PDF Monthly Supplement Report Chronic Inflammation: Rocking the ...

Monthly Supplement Report

Chronic Inflammation: Rocking the Medical World

The world of medical science is undergoing a radical upheaval in how it understands the cause of almost all modern debilitating and "killer" diseases including: Heart disease, cancer, stroke, diabetes, Alzheimer's, rheumatoid and osteoarthritis, multiple sclerosis, fibromyalgia, chronic fatigue, macular degeneration, Crohn's, allergies and more. The two words that are rocking the medical world are: CHRONIC INFLAMMATION.

Dr. Paul Ridker, a cardiologist at Brigham and Women's Hospital, and the father of modern inflammation research said in a cover article about chronic inflammation in Time magazine (February 23, 2003), "Just a few years ago, nobody was interested in this stuff. Now the whole field of inflammation research is about to explode."

Dr. Andrew Weil (), leading integrative medicine specialist says, "Chronic inflammation just may be the root of all degenerative disease." And professor of gastroenterology at the University of Aberdeen, UK, Emad ElOmar, says in an article in The

by Mairi R. Ross, B.A.

Scientist (July 14, 2003), "I personally believe that chronic inflammation is the root of all evil." Time magazine states,

"A substantial body of evidence supports the conclusion that chronic inflammation

can predispose individuals to cancer...

the longer the inflammation persists, the higher the risk."

"Instead of different treatments for, say, heart disease, Alzheimer's and colon cancer, there might be a single, inflammation-reducing remedy that would prevent all three."

Medical research supports what these medical experts are saying. The cancer medical journal Oncology published a landmark study, "Chronic Inflammation and Cancer" in its February, 2002 issue. The authors concluded, "A substantial body of evidence supports

the conclusion that chronic inflammation can predispose individuals to cancer... the longer the inflammation persists, the higher the risk."

Researchers at Johns Hopkins Kimmel Cancer Center announced on their web site in April, 2002, that the earliest stages of prostate cancer are associated with chronic inflammation and may be reversible with anti-inflammatory treatment and dietary supplements. The prestigious New England Journal of Medicine published several studies in 2000 showing that high levels of chronic inflammation signal significantly greater risk for heart attack, stroke and Alzheimer's (Lindahl et al 2000; Packard et al 2000; Rader 2000) and later studies showed that chronic inflammation increases the risk of macular degeneration (February, 2004) and diabetes (July, 2001).

Over 140 studies have firmly established that high levels of chronic inflammation predict significantly greater risk for serious disease and death. (National Library of Medicine, ncbi. nlm.entrez.)

Health Matters ? Fall Issue 2004 ? 1

The evidence is piling up. Chronic inflammation is the culprit in almost all degenerative disease and aging.

What is Chronic Inflammation?

Chronic inflammation is nature's way of telling us that something is going very wrong in our body. Inflammation is our basic defense and all inflammation begins with a triggering event. A bacteria, virus, parasite, or toxin invades the body; a blow, fall or surgery injures the body; or you eat food that is harmful. After the trigger has been pulled, white blood cells (macrophages) rush to the area where the invader has entered or the injury has occurred. Macrophages produce pro-inflammatory cytokines, chemical messengers that attack and clean up cells in the affected area. If the inflammatory trigger continues, cytokine production rises, sending more and more signals to destroy more and more cells which will eventually lead to organ damage. In some cases, especially in the elderly, the body loses its ability to stop the cytokine production and "downregulate" the inflammation.

Unfortunately, the internal defensive chronic inflammatory response may be happening without your knowing about it until the tissue destruction shows up as a serious disease. Therefore, it is vitally important to know if you have chronic inflammation and to be able to identify the triggers that are causing it.

High levels of the following cytokines may indicate harmful inflammation:

The Highly Sensitive C-reactive Protein Test -- Optimum Levels

Below 1.3 mg/L of blood is safe. Below .5 mg/L of blood is ideal.

The Inflammatory Cytokines Profile Panel

CRP ? C-reactive protein TNF-a ? Tumor necrosis

factor-alpha IL-6 ? Interleukin-6 IL-1b ? Interleukin-1 beta IL-8 ? Interleukin-8

(Optimum numerical test levels for the above cytokines except for CRP will vary by laboratory. Consult your doctor to interpret results.)

The Two Most Important Medical Tests You Can Take!

In the early 1990s, Dr. Paul Ridker became convinced that some sort of inflammatory reaction and not cholesterol was causing plaque in the arteries to burst and cause heart attacks. He needed a simple blood test that could provide a marker for chronic inflammation. He decided the best marker would be C-reactive protein (CRP), a molecule produced by the liver in response to an inflammatory signal. The higher the level of inflammation, the higher the level of CRP. Everyone who suspects they might have chronic inflammation,

and every senior, should ask their doctor for a Highly Sensitive Creactive Protein (HSCRP) test.

Why is this test so important? A New England Journal of Medicine study showed that people with high levels of CRP were almost three times as likely to die from a heart attack, regardless of their cholesterol levels (Ridkar et al 1997).

Another study published in the July 16, 2001 issue of the Journal of the American Medical Association studied the risk of diabetes and chronic inflammation. They used the CRP test plus a test for another inflammatory marker, IL-6. Women with higher levels of IL-6 were 7.5 times more likely to develop diabetes and women with the highest levels of CRP were 15.7 times more likely to become diabetic (Type II). The study concluded that these two tests, CRP and IL-6, can predict your chances of developing Type II Diabetes -- before it's too late to do much about it.

High levels of C-reactive protein also indicate who is more likely to get colon, esophageal, liver, stomach, prostate and lymphoma cancers (Oncology, Vol. 16, No 2, Feb 2002, "Chronic Inflammation and Cancer").

Heart Disease

It was research on heart disease that started the new medical revolution based on diagnosing and treating chronic inflammation. The standard medical treatment for heart disease was based on the concept that fatty deposits built up on the insides of major coronary

2 ? Health Matters ? Fall Issue 2004

arteries until they blocked the supply of blood to the heart. The culprit was identified as cholesterol, especially bad cholesterol (LDL). Anyone with high cholesterol or high LDL was told they were at great risk of having a heart attack.

There was only one problem -- half of all heart attacks occur in people with normal cholesterol levels. Plus, doctors found that the most dangerous plaques built up in the arteries weren't that large and they weren't blocking anything. Something else was causing the plaque deposits to burst, triggering massive clots that cut off the coronary blood supply. In the 1990s, Dr. Paul Ridkar became convinced that "something" was an inflammatory reaction. In order to test his hunch, Dr. Ridkar needed a simple blood test to measure inflammation. He used the CRP test. By 1997 he and his colleagues at Brigham and Women's Hospital had shown that healthy middle-aged men with the highest levels of CRP were three times as likely to suffer a heart attack in the next six years as those with the lowest CRP. The danger of high inflammation levels is even more dangerous in women. Having a CRP reading of 3.0 mg/L or higher can triple your risk of heart disease.

Alzheimer's

Chronic inflammation with its release of cytokines and other pro-inflammatory chemicals destroys brain cells. In a study of 1,050 men over a period of 25 years, men in the upper three quartiles of CRP were three times more likely to contract

Once an inflammatory response is triggered

in the elderly, it is easier for it to turn into chronic inflammation.

Alzheimer's disease or vascular dementia (Ann Neurol 2002 Aug:52(2):168-74).

Diabetes II

Research studies show that people with high levels of CRP and IL-6 are at significantly greater risk of developing diabetes. In a study of thousands of women, women with higher levels of IL-6 were 7.5 times more likely to develop diabetes while women with higher CRP were 15.7 times more likely to develop the disease. The doctors who authored the study reported, "Elevated C-reactive protein and IL-6 predict the development of Type II Diabetes mellitus." Authors of a follow-up study published in Diabetes journal in July 2003 confirmed the earlier study's conclusion, "A low-grade inflammation predicts incidence of Type II Diabetes."(Pradhan et al. Creactive protein, interleukin 6, and risk of developing Type II Diabetes mellitus. JAMA 2001 Jul 18:286(3);327-34, and Duncan et al. Low-grade systemic inflammation and the development of Type II Diabetes. Diabetes, July 2003, Vol. 52, Number 7.)

Cancer Survival

Not only does chronic inflammation "predispose" individuals to getting cancer, the magnitude of the inflammation as measured by CRP predicts what chance you have to survive. The Surgical Oncology Inflammation Group of the University of Glasgow, UK, published a report on their web site in July, 2004, stating, "We have shown that, independent of stage (editor's italics), the presence of systemic inflammatory response is associated with increased recurrence and reduced survival of cancer patients." These medical researchers specializing in cancer and inflammation concluded that markers of chronic inflammation (such as CRP) can predict the chance of getting cancer and the chance of recovery -- no matter what stage the tumor is in. The lower the cytokine inflammation level is, the greater the chance of recovery.

Aging

It is not known why, but as people age they do not "down-regulate" their inflammatory response to toxic food, pathogens or injury as effectively as young people (Van der Meide et al. "Cytokines and the immune response," Biotherapy, 1996;8(3-4):243-9). Once an inflammatory response is triggered in the elderly, it is easier for it to turn into chronic inflammation. Preventive measures as outlined below are especially important as we age.

Macular Degeneration

The Journal of the American Medical Association published a study in February 2004, that

Health Matters ? Fall Issue 2004 ? 3

concluded, "Elevated C-reactive protein level is an independent risk factor for age-related macular degeneration and may implicate the role of inflammation in the pathogenesis of age-related macular degeneration." Again, high levels of CRP indicate an increased risk for this age-related disease.

Fibromyalgia and Chronic Fatigue

Syndrome

Fibromyalgia sufferers experience intense pain all over their body. Painkillers are little help. Sufferers of chronic fatigue become incapacitated and unable to work due to bone-grinding fatigue. Doctors have been unable to solve the mystery of these diseases. At first, they said, "it was all in your head." Now, researchers are identifying chronic inflammation as the culprit. A study published in Rheumatology journal (Wallace et al 2001) discovered that cytokine levels in fibromyalgia patients were altered in the early stages and that cytokine levels increased with the duration of the illness. The authors of the study concluded that their results supported, "earlier, aggressive intervention" to lower cytokines and inflammation and, "prevent a chronic pattern from developing."

Research has not yet determined whether high cytokine levels are a direct cause of fibromyalgia or secondary to other factors that cause cytokines to rise such as sleep disturbances.

Dr. Nancy Klimas, an immunologist studying Chronic Fatigue Syndrome (CFS), has seen unusually

high amounts of cytokines in CFS patients which she believes may cause the hormonal imbalances reflected in CFS and their relation to neuropsychological factors (Klimas, "Cytokine and other immunological markers in CFS", Applied Neuropsychology 8 (1);51 (2001).

Stroke

People with elevated CRP also have two to three times greater risk of stroke. Studies have shown that if you have already had a major stroke, it is important to monitor your CRP level because higher levels of CRP predict a much greater possibility of suffering another stroke or heart attack or dying within the following year (Di Napoli et al "Prognostic influence of increased C-reactive protein and fibrinogen levels in ischemic stroke," Stroke 2001 Jan 32(1):133-8).

Frailty in the Elderly

Frailty is not an inevitable condition of age. It is possible to live to advanced age and remain vigorous and energetic. In a study of nearly 5,000 elderly people, researchers discovered that those elderly with high levels of inflammation were the ones most likely to have muscle weakness, fatigue and disability. The elderly with low levels of inflammation had much less incidence of these symptoms (Walston et al, Arch Intern Med 2002 Nov 11; 162(20):2333-41).

Allergic Diseases

We tend to think of allergies as a seasonal affliction of sneezing and

runny nose. However, for many people, an allergic reaction is a lifethreatening disease such as asthma or intestinal bowel disease. An allergic reaction indicates that something has invaded the body that the immune system perceives as toxic. It then triggers an inflammatory response to destroy the invader. In some instances, there is no identifiable outside invader and the body turns its inflammatory response on itself. This is an autoimmune allergic response, which may affect many areas of the body including the gastrointestinal tract and the lungs. Inflammatory cytokines induce the autoimmune reaction in allergic diseases. A landmark study in the Journal of Clinical Investigation, 2000 (105:61-70) on allergic disease, found that healthy gastrointestinal flora generates a chemical called transforming growth factor which plays an essential role in suppressing allergic inflammation (see below for more information about the role of probiotics and chronic inflammation).

Arthritis

Rheumatoid arthritis is an autoimmune disease characterized by high levels of inflammatory cytokines. Tissue destruction due to chronic inflammation leads to scar tissue in place of cartilage and the development of rigid bone fusion. In osteoarthritis, the inflammatory process destroys the cartilage until bone rubs on bone (Immunol 2001 Nov 1:167 (9)).

Aging Skin

Wrinkles, aging skin, age spots and other signs of skin dete-

4 ? Health Matters ? Fall Issue 2004

rioration are some of the most dreaded signs of aging. Yet Nicholas Perricone, M.D., Yale University of Medicine anti-aging expert, says these signs of "aging" are not the fault of time, but the result of inflammation. In fact, he states that aging is inflammation and if you want to attack aging, you must defend yourself against inflammation.

Multiple Sclerosis

According to V. Hugh Perry, Professor of Experimental Neuropathology at the University of Southampton, UK, multiple sclerosis (MS) is an inflammatory disease of the central nervous system. T-cells and macrophages invade the central nervous system, they damage the blood-brain barrier and cause demyelination and axon injury. The macrophage populations in MS brains are more activated than those in the normal brain. Professor Perry also notes that infections, surgery, or injuries in the elderly may generate a more pronounced chronic inflammatory response, which may then be further amplified within the brain. Protecting against the inflammatory response is crucial as people age.

Predictor of Death

The scientific evidence solidly supports the ability of one's inflammation levels as measured by the HSCRP and the Inflammatory Cytokines Profile Panel tests to predict heart attacks, stroke, Alzheimer's, cancer, and Type II Diabetes, among other diseases. Can it also predict death from all

causes? Researchers followed a sample of 1,293 healthy elderly for 4.6 years. They found that higher IL-6 levels were associated with a two-fold greater risk of death. Subjects with high CRP and IL-6 were 2.6 times more likely to die. The researchers concluded that anti-inflammatory intervention with people with high levels of CRP and IL-6 may be able to reduce mortality (Harris et al, Associations of elevated IL-6 and CRP levels with mortality in the elderly Am J Med 1999 May: (106(5):506-12).

Depression, Pancreatitis, Asthma, Lupus, Anemia,

Parkinson's, Fibrosis, Kidney Failure,

Pancreatitis, Psoriasis, and Surgical Complications

All of these diseases have solid scientific evidence that implicates chronic inflammation as a direct cause of the disease or complication. The inflammatory cytokines of chronic inflammation destroy the tissue or induce autoimmune attack. There are nearly 150 research studies documenting the effects of chronic inflammation on serious diseases and how natural treatments can reverse and repair chronic inflammation (National Library of Medicine, ncbi. nlm.entrez.)

The evidence is stunningly conclusive. Chronic inflammation leads to the destruction of cellular tissue, organ destruction, disease and death. But what triggers chronic inflammation and what can be done about it?

The #1 Cause of Chronic Inflammation --

The Standard American Diet (SAD)

The most common cause of chronic inflammation is fortunately no exotic virus, unknown bacteria, or incurable trauma. According to medical experts Andrew Weil, M.D., Nicholas Perricone, M.D., Jeffrey Bland, Ph.D., Richard Fleming, M.D., and many others, the most prevalent trigger for inflammation is the standard American diet (SAD) of processed foods and junk food. Cardiologist Dr. Richard Fleming goes so far as to call sodas, French fries, chips, burgers and other junk food, chronic inflammation's Weapons of Mass Destruction (WMDs). He says, "Every day there are WMDs of our diet that assault our bodies rendering countless damage and casualties to our body's defenses, yielding more and more inflammation and damage." The bad news is that if you want to control inflammation you have to give up junk food. The good news is that it may save you from suffering from cancer, heart disease, diabetes, stroke, arthritis and other diseases caused by chronic inflammation.

Trans Fatty Acids (hydrogenated oil, partially hydrogenated oil): Trans fatty acids in foods such as chips, French fries, crackers, cookies, processed foods and margarine is positively associated with increased markers of chronic inflammation according to a study, "Dietary intake of trans fatty acids and systemic inflammation in

Health Matters ? Fall Issue 2004 ? 5

women" published in the American Journal of Nutrition, April, 2004. The Journal of Cancer Epidemiology, Biomarkers and Prevention (September, 1997) reported that women with breast cancer have higher levels of trans fatty acids stored in their bodies. Higher levels of trans fatty acids increased risk of breast cancer by 40%. American women have higher levels of stored trans fatty acids than the European women studied because American diets contain more of these type of fats, said Dr. Lenore Kohlmeier, professor of epidemiology and nutrition at University of North Carolina schools of public health and medicine. Plus, Dr. Richard Fleming, nuclear cardiologist and founder of Fleming Heart Institute said in an interview with ABC News, " Trans fatty acids interfere with enzymes that process healthy omega-3 fatty acids, an antiinflammatory fat." Since the statistical chance of getting any kind of cancer is one in two for American men and one in three for American women, you can dramatically reduce your chance of getting cancer by eliminating trans fatty acids from your diet and the diet of your children.

Refined Carbohydrates/Sugar/ High Glycemic Foods: A diet high in white flour, white sugar and other refined carbohydrates definitely increases inflammation markers according to a study by Simin Liu, M.D., Ph.D., Harvard Medical School. Women eating diets that included potatoes, breakfast cereals, white bread, muffins and white rice had elevated CRP levels. He concluded that high-glycemic foods con-

tribute to chronic inflammation (Current Opinion Clin Nutr Metab Care 2003 March:6(2) 165-76). Dr. Perricone, aging specialist from Yale Medical School, states that sugar in high-glycemic foods is responsible for 50% of skin aging. Sugar molecules react with collagen and release a burst of free radicals, damaging the cells of the skin.

Arachidonic Acid Foods: Large amounts of beef (especially from corn-fed cattle), egg yolk and dairy products are high in arachidonic acid. The body's enzymes (Cox-2 and 5-LOX) degrade arachidonic acid into inflammatory promoting prostaglandin E2 and leukotriene B4 (Life Sci 1985 36:579). The recommended amount of beef at one serving is about three ounces, the size of a pack of playing cards. Many experts also advise reducing the amount of Omega-6 oils such as corn, soy, safflower and sunflower because they also produce inflammatory prostaglandins.

Foods Cooked at High Temperatures: Eating foods cooked at high temperature such as burgers, French fries, fried foods, and chips contributes to the production of inflammatory cytokines. Eating these foods leads to the formation of advanced glycation end products which bind a protein molecule to a glucose molecule resulting in the formation of damaged protein structures in the body. As these damaged proteins accumulate they cause cells to emit signals that increase the production of inflammatory cytokines (Basta et al, Advanced Glycation EndProducts and Vascular

Inflammation Implications for Accelerated Atherosclerosis in Diabetes, Cardiovasc Res 2004 Sep 1:63(4):582-92.)

The 5 Worst Foods You Can Eat

1. French fries: The combination of trans fatty acids, cooking at high temperature, and high-glycemic index is a lethal cocktail that can trigger proinflammatory cytokines.

2. Donuts: High in trans fatty acids, cooked at high temperatures, high in sugar -- all of which contribute to chronic inflammation. Store-bought donuts are about 35%-40% trans fatty acids. If you are older, triggering inflammation by eating junk food may set off an inflammatory cascade that is hard to stop.

3. Cookies/Crackers/Commercial Pastries: Check the ingredients. If you see hydrogenated fats or partially hydrogenated fats, don't buy them. Even supposedly healthy whole-wheat crackers may have high levels of trans fatty acids. High glycemic carbohydrates also cause an excess production of insulin that leads to high levels of arachidonic acid -- a precursor to inflammatory prostaglandin E2 and pro-inflammatory leukotrienes (Kreisberg et al, "The effects of insulin, glucose and diabetes on prostaglandin production etc." Prostaglandins Leukot Med 1983 Aug).

4. Potato and Corn Chips/Tortilla Chips: High

6 ? Health Matters ? Fall Issue 2004

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download