammation. “Athletes may not get as much of a benefit as people who exercise recreationally—too much may actually increase inflammation, at least temporarily,” he says. The bottom line: Do your Curves workout, and fit in a few other fun activities—like gardening or swimming— when you can.
By switching to foods with a lower glycemic index—a scale from 1 to 100 that measures how much blood sugar your body produces in response to eating—you'll help reduce your levels of inflammation.
| ENJOY | GLYCEMIC INDEX | INSTEAD OF | GLYCEMIC INDEX |
|---|---|---|---|
| Whole-wheat bread | 49 | White bread | 71 |
| Sweet potato | 48 | Baked white potato | 94 |
| Low-fat yogurt | 26 | Doughnut | 76 |
| Brown rice | 50 | White rice | 86 |
| Peanuts | 13 | Pretzels | 83 |
| Fat-free milk | 32 | Soda (nondiet) | 63 |
TRULY HEALTHY OILS—RATHER THAN JUST TRANS-FAT-FREE ONES.
Public pressure has forced many manufacturers to remove artery-clogging trans fats from their products. “But you have to be careful of what you wish for,” warns Dr. Sears. Some companies are replacing the trans fats with soybean, sunflower, safflower, or corn oils, which increase the activity of proteins that trigger inflammation. The kinds of oil you want to see listed on the label and cook with yourself: olive or canola.
A MILK MUSTACHE.
The vitamin D and fatty acids in milk may help reduce inflammation, according to two research studies. The first from Tufts University found that nonsmokers with the highest levels of vitamin D were 20% less likely to have bleeding gums—a sign of inflammation—than those with the lowest levels. Another showed that a type of fatty acids in dairy products may help inhibit proteins from creating an inflammatory reaction. If you don’t like to drink milk, seek out one of the growing number of yogurts that now have vitamin D added, such as Dannon Light & Fit, Yoplait (any variety), and Stonyfield Farm 2-a-Day.
If you’re age 45 or older, ask your doctor about checking your levels of C-reactive protein (CRP), an indicator of inflammation, especially if you don’t have any signs of heart disease, suggests Samia Mora, MD, a cardiologist at Brigham and Women’s Hospital in Boston. In her recent large-scale study, the simple blood check covered by some insurers beat out 34 other tests in determining a seemingly healthy woman’s long-term risk of suffering a heart attack or stroke. “The purpose of the test is to pick up clues of heart disease in women who have normal cholesterol and blood pressure,” explains Dr. Mora. “If you already have heart disease, you should be treated for it—and this test won’t be of much benefit.”
A CLEAR HEAD.
Meditation isn’t just New Age nonsense; there’s actually a medical explanation about how it helps reduce inflammation. Several years ago, researchers discovered that the brain and the immune system are linked through the vagus nerve, which begins in the brain stem and travels through the torso. In a conference last year on integrative medicine at Columbia University, neuroscientist Kevin Tracey, MD, noted that this nerve controls the production of tumor necrosis factor (TNF), a protein that signals the body to mount an inflammatory response. Decreasing the nerve’s activity— through meditation—would cut back on the production of TNF and, as a result, inflammation, says Dr. Tracey. In fact, in one study, the thickness of blood vessel walls—a risk factor for heart disease and stroke—decreased in participants who meditated twice daily for 20 minutes compared with it worsening for those who simply engaged in leisure activities. For a good primer on how to get started on meditation, go to health.discovery.com.
CLEAN AIR.
Secondhand smoke causes inflammation that leads to decreased lung function in women, especially those with asthma, according to a study by the University of California-San Francisco. Pollutants like ozone take a toll as well. In fact, a recent study from Harvard University found that air pollution brought on short-term increases in inflammation in a group of men and women who were age 60 or older, particularly those who already had diabetes or high blood pressure, or were overweight. But whatever your age, Dr. Meggs suggests you move your workouts inside on days when air quality is low. To check on your local air quality, go to cfpub.epa.gov/airnow.
A BIG BOWL OF CHERRIES.
Skip the salty, high-fat snacks and instead nosh on dark, sweet Bing cherries this summer. When USDA researchers instructed 18 men and women to add about 50 pitted cherries to their diet daily for a month, their levels of CRP fell 25%. Now that’s something to be jubilant about.
A HEALTHY WEIGHT.
Fat cells secrete all kinds of inflammatory compounds. So it’s no surprise that people who are overweight are much more likely to have high levels of inflammation than those who are at a healthy weight. Dr. Mora’s study on more than 27,000 healthy women found that those who were overweight had about twice the risk of having a high level of inflammatory compounds than normal-weight women, and those who were obese had at least a seven times increased risk. “Being overweight was worse for inflammatory measures than being inactive,” she says. “But even for significantly overweight women, those who exercised had lower levels of inflammation than those who didn’t.” Fortunately, losing weight can help return your body’s level of inflammation to normal.
Your first step: Find your Body Mass Index. (Search for “BMI calculator” at http://www.cdc.gov and plug in your height and weight.) It’ll tell you whether you are underweight, normal weight, overweight, or obese. If you’re overweight, play around with the calculator to see how many pounds you’d have to drop to be at a healthy weight. If you’re obese, do the same to determine what you have to lose to be in the overweight category. Once you figure out that number, set that as your weight-loss goal. Continue with your Curves workouts and if you’re not already following the Curves weight-loss program, talk with the owner or manager of your club to find out how to get started.
KAREN CICERO is a contributing editor to diane.
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