Whether the injury comes from running outside or tripping while watching Netflix in the dark, a twisted ankle can ruin your week. Know that the puffiness you notice and the heat you feel around the base of your foot means your body has entered repair mode. The painful swelling is the body’s acute inflammatory response, when additional white blood cells, plasma proteins, and other specialized helpers rush to repair the damage, says Refaat Hegazi, M.D., Ph.D., medical director at Abbott, a healthcare and pharmaceutical company. It’s your immune system’s way of remedying any problem, from sprains to infections. (Phew!)
The inflammation usually dies down in three to five days, when you can get on with your life like that clumsy fall never happened. But in some cases, the off switch for inflammation never gets flipped, and that’s when you start to encounter chronic inflammation, says James Marion, M.D., a gastroenterologist specializing in inflammatory bowel disease at Mount Sinai Hospital. When that happens, some trigger—and often it’s hard to identify—sends distress signals even when there’s no problem to fix, so the immune system still dispatches microscopic helpers to your body’s tissues.
As they hang out there over time, they can cause damage to nearby organs, says Veena Taneja, Ph.D., an associate professor of immunology at the Mayo Clinic. Since this is all happening internally, you don't tend to feel symptoms of chronic inflammation until it turns into something bigger.
In particular, chronic inflammation been linked to a number of autoimmune diseases, including lupus, rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. Systemic inflammatory and autoimmune disorders. Pohl D, Benseler S. Handbook of clinical neurology, 2014, Mar.;112():0072-9752.
Multiple Associations Between a Broad Spectrum of Autoimmune Diseases, Chronic Inflammatory Diseases and Cancer. Franks A, Slanksy J. Anticancer Research. 2012 Apr; 32(4): 1119–1136. More research needs to be done to determine the role that inflammation plays in these diseases (e.g. is it causation or merely correlation?), but the prevailing scientific thought is that we should try and decrease chronic inflammation. The question is, how?
Your Action Plan
Some people have genes that predispose them to inflammatory responses, which we have little control over, Taneja says. Luckily, researchers are starting to uncover ways that we can limit chronic inflammation.
Anti-inflammatory diets are all the rage today. “Foods with anti-inflammatory properties include those that are naturally fatty, naturally leafy, contain protein, and contain fiber,” Hegazi says. A number of small studies have found that foods often associated with the Mediterranean diet (tomatoes, leafy greens, nuts, fish, olive oil) reduced chronic inflammation in test subjects. Tomato juice consumption reduces systemic inflammation in overweight and obese females. Ghavipour M, Saedisomeolia A, Djalali M. The British journal of nutrition, 2012, Oct.;109(11):1475-2662.
Anti-inflammatory and joint protective effects of extra-virgin olive-oil polyphenol extract in experimental arthritis. Rosillo MÁ, Alcaraz MJ, Sánchez-Hidalgo M. The Journal of nutritional biochemistry, 2014, Sep.;25(12):1873-4847.
Anti-inflammatory effects of violaxanthin isolated from microalga Chlorella ellipsoidea in RAW 264.7 macrophages. Soontornchaiboon W, Joo SS, Kim SM. Biological & pharmaceutical bulletin, 2012, Dec.;35(7):1347-5215.
Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Wall R, Ross RP, Fitzgerald GF. Nutrition reviews, 2010, Aug.;68(5):1753-4887. But Peter Bloomfield, a neuroscience researcher at Imperial College London, and Marion both caution that these findings are only preliminary and cannot be thought of as cure-alls at the moment.
Reach for a bottle of turmeric, mangosteen, or cat’s claw, and you’ll find they all tout their anti-inflammatory properties. These supplements are common parts of treatment regimens prescribed by integrative medicine practitioners like Douglas Lord, M.D., the medical director at Nava Health and Vitality Center. Lord says he’s found success using these supplements with patients, and an initial batch of studies backs up these claims. Anti-inflammatory and anti-oxidant properties of Curcuma longa (turmeric) versus Zingiber officinale (ginger) rhizomes in rat adjuvant-induced arthritis. Ramadan G, Al-Kahtani MA, El-Sayed WM. Inflammation, 2011, Dec.;34(4):1573-2576.
Xanthones from mangosteen inhibit inflammation in human macrophages and in human adipocytes exposed to macrophage-conditioned media. Bumrungpert A, Kalpravidh RW, Chuang CC. The Journal of nutrition, 2010, Feb.;140(4):1541-6100.
Current nutraceuticals in the management of osteoarthritis: a review. Akhtar N, Haqqi T. Therapeutic Advances in Musculoskeletal Disease. 2012 Jun; 4(3): 181–207. But Taneja and Bloomfield again note that research needs to be more substantial before drawing a direct connection between supplements and lowered inflammation.
If you need another reason to ditch cigarettes, put chronic inflammation at the top of your list. Most smokers experience background inflammation for years after they quit, Taneja says. On the other hand, moderately intense exercise can help decrease inflammation—so now you have another motivation to get your sweat on. Effects of chronic exercise training on inflammatory markers in Australian overweight and obese individuals in a randomized controlled trial. Ho SS, Dhaliwal SS, Hills AP. Inflammation, 2014, Feb.;36(3):1573-2576.
4. Future Treatments
Just a few years ago, science had a huge breakthrough in the study of inflammation: Turns out, it might come from our gut. More specifically, Taneja says, from our gut microbiome—the combination of bacteria in our digestive tract. Taneja has conducted research that found one type of bacteria prevented or halted rheumatoid arthritis and multiple sclerosis in mice. Next step: Test it on humans.
While new findings about inflammation and the gut are exciting, we have more questions than answers at this point. But if you suspect you are dealing with chronic inflammation or one of the possibly related diseases, it’s worth consulting with your doctor.