Chronic Low-grade Inflammation

Diseases | Risk Factors | Modalities | Foods Increase | Foods Decrease | Supplements

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Associated Diseases

Elevated markers of chronic low-level inflammation (eg: C-reactive protein, cytokines) have been associated with a higher prevalence of many diseases including autoimmune disease and diseases associated with metabolic syndrome.

  • Cardiovascular Disease
    • Peripheral arterial disease, heart failure, atrial fibrillation, stroke, and coronary heart disease
    • Singh 2011, Emerging Risk Factors Collaboration 2010
  • Certain Cancers
    • Lymphoma, prostate, ovarian, pancreatic, colorectal and lung
    • Aggarwal 2006, Kundu 2008, Balkwill 2009
  • Type 2 diabetes
    • Pickup 2000, Nappo 2002, Ortega Martinez de Victoria 2009
  • Osteoporosis
    • Cao 2011
  • Age-related macular degeneration - AMD
    • Hong 2011
  • Depression
    • Gimeno 2009, Copeland 2012
  • Cognitive decline
    • Alzheimer’s and vascular dementia
    • Singh 2011

Risk Factors

  • Age
    • Singh 2011
  • Low Sex hormones
    • Testosterone and estrogen may repress the production and secretion of several pro-inflammatory markers
      • Keller 1996, Ray 1997, Deshpande 1997
    • Lower testosterone levels in elderly men have been linked to higher inflammatory markers
      • Khosla 2002, Maggio 2006
    • Surgical or natural menopause increase inflammatory markers
      • Gameiro 2010, Singh 2011
    • Hormone replacement therapy may decrease risk of several inflammatory diseases
      • < atherosclerosis, asthma in women, and rheumatoid arthritis in men
        • Gilliver 2010
      • < coronary heart disease and inflammatory bowel disease
        • Anderson 2004, Vural 2006, Kane 2008
  • Obesity
    • Fried 1998, Mohamed-Ali 1997, Weisberg 2003, Trayhurn 2005, Schrager 2007, Ortega Martinez de Victoria 2009
    • Interstitial abdominal adiposity and waist circumference
      • Pedersen 2003, Rogowski 2010
    • Fat loss decreases markers for inflammation
      • North 2009, Moschen 2010
  • Smoking
    • Arnson 2010
  • Environmental Pollutants
  • Sleep Disorders
    • Vgontzas 1997, 2000, 2003
  • Periodontal disease
    • Slade 2003, Pradeep 2011, Vaishnava 2011
  • Physical and Emotional Stress
    • Pervanidou 2011
  • High Blood Glucose
    • Basta 2004, Uribarri 2005, Toma 2009
  • Inactivity
    • Pedersen 2003

Other Factors

  • Exercise
    • Lowers inflammation independent of weight loss
      • Bruunsgaard 2005
    • Induces Myokine secretion from muscles
      • > gp130 receptor cytokine Interleukin 6 (IL-6)
      • increases exponentially in proportion to
        • exercise intensity and duration
        • amount of muscle mass engaged during exercise
      • up to 100 fold increase
    • Followed by:
      • > IL-1 receptor antagonist (IL-1ra)
      • > anti-inflammatory IL-10 (Interleukin 10)
      • < TNF-alpha production
      • Petersen 2006
  • Calorie restriction
    • Decreases inflammation
      • Ahmadi 2011, González 2012
    • Chronic calorie restriction of more than 30% in rats increased their lifespan by up to 50%.
    • Calorie restriction is thought to activate the SIRT-1 gene
  • Diet
    • See below...

Also see Testing for Chronic Low-level Inflammation.

Foods that Increase Chronic Inflammation

  • Sugar
  • Foods high in Omega 6 Fatty Acids
  • Fried Foods
  • Excessive Calories
    • High glycemic index and high glycemic load diets
      • Modest increase in proinflammatory markers
      • Levitan 2008, Du 2008, Galland 2010
    • High saturated fat diet
      • Association with higher pro-inflammatory markers
        • Association particularly with diabetic and overweight subjects
          • Nappo 2002, Peairs 2011
        • No association with healthy individuals
          • Poppitt 2008, Payette 2009, Myhrstad 2011

Foods that Decrease Chronic Inflammation

  • Foods high in Omega 3 Fatty Acids
    • Fatty Fish
      • Pischon 2003, Lopez-Garcia 2004, Zampelas 2005, Marik 2009, He 2009
  • Olive Oil (polyphenols and oleocanthal)
  • Tea
    • Polyphenols (EGCG and Theaflavin)
      • De Bacquer 2006, de Mejia 2009, Cavicchia 2009, Singh 2010, Melgarejo 2010
    • Black Tea was more effective than green tea
      • Galland 2010, Steptoe 2007, Bahorun 2010
  • Probiotics
    • Eg: Yogurt, Miso, Sauerkraut
  • Vegetables
    • Dark Leafy Greens (Vitamin E)
      • Eg: spinach, kale, broccoli, and collard greens
    • Soys
      • isoflavones, particularly Genistein
      • Eg: soy milk, tofu, and edamame (boiled soybeans)
    • Beets
    • Garlic
    • Onions (Quercetin and Allicin)
    • Ginger
  • Fruits
  • Berries (Possibly anthocyanins)
  • Tart Cherries
  • Mulberry (Reveratrol)
  • Grapes (Reveratrol and Pterostilbene)
    • Reveratrol and Pterostilbene
      • Khanduja 2004, Pan 2008, Clarke 2008, Jha 2010, Ghanim 2011
  • Pineapple (Bromelain)
    • Animal Studies
      • Secor 2005, Fitzhugh 2008, Secor 2008, Onken 2008
    • Human pain relief studies
      • Walker 2002, Akhtar 2004, Yuan 2006, Klein 2006
  • Fiber
    • eg: whole grains, fruits and vegetables
    • North 2009
  • Sesame (sesame lignans)
    • Chavali 1997, Wu 2009, Harikumar 2010
  • Turmeric (and curry spice)
    • Curcumin
      • yellow pigment in turmeric
        • 500 mg daily
        • Safe dosage: up to 8-12 grams
    • Chainani-Wu 2003, Bengmark 2006, White 2011

Supplements that Decrease Inflammation

  • Magnesium
    • Cavicchia 2009, Galland 2010, Chacko 2010
  • Selenium
    • Human intervention studies are lacking
    • Probable anti-inflammatory effect
      • Duntas 2009
    • Observational studies showing relationships between low Selenium and diseased patients
    • Maehira 2002
  • Vitamin D
    • Human intervention studies are lacking
    • Probable anti-inflammatory effect
      • Krishnan 2010
    • Observational studies showing relationships between low Vitamin D and diseased patients
      • Guillot 2010, Awad 2012, Reid 2011
  • Vitamine E
    • “the combination of [alpha-tocopherol] and [gamma-tocopherol] supplementation appears to be superior to either supplementation alone on biomarkers of oxidative stress and inflammation and needs to be tested in prospective clinical trials...”
    • Devaraj 2008
  • Zinc
    • Mariani 2006, Kahmann 2008, Prasad 2009, Duntas 2009, Bao 2010, Kelishadi 2010, Wong 2011
  • Carotenoids including Beta-carotene,
    • Walston 2006, Cavicchia 2009
  • Oregon grape, Barberry (Berberis), and Goldenseal
    • Berberine found in these plants
      • 1-2 g daily divided into 3-4 servings.
    • May inhibit muscle growth
  • DHEA
    • 50 mg/day
    • Gordon 2001, Weiss 2011


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