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Holistic Approaches to Inflammation and Chronic Disease

An Introduction to Chronic Inflammation

In many chronic disease states, inflammation is a common underlying factor.  If you are suffering from something that ends with “itis” (arthritis, tendinitis, pancreatitis, diverticulitis, etc), this is a medical term for “that part of your body has inflammation”. So what is inflammation?  On the large scale, we look for heat, redness, pain, and swelling; these are all key factors that tell us inflammation is taking place. Microscopically, we see that blood vessels become more permeable and extra fluid and immune cells come to the area to protect and heal the body and remove waste from the area.

What is the purpose of inflammation?  It is your body’s natural defense system: this is how your body protects and heals itself in cases of infection, allergy, and injury. When a foreign organism such as a bacteria, virus or fungus enters the body, your immune system launches a highly sophisticated attack to kill the invader and then clean up the remains of the battle afterwards.

While inflammation is a very important and appropriate action for the body to take, when it pops up in inappropriate places or continues on beyond the normal course of infection or injury it causes chronic pain and damage to that part of the body.

Chronic inflammation is the underlying cause of many very common chronic diseases.  Cardiovascular disease, arthritis, asthma, autoimmune thyroid disease, IBS and other digestive disorders, and eczema are all cases of chronic inflammation. When inflammation becomes chronic the area will be in a state of simultaneous destruction and healing, which over time can lead to scarring and loss of function.

Conventional treatment for inappropriate inflammation primarily relies on four types of drugs, all of which act by suppressing a key component of the body’s inflammatory response: Steroids such as prednisone mimic your body’s stress hormones’ ability to suppress inflammation.  Nonsteroidal antiinflammatories such as ibuprofen and acetomenophen suppress an enzyme called cyclooxygenase that creates the mediators that cause inflammation in the body.  Biologic drugs such as embrel and humira block the action of another inflammation-causing protein called Tissue Necrosis Factor. For more allergic sypmtoms, antihistamines such as Allegra suppress the release of histamine from allergic cells.  Although the effects of all of these drugs have different effects and can be quite useful to control symptoms in the short term, what they all have in common is that they suppress our body’s natural reaction to an underlying issue and can have significant unwanted side effects.  

There are a few primary concerns regarding the use of conventional medications for reducing inflammation. In the case of steroids and biologic drugs, they can suppress your immunity, leading to unwanted infection that can be difficult to treat.  NSAIDs can damage the liver, gut and kidney.  Antihistamines impact the nervous system and can cause drowsiness, hyperactivity, a decrease in secretions to the eyes, nose and mouth, and difficulty in urination. Rather than suppressing natural function, the goal with natural treatments is to divert the body’s innate function towards anti-inflammatory pathways.

Natural options for minimizing inflammation

There are three key elements to minimize inflammation holistically:  Exercise, Diet, and Supplements.  If you feel good now and want to minimize inflammation in the long-term, diet and exercise are a great place to start.  If you are already in a position where inflammation is a concern for you, botanicals and supplements may be necessary to get things under control.

Exercise:  While in the short-term exercise can trigger an acute inflammatory reaction, research has shown a long-term moderate training regimen decreases the body’s production of inflammatory cytokines.  The inflammation that is caused by working out is important for remodeling and building muscle mass.  In fact, post-workout treatments such as ibuprofen and icing the area have been shown to decrease the body’s ability to build muscle mass.  As the initial inflammation post-workout decreases, though,  It is important to keep in mind, however, that repetitive exercise that pushes the muscles past their capacity, such as long-distance running and body building, cause short-term inflammation (aka, delayed soreness after working out) that over time causes scarring damage to the muscle fibers.

Diet:  There are three basic components to reducing inflammation in the diet:  Eat more antiinflammatory foods, eat fewer pro-inflammatory foods, and avoid allergens or sensitivities.

Antiinflammatory Foods are those that support healthy digestion and improved liver function help the body rid itself of wastes that can trigger inflammation.  These include high fiber foods such as leafy greens, broccoli, and carrots, foods high in soluble fiber such as apples, flax, pears, and chia, foods high in omega-3 fats such as fish and flax, liver support foods such as beets, cucumbers, and greens, and probiotic foods such as kefir, yogurt, natural sauerkraut and pickles, miso, and kombucha.

Pro-Inflammatory Foods encourage the formation of pro-inflammatory cytokines.  While meats can be beneficial for other reasons, they are good to consume in moderation because their fat content can create more inflammation.  Refined carbohydrates in white flours and sugar can cause inflammation in the digestion; they also spike the blood sugar, which in turn can cause the formation of excess triglycerides which then causes inflammation in the blood vessels and can lead to cardiovascular disease and diabetes.  Alcohol depresses the ability of the liver to move toxins from the body which can create more inflammation and also spikes the blood sugar.

Finally, food allergens or sensitivities can compromise the integrity of the lining of the digestive tract, which allows larger particles of foods to enter the bloodstream, which in turn can cause the body to have an immune reaction to those particles.  One particularly good example of this is the association between celiac disease and autoimmune thyroid disease.  The most common food sensitivites tend to be dairy, gluten, egg, and soy, but the body can react to any food; testing or elimination diets can be useful to help sort this out.

Omega-3 fatty acids:  These fats have gotten a lot of press in the past 15 years because of their remarkable ability to decrease inflammation and improve the texture and quality of the skin and mucus membranes.  Omega-3 fats divert the biochemical pathway that normally creates inflammatory cytokines to a pathway that creates anti-inflammatory mediators.  There are several good sources of Omega-3 fats on the market today: generally, our bodies are able to use animal derived sources (such as those found in fish)  more readily than vegetarian sources (such as flax or borage seed).  While krill oil has recently become quite popular as a supplement, I do not recommend it because I have been hearing reports that krill populations are becoming threatened due to overharvesting: I prefer to leave them for the whales.

Botanicals and Supplements:  There are a number of plant medicines available that are quite useful for decreasing inflammation.  These include curcumin, derived from the turmeric plant, quercetin, derived from onions, and boswellia, or frankincense.  Supplements such as deglycyrrhizinated licorice (DGL) and L-glutamine can help restore the integrity of the digestive tract.  There are also a number of proteolytic enzyme products on the market that can be useful for decreasing scar tissue that can form during times of chronic inflammation, which will decrease pain and increase the ability of the area to heal.

 

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“If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”  John Quincy Adams

As an “alternative” health care provider, I have seen over the years a tendency for patients to expect miracles. I am coming out today to announce that I don’t perform miracles. My job is to educate and inspire you to work your own miracles! I’ve mentioned this before, but my favorite part of this job is watching people develop greater self-awareness, and then powerfully use that awareness to improve their health. I have noticed that people who come in with a positive outlook and strong life purpose seem to make those improvements the most successfully, so I did a little digging to see what the research shows.

There is a growing body of evidence that shows our state of mind can positively influence our physical health. Studies have found that people with a well-defined sense of life purpose are overall more proactive about their health and more frequently take the time to utilize preventative health resources. Even beyond this, people with a strong sense of purpose have a decreased risk of stroke and heart attack, spend fewer overall nights in the hospital, and have an increased lifespan. Finding and maintaining an active engagement with our inner world and the world around us improves health.

The rapidly expanding field of epigenetics explores how environmental factors influence the expression of our DNA. While we are each given a packet of chromosomes at birth, the genes that are activated throughout our life that determine our physical and behavioral traits will vary based on our experiences and physical interactions. Interestingly, we are finding that people who have an overall perspective of well-being can actually shift their genetic expression towards greater health. Not only this, but it is possible that our attitude has an even greater effect than our conscious experiences. This means we have the ability to make our own health or at least shift the course of disease just based on the way we approach life.

Creating your own health is not just about being an optimist: health creation is a practice that you can consciously work on each day. One study showed that introducing a simple practice of gratitude improved subjects’ sense of well-being, sleep, and blood pressure. Each time you choose to eat something you know will make you feel good, get up a few minutes early to get some exercise, take a deep breath and smile at someone you care about instead of thinking about how they make you crazy, or ask someone for help when you need it, you are choosing health. And making your own miracles!

Yu L1, Boyle PA2, Wilson RS2, et al. Purpose in life and cerebral infarcts in community-dwelling older people. Stroke. 2015 Apr;46(4):1071-6

Kim ES1, Strecher VJ2, Ryff CD3. Purpose in life and use of preventive health care services. Proc Natl Acad Sci U S A. 2014 Nov 18;111(46):16331-6.

Barbara L. Fredrickson, Karen M. Grewen, Kimberly A. Coffey et al. A functional genomic perspective on human well-being. PNAS August 13, 2013 vol. 110 no. 33 13684-13689

Jackowska, Marta, Brown , Jennie, Ronaldson, Amy., et al. The impact of a brief gratitude intervention on subjective well-being, biology and sleep. J Health Psychol. 2015 Mar 2.

McKnight, Patrick E.; Kashdan, Todd B. Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory. Review of General Psychology, Vol 13(3), Sep 2009, 242-251.

Kim ES, Sun JK, Park N, Kubzansky LD, Peterson C Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: A two-year follow-up. J Behav Med 36(2):124–133. 2013

Kim ES, Sun JK, Park N, Peterson C Purpose in life and reduced incidence of stroke in older adults: ‘The Health and Retirement Study’ J Psychosom Res 74(5):427–432. (2013)

Hill, Patrick L., Turiano, Nicholas A. Purpose in Life as a Predictor of Mortality Across Adulthood Psychol Sci. 2014 Jul;25(7):1482-6

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In honor of Food Day, Chef Lilly Steirer and I have been talking about some of the great ways to incorporate more nourishing foods into our diets. One of the things she asked me was to comment on some strategies for helping our kids to eat well. Kids, mine included, can be very picky eaters, so here are some of my strategies for helping them to make nutritious choices:

Repetition–Often, just having a healthy option on the table, and asking the kids to eat just a little of it, will pay off over time as they become accustomed to it.

“Deconstructed” meals–One thing that has been helpful for getting my kids to eat well is recognizing that, while the whole meal may not look appealing, the individual components of the meal often are. I often serve “deconstructed” meals. For instance, if you make a chicken curry, you can reserve some of the plain cooked chicken, veggies, and rice and allow the kids to use the sauce as they please.

Healthy alternatives–Have fruits, veggies, nuts, and healthy crackers available when they reach for a snack. At dinner time, make sure there is a protein, a healthy starch such as brown rice, quinoa, or whole grain pasta, and a vegetable available.

Ownership–letting your kids choose from an array of healthy options helps them be more excited about eating. My kids always eat more of their lunches when they make their own or we talk about what they want to eat when I pack it.

Gardening– Gardening has also been a great way to get my kids excited about eating fresh fruits and vegetables because they have seen them from seed to table and they feel a sense of ownership and pride with the produce we have produced.

Good Attitude–If your kids see you being picky about food, they are more likely to be less adventurous.

Moderation–Treat treats like treats, not habits. A small bite of good quality dark chocolate is not the same as an entire Hershey bar. Instead of soaking pancakes in syrup, my kids love a small pool to dip in. Life and eating should be fun, just keep things in check.