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Inflammation: It’s Not Always A Bad Thing

A number of buzz-words appear repeatedly in health claims, such as natural, antioxidants, organic, and inflammation. Inflammation has been implicated in a number of chronic diseases, including diabetes, Parkinson’s, rheumatoid arthritis, allergies, atherosclerosis, and even cancer. Inflammation has been demonized, and is usually thought of as a bad thing. But it is not all bad.

In a study in Nature Medicine in September 2011, a research group led by Dr. Umut Ozcan at Children’s Hospital Boston (a teaching hospital affiliated with Harvard Medical School) reported that two proteins activated by inflammation are crucial to maintaining normal blood sugar levels in obese and diabetic mice. This could be the beginning of a new paradigm. Ozcan says

This finding is completely contrary to the general dogma in the diabetes field that low-grade inflammation in obesity causes insulin resistance and type 2 diabetes. For 20 years, this inflammation has been seen as detrimental, whereas it is actually beneficial.

Increasing levels of these inflammatory signals might actually be therapeutic in diabetes and obesity. On the other hand, they might worsen inflammatory diseases like asthma and rheumatoid arthritis. Ozcan’s findings are intriguing and might eventually lead to new treatments, but there are no clinical applications as yet.

Inflammation is part of the body’s response to infection and tissue damage, and it is crucial to the healing process. It is important for muscle growth with exercise, but conversely, chronic inflammation may be part of the reason for muscle loss in aging. When inflammation is chronic, it can lead to a number of diseases, from atherosclerosis to rheumatoid arthritis. Inflammatory markers are prominent in obesity, and higher levels are associated with meals high in calories and in saturated fat. Strenuous exercise markedly increases the levels of inflammatory markers.

It is simplistic to talk of “inflammation” as a single phenomenon, since it is a complex response involving many different physiological processes, from vasodilation to neutrophil infiltration, from the complement system to cytokines. And its relationship to health is even more complex. The human organism is a mesh of interrelated networks, and it could be hazardous to meddle with one element without understanding how our intervention might affect other parts of the system.

Certain foods are hyped as anti-inflammatory and certain dietary supplements are marketed with claims that they are anti-inflammatory. Integrative medicine guru Andrew Weil promotes both foods and supplements. Unfortunately, it is not clear that they can actually reduce the kind of inflammation that is associated with chronic diseases, or that such reductions actually prevent or improve the clinical course of those diseases. It is conceivable that they might  lead to harm as well as benefit. If they really diminish the body’s ability to mount an inflammatory response, wouldn’t that also tend to impair wound healing and response to infection? Fortunately, most of the anti-inflammatory diet recommendations are consistent with consensus recommendations for a healthy diet (lots of fruits and vegetables, etc.). Anti-inflammatory medications like NSAIDs and steroids do reduce inflammation, but they have had limited use in treating diseases associated with chronic inflammation, and they have problematic side effects. In fact, steroids make people more vulnerable to infection.

For the present, we have only hints. Research like Dr. Ozcan’s will help us better understand the risks, benefits, and complexities of inflammatory processes. Meanwhile, it’s a mistake to oversimplify and to assume inflammation is always a bad thing, and trying to prevent or treat it with special foods and supplements is little more than a shot in the dark, a gamble based on speculation. Eat your vegetables and stay tuned!

*This blog post was originally published at Science-Based Medicine*

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