Body: This Inflammation Business

 

Fire pit. December 2010. Credit: Mzuriana.

My old, narrow mental model of inflammation

Historically, when I have seen the word inflammation, I have thought swelling., and depending on the source and location of the inflammation on the body, a swelling accompanied by reddened skin. Inflamed skin. Inflammatory speeches that incite violent reactions from the audience. On fire. Engulfed in flames.

My biases 

Bias #1: By nature, my brain goes oppositional when I start to see specific terms crop up frequently in our societal conversations. The influx of the term "anti-inflammatory" in recent years - sans any definition of same - earned my skepticism as a woo-woo catchall designed to promote the nutrition supplement industry, mass-market nutrition gurus, authors of best-selling diet books, and the like. 

In this context, my skepticism applied to the term anti-inflammatory as a mysterious and Very Bad Systemic Thing, and not to the concrete definition of inflammation I cited at the start. 

Bias #2: I view much of what's out there re: nutrition, supplements, food behaviors, et al as noise that may or may not have the empirical research to back it up. I look toward reliable sources of information, such as the Mayo Clinic, Cleveland Clinic, Johns Hopkins, or Harvard Medical websites. 

Bias #3: Even healthcare professionals, specifically doctors, physician assistants, and nurse practitioners - all highly educated, respected by me, and skilled - are vulnerable to trends. They're also susceptible to easy answers: It's a part of normal aging. Drink water. Exercise. Stop smoking. Lose weight. 

Bias #4: If we (professionals and patients alike) see a statistic or statement cited often enough, we tend to ascribe truth to it, without investigating the source or accuracy of the belief. A good example relates to how much water we should drink every day. I remember one widely-popular claim that averred: "If you are thirsty, it means you are already dehydrated." I'm willing to bet that the originator of that meme just pulled that out of her ass because it sounded good. 

Bias #5: Not all doctors are reliable sources of information. Dr. Oz, for one. 

So ... what is inflammation (systemic)? 

I like the University of Chicago's School of Medicine's  definition of inflammation. It is simple and clear:  

What is inflammation?

Inflammation is the body’s response to a problem. It’s a normal, important reaction that signals to the immune system that something is wrong, so it can then fight off infection or heal injuries. When you have influenza and run a fever, that’s inflammation. When you eat something bad and get diarrhea, that’s inflammation. Swelling after you twist your ankle? That’s inflammation, too. We need a little inflammation. We would die if we did not have inflammation.

Chronic inflammation, however, is another story. Chronic inflammation can damage healthy cells, tissues and organs. Over time, it can lead to diseases like diabetes, rheumatoid arthritis and heart disease.

 

When I read the above, and similar, definitions of inflammation, a light bulb flashed on. Nay, a floodlight. 

Ohhhh, I realized. This is very much like the physical manifestations of burnout! Where our body's stress reaction (fight or flight) doesn't stand down. Instead, it remains on high alert. Which means that the chemical soldiers that our bodies deploy for our stress response never return to their barracks to sleep, never go on R&R. 

In one of my past lives, I was a professional development trainer. To prepare for workshops on stress management and burnout, I had learned that when our bodies (including our brains) do not stand down from stress, a protracted stress response state most assuredly brings physical consequences. 

Of course our bodily soldiers cannot remain on high alert 24/7 without consequences. 

So I think I get it now. The whole thing about anti-inflammatory foods, supplements, exercise, etc. 

From Smithsonian, here's a list of how our minds and bodies respond to an acute stressor, readying us for fight or flight: 

... the nervous system instructs our bodies to release stress hormones including adrenaline, noradrenaline and cortisol. These produce physiological changes to help us cope with the threat or danger we see to be upon us. This is called the “stress response” or the “fight-or-flight” response.

... the respiratory system is immediately affected. We tend to breathe harder and more quickly in an effort to quickly distribute oxygen-rich blood around our body. ... 

... Cortisol released in our bodies suppresses the immune system and inflammatory pathways, and we become more susceptible to infections and chronic inflammatory conditions. Our ability to fight off illness is reduced.

... Our muscles tense up, which is the body’s natural way of protecting ourselves from injury and pain. Repeated muscle tension can cause bodily aches and pains, and when it occurs in the shoulders, neck and head it may result in tension headaches and migraines.

When stress is acute (in the moment), heart rate and blood pressure increase, but they return to normal once the acute stress has passed. If acute stress is repeatedly experienced, or if stress becomes chronic (over a long period of time) it can cause damage to blood vessels and arteries. This increases the risk for hypertension, heart attack or stroke.

The endocrine system also suffers. This system plays an important role in regulating mood, growth and development, tissue function, metabolism and reproductive processes. Our metabolism is affected. The hypothalamus is located in the brain and it plays a key role in connecting the endocrine system with the nervous system. Stress signals coming from the hypothalamus trigger the release of stress hormones cortisol and epinephrine, and then blood sugar (glucose) is produced by the liver to provide you with energy to deal with the stressful situation. Most people reabsorb the extra blood sugar when the stress subsides, but for some people there is an increased risk of diabetes.

... We might experience heartburn and acid reflux especially if we have changed our eating habits to eat more or less, or increased our consumption of fatty and sugary foods. The ability of our intestines to absorb nutrients from our food may be reduced. We may experience stomach pain, bloating and nausea, diarrhoea or constipation.

But. 

What is missing from almost all of the anti-inflammation stuff out there is how meditation and active stress management is likely necessary. Eating more oatmeal ain't going to be enough. 

And this leads me back to some old friends: 

• Dr. Dean Ornish
• Aldous Huxley's The Island
• Stephen Covey's Circle of Influence and Circle of Concern
• Victor Frankl's Man's Search for Meaning

Why Dr. Dean Ornish? Because he did not just follow a medical model of prevention and treatment for cardiovascular health. He integrated two non-medical components to his prescription: 

1. Stress management
2. Sustaining close, loving relationships with others, whether they be friends, family members, or both

Why Aldous Huxley's The Island? Because in this utopian novel, the practice of meditation and mindfulness ("here and now boys, here and now") were intrinsic to his utopian model of a healthy culture. 

Why Stephen Covey's Circle of Influence and Circle of Concern? Because the distinction between the two circles keeps us in our own lanes. We have power over things we can control (influence), such as how we choose to respond to others' behaviors. If we try to manipulate, manage, or worry about things and people over which we care about, but over which we have no control, then not only do we divert ourselves from effectiveness in our own lives, we may actually do harm to our relationships or to others, in general. Furthermore, the stress we feel when trying to manage or manipulate what others do or believe hurts us.

Why Viktor Frankl's Search for Meaning? Because he concluded, in his experience of the Holocaust, that we can't control all that happens to us, but we do have control over how we respond. We decide the meaning we place on what happens on us. 

Yeah, yeah, and so what? How does this relate to me as I travel in age?  

Well, now the inflammation thing makes sense to me. I'm now willing to take it seriously as a Real Thing that has gravitas; something I need to attend to. 

I want to stay in the Third Age as long as possible, before walking the inevitable trail to the Fourth Age. 

So for me, this new understanding translates into these actions: 

1. Be more prescriptive about what I eat. Choose foods that I enjoy and that seem to possess anti-inflammatory and anti-oxidant properties. 
2. Keep up the brisk walking discipline, not only most days, but for longer distances. 
3. Meditate. 
4. Gather and use tools to best manage stress. Practice mindfulness. 
5. Continue to build and sustain a close circle of hearts (family members and friends of diverse ages, backgrounds, and perspectives) that I give to and receive from. ' 
6. Embrace more real-life skill acquisition and problem-solving (I suspect these are more effective at maintaining or growing brain stuff than doing puzzles or word games.)

Dwan Light Sanctuary. Montezuma, New Mexico. August 2013. Credit: Mzuriana.