Dietary Modulation of Inflammation

Mary Vernon, MD, CMD

Inflammation

What does this mean, exactly?

In “doctor speak”, inflammation refers to both the end product and the pathway to the end product. The inflammatory response is a series of chemical messages which lead to a change in the function of the body.

So, when you receive a mosquito bite, the mosquito saliva is recognized by your body as “foreign”-not “self”. This initial recognition process triggers a cascade of chemical responses which cause blood vessels to dilate and leak, white blood cells (neutrophils, the primary invader fighters) to migrate to the area and out from the blood vessel into the tissue from whence the alarm was sent. Once these front line fighters arrive on the scene, they deposit packets of digestive enzymes onto the invading substance -which is marked for them by chemical tags placed by the cells that did the initial me/not me assessment. (Does this sound like a game of paintball?)

The chemical tags that attach to the invader saying “not me, destroy” are released by cells already distributed throughout your body. These cells send out the chemical messages that diffuse through the fluid between the cells and even into the blood stream. The neutrophil blood hounds pick up the scent, and while trailing the scent to the target these cells release more hormones (chemical messengers) to lead others to the site of the invasion. Pretty soon the mosquito bite area itches, swells and turns red. (These changes are the outcome of the blood vessel swelling and the digestive enzymes from the white blood cell.) Here is an important point-IT ISN”T THE MOSQUITO, IT”S YOUR BODY’S RESPONSE that cause the irritating sensation.

Of course, this might be a good thing-if it keeps you swatting mosquitoes and avoiding West Nile disease or malaria, and/or a bacterial infection from the mosquito’s mouthparts.

There are, of course, ways this system can go awry. Because the system is genetically determined (there are different tissue “types” just as there are different blood types) differences exist in how vigorously an individual’s body responds. This can vary both in the “turn on” and "turn off” areas of control. Obviously, the response must have a way to be turned off just as it is turned on. All true-and all subject to genetic variation.

An example of this is red-headedness-that pattern of skin pigmentation that is associated with fair skin, red hair and blue eyes. Red heads have thinner skin (literally-they are not just irritable), more blood vessels per body surface, and often don’t turn off one of the inflammation signals (IGE) very well. They lack the “turn off” gene. This results in a situation called allergy. All that sneezing and runny nose and itchy eyes happens because the body won’t quit when faced with the foreign invader: pollen.

Some enterprising thinkers believe this response had an evolutionary benefit-such as fewer parasites. Maybe so. Hard to prove.

Here is another problem. Sometimes your body recognizes itself as foreign. Then this destructive response is directed against one of your own tissues-and since your body continually replenishes those tissues, there is an almost endless supply of substrate to trigger this immune response.

This is the case in many of the vasculitis related disease processes-like Wegner’s and lymphomatiod granulomatosis, lupus, etc.

What can one do about this? If you have this problem, must you simply be a victim of your genetics? Not necessarily.

Actually, there are things you can do.

Your body has a baseline level of inflammatory chemicals-what we call “constitutive inflammation”. You are born with that program in place. But due to some interesting chemistry, you can alter this somewhat by (can you believe it) what you eat!

Most animals, you included, can’t make all of the chemical building blocks your body uses to construct itself. For example, your body can make glucose and most kinds of fat. But you can’t make the “essential” fatty acids or the “essential” amino acids. You must eat these-then your body can use them to build other things. FYI-plants can make the “essential” fatty acids that animals can’t make. So the good thing about fish oil are the oils the fish saves from the plankton it eats-or the plankton eaten by the fish the fish eats.

In spite of the buzz in our culture about fat (most of which I think is incorrect), fat is critical in the assembly of membranes and cell structure. Cells are enclosed by membranes which keep the outside out and the inside in and most importantly, move molecules in and out as needed. Because of this ability to move stuff in and out, the membranes are called “semi-permeable”. Fats in the membrane determine structure (how stiff or deformable the membrane is), what goes through the membrane and (wait for it) these same fats are the basis for the inflammatory signals discussed earlier.

Yes, right there in the cell wall of your skin cell are the building blocks of the chemical inflammation messages.

These building blocks are of 2 kinds-both related to fats you can’t make yourself, but must get from your diet.

These are called the omega-3 and the omega-6 fatty acids.

Here are the general characteristic of each:

Omega-3s make membranes less stiff, more easily deformed, decrease clotting and are the precursors to anti-inflammatory chemical messages-the “laid back” type.

Omega-6s make membranes stiffer, increase clotting, and are the precursors to the inflammatory chemical messages-the “pugilistic” type.

You need both of these. Omega-6s are the precursor to arachadonic acid (first identified as a portion of the spider skeleton and thus the name) which does many things. The arachadonic acid in the cell wall helps to hold the shape of the cell, if that function is needed. The enzymes that make the inflammatory messengers nip off fatty acids from nearby membranes as the starting point for the construction of the inflammatory messengers. The building blocks of the pathways are the same-so one has either arachadonic acid (ARA) or eicosapentanoic acid (EPA) as the end product of this construction pathway.

Way back when, about the time early hominids were making drawings in caves in France, the ratio of the omega 3/omega 6 fatty acids in the diet was about 1:2. Today it is about 1:20. That’s a pretty big increase in the amount of the pro-inflammatory essential fatty acids in our fuel source.

Why is that, you wonder? Well, because we eat foods that are high in either these oils themselves (like corn and soy) or we eat animals fed corn and soy. You might be surprised to know that foods advertised to be healthy, such as farmed salmon, which is fed artificially colored grain pellets, is high in omega 6s. Wild salmon is high in omega 3s-because the wild salmon ate fish that ate plankton and algae which are high in omega 3s.

So one intervention that is simple to make and potentially helps change the baseline inflammation in your body is to change the amount of omega 3 fatty acids in your diet. Of course, choosing grass fed beef and free range chicken and eggs and eating leafy greens is helpful. You can eat algae yourself-but the amounts needed are huge. The world’s oceans and fish stocks can’t tolerate us all eating wild fish-we have already impacted this resource in an unfavorable way. And those fish oils you buy to help your heart are made from squished fish-which impacts the marine environment and has the potential for contamination from anything we dump in the oceans. (Nauseated yet?)

Is there a solution? Yes. A company in Boston called Martek grows algae in clean water under glass and extracts the oils. (I do not own their stock.) This is this supplemental oil which the FDA allows to be used in baby formula. They sell this as DHA-another fatty acid in the chain on the way to constructing the EPA which is the anti-inflammatory end product fatty acid. Because of various metabolic quirks, our bodies easily take DHA to EPA. So ask your health food store to get Martek DHA-which they can buy from Martek but is sometimes re-packaged by other companies like Solaray.

A good starting dose is one tablet with each meal.

Add a mixed gamma tocopherol tablet (be sure it says mixed gamma, not alpha, tocopherol) once a day. This is a good anti-inflammatory baseline.

Baseline? Is there something else one can do to help the inflammation in the body?

Yup, sure enough.

This is my area of personal interest because it has to do with the fuel source in the body.

Your body can burn fat or carbohydrates (sugars and starches) for energy. It can turn protein into sugar to be burned, but it does not directly burn protein.

Your body tightly controls blood sugar, keeping it in a narrow range as long as possible. Any excess sugar above that range is rapidly burned or stored-and your body cranks up the hormone insulin to trigger fat storage whenever you eat carbohydrates or your blood sugar rises.

Even though this allows one to store energy for future use (an evolutionary leap so impactful that all animals on earth have the hormone insulin, even earthworms), there are some downsides to burning large quantities of carbohydrates.

When carbohydrates are burned in the cellular furnace called the mitochondria, some by-products called reactive oxygen species (ROS) are formed. (Think of the ROS as the equivalent of the sparks released when you have a wood fire.) These ROS “spark” into the cell membranes and cause damage. The accumulated damage destroys membranes and connective tissue.

On the other hand, when fat is burned in the mitochondria, these ROS aren’t made, at least not rapidly. A further benefit of fat burning is that a by-product of fat breakdown called ketones may actually quench some of the ROS.

Wait a minute! It sounds like burning fat for fuel is actually good for a person. Yes, that is indeed what I mean to say. Fat good, sugar bad. Not the usual diet buzz, eh?

Here is another reason why I believe the above: Sugar and starch in the diet (carbs) trigger the production of the storage hormone insulin. I know, I already said this. So what is bad about insulin?

Nothing, when it is present in the right amounts at the right time. The right amounts are small and basically get you from breakfast to lunch in terms of storage-not the equivalent of a year of fuel packed on as fat.

When insulin levels are chronically high and don’t drop down between meals, then fat burning is blocked. (Insulin’s goal is fat synthesis and protection.) Approximately 75 % of the population of the US and Canada is in this situation-excessive fat storage due to excessive insulin.

Check it out-in addition to shifting the fuel source of the body toward the sugars, which make ROS, insulin tells your liver what fats to make (cholesterol and triglycerides) and it blocks some of the pathways in the fatty acids construction.

High levels of insulin:

1) Increase production of ROS

2) Block fatty acid pathways

3) Block fat burning

4) Block the production of fat breakdown products which might help in the clean-up of the ROS.

YOU WILL NEVER EAT ANOTHER DOUGHNUT, YES?

Credentials:

President, American Society of Bariatric Physicians

Co-author, Atkins Diabetes Revolution

Email: mvernonmd@yahoo.com