Do you suffer from acid reflux disease or irritable bowel syndrome? Do your gums bleed when you brush your teeth or eat hard foods? Are your joints or back frequently achy and uncomfortable? Are you overweight and inactive?
If you answered "yes" to any of these questions, you could have chronic inflammation, something more damaging to your heart than high blood pressure or even high cholesterol. "I can talk to a person for five minutes and determine whether they are at risk of a heart attack by asking those questions, because they pinpoint some of the most common sources of inflammation in the body," says Decker Weiss, NMD, FASA, a naturopathic cardiologist at the Arizona Heart Hospital in Phoenix.
Although inflammation is not inherently bad—without it, our bodies wouldn't be able to heal cuts or broken bones or defend against foreign invaders, such as viruses or bacteria—chronic inflammation can be extremely damaging, particularly to the heart. According to a 2002 study, chronic low-grade inflammation increases heart attack risk even in people with normal or low cholesterol levels (New England Journal of Medicine, 2002, vol. 347, no. 20). "It is not cholesterol alone that causes heart disease; inflammation is the main reason," says Nancy Appleton, PhD, author of Stopping Inflammation (Square One, 2005). In fact, 50 percent of heart attacks occur in people with total cholesterol levels below 150—generally considered optimal by health practitioners, says Richard Fleming, MD, author of Stop Inflammation Now! (Putnam, 2004).
Fortunately, you can take steps to dampen chronic inflammation—or, better yet, prevent it from occurring in the first place. Here are some concrete ways to create a healthy, anti-inflammatory lifestyle.
Inflammation for better or worse
Inflammation is the body's first line of defense against injury and infection. If you cut yourself, for instance, acute inflammation is what arouses the immune system and causes the redness, heat, swelling, and pain around the injury. These symptoms are signs that the body is rushing blood and immune factors to the wound to prevent infection and jump-start the healing process.
But unlike acute inflammation, which usually dissipates within a few days after healing, chronic inflammation doesn't go away. "It's a continual response of the immune system to what it perceives as an ongoing problem," Appleton says. It has been linked to degenerative conditions, such as asthma, diabetes, Alzheimer's disease, and cardiovascular disease.
Chronic inflammation is also linked to cholesterol buildup within the arterial walls. "Inflammation boosts the immune system, which is what carries cholesterol into the arteries to make the blockages," Weiss says. These blockages can rupture and lead to a heart attack or stroke.
The causes of chronic inflammation are many and include periodontal disease, rheumatoid arthritis, and viral and bacterial infections. Smoking, obesity, inactivity, and a poor diet that includes more sugar and processed foods than fresh fruits and vegetables also promote chronic inflammation.
Pain or swelling usually accompany inflammation, but, as Appleton explains, "many times you can have this low-grade inflammatory response that is very destructive to the body and not even realize it." To gauge your inflammation level, ask your doctor to test your blood for C-reactive protein (CRP). Many doctors now believe that testing CRP levels is critical to assessing cardiovascular disease risk because the higher your CRP levels, the greater your chances of having a heart attack. "In the future, the CRP test will be part of the normal blood tests conducted during a routine physical exam," Appleton predicts.
Don't feed the fire
What you put into your mouth plays a major role both in preventing and promoting inflammation. High-glycemic foods, such as sugar, white bread, doughnuts, and processed cereals, cause the body's blood sugar levels and insulin levels to spike. Prolonged high insulin levels can damage tissue, which in turn will crank up inflammation. A 2002 Harvard Medical School study found that women who ate large amounts of high-glycemic carbohydrates had significantly higher CRP levels, which have been linked to increased risk of heart attack (American Journal of Clinical Nutrition, 2002, vol. 75, no. 3).
Saturated fats and partially hydrogenated oils (trans fats) amplify inflammation by boosting the production of pro-inflammatory cytokines, a hormone made up of fatty acids. Most omega-6 fats—found in safflower, sesame, sunflower, corn, and some other vegetable oils—also promote inflammation.
But not all fats feed inflammation. Omega-3 fatty acids—found in deep-water fish (such as salmon, mackerel, tuna, and herring), walnuts, and flaxseed—actually suppress the inflammatory process by increasing the production of anti-inflammatory prostaglandins. One helpful omega-6 fat, gamma-linolenic acid (GLA), improves the anti-inflammatory effect of omega-3 fats. GLA has also been found to help with joint pain and other inflammatory conditions.
Fresh fruits and vegetables should be the mainstay of an anti-inflammatory diet because they are packed with antioxidants, which prevent inflammation by limiting free radical damage to the cells. Studies have also linked the consumption of vitamin C and other antioxidants to decreased CRP levels. Blueberries, cranberries, onions, and broccoli are particularly rich in antioxidants. Also, "eating lots of fruits and vegetables automatically controls your saturated-fat intake and prevents you from consuming more calories than you need," Fleming says.
Supplements can help battle inflammation, as well. Ginger, for instance, is believed to suppress cyclooxygenase-2 (COX-2) and other inflammation-related enzymes. Ginger can also help prevent blood clotting by keeping fibrinogen levels low in the blood. (See "Supplements to Decrease Inflammation" below for more information on helpful anti-inflammatory nutrients.)
Create an anti-inflammatory lifestyle
Maintaining a healthy weight bolsters heart health because it means fewer fat cells; these produce cytokines, or pro-inflammatory proteins. Although it is best not to carry any extra weight, abdominal fat poses the greatest risk because the fat cells here appear to produce the most cytokines. Being "shaped like an apple is dangerous; being shaped like a pear isn't as bad," Weiss says.
Daily exercise, such as yoga and brisk walking, can reduce inflammation by helping to shed excess pounds. Meditation, journaling, and other stress busters also serve as important components of an anti-inflammatory lifestyle because stress can trigger the production of the hormone cortisol, which can promote inflammation.
To prevent gum disease—another cause of inflammation—maintain a healthy mouth by brushing and flossing daily and regularly visiting the dentist. Also, find natural remedies for chronic ailments, such as working with a chiropractor to eliminate back pain or changing your diet to ease acid reflux, because this, too, will help stamp out low-grade inflammation. Says Weiss: "As your back pain and heartburn get better, you will know you are helping your heart, too."
Researchers continue to investigate the causes of chronic inflammation and its connection to heart disease and other ailments. The good news is that the choices you make in the foods you eat—and don't eat—and the activities you pursue can improve your heart health by dousing the inflammation quietly burning in your body.
Freelance writer Carlotta Mast can be found preaching the benefits of omega-3 fats, antioxidants, and other inflammation busters in Boulder, Colorado.