Nutrition and Inflammation

Nadia Rudenko Msc. R.D.

Objectives:

Definition Types of immune system & inflammation Mechanism of combating infection /disease Components of anti-inflammatory lifestyle

Inflammation in broader sense , is the body's response to tissue injury

More precise definition:

Inflammation is a response to cellular injury marked by vasodilation, white blood cell infiltration, redness, heat, pain, swelling, and often loss of function; a mechanism for eliminating noxious agents and damaged tissue

It is a normal process of healing mediated by immune system

Immune system

Innate or non specific immune system.

Fist line of defense system

Quick to respond to invaders

Not antigen specific Does not remember

previous encounters

Adaptive (acquired) or specific immune system Takes time to react

Antigen specific Remembers previous

encounters

Types of inflammatory response

Acute: involves vasoconctraction followed quickly by vasodilation, leaky endothelial cells.

The names given to conditions refers to tissue site

Chronic inflammation does not always arise from uncontrolled acute inflammation.

Often marked by slow and often asymptomatic onset.

Secondary to persistent infection

Exposure to exogenously or endogenously produced toxic agents

Chronic inflammation

Chronic inflammation is the underlying cause of many “so-called” age-related diseases.

The main complication of it is overproduction of collagen (the main protein of connective tissue) leading to the condition known as a fibrosis .

Cells – fibroblasts enter the damaged tssue and produce collagen.

Examples of acute and chronic inflammation

Acute:

Meningitis or Encephalitis

Pericarditis

Esophagitis or Colitis

Appendicitis

Hepatitis or Pancreatitis

Osteomyelitis (Bone)

Cellulitis(Subcutaneous tissue)

Arthritis

Chronic:

Arthritis

Atherosclerosis

Lupus

Celiac disease

Vasculitis COPD

Tuberculosis

IBD

Psoriasis & Pancreatitis

In addition

There is evidence that chronic inflammation involved in:

Alzheimer's Fibromyalgia Cancer

All of these conditions are stem from the common denominator of uncontrolled, often undetected systemic inflammation

The endothelium is the “gatekeeper” of the blood vessels.

Functions:

Vasoconstriction / vasodilation

Inflammation

Blood clotting/ blood viscosity

Platelet adhesion /plaque accumulation

The formation of new blood vessels

The passage of WBC in/out of the blood stream

Fluid balance

Sources of Endothelial Dysfunction

Immune complexes Blood lipids Angioplasty Germs HTN Stress

Hypoxia Acidosis Smoking Aging DM Trauma Surgery

Chronic inflammatory diseases that contribute to Endothelial dysfunction

Obesity Infections Periodontal disease Environmental toxins, drugs and tobacco Autoimmune disease

Endothelial dysfunction has been associated with all known CVD

Sources of damaged endothelial cells

Oxidative stress or free radicals (excessive production of oxidative substances)

Insufficient amount of antioxidants to neutralize free radicals from endogenous or exogenous sources.

Several possibilities for prevention

Risk assessment and control Analyzing Markers of inflammation Diet Therapy Physical Activity Smoking cessation Lifestyle modification

Risk factors contributing to inflammation and endothelial

dysfunction MS/ DM /Prediabetes Blood Markers(App B; A-1; TG; SDLDL; Oxidazed

LDL, Antibodies against LDL; Lipoprotein (a;) Homocysteine.

IL-6; CRP;

CRP is a protein produced by the liver in response to inflammation.  Any condition that leads to inflammation will cause the production and release of CRP. Smoking, genetics, stress, arthritis, diabetes, obesity, rheumatoid arthritis, dementia, high blood pressure colorectal cancer, the aging process, and damaged and an inflamed arterial endothelium will all cause an elevation of C reactive protein.  It is an indirect, non-specific measurement of inflammation and oxidation.

Understanding C- Reactive protein

Interpretation hs-CRP & Homocysteine Results

CRP Lower than 1.0 mg/L- Low Risk

CRP- 1.0-3.0 mg/L-Average Risk

CRP higher than 3.0 mg/L-High Risk

Homocysteine less than 6.5 = Low Risk for CVD

Homocyseine 8.1 to 10.4 = Moderate-High Risk for CVD

Homocysteine greater than 10.4 = High Risk for CVD

Methods for reducing inflammation

Drugs Diet Activity Smoking cessation

Drugs: NSID- (Ibuprofen, Naproxen,

Cox-2 inhibitors) Aspirin Statins & Fibrates

Side effects: liver, nerve, muscle, and heart damage,

Statin drugs have been shown to exert an anti-inflammatory effect, and it is the modest anti-oxidant, anti-inflammatory effect that is responsible for a reduction in oxidized LDL cholesterol and arterial inflammation. Less oxidized LDL cholesterol and less arterial inflammation, the less plaque that will build up within the arterial endothelium.

However, natural antioxidants, vitamin C, turmeric extract, essential fatty acids (fish oil) do more to reduce oxidized LDL cholesterol and arterial inflammation and lower CRP than cholesterol-lowering statin drugs, AND without the dangerous side-effects of statins (liver, nerve, muscle, and heart damage, ….let alone death). The B complex vitamins and betaine (tri-methly-glycine) lower homocysteine levels, which means less “scratching up” of the endothelium, i.e., less arterial inflammation, and lower CRP levels.

Role of Diet & Activity

Fat: Omega-3, Omega-6, Ratio of n-6/n-3 Monounsaturated fats:

Plants sources include avocado, raw soaked nuts (almonds, cashews, pecans and macadamia) and olive oils. Eating monounsaturated fats reduces inflammation by interfering with leukotrienes (naturally produced molecules that contribute to inflammation

Helpful Diets

Mediterranean Diet: Portfolio Diet: Optimal Diet:

Portfolio Diet

Nuts

Plant's sterols(soy protein flax seeds)

Soluble Fiber (oatmeal, chia seeds, berries...)

Vegetable Protein (soy beens, lentils, beans, amaranth, quanua)

Greens, crusifirous vegetables

Omega- 3 (chia seed/ flax seed oil supplements, Fish oil, DHA Microalge)

Optimal Diet

Role of Diet & Activity

Dietary pattern

Supplements & Spices

Spices:

Turmeric,Curry,Ginger,

Garlic and chili peppers

Supplements:

Vit C, B , D,

Fish oil

Olive extract,

Grape seed Extract

Betaine, Magnesium

Anti-inflammatory foods

Foods that contain omega-3 fatty acids

(Fish like tuna, cod, herring, trout, salmon, sardines, snapper)

Nuts and seeds like walnuts, almonds, hemp seeds, chia seeds, hazelnuts, pumpkin seeds, flaxseeds/linseeds.

Good oils like olive oil, avocado oil (be careful of the amount of oil you are eating – as they are still high in fat!!)

Fish oil supplements can also be taken if you don’t eat fish. N-3 from Microalgy.

Green leafy vegetables

A range of colored fruits, but particularly berries, like blueberries and strawberries

Soybeans, tofu, and soy milk

Whole-grain breads, cereals and pasta

Foods rich in omega-3 fatty acids:

Animal Sources: wild salmon, anchovies, mackerel & sardines

Plant Sources: hemp, chia seeds, flaxseed meal and walnuts

Pro-inflammatory foods

Junk foods and processed foods Fast foods and take-away foods High-fat dairy foods like full cream dairy products –

choose low fat options Fatty cuts of meat, especially red meats, mince and

chops Processed meats (luncheon meats, hot dogs etc) High-sugar foods

Web Resources

www.Nutrition MD.org

www.CancerProject.org

www.drmcdougal.com

www.vrg.org

http://5aDay.gov

www.enthusiasticlife.net

Q/A