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Bryan Christie Studio En español | "Low-grade inflammation.” It hardly sounds serious at all. An inconvenience, perhaps, like maybe a mild fever or a creaky joint. In the lexicon of
aging and disease, there are far more worrisome words: cancer, heart disease, dementia, diabetes. But researchers have suspected for years that all of these health issues, and more, have at
their heart one common trigger: low-grade inflammation. And now they may finally have proof. Cardiologists in Boston have reported on a clinical trial with more than 10,000 patients in 39
countries (mean age: 61) that tested to see if an anti-inflammatory drug could lower rates of heart disease. They discovered that it could. But they also found that the same drug,
canakinumab, reduced lung cancer mortality more than 77 percent, and reports of gout and arthritis (conditions linked to inflammation) also fell. "Inflammation plays a role in
everyone's health,” says Dana DiRenzo, a rheumatologist and instructor of medicine at Johns Hopkins University School of Medicine in Baltimore. When inflammation levels increase, so
does the risk of disease. But understanding inflammation can be tricky because, when you get a disease, inflammation levels naturally increase as your body fights the condition.
Inflammation, in other words, is both good and bad. Given how crucial this issue is to your health, AARP spoke with some of America's top experts in the field, pored over the latest
studies and created this guide to understanding — and overcoming — inflammation. WHAT EXACTLY IS INFLAMMATION? Think about when you catch the flu and your body temperature rises to fight the
virus. That's a form of inflammation. So is the redness and swelling that occur when you sprain your ankle; it's the process your body uses to provide the healing chemicals and
nutrients needed to help repair the damage. These are examples of acute inflammation, a temporary, helpful response to an injury or illness. Once the danger goes away, so does the
inflammation. Chronic inflammation, on the other hand, is a slow, creeping condition caused by a misfiring of the immune system that keeps your body in a constant, long-term state of high
alert, says Robert H. Shmerling, clinic chief in the department of rheumatology at Beth Israel Deaconess Medical Center in Boston. WHY IS CHRONIC LOW-GRADE INFLAMMATION A PROBLEM? "Over
time, inflammation damages healthy cells,” says Roma Pahwa, a researcher for the National Institutes of Health who specializes in the inflammatory response. Here's why: When cells are
in distress, they release chemicals that alert the immune system. White blood cells then flood the scene, where they work to eat up bacteria, viruses, damaged cells and debris from an
infection or injury. If the damage is too great, they call in backup cells known as neutrophils, which are the hand grenades of the immune system — they blow up everything in sight, healthy
or not. Each neutrophil has a short life span, but in chronic inflammation, they continue to be sent in long after the real threat is gone, causing damage to the healthy tissue that remains.
The inflammation can start attacking the linings of your arteries or intestines, the cells in your liver and brain, or the tissues of your muscles and joints. This inflammation-caused
cellular damage can trigger diseases like diabetes, cancer, dementia, heart disease, arthritis and depression. And because it's low grade, “its slow and secret nature makes it hard to
diagnose in day-to-day life,” Pahwa says. “You have no idea it's even happening until those conditions show symptoms." HOW CAN SOMETHING NATURAL TO OUR BODIES BE SO TOXIC TO OUR
HEALTH? "It can be complicated to figure out if inflammation is friend or foe,” Pahwa says. Looking at the four main causes of chronic inflammation, however, sheds some light. * AN
OUTSIDE INFECTION THAT'S HARD TO KILL: You contract a chronic infection like hepatitis C or Lyme disease that lingers in the body for a long time. Your body responds with inflammation
that also lingers a long time. In fact, it's often the chronic inflammation, not the viruses themselves, that causes much of the long-term damage related to these diseases. * GENETICS:
You inherit a genetic propensity toward a health issue. In some cases, the genes related to these health issues can be turned on by inflammation: Diabetes and cancer are two genetically
related diseases that can be triggered by inflammation. In other cases, the gene itself causes a misfiring of the immune system that causes the inflammation in rheumatoid arthritis, multiple
sclerosis, lupus and other diseases. * ENVIRONMENT: Pollution, air and water quality, environmental allergies and a host of other environmental factors can trigger and sustain inflammation.
* LIFESTYLE: Obesity, unregulated stress, tobacco use, drinking too much, lack of physical activity, lousy sleep and, of course, poor diet are all linked to chronic inflammation. AND
GETTING OLDER INCREASES INFLAMMATION, TOO? Unfortunately, yes. The older we are, the more exposure we've had to stuff like environmental toxins, stress, alcohol, bad foods and chronic
diseases. Plus, aging makes it more difficult for our bodies to properly manage our immune systems, to extract nutrients from food and to shed extra pounds. “There are thousands of articles
in the science literature related to aging and inflammation,” says Thomas Buford, an associate professor with the University of Alabama at Birmingham School of Medicine's division of
gerontology. SO WHAT MAKES CHRONIC INFLAMMATION HAPPEN? Chronic inflammation is a cascading effect of reactions in the body, Pahwa says. Here's a (very) basic breakdown of what's
going on. * SOMETHING TRIGGERS THE IMMUNE SYSTEM. Whether it's a chronic disease, an autoimmune disorder, weight gain, psychological stress, poor nutrition, exposure to chemicals or
allergens — something puts your body in a state of stress and keeps it there. * THE IMMUNE SYSTEM RESPONDS. The body goes into attack mode with its inflammatory response, which also includes
blood vessel expansion to increase blood flow to the problem areas. Blood is the primary delivery system for all these substances. * AND RESPONDS … AND RESPONDS … AND RESPONDS. An endless
cycle of pro-inflammatory foods, rampant stress, bad sleep and more keeps this process in constant motion because we never give the body a break. THERE ARE “PRO-INFLAMMATORY FOODS"?
Yes, and they're the same foods you've been warned about by everyone from your dentist to your cardiologist. (And that's no surprise, because gingivitis and sclerotic arteries
are both inflammatory conditions.) Foods high in sugar or high in unhealthy fats (think deli meats and fried foods) are top of the list. "We don't fully understand it yet,” Buford
says, “but now we know our gut microbiome, made up of trillions of bacteria, influences physiologic processes throughout the body.” We're born with a balance between good and bad
bacteria in the gut. When that balance is thrown off — known as dysbiosis — it can lead to trouble. “A disregulated microbiome has been associated with metabolic diseases, pulmonary
diseases, nervous system conditions, Alzheimer's — and these associations grow as we learn more and more,” Buford says. ------------------------- WHAT CAUSES? WHAT SOOTHES? FOODS AND
ACTIVITIES THAT SPARK — AND HELP REDUCE — INFLAMMATION * LIST * | * SLIDESHOW * Photos * * * 1 of * PHOTO BY: Xinzheng / fcafotodigital / Getty Images WHITE BREAD: A diet low in fiber can
allow unhealthy bacteria to gain the upper hand in your digestive system, contributing to a leaky gut, in which toxins are allowed to pass through into your body rather than being swept away
by the digestive system. WHOLE-GRAIN BREAD: As the body digests fiber, like that found in whole grains, it creates butyrate, a beneficial fatty acid with anti-inflammatory powers. Butyrate
seems to cross the blood-brain barrier and may help prevent neurological decline. * * * 2 of * PHOTO BY: James Baigrie / Image Source / Getty Images DEEP FRYERS: Advanced glycation end
products (AGEs) are inflammation-causing compounds produced when meats and grains are cooked at high heat — think doughnuts, french fries and fried chicken. FRUIT BOWLS: Dark-colored fruits,
vegetables and beans contain polyphenols, plant compounds with antioxidant and anti-inflammatory properties. Examples you may have heard of: resveratrol (wine, grapes), catechins (tea,
apples, berries). * * * 3 of * PHOTO BY: Colin Hawkins / Jeremy Maude / Getty Images BAD ATTITUDES: If you handle stress poorly, or feel helpless or put-upon, your body goes into
fight-or-flight mode and releases cortisol, a hormone associated with inflammation. YOGA: In one small study, women who were experienced at yoga were 4.75 times less likely to have
detectable levels of C-reactive protein as those who were novices, showing that regular yoga seems to reduce inflammation. * * * 4 of * PHOTO BY: Warren Price / kirin photo / Getty Images
PUDDING: Most processed foods, especially desserts, are low in fiber, high in sugar and packed with chemicals, all of which are bad for the gut. The more you cook at home with unprocessed
food, the better. YOGURT: Live culture yogurts contain healthy bacteria called probiotics, which help keep the bad gut bacteria in check. * * * 5 of * PHOTO BY: South agency / Caiaimage /
Getty Images ROADHOUSES: The dancing and socializing at your favorite bar are healthy, but the smoking and drinking aren’t. Alcohol and tobacco mean party time for free radicals, compounds
that cause cell damage and premature aging. And leave those fried chicken wings alone! CHURCH: Mindfulness techniques such as prayer and meditation have been shown to reduce some markers of
inflammation and can help people suffering from chronic inflammatory conditions. * * * 6 of * PHOTO BY: EyeEm/ Science Photo Library / Getty Images BELLY FAT: Having a big belly means you
have an excess of visceral fat, which builds up near your intestines and other internal organs. Visceral fat has been shown to secrete molecules that increase inflammation. HEALTHY FATS:
Monounsaturated fats (olive oil, avocado, nuts) have been shown to lower the risk of heart disease, while polyunsaturated fats (fish, flax, oils) include an inflammation-busting mix of
omega-6 and omega-3. * * * 7 of * PHOTO BY: Comstock / Westend61 / Getty Images BOTTLED SALAD DRESSINGS: Look at the label of your favorite dressing. The first three ingredients are probably
water, sugar and soybean oil. Soy and vegetable oils are high in omega-6 fatty acids — which we tend to eat a lot of. Make your own salad dressings with inflammation-fighting olive oil,
lemon or vinegar, and spices. BIG, COLORFUL SALADS: The vitamins and minerals that are found in fruits and vegetables help prevent cell damage via oxidative stress — in other words, they
fight inflammation. There are hundreds of antioxidants, such as vitamins A, C and E, as well as lycopene and selenium. ------------------------- We're still learning how these processes
work, but one thing we do know is that foods high in sugar and fats, and low in fiber, feed the “unhealthy” bacteria in our digestive tract. When the bad gut bacteria become too numerous,
they can damage the lining of the digestive tract. “The intestinal barrier that separates the microorganisms from the rest of your body can become permeable, allowing particles to escape
into the body circulation,” Buford says. This is known as leaky gut. The immune system recognizes these particles as foreign invaders and attacks. But since the gut keeps leaking, the immune
system keeps attacking, and — boom — you have chronic inflammation. High-fiber foods like whole grains, fruits and vegetables help to restore gut balance. HOW DO I KNOW IF I HAVE CHRONIC
INFLAMMATION? First, it's not that you either have it or don't have it. By a certain age, we all have some degree of inflammation in our bodies; the key is to keep it at a
flickering ember and not let it erupt into a forest fire. If you smoke, drink a lot, carry a lot of extra weight (especially in your belly), never exercise, eat poorly or constantly feel
agitated by stress, your chances of having some level of chronic, elevated inflammation are high. If you are lean, are healthy and lead a balanced lifestyle? You should have less of it. “But
it's tricky,” says Shmerling. Inflammation can be measured only by a blood test and interpreted by your doctor. DID YOU SAY THAT MY BEING OVERWEIGHT IS CAUSING INFLAMMATION? Yes, we
did. “Fat, especially belly fat, is a highly inflammatory tissue,” DiRenzo says. Every day, your belly fat is creating and releasing inflammatory compounds with Bond-villain names such as
interleukin 6 and tumor necrosis factor-alpha. It's why lifestyle factors such as not sleeping well can cause weight gain; it's not just about calories, but about inflammation as
well. Remember, inflammation is a response to cell damage — and fat cells are the body's damsels in distress. They're bloated with triglycerides (a substance similar to diesel
fuel) and as a result, they are very fragile and can easily burst and die. When they do, they trigger an inflammatory response as the immune system sends white blood cells to clean up the
spilled fuel. IS THERE A CONNECTION BETWEEN STRESS AND INFLAMMATION? There sure is. Chronic stress causes an increase in hormones like cortisol and adrenaline, which directly trigger a rise
in inflammation. If you have an autoimmunity-based skin condition like psoriasis, you've probably witnessed this phenomenon yourself, says DiRenzo, who often sees it in her autoimmune
patients. “They'll say, ‘Oh, I had a big stress week that triggered a flare-up,’ “ DiRenzo says. “And I say, ‘I believe you.’ “ SOUNDS LIKE I SHOULD BE ASKING MY DOCTOR TO TEST ME FOR
INFLAMMATION. Here's the problem with testing: First, remember that we all have a certain amount of inflammation in our bodies. In fact, our levels fluctuate constantly, so a reading at
8 a.m. will be different from one at 8 p.m. Also, even something harmless like the common cold will spike the levels of disease-fighting chemicals in our blood, DiRenzo says. Plus, if
you're a generally healthy person with no diagnosed issues and you test high for inflammation, what are you going to do about it? For starters: Eat better, reduce stress, exercise more
and lose weight. And that's what you should be doing regardless. That's why doctors don't routinely test for inflammation, DiRenzo says: “Testing should come as a result of
certain symptoms like swollen joints.” For example, if you have heart disease, your doctor may test for C-reactive protein (C-RP), an inflammation marker that's been linked to cardiac
issues. But just chasing inflammation itself, without specific indicators, can open a Pandora's box of unnecessary testing for patients, DiRenzo says. “Instead of trying to pin down
this nebulous term ‘chronic inflammation,’ work closely with your doctor to ID specific-enough symptoms that may lead to a diagnosis of an inflammatory issue." HOW ABOUT I JUST TAKE
ANTI-INFLAMMATORIES LIKE IBUPROFEN? Nice try, but no. While researchers continue to experiment with anti-inflammatory drugs, none has been approved for use in fighting chronic low-grade
inflammation. “Ibuprofen has side effects such as stomach bleeding and increased blood pressure,” says physician Elizabeth Boham, medical director at the Ultrawellness Center in Lenox,
Massachusetts. “There are much more effective ways to address chronic inflammation." I ASSUME THAT WOULD BE LIFESTYLE CHANGES. Bingo. Lifestyle is the thing you can change fastest and
the one thing you can control. The easy steps are to stay up to date on your vaccinations and wash your hands regularly, because infections trigger inflammation, Shmerling says. Beyond that,
food, exercise, sleep and stress relief are the big four. I ALREADY EAT MY VEGGIES. Brilliant. From an anti-inflammatory food perspective, eating a wide variety of colorful fruits and
vegetables is about as good as it gets, because the antioxidants found in fruits and vegetables help to mitigate the cellular damage created by inflammation. Cutting down on pro-inflammatory
foods like processed flour, sugar and anything high in fat will also help, even if you can't stand the sight of cauliflower, DiRenzo says. WHAT ELSE SHOULD I EAT? If all else fails,
fiber. High-fiber foods feed the good microbes in your gut during digestion, helping to correct dysbiosis. “There's a lot of evidence that a high-fiber diet provides a positive balance
of microbes and can potentially down-regulate inflammation,” Buford says. Also important: Avoid unhealthy fats because, he says, “even one high-fat meal can change the
microenvironment." SO, LESS BACON, MORE BROCCOLI. IS A VEGETARIAN DIET THE ANSWER? Nope, unless that's what you want to do. It's true, plant-based foods pack the strongest
anti-inflammatory punch. It's also true that red and processed meats can cause inflammation, but you don't have to banish meats from your diet, Boham says. This is particularly
important for older adults because protein consumption may help prevent age-related muscle loss. “I recommend a balance between plant — nuts, seeds, beans, grains — and animal protein,” she
says. She recommends organic, grass-fed meats and wild-caught fish, which have a lower inflammation factor because they feed on plants and animals that are high in phytonutrients. Try to eat
one food from every color of the rainbow every day. I'M NOT MUCH OF AN EXERCISER. HOW PROBLEMATIC IS THAT? Well, research has shown that you don't have to be a marathoner to lower
inflammation. In fact, a University of California, San Diego, study found that just 20 minutes of moderate exercise suppressed the inflammatory response. One reason, Buford says, is that
exercise can positively affect your gut health (yes, that again). Maybe DiRenzo puts it best: “The difference between someone feeling OK and feeling great is exercise." BUT EXERCISE TO
ME IS UNPLEASANT AND UNCOMFORTABLE. So is heart surgery. Which would you prefer? Ultimately, the anti-inflammatory benefits of exercise are worth the temporary discomfort. Even if you have
physical limitations — bad knees, for example — exercise will most likely improve them. To get started, DiRenzo suggests picking an activity you can do for five minutes a day. Next week, do
it for seven minutes. It could be as simple as a brisk walk. “Yeah, you're gonna be sore,” she says, “but this is a good sore. Build and build and you will start to feel better."
IF I'M GOING TO BE SORE, DOESN'T THAT MEAN MY MUSCLES AND JOINTS HAVE MORE INFLAMMATION? Sore muscles would be acute inflammation that'll go away in a day or two. (Good try,
though.) YOU MAKE IT SOUND LIKE WHOLESALE LIFESTYLE CHANGES ARE EASY. THEY'RE NOT, YOU KNOW. True. But isn't attacking one enemy — inflammation — a lot easier than worrying about
dozens of them? Here's an idea: If you have to pick one lifestyle area to improve, focus on sleep, both the quantity and quality. It not only lowers your inflammation levels, it also
helps you do everything else better. “I find when people give their body time to rest and lower stress, they have an easier time making smart food choices and getting exercise the next day,”
Boham says. _Mike Zimmerman is the author of more than a dozen health books, including_ The 14-Day Anti-Inflammatory Diet_._ VIDEO: THE BEST FOODS TO FIGHT INFLAMMATION MORE ON INFLAMMATION
* Foods that can help lower inflammation * Chronic inflammation linked to memory loss _Editor's note: This article was originally published on November 1, 2019. It has been updated
with the AARP Top Tips video._