Last week we started a series on systemic chronic inflammation, which we discovered is the common denominator to a whole range of common lifestyle-related diseases affecting a large part of the world’s population – especially in the Western world.
Conditions such as obesity, diabetes, heart disease, auto-immune disease, cancer and Alzheimer’s disease all have chronic inflammation as their basis.
This means that if we can prevent the chronic inflammation in the first place, or reverse it, we have a good chance of reversing the disease processes that affect so many people. Thankfully this has been the subject of intense research, and there is so much good scientific confirmation of this thesis.
Actually the specialty of lifestyle medicine is founded upon the principle that reversal of lifestyle diseases is within the possibility of each of us through lifestyle interventions. These include dietary changes, exercise, adequate rest, dealing positively with stress, living a purpose-filled life, social connectedness and spiritual fulfilment.
Over the next few weeks we will be examining how each of these interventions has been shown through research to suppress inflammation and restore health.
We also discussed some of the triggers of acute inflammation – infection, trauma, chemical injuries, but also metabolic noxious stimuli (toxins related to disturbed metabolism).
However chronic inflammation is not as likely to be caused by infection and trauma, but more likely by chemical and noxious stimuli. It often increases with age – we know this by the measurement of higher levels of cytokines, chemokine and reactive proteins, as well as greater expression of genes involved in inflammation.
One of the simplest ways of checking for inflammation is by measuring the CRP (C-reactive protein) which is a simple test available in all medical laboratories.
Unfortunately this chronic inflammation causes collateral damage to tissues and organs over time. Here are some of the diseases involved:
- Metabolic syndrome – including high blood pressure, high blood sugar, high cholesterol
- Type 2 diabetes
- Non-alcoholic fatty liver disease
- High blood pressure on its own
- Cardiovascular disease (which can result in heart attacks, strokes, peripheral vascular disease and aortic aneurysms)
- Chronic kidney disease
- Various types of cancer
- Depression
- Neurodegenerative diseases (like dementia, Alzheimer’s disease, Parkinson’s disease)
- Autoimmune diseases
- Osteoporosis (fragility of bones)
- Sarcopenia (loss of muscle mass, common as people age)
The strongest evidence of the relationship between chronic inflammation and lifestyle diseases is found between rheumatoid arthritis and metabolic syndrome, type 2 diabetes, heart disease and cancer. People with rheumatoid arthritis – a chronic inflammatory condition have a higher rate of these other diseases.
Another fact is that elevated CRP levels are a predictor of cardiovascular events in both men and women. This fact was demonstrated in a recent meta-analysis of 160,000 people in 54 long-term prospective studies.
Another compelling evidence is how interventions that suppress pro-inflammatory cytokines can reduce insulin resistance in patients with rheumatoid arthritis.
The ability to assess chronic inflammation is still at an early stage of development, and it is likely that better methods will be available in the future with more research. However what is more important than being able to assess inflammation is knowing how we can suppress or reverse the inflammation.
Next week we will look at the actual sources of many of the factors associated with both ageing and increasing inflammation so often associated with chronic lifestyle diseases. Much of this information comes from a comprehensive article by Dr David Furman and colleagues.
I’m looking forward to sharing with you different ways of reducing chronic inflammation and improving your health.
Don’t get lax with social distancing, hand washing, mask-wearing and avoiding touching your face, nose and eyes with unwashed hands. Covid is exploding locally, and we are seeing more and more people we know personally that have been infected.
Dave Glass
Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.
He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.
An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.
He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.
