The More You Know: The Damaging, Cyclical Nature of Chronic Inflammation
Last week I gave you a brief introduction to what inflammation is and the repercussions of chronic inflammation in our bodies. Today, I want to break that down a little further by diving into a couple of the processes that provoke inflammation and how that drives conditions like type II diabetes (T2D), obesity (the combination known as “diabesity”), and heart disease. You may get some repetition from last week’s post, but I would bet many of you could use some reiteration. 😉 Let’s start with a little review of inflammation and its relationship to type II diabetes and obesity.
“Diabesity is an autoimmune, inflammatory disorder involving a pathological expression of the innate immune system”(1). I want to touch on the diabetes/obesity combination because I believe the driver of the condition is so important to understand. I also want to highlight that the cause(s) of this combo is partially unique to T2D and obesity, but not exclusively unique. People have many different ways their bodies manifest inflammation and problems in the body, so please do not discount that this or something this serious, could happen to you too if not addressed.
If we remember back to last week, we know that the innate immune system is the one that is non-specific-acting as a physical and chemical barrier to foreign invaders without the ability to “recognize” their presence time and time again. It provokes an immune response that includes inflammatory cells that aid in clearing, fighting, and killing the invaders.
So how does this relate to diabesity?
Well, diabesity is characterized by chronic, low-grade inflammation and a continuous stimulation of the innate immune system (1). The causes for the inflammation and eventual progression to the disease are multi-faceted and have been correlated with:
- Dietary toxins (primarily refined wheat, fructose and industrial seed oils);
- Environmental toxins (chemicals like Bisphenol A, pesticides, phthalates, flame retardants, and heavy metals);
- Micronutrient deficiencies (especially magnesium and vitamin D);
- Chronic stress (emotional, psychological, physiological);
- Altered gut microbiota (caused by antibiotic use, poor diet, formula-feeding during infancy);
- Sedentary lifestyle
Diabesity has quite a few metabolic dysfunctions associated with the condition: leptin resistance, impaired fat and glucose metabolism, insulin resistance, and beta-cell destruction. Inflammation directly contributes to every single one of these (1). Let’s go over a few:
Leptin and Insulin Resistance
Leptin is a hormone that tells your brain to decrease appetite, increase metabolic rate and increase physical activity. It is produced by body fat. So, this makes sense, right? The more fat you have, the more leptin produced, the more your body should suppress appetite, be encouraged to move more, and burn more fat. Unfortunately, this communication can be largely interfered with through a process called Leptin Resistance. Exactly what it sounds like, your body lacks the proper signaling with leptin, therefore influencing your appetite, metabolism, and activity, resulting in weight gain.
Inflammation of your fat tissue causes insulin resistance (2). When your cells are “resistant” to insulin, you lack the ability to pull sugars out of your blood stream and into your cells, which leads to higher blood sugars, and MORE inflammation. It’s really quite the awful cycle. In my last blog, I also mentioned cytokines and their roll I inflammation. Well, these proteins that are released during an inflammatory response of the innate immune system are usually VERY beneficial for the healing process, but they have been shown to cause insulin resistance with their chronic output (2).
Also, if your gut is inflamed due to poor health of your gut microbiome and/or digestive tract, this can also lead to leptin and insulin resistance (1,2). The mechanism of this may be due to an increase in an endotoxin called lipopolysaccharide that has been shown to cause inflammation, insulin resistance in the liver and weight gain. Endotoxins are the WORST when it comes to your gut health. Be very careful with your exposure to these by eating CLEAN CLEAN animal products and taking care of your gut microbiome.
Inflammation, fat, and Mitochondria.
Inflammation begins in the fat cells themselves. I repeat, inflammation begins in the fat cells themselves. This is NOT to say, that all fat produces inflammation. The most problematic is the visceral fat (5)- the fat around your organs, deeper than the fat just under your skin. So please be cautious when analyzing your own tissue and believing you have loads of inflammation because you lack a thigh-gap.
Fat cells and their cellular function are the first to be affected by the development of obesity. As fat mass increases, inflammation increases (2, 3, 5). Why? One explanation for this may be because of mitochondrial dysfunction caused by the additional stress obesity places on cellular function (2).
Mitochondria are responsible for producing energy and regulating cellular metabolism. So, affecting their function can be VERY problematic for folks.
Another mechanism may be oxidative stress (I will elaborate on what this next). As a person eats more carbohydrates/sugars, the extra glucose goes to the fat cells to be stored and produces an excess of reactive oxygen species (ROS) which in turn starts an inflammatory cascade within the cell (2).
As you can see, the cyclic nature of increased inflammationàweight gainàmore inflammation is pretty awful. Weight gain in general is usually unwanted, now we have more reasons to gear away from too much of it. Again, I want to reiterate, not all fat is created equal! If you are making positive lifestyle choices in your life like staying physically active, eating whole foods, practicing stress management, getting good sleep, and staying in a positive community of people, I believe the fat on your body is of little concern.
Before wrapping up, I would like to address oxidative stress and the connection to inflammation and disease. Oxidative stress is something I mention often with clients, especially when talking about those poor quality fats (soybean, sunflower, safflower, canola…) because of their susceptibility to being oxidized. I get blank stares most of the time, and so I figure throwing an explanation of this is quite appropriate. The more you know, right??
A recent study published in the American Journal of Pathology (6) supports the already large amount of evidence that suggests inflammation is a primary cause of heart attacks and strokes (7). Inflammation and oxidative damage are the primary causes of heart disease. When our bodies accumulate plaque on our arteries, we have inflammatory reactions with that plaque that can induce clots (7). For example, say the lining of an artery gets damaged. We have our response in place that floods the area with white blood cells and creating inflammation. This response can further damage the walls and lead to stiffer arteries that are more prone to buildup and leaving the existing plaque more susceptible and likely to burst (7).
What is oxidative stress?
Oxidative stress is an imbalance between production of free radicals and reactive metabolites (oxidants or reactive oxygen species-ROS), and their elimination by protective mechanisms-antioxidants (4). I wouldn’t be surprised if that was a confusing sentence for many of you, so let me break it down a little. We want a balance between free radicals and antioxidants for proper physical function.
So, what are free radicals?
In order to explain this, I need to get a little science-y with ya’ll. A free radical is an atom or group of atoms that has an unpaired electron. This means it is highly unstable and reactive-something that is NOT good to be flying around your body. They form when a weak bond breaks between electrons and an uneven number remain. This often happens due to heat, light, or something environmental. Your body can also produce free radicals purposefully to neutralize viruses and bacteria (8). However, if they overwhelm the body’s ability to regulate them, this leads to oxidative stress (7). For example, heating up that highly processed canola oil you have in the cupboard can create unstable bonds in the chemical structure of the fat and create oxidative stress in the body. They can also be derived from other metabolic processes in the body, exposure to x-rays, ozone, cigarette smoking, air pollutants, and industrial chemicals (9). They in turn adversely alter lipids, proteins, and DNA and trigger a number of human diseases (9). One of which is heart disease. Studies have shown that oxidated LDL cholesterol is 8x greater stronger a risk factor for heart disease than normal LDL (7). We need to limit oxidative damage and minimize inflammation to help lower our risk of heart disease, age-related diseases, neurodegenerative diseases like Parkinson’s and more!
Four main causes of oxidative damage and inflammation (7):
- Poor nutrition
- Physical inactivity
I will no doubt be covering how to optimize your “exposure” to all of these (if I haven’t already in some posts) in the future. But for now, consider your own involvement with all of these. Additionally, this is why we like to also consume antioxidants like vitamin E, vitamin C, beta carotene, selenium, copper, iron, and zinc (10). . It is wise to attempt to balance out the affect on the body.
Overall, you can see the rampant effects chronic inflammation has on the body, particularly through the mechanisms that drive type II diabetes, obesity, and heart disease. I am hoping that education around these conditions will help at least plant the seed of awareness for you all while you make your lifestyle choices every day. You have the ability to live a life with vitality, energy, and longevity and it takes choices EVERY DAY to help make that happen. Choose wisely.
Alright, that is all for now! Stay tuned next week for some talk on autoimmune conditions and let me know if there are questions or topic requests!
Therese Martinez, MS, RD, CPT
- https://www.ncbi.nlm.nih.gov/pubmed/19149749 (Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer.)