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The Inflammation Connection

What autoimmune response has to do with heart disease and depression

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The cure for the common hangover has proved elusive. Some opine that the only way to get rid of that persistent headache and knotted stomach is through bed rest and plenty of water. Anti-inflammatories like ibuprofen have been a mainstay of hangover cures and, increasingly, modern science is verifying that feeling sick after a night of hard drinking is a symptom of a body’s autoimmune response.

In fact, medical researchers are linking inflammation to more than commonly accepted causes like injury and infection. The same chemicals that make us feel headachy and ill with that cold that’s going around, or tender after spraining an ankle, may be behind chronic conditions like gluten intolerance, rheumatoid arthritis and even depression. And long-term inflammation has been tied to some of the biggest killers in America: cancer and heart disease.

“Uncontrolled inflammatory disease of any kind has global effects on health within a body,” said Dr. James Loveless. Loveless is a Boise rheumatologist who has been in practice for 23 years. In that time, he has seen a revolution in how physicians see the connection between autoimmune response—our body’s natural reaction to injury and disease—and negative long-term health issues. While tenderness around a burn or lethargy as the result of illness are perfectly healthy manifestations of that response, conditions like rheumatoid arthritis and lupus are examples of it going awry. The trouble is, nobody’s certain what prompts a good thing like our bodies’ fighting off infection and repairing damaged tissue to go bad.

“That’s a Nobel Prize,” Loveless said. “Normally we think of the immune system as being in place to help fight off foreign invaders, but in autoimmune diseases, there’s a trigger that kicks off the immune system and it attacks one’s own tissues.”

While science has yet to give a definitive answer, there are a number of compelling theories including infectious processes, environmental factors like toxins, allergies, genetics and stress. All autoimmune responses release chemicals called cytokines into the bloodstream. In sufficient quantities or over a long enough period of time, exposure to cytokines can damage tissue, and they’ve been linked to arterial inflammation and hardening, leading to increased risk of coronary artery disease, heart attack and stroke.

Cytokines can also cross the blood-brain barrier to damage tissues in the brain, leading some researchers to link chronic or off-the-rails inflammatory response to neurological conditions like depression and anxiety. In 2006, researchers at universities around the world published an article in Molecular Psychiatry, concluding that adding anti-inflammatory agents to antidepressants improved patient outcomes and the likelihood of drugs’ effectiveness on a given patient.

According to a 12-year study conducted on almost 45,000 women ages 50-77 and published in Brain, Behavior, and Immunity, women whose diet includes foods that trigger inflammation like red meat, sugars, gluten and soy products like margarine, and fewer foods that control inflammation, are at a 41 percent greater risk of being diagnosed with depression. While previous studies concluded that there was a relationship between inflammation and depression, this one concluded that diet plays a significant role in creating the conditions in which some psychiatric conditions arise.

The senior author of the study, Harvard University Professor of Epidemiology and Nutrition Alberto Ascherio, told the Harvard School of Public Health, “From a public health perspective, it is reassuring that what is good for the body is also good for the mind.”

While our understanding of what triggers chronic autoimmune response is incomplete, much more is known about the conditions that aggravate it. Significantly, body fat has been linked to inflammation, and losing 2.2 pounds of fat has been linked to a decrease of 0.13 mg/L of inflammation measure C-reactive protein, according to the American Heart Association. Measures of 1 mg/L of this protein indicates a low risk of cardiovascular disease, while 3 mg/L or higher is associated with a high risk.

Behaviors that reduce body fat and low-fat diets that contain anti-inflammatory agents are associated with lower levels of cytokines in the blood—behaviors like a balanced diet and exercise. But more specifically, there are foods that are known to reduce inflammatory responses in humans like olive oil, red wine and almonds. Foods high in essential fatty acids, like fish and flaxseed oil, also perform this function.

Reducing consumption of foods like gluten, which is found in breads and pastas, as well as saturated and trans fats, and plans in the nightshade family like potatoes and tomatoes, can also help reduce inflammation.

According to University of Idaho Associate Professor and dietitian Dr. SeAnne Safaii, the so-called “Mediterranean diet,” which is high in olive oil and low in gluten, has been related to improved cardiac outcomes. Tofu, curry, ginger and sweet potatoes—mainstays of diets in many Asian countries—are also linked to longevity and reduced arthritis-related inflammation.

“Of course,” Safaii wrote in an email, “maintaining a healthy weight is also important for reducing inflammation from arthritis.”