(© Bonnie Schiedel. Originally published in Chatelaine, May 2006)

Chronic inflammation is the smouldering ember that can spark a stroke, heart disease or Alzheimer’s. Extinguish your worries with eight quick tips. 

Not all inflammation is the same. When you cut your finger, twist your ankle, catch a cold or get a zit, your immune system snaps to attention and sends white blood cells and other compounds to attack the affected area. This complex cellular chain reaction results in some swelling, tenderness and mild redness and heat. That’s the good kind of inflammation: think of it like a friend who rushes over to kick some butt–and hold your hand—after you’ve been insulted. Good inflammation doesn’t last very long, and it helps to heal, protect and clean up the problem.
But sometimes your body gets the wrong information. It starts attacking the wrong cells for the wrong reasons – kind of like a paranoid friend who sees an insult when there isn’t one, and carries on about it until everyone around her is miserable and aggravated. That response leads to chronic inflammation; the kind of conditions that end in “itis,” like arthritis and colitis (inflammatory bowel disease). Cutting-edge research from top-level universities and scientists shows that when your body’s inflammatory response is triggered on a long-term basis, it can be part of the puzzle that adds up to serious conditions like heart disease, cancer, Alzheimer’s disease and diabetes. Women with rheumatoid arthritis, for example, are twice as likely to have a heart attack, in part because the inflammation from the arthritis affects arteries and the heart, according to a recent Harvard study.

Don’t have any “itis” conditions? You’re not off the hook. Scientists have discovered that chronic inflammation can also result from living an unhealthy life. And yep, that means eating refined and fatty foods, carrying extra weight, smoking, not dealing with stress and generally not taking care of yourself. And you may not even know you have this internal inflammation (see Are you feeling the burn?).
The good news is that one of the easiest and most effective ways to douse levels of harmful inflammation – and keep them from flaring up in the first place – is found right in your fridge and cupboards. Delicious healthful foods like berries, walnuts and (yay!) red wine all help to combat the harmful fires within. And don’t worry about scrambling to get a certain amount of one type of anti-inflammatory food, advise researchers. It’s better (and easier!) to focus on eating a wide variety of nutritious foods every day. We’ve talked to the experts about the very best foods to toss in your shopping cart, and also created an anti-inflammatory meal plan. Read on to learn how to douse the flames! 

Fire extinguisher #1: Pick jewel-toned foods
Deeply hued purple, red and blue produce appear to be particularly adept at fighting inflammation. Preliminary research shows that purple grape juice, made with Concord grapes, significantly lowered inflammation in people with coronary artery disease, according to researchers at the Boston University School of Medicine, although the reasons why aren’t clear.
A recent study published by the Journal of Natural Products found that bright red tart cherries (also known as sour cherries or pie cherries) contain compounds called anthocyanins which inhibit inflammation. And blueberries may lessen brain inflammation linked to Alzheimer’s disease, says James Joseph, director of the Neuroscience Lab at the Human Nutrition Research Center on Aging at Tufts University in Boston. Savour wild blueberries when you can. “Gram for gram, wild blueberries have more anthocyanins than cultivated blueberries, and a growing body of evidence links anthocyanines to anti-inflammation,” says Marva Sweeney-Nixon, a biology professor at the University of Prince Edward Island in Charlottetown. 
shopping list: Concord grape juice, sour cherries, red cabbage, chokecherries, pomegranates, red grapes, lots of berries

Fire Extinguisher: #2 Eat like the Greeks and Italians
The Mediterranean diet – heavy on whole grains, fruits, vegetables, low-fat dairy and fish; moderate on wine and nuts; easy on sweets and red meat – has long been considered a heart-healthy choice. Greek researchers decided to take a look at why dining on these foods promotes heart health. Their study of 3,000 men and women, published in the Journal of the American College of Cardiology, found that people who followed this traditional diet had lower levels of an inflammation marker called C-reactive protein (CRP) in their blood (see “Are you feeling the burn?). Another new study found that olive oil, one of the Mediterranean mainstays, contains a naturally occurring chemical that actually acts as a non-steroidal, anti-inflammatory agent just like ibuprofen does. 
And if you can’t do it for your insides, do it for your skin! “More and more, we’re finding that a healthy diet protects skin cells from the same inflammatory responses that harm the rest of our body,” says Samantha Heller, a senior clinical nutritionist at the NYU Medical Center in New York. She adds that eating good foods also helps your skin deal with inflammation caused by pollution and the sun. 
shopping list: whole grain pasta and bread, brown rice, low-fat dairy, olive oil, fish, nuts

Fire extinguisher #3: Swallow a supplement 
While getting your vitamins and minerals from food is a great idea, vitamin supplements can also play a role. Researchers at the University of California, Berkeley, found that people who took 500 mg of vitamin C daily for two months slashed their CRP levels by 24 per cent. Another six-month trial showed that popping a multivitamin significantly lowered CRP levels. 
Researchers aren’t sure why vitamins, particularly vitamin C, work, but one theory is that inflammation develops when blood pounds against blood vessels, leading to narrowed arteries and heart attack and stroke. Vitamin C may help prevent this inflammation and the damage that follows. 
shopping list: a daily multivitamin 

Fire extinguisher #4: Deal with stress 
There are a number of connections between inflammation and depression. The inflammation response is under the control of the central nervous system. “That system sends signals out to your body and changes all sorts of hormones and metabolic levels which affect your brain, ” says Dr William Joel Meggs, author of The Inflammation Cure (McGraw-Hill). Researchers at Ohio State University found that people who were caregivers to spouses with Alzheimer’s disease and other forms of dementia were both mildly depressed and had blood markers that indicated long-term inflammation. A new study from the Journal of Occupational Health and Psychology also revealed that women suffering from job burnout had an increased risk of higher CRP levels. This may have to do with the stress hormone norepinephrine, which is thought to kick start the part of the immune system that contributes to chronic, low-grade inflammation. 
shopping list: a fun night out, career counselling, talking to a supportive friend or therapist

Fire extinguisher #5: Stock up on salmon
Essential fatty acids called omega-3s show promise as powerful anti-inflammation warriors. Cold water fish such as salmon and mackerel contain lots of omega-3s called EPA and DHA, which have zapped inflammation in many studies. A third type of omega-3, called alpha-linolenic acid (ALA), is found in flaxseed oil, walnut oil and walnuts. A study from Penn State showed that people who had an ounce (tk g) of walnuts, a tablespoon (15 ml) of walnut oil and a teaspoon (5 ml) of flaxseed oil a day dramatically reduced their CRP levels. “Look for dairy products like yogurt and milk, as well as eggs that are labelled ‘omega-3’,” advises Patricia Reller, a Toronto registered dietitian.
Nutritionists are finding omega-6 fatty acids, which are found in safflower, sunflower and corn oils and some soft non-hydrogenated margarines, work with omega-3s to provide the body with “good fat.” Most of us get more omega-6 fatty acids from processed foods, than omega-3s in our day-to-day diet, an imbalance which promotes inflammation, says Dr. Patrick McGeer, a neurological researcher at the University of British Columbia. Make a point of reaching for foods rich in omega-3s to match up with the omega-6s you’re already eating. 
shopping list: flaxseed oil, walnut oil, walnuts, ground flaxseed, low-fat dairy and egg products labelled “omega-3,” salmon, (choose wild salmon when possible. Canned salmon is generally wild salmon, according to Health Canada), mackerel, sardines

Fire extinguisher #6: Munch on a rainbow of fruits and veggies
Everyone knows that fruits and vegetables are packed with all kinds of disease-busting compounds, so make sure you include a wide range of the crunchy stuff in your diet. An American Journal of Clinical Nutrition study found that when participants boosted their servings of produce from two to eight a day, their CRP levels dropped significantly. Most of the produce was brightly coloured red, yellow and orange veggies, particularly carrots, leading the researchers to theorize that the antioxidant carotene played a role in reducing inflammation. 
Broccoli sprouts zap inflammation too. A new study from John Hopkins shows the little green sprouts reduce stomach inflammation in people who suffer from chronic bacterial gastritis, a stomach inflammation caused by a particular strain of bacteria, which can lead to ulcers and even cancer. Broccoli sprouts can be hard to come by, so check local health food stores as well as the Saskatchewan-based www.sprouting.com.
Fruits and veggies are also good sources of fibre, which – you guessed it – lowers CRP, possibly because fibre may both reduce inflammatory compounds in the bowel and help the body fight off oxidative stress. 
shopping list: carrots, broccoli sprouts, sweet potatoes


Fire extinguisher #7: Drink shiraz with Indian takeout
Here’s something to toast: Moderate alcohol consumption (which means five to seven drinks over a week), lowers CRP levels, according to a study published by the American Heart Association. Does the choice of alcohol matter? One study by medical researchers at Thomas Jefferson University in Philadelphia found that while both red wine and gin lowered inflammatory blood markers, red wine was much more effective. And consider having some curry with that glass of vino. Curcumin, which gives the spice turmeric its bright yellow colour and is commonly found in curry, is a natural anti-inflammatory. Findings are preliminary, but curcumin appears to partially block the effects of CRP on cells, as well as squash pro-inflammatory compounds. “Turmeric is often quite effective at decreasing inflammation from arthritis,” notes Reller. 
shopping list: red wine, yellow curry paste

Fire extinguisher #8: Butt out and thin down
Smoke from that cigarette may be causing a slow burn within your body, too. Studies show that smokers have significantly higher levels of CRP than non-smokers, and that when you butt out, your levels return to that of non-smokers within five years. Getting off the couch can also do the trick. Researchers at the University of Pennsylvania found that getting your blood pumping through exercise can reduce inflammation, possibly because the increased blood flow may help cells to produce their own anti-inflammatory response.
Carrying too much body fat can also stoke inflammation, because it can produce cytokines that contribute to the burn. Not surprisingly, studies have shown that when the number on the scale goes down, so do inflammation levels. 
shopping list: workout gear and shoes, quit smoking plan


Are you feeling the burn?
Yes, we know you’re one hot mama, but how do you know if chronic inflammation is doing a number on your health? You likely can’t tell on your own. Scientists who conduct studies about inflammation do blood tests to detect signs of specific blood markers. The most commonly studied one is called C-reactive protein (CRP), which is produced by the liver when inflammation occurs in the body. 
Some doctors, especially cardiologists, test for CRP, but it’s not a routine part of most yearly physicals. More research is needed to see if testing for CRP levels is worthwhile for everyone. “CRP can be a tool to help assess cardiovascular risk,” notes Dr. Jacques Genest, chief of cardiology at McGill University Health Centre in Montreal. “If a patient is at intermediate risk for heart disease – say she has some combination of obesity, physical inactivity, smoking, high blood pressure or low HDL (good) cholesterol – her doctor may take her family history and CRP levels into account when deciding on treatment.”
Bottom line: “Your best bet is to build long-term health through a healthy diet and exercise,” says inflammation researcher Dr. Patrick McGeer.

Inflammation and disease
Chronic inflammation is definitely considered one of the bad guys when it comes to health. “Just about every major disease – everything from arthritis to diabetes to Alzheimer’s disease – has an inflammation component,” says James Joseph, a neuroscientist at Tufts University in Boston. It affects the body in many different ways: by damaging cells and DNA, possibly leading to cancer, particularly breast and colon cancer; promoting plaque in arteries, which lead to arteriosclerosis, heart attack and stroke; possibly making your body more resistant to insulin and, therefore, contributing to diabetes; and making the brain more vulnerable to cognitive decline as you age. It practically deserves its own “Most Wanted” poster at the post office!

The anti-inflammatory meal plan

Eating a variety of fruits, vegetables, whole grains, fish, lean protein, nuts and low-fat dairy products gives you the fuel you need to lead a healthier life and help keep inflammation in check. Ramona Josephson, Chatelaine’s ask a nutrition coach columnist, suggests you mix in some of these anti-inflammatory all-stars as often as you can:

Breakfast choices
whole grain cereal such as oatmeal, topped with skim milk, flaxseed and berries
whole grain toast with nut butter or sour cherry jelly

Lunch choices
spinach frittata made with omega-3 eggs
lentil or pea soup
curried carrot soup with a dollop of omega-3 plain yogurt
green salad topped with walnuts, berries and a flaxseed oil and pomegranate juice dressing
mixed bean salad made with olive oil vinaigrette
salmon salad sandwich on whole grain bread, topped with broccoli sprouts and your choice of condiments (choose wild salmon when possible. Canned salmon is generally wild salmon, according to Health Canada.)

Dinner choices
grilled salmon steak or salmon burger 
wild rice with sautéed onions and walnuts
roasted root vegetables, including carrots, tossed with olive oil
baked sweet potato fries
glass of red wine

Snack choices
Concord grape juice
omega-3 yogurt garnished with berries
smoothie made with fruit, yogurt and ground flaxseed
a handful of berries, especially wild blueberries