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What is Inflammation? The Good and the Bad

by Carolyn Williams, PhD, RD: Most people are surprised to learn these two things about inflammation:


  1. Inflammation isn’t a diagnosed disease or condition. Rather, it’s more like a fire in the body, one that starts small and contained but can easily be provoked and spread, increasing your susceptibility to chronic conditions.
  2. Not all inflammation is bad. There are two types, one of which keeps you healthy.

Here’s an overview of inflammation and how it impacts your health.

Key Terms:

  • Pathogen: a harmful microbe like a bacteria, virus, parasite, or fungus
  • Antigen: pathogen or substance that the body perceives as a foreign invader or threat
  • Cytokines: inflammatory compounds secreted by white blood cells
  • Innate Immunity: the body’s first line of defense that is general and nonspecific
  • Adaptive Immunity: the body’s more specific, second line of defense
  • Antibodies: proteins designed to identify and attach a specific antigen

“Good” or acute inflammation

Inflammation is a natural immune system response designed to keep the body healthy. In fact, we need short-term or acute inflammation for survival to fight off foreign bodies and heal the body. Foreign invaders include pathogens (harmful microbes), such as bacteria and viruses; physical objects, like splinters; and compounds, like chemicals and toxins. Collectively, these foreign invaders are referred to as antigens.

When the immune system detects an antigen, it triggers an inflammatory response, sending white blood cells to the area under attack and secreting inflammatory compounds known as cytokines. What follows is a mounted attack by the white blood cells and cytokines to get rid of the antigen or, in the case of an injury, stop additional tissue damage and assist in blood clotting. Like a real battle, there’s some collateral damage, but macrophages, a type of white blood cell, tend to the damage and remove debris once the situation is under control. Noticeable signs of this include swelling, pain, redness, fever, or pus, which flare up quickly but go away as the attack and inflammatory response subsides.

This acute response is known as innate immunity, and it is the body’s broad, first line of defense. When the innate response needs additional help, the body’s adaptive immune response (a much more targeted defense against the specific antigen attacking the body) steps up and rallies white blood cells known as B cells and T cells. B cells produce antibodies (proteins designed to identify and attack a specific antigen), and T cells attack antigens directly and release additional cytokines. Another inflammatory battle ensues, like the innate defense but more complex, to rid the body of the antigen. Sometimes antibiotics or other treatments may be needed to help the healing process along, but the overall response is acute and slowly dissipates.

The key to “good” inflammation is that it’s acute; the inflammatory response goes away once the antigen is destroyed. This is crucial for overall health for two primary reasons:

  1. After the acute inflammation goes away, the immune system can take a quick “breather” and rest, which is necessary to maintain immune system health. This brief downtime is what allows the immune system to function effectively and at full capacity in the future.
  2. During these battles, friendly fire from the immune system’s artillery (white blood cells or higher levels of circulating cytokines) harms a few healthy bystander cells. Since the acute inflammatory response is brief or acute though, the injuries are minor, especially in terms of overall health. However, the damage to healthy cells accumulates if the response continues, which is why long-term inflammation is so harmful.

“Bad” or chronic inflammation

Chronic inflammation occurs when an inflammatory response is triggered, and it doesn’t resolve or go away. Instead, it sticks around. The problem with chronic inflammation is the ongoing inflammatory response slowly wears down the immune system, causing it to be less effective in fighting off antigens that we encounter daily (such as the pathogens that cause the common cold or flu).

It also becomes dysregulated and hyperreactive to environmental and lifestyle factors. These are things like toxins in our food and water supply, inflammatory foods, a lack of adequate sleep, a sedentary lifestyle, and unmanaged or ongoing stress.

Sometimes chronic inflammation happens when an antigen is resistant to attacks by antibodies and antibiotics. This is the case with some bacteria and viruses. However, most chronic inflammation today is due to a combination of environmental exposures and lifestyle factors. A dysregulated, hypersensitive immune system can perceive these factors as antigens or irritants that elicit, aggravate, and escalate the existing inflammatory response. And because they are such constants, they establish a low level of chronic inflammation that sticks around until lifestyle changes are made.

While none of this is good, the bigger issue is that the immune system isn’t separate or siloed from the rest of the body. Both the nervous and endocrine systems are intricately connected to the immune system, as each system relies on interactions with the other two to maintain homeostasis. Chronic inflammation is a type of immune dysregulation, so as it develops, it leads to altered responses from the nervous and endocrine systems, which then begins to create a snowball of inflammatory effects that cause cell and tissue damage. Immune dysregulation, coupled with environmental toxins and lifestyle irritants, promotes gene expression. This refers to the activation of certain genetic variants that can also cause cell damage and “turn on” genes that you may have a predisposition for, such as autoimmune conditions.

  1. Ongoing inflammation causes the immune system to become dysregulated and hyperreactive, which in turn disrupts nervous system activation and signaling, and hormone regulation.
  2. An inflammatory cascade of effects is set in motion due to dysregulation occurring in and among all three systems (immune, nervous, and endocrine) and gene expression.
  3. Tissue damage results in compounding dysregulation and inflammation. Signs are often evident (excess body fat and/or high blood pressure, triglycerides, and blood glucose) but others (like mutated precancerous cells and autoimmunity) may not be.
  4. Signs worsen to meet diagnostic criteria for conditions such as diabetes, heart disease, thyroid and adrenal dysfunction, reproductive issues, joint deterioration, cancer, and autoimmune disorders.

All combined, these inflammatory effects pave the way for disease onset. In fact, inflammation plays a role in the development, progression, or underlying etiology for top health conditions affecting Americans today, such as hypertension, high cholesterol, obesity, insulin resistance, and depression. It also plays a role in most of the leading causes of death in the world, including heart disease, stroke, type 2 diabetes, cancer, Alzheimer’s, and chronic lung and kidney diseases.

Inflammation is hard to avoid, but the good news is that small changes to daily habits reduce ongoing inflammation, and it’s never too late to start. What’s even better is that upgrading and changing the foods you eat is one of the quickest, most impactful ways to do this.

Reducing chronic inflammation:

  • Improves and maintains physical and mental health
  • Decreases susceptibility to everyday illnesses like colds and infections
  • Slows the aging process
  • Stops the progression of many chronic diseases and eases symptoms
  • Reduces risk and prevents the onset of chronic diseases
  • Aids in management of autoimmune conditions and flare-ups
  • Prevents additional cell and tissue damage
  • Allows for hormonal balance

How do you know if you have chronic inflammation?

Most American adults have some level of ongoing inflammation in their bodies, which fluctuates based on health habits and life events. The inflammation may be tiny and contained, with signs that only pop up during stressful periods, or it may be bigger, with signs and symptoms that are easier to identify. If nothing is done, these small inflammatory fires can start new fires in other parts of the body. As this happens, symptoms and signs become more overt and measurable. These small fires begin to feed off each other, slowly progressing to systemic inflammation and finally resulting in diabetes, heart disease, dementia, and other inflammatory conditions.

Now, here’s the good news: Low levels of chronic inflammation can usually be resolved with small lifestyle changes, and the earlier you act, the easier this can be. Identifying and addressing the cause of these warning signs and indicators is what prevents inflammation from progressing, so use the Early Warning Signs and Early Indicators of Chronic Inflammation to help you identify inflammation. Then, use the recommendations to help you reduce and prevent it.

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Source: Blue Zones


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