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Melanie Cole (Host):  Inflammation is your body’s way of fighting infections and coping with injuries but there’s a growing evidence that another kind of inflammation – low level chronic inflammation -- can contribute to many diseases in chronic health conditions from arthritis and Alzheimer’s to heart disease and cancer.  My guest today is Dr. Nancy Van Sloun.  She’s an integrative medicine doctor at Penny George Institute for Health and Healing, WestHealth.  Welcome to the show Dr. Van Sloun.  Tell us a little bit about inflammation.  People hear about inflammation in their hands or in their knees and they think arthritis but we’re talking about all kinds of inflammation here, aren’t we?

Dr. Nancy Van Sloun (Guest):  Yes, we are and I like to distinguish between what we call acute inflammation which is something that is short-lived.  It occurs in response to injury or infection.  When that occurs, say you sprain your ankle, there are different mediators that are released into the bloodstream that create this inflammatory response.  In this setting where inflammation is occurring in response to an injury, it actually is part of how the body responds to the injury and how the body heals.  With acute inflammation, it is a good thing.  It’s part of how the body heals and gets better.  That is contrasted with chronic low-grade inflammation.  The difference with that is that it’s not really occurring in response to any event.  It is something that can be related more to different lifestyle factors.  In contrast with acute inflammation that is healing and helpful, this chronic low-grade inflammation actually can cause tissue destruction.  We’ve finally begun to realize how much it plays a role in many of our chronic diseases and conditions. 

Melanie:  That was an excellent explanation of that because people really do hear this term and now we’re hearing it more in line with heart disease and cholesterol levels and all of these things. If we have arthritis in our knuckles, we can see it’s inflamed. That’s chronic and that’s the acute inflammation.  But how do we know if we have this low-level chronic inflammation?  Is there a test?

Dr. Van Sloun:  There are blood tests that doctors can do that measure inflammation and we call them “inflammatory markers”.  One that’s commonly used is called CRP.  That stands for C-reactive protein.  There’s another test we sometimes do when we are looking at joint inflammation and trying to decide how much of that is truly an inflammatory response.  That test is called a “sedimentation rate”.  So, those are some tests that are done at the doctor’s office.  The CRP is probably the one that people hear about most commonly in terms of testing that can be done.  When research is done and they are trying to assess inflammation, they sometimes use other tests that a different mediator is involved in inflammatory pathways but that is probably more research tools as opposed to something that somebody would get at the doctor’s office.

Melanie:  Are there some causes that we can look to?  Is there anything we can do to try to prevent or reduce this type of inflammation?

Dr. Van Sloun:  Absolutely.  The interesting thing is that many of the contributing factors to inflammation are related to lifestyle.  So, I’ll give you a list of them and diet is one of the most important.  I’ll leave that for last.  Physical activity is one.  Studies have looked at how active people are and if people are more physical active, they have lower markers of inflammation whereas if they are sedentary, they have higher markers of inflammation in the blood.  Simply getting moving and being active can reduce inflammation.  Another factor is stress.  I think of stress as not necessarily the events in our lives but how we are reacting to them and handling them.  If people feel like they can just tell from their body that they are feeling stressed much of the time, that chronic stress can be a factor that increases inflammation.  So, chronic stress is another thing that plays a role in low-grade inflammation.  There can be environmental factors such as cigarette smoke, whether a person individually is smoking or is exposed to cigarette smoke.  Another factor is being overweight or obese.  We know that being obese, particularly if people are carrying weight around their abdomen, that creates a chronic low-grade of inflammation.  So, paying attention to weight and trying to keep weight within a healthy zone is important.  Lastly, diet is a big factor in terms to this chronic low-grade inflammation.  We know that over the past 50 plus years that the diet in the United States has really changed a lot.  It’s changed in a way that’s made our diet more pro-inflammatory in terms of the foods we’re eating.

Melanie:  What are some of those foods that we are eating that could be contributing to this?

Dr. Van Sloun:  The foods we know that are associated with increased inflammation, one category is trans fats and that’s the type of fat that was manufactured and created because it extends the shelf-life of food.  That is still in fast food preparation often times.  It can be in bakery goods that are at the grocery stores.  It can be in some snack foods.  It’s in refrigerated doughs.  You can check the ingredient label on foods to look for trans fats.  If you want to look at an ingredient list, you look for partially hydrogenated oils.  We know the trans fats really are a big contributor to inflammation, so that’s a key one to watch for.  Another category is saturated fats and those are fats that are found in dairy products or meats.  They are associated with increased inflammatory markers.  Lastly, we think about foods that create higher increases in blood sugar and subsequently higher increases in insulin levels.  That is going to include foods that we know have added sugar.  There’s a lot more sugar in our diets.  So, sugar, soda or candies or other foods where you can see that there’s a lot of sugar added.  In addition, it includes more processed carbohydrates because carbohydrates are all broken down into blood sugar eventually or sugar in your bloodstream and if those foods are more processed, meaning they are made with white flour, they can be turned into sugar and digested into sugar much more quickly which creates a higher blood sugar level and an increased insulin response.  Those things--increased blood sugar and increased insulin response--contribute to inflammation.

Melanie:  I know there are certain foods that have an anti-inflammatory effect on us, pineapple being one of them.  Tell us some foods that can reduce inflammation and what that diet would look like. 

Dr. Van Sloun:  There are several categories here.  Fruits and vegetables is one.  Fruits and vegetables have antioxidants that help with inflammation.  They also have fiber and that helps with inflammation.  So, thinking about getting lots of fruits and vegetables, different kinds, different colors is important.  High fiber foods, which is going to include fruits and vegetables but also whole grains like barley or other intact grains, steel cut oats, things like that.  High fiber foods also help to reduce inflammation.  Within that category also are legumes.  Some of those plant-based foods that are high in fiber are important.  Omega-3 fatty acids are a big category that reduces inflammation.  That includes fish, particularly cold water, fatty fish like salmon, sardines, and herring.  There are also some plant-based sources of Omega-3 fatty acids like walnuts, flaxseeds, leafy greens that also help to reduce inflammation.  The last category we think of are monounsaturated fats.  That includes things like olive oil, olives, nuts and seeds and avocados.

Melanie:  Avocados is really one of nature’s most perfect foods.  People hear about the words “the Mediterranean Diet”.  We don’t have a lot of time Dr. Van Sloun, but if you could tell us about the Mediterranean Diet and please give us your best advice for reducing this chronic inflammation.

Dr. Van Sloun:  Mediterranean Diet is going to be plant based.  Lots of fruits and vegetables, nuts, whole grains, legumes.  Olive oil is a primary fat source.   It’s going to include some low fat dairy.  Fish with those Omega-3 fatty acids.  Some poultry and eggs but limiting red meat, processed foods, and refined sugar.  That’s a Mediterranean-style diet and that is an anti-inflammatory diet.  Overall, if we are trying to reduce inflammation, the more closely you can adhere to a Mediterranean-style diet, that’s going to be in your favor.  In addition, being physically active, controlling weight, not smoking and managing stress – all those things are very powerful in terms of reducing inflammation and reducing risk for diseases.

Melanie:  Thank you so much for such great information.  You’re listening to The Wellcast with Allina Health.  For more information you can go to allinahealth.org. That’s allinahealth.org.  This is Melanie Cole.  Thanks so much for listening.