A term coined by the ancients and widely ascribed to a range of MSK presentations, the word comes from the Latin, ‘inflammare’, to set on fire, and can be characterised by the four cardinal signs that we today, recognise as a classic response to injury, infection or danger;
- Rubor – redness
- Tumour – swelling
- Calore – heat
- Dolore – pain
Inflammation is driven by our immune system. It is a form of oxidative stress and acts as powerful, and necessary, defence against insult or invasion.
This important phase in the repair response can be considered as the first stage of healing but one which, by virtue of its defensiveness, inflicts unintended collateral damage upon our tissues. For this reason, the inflammatory phase of healing is only ever designed to be acute – a short term assault, persisting for about 1-3 days.
While inflammation in the short term is adaptive, when it persists beyond the acute phase, is triggered without an appropriate insult or becomes dysregulated, it is no longer considered healthy. This chronic or ‘silent’ inflammation is low grade and lingering, often below the level of perceived pain, and rather than being a repair mechanism, becomes disease-promoting. An increasing number of non-infectious diseases (such as autoimmune conditions, neurodegenerative disease, metabolic disease and cardiovascular disease) are now considered as being driven by chronic inflammation.
Although we do not know precisely what induces chronic inflammation and promotes its prolongation, it is useful to consider that there are a number of things that affect our bodies ability to heal, some of which lie within our control and others beyond. Removal of the initiating stimulus (such as repetitive micro-trauma) is necessary to allow resolution and a return to the status quo, but factors such as age, nutritional state, medication use, a sedentary lifestyle, systemic disease and stress are also involved in modifying our response to inflammation.
So what are some simple and effective lifestyle considerations that we can implement in order to promote a healthy immune response to injury or infection and prevent a tendency towards rising inflammation?
- Reduce the duration of a stress response
Our autonomic nervous system is made up of two branches, the sympathetic and the parasympathetic, which work together (largely unconsciously) to regulate functions such as heart rate, digestion, respiratory rate and body temperature. Sympathetic input to your heart increases your heart rate and parasympathetic input lowers it. If your heart needs to beat faster, the tone of the sympathetic input is raised and the tone of the parasympathetic input is reduced but both continue to provide input.
When we experience stress, our body sets off a series of chain reactions that prepare the body for threat. The sympathetic tone increases, the parasympathetic tone falls and the hypothalamus (the hormonal control centre within the brain) triggers the release of the stress hormone cortisol. A healthy adaptive response to stress (whether it be psychosocial or physical) is a return to baseline after a stressful experience. We can support an increase in the parasympathetic tone of our nervous system in a number of ways.
- Use the power of breath. Slowing your breathing rate down, aiming for 6-7 breaths per minute
- Engage your senses. Listen to nature, go into nature, listen to music you love
- Engage in light exercise
- Invest in a good social network and prioritise loving relationships
- Hug the people you love. Simple human touch is a powerful tool for raising oxytocin levels
- Support a healthy microbiome and intestinal wall integrity
Our microbiome plays an important regulatory role in the function of our immune system and the modulation of our response to stress with a robust microbiome being resilient and adaptable to change. Diversity is the key in supporting a variety of organisms that can collectively downregulate invading pathogens and an inflammatory response.
Our intestinal wall acts to provide a barrier between self and the outside world. A checkpoint for the immune system, it is here that unwelcome agents such as viruses or bacteria are prevented from entering the body and citing an inflammatory response, usually without the characteristic signs of inflammation that we know. Intense exercise, heat exposure, and stress, as well as medications such as NSAIDs and a poor diet all, contribute to a ‘leaky gut’ by increasing the permeability of the intestinal lining.
- Regular exercise can reduce stress but intense exercise is stressful and leads to chronic inflammation. Incorporate recovery into your exercise routine
- Be judicious about your use of medications such as NSAIDs (aspirin, ibuprofen)
- Avoid artificial sweeteners and any form of processed sugar
- Alcohol is best avoided
- Consider reducing your intake of red meat and dairy products; both are thought to be disruptive to the intestinal barrier
- A high-fat diet increases intestinal permeability
- Try to eat a wide selection of plant-derived sources of fibre every day; include a portion from different plant groups such as seeds, nuts, legumes, cruciferous vegetables, tubers, fruits, spices, grains. Different bacteria thrive on different substrates and dietary fibre strengthens the integrity of the mucous layer that lines the intestinal wall. Eat the rainbow!
- If your diet permits, enjoy eating oats on a regular basis. They are a rich source of soluble fibre
- Zinc has an important role in the repair of the gut wall. Nuts, vegetables and meat all contain zinc
- Use a good quality probiotic, recommended to you by someone you trust! Regularly adding good bacteria to your armoury is supportive
- Consider ferments such as yoghurt, sauerkraut, natto and kimchi in small amounts
- Promote healthy insulin dynamics
Insulin resistance is one of our bodies response mechanisms to stress. By design, it is protective, such that our brain is able to coordinate an escape strategy in the face of danger. When our stress levels remain elevated in the long term, we become less responsive to the hormonal cues of insulin, signalling the transport of glucose from the blood into our bodies cells, resulting in increasingly high blood sugar levels.
Dietary patterns, sedentary behaviour and irregular sleep all have associations with insulin resistance.
- Magnesium intake has been shown to improve insulin dynamics. You can improve your dietary intake by consuming dark green vegetables, seeds and nuts such as pumpkin seeds, sunflower seeds, almonds and cashews!
- Choose whole forms of grain over flour
- Dense, non-leavened breads are better for your insulin dynamics as are slow-digested starches i.e. green bananas
- Adding psyllium husks to a carbohydrate-based breakfast improves insulin dynamics
- Unless you are an athlete avoid processed protein powders
- Consider adding turmeric to your cooking! In addition to its anti-inflammatory benefits, it may help against insulin resistance. Take turmeric with a tiny bit of black pepper and a little fat.
- Physical activity, regardless of diet, reduces your risk of insulin resistance. Take a walk after every meal. If you have a sedentary job, stand up and walk around once every 30mins. Minimise your seated time! Schedule walking meetings and phone calls and walk instead of using public transport
- Insulin sensitivity is best during the ‘active’, daytime hours in humans. It is best to restrict eating to the daytime for this reason! Try to limit eating from evening onward
- Try to sleep at least 7 hrs every night
The article was written by Dr Bryony Sullivan (Chiropractor)
- STORONI M, 2019. Stress proof. The ultimate guide to living a stress-free life. Great Britain; Yellow Kite, Hodder & Stoughton Ltd.
- RUSCIO M, 2019. Healthy gut, healthy you: the personlised plan to transform your health from the inside out. Nevade; The Ruscio Institute, LLC.
- MACCIOCHI J, 2018. The inflammatory mind. <https://www.drjennamacciochi.com/blog/2018/7/13/inflammatory-mind-matters>