April 05

The Hidden Fire
If you believe inflammation is just about swollen, painful joints, think again. It may actually trigger major killers such as heart disease and cancer. Learn how you can dampen this insidious blaze inside your body before you get burned.

By Lisa James

   You can’t see it and you can’t feel it. It can quietly simmer within your body for years—even decades—before making its presence known. If it does appear, chances are you still won’t see it for itself, but you will recognize its results: The diseased heart, the sky-high blood sugar, the abnormal spot on an MRI.
   It is inflammation, the intricate physiological response called forth to protect the body against the mishaps—a tumble off a step, an encounter with an angry germ—of a hazard-filled world. When this biological fire functions as it should, it serves an important purpose. But inflammation that continues unchecked can, like a campfire-turned-wildfire, wreak widespread havoc on your health.
   Immune-system chemicals called eicosanoids (I-kO-sa-noids) control the inflammatory response; some trigger it, others quench it. Twist an ankle, for example, and pro-inflammatory eicosanoids produce swelling, redness, heat and pain—the familiar signs of acute inflammation. This indicates an immune system hard at its healing work (the pain forces you to keep off that bum leg, for starters). After a few days the discomfort subsides, thanks to anti-inflammatory eicosanoids.
   When the pros constantly overwhelm the antis, though, the body can go into a state of chronic inflammation (also known as silent inflammation). “The difference lies in the perception of pain,” says Dr. Barry Sears, creator of the Zone Diet and author of The Anti-Inflammation Zone (ReganBooks). “In classic inflammation, something hurts and you take action. Silent inflammation is below the perception of pain so that it can linger on for years.”

Feeding the Flames
   Eicosanoids are formed from fatty acids, which come in two basic types—pro-inflammatory omega-6s (especially arachidonic acid, or AA) and anti-inflammatory omega-3s (especially eicosapentaenoic acid, or EPA). Up until the early 20th century, most people ate diets in which the ratio of omega-6 to omega-3 was roughly 2:1. However, omega-3 has a shorter shelf life, which is why it has been mostly eliminated from the processed consumables that started pouring out of food factories at the beginning of the 20th century. Nowadays the omega-6/omega-3 ratio is about 20:1—and a higher ratio means more inflammation.
   The amount of sugar and other refined carbohydrates in the standard American diet also fuels the silent fire. “High blood sugar leads to high levels of insulin, which causes an increase in the fatty acids that cause inflammation,” says Dr. Sears, who notes that insulin also promotes production of interleukin-6 (in-ter-'lü-kin), an inflammatory immune-system chemical. In addition, excess sugar binds with protein to form advanced glycation end products (AGEs), which accumulate in tissues with inflammation-provoking results.
   Some alternative-medicine practitioners believe that inflammation is on the increase because of rising allergy rates (about 30% in most developed countries). “Children are filled with allergies and adults are, too, although they don’t know it,” says Nancy Appleton, PhD, nutritionist and author of Stopping Inflammation: Relieving the Cause of Degenerative Diseases (Square One). She says that food allergies in particular are more common than many people think; such allergies can cause leaky gut syndrome, in which disordered bowel walls allow toxins and wastes to invade the bloodstream, spreading inflammation throughout the body.
   All of this inflammation prompts the body to create cortisol, the main anti-inflammatory hormone. And while a little cortisol is good thing, continued inflammation means continued cortisol production, which can cause anything from insulin resistance (a diabetes precursor) to dying nerve cells to immune-system suppression—not a pretty sight.
   Like an underground fire burning its way upward, the dangers posed by silent inflammation are starting to surface in the public consciousness—”It’s a complex subject, but they know it’s bad,” says Dr. Sears. The reason? CRP.

The Inflamed Heart—and Beyond
   Several years ago, doctors noticed a connection between heart disease and an inflammation marker called C-reactive protein (CRP). This protein, which can be detected via a simple blood test, was found to be an even better predictor of heart attack or stroke than cholesterol, according to a study of nearly 28,000 women in The New England Journal of Medicine (11/14/02). In fact, of the women who eventually developed heart disease, more than half had “normal” cholesterol levels.
   Heart attacks are commonly caused by the rupture of fatty deposits called plaques within coronary arteries. “Pro-inflammatory eicosanoids inside an unstable plaque can trigger the inflammation that increases the likelihood of rupture,” says Dr. Sears. And if that wasn’t enough, inflammation amplifies the cardiovascular risks posed by high blood pressure.
   “You can look at virtually every chronic disease and see a considerable inflammation content,” says Dr. Sears. Take diabetes, for example: According to Dr. Sears, the incidence of this disorder has gone up 33% over the past decade—the same time period that has seen dramatic jumps in both obesity and silent inflammation.
   The brain, too, suffers when inflammation goes out of control. Dr. Sears says that people who have taken anti-inflammatory agents long-term “have a much lower incidence of Alzheimer’s disease than the general population.” Other neurological disorders—including multiple sclerosis, attention deficit disorder and Parkinson’s—also have strong inflammatory components.
   Cancer, the disease many people fear the most, is another disorder aided by silent inflammation. Dr. Sears explains that cancer becomes lethal when it spreads from its point of origin, a process fostered by eicosanoids formed from the inflammatory omega-6 fat arachidonic acid. Research is starting to confirm the cancer-inflammation connection; one study has shown a link between high CRP and an increased risk of colon cancer (JAMA 2/4/04).

Dousing the Flames
   Is there any good news about silent inflammation? Yes—that you can take refuge in your kitchen instead of a prescription bottle. “Fighting silent inflammation is a lifelong struggle and therefore diet becomes your most cost-effective way to keep it under control,” says Dr. Sears.
   You can start by ditching the sugar bowl (along with other refined carbs, such as white bread, pastries and pasta). “Sugar is addictive, literally, just like cocaine, alcohol, caffeine or tobacco,” says Nancy Appleton. “I was on a call-in show and a man yelled, ‘Help me! I’ve lost my job, my wife is threatening to leave me and I just can’t stop eating the stuff!’” Soft drinks are a particularly insidious sugar source; lemon water is a good alternative. Dr. Appleton also recommends building your diet around vegetables, fish and—if you aren’t a vegetarian—free-range, organically fed meat. Be sure to avoid foods that provoke a discomforting response; even healthy foods such as apples, whole wheat and mushrooms can cause allergic reactions in sensitive people.
   The other step is to get more of the healthy, inflammation-easing omega-3 fats into your life. Flax—either the seed or the oil—is a good source of alpha linolenic acid (ALA), which your body can convert into EPA. However, Dr. Sears suggests you obtain your EPA directly in the form of high-dose fish oil, taken with food.
   Silent inflammation not only threatens your health, it menaces the healthcare system as we know it. “Six years from now, in the year 2011, our entire healthcare system will crash into chaos when the baby boomers, suffering from inflammation-based diseases, can access Medicare,” warns Dr. Sears. “We can’t pay the bills looming ahead, no matter how rich our nation is.” Preventing disease by quenching inflammation’s hidden fires is the best way to go for the country—and for you.

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