When the balance of our body is threatened, mainly by infections, injuries or blows, an ancient protective mechanism comes to the rescue: inflammation.
“The main characteristic of the inflammatory response is the emission of chemical signals to mobilize the cells of the immune system to a specific place in the body,” explains Jaime Millán, head of the Cellular Biology of Inflammation group at the Severo Ochoa Molecular Biology Center ( CBM, CSIC-UAM).
And not only that. Inflammation in turn helps repair damaged tissues, eliminate waste, and modify blood vessels so that immune cells reach the affected area more easily.
Although inflammation is essential for our survival, everything in its right measure. “When there is something in our body that tends to chronically alter its balance, the body reacts. And this includes everything from the nutrients we take to aging. For this reason, in recent years, scientists have realized that inflammation is a very important component of most, if not all, pathologies and particularly in chronic ones,” explains Millán.
The researcher gives the example of excess cholesterol: it accumulates in the blood vessels, which causes the surrounding cells to begin to emit the aforementioned chemical signals at low levels, but constantly. The cells of the immune system cannot go to the source of infection and eradicate it because it does not exist as such. Instead, they accumulate under the vessels, transform and begin to secrete more signals, producing the growth of an atheromatous plaque that can lead to blockage of the blood vessel.
This would be the origin of atherosclerosis, a chronic cardiovascular disease characterized by the narrowing and hardening of the arteries due to the aforementioned plaques, consisting of deposits of fat, cholesterol, tissue, inflammatory cells and other substances.
Controlling inflammation can help, in part, with the appearance of diseases or their management. Pathologies are influenced by both genetic and environmental factors. The first are what they are and, for the moment, little can be done to modify them. But in the latter there is some capacity for maneuver.
One of the main places from which to act is eating habits. It is not about choosing specific foods or nutrients with supposed anti-inflammatory effects, but rather about achieving a healthy balance.
“A diet rich in fruits, vegetables, legumes, and non-ultra-processed foods has been associated with greater prevention of inflammatory diseases,” says Beatriz Cabanillas, head of the Allergy Research group at the Hospital 12 de Octubre Research Institute.
The Mediterranean diet stands here as the one with the most evidence behind it. This eating pattern implies, in addition to the foods mentioned by Cabanillas, vegetable oils, fish and lean meats, and, occasionally, red meats and sweets.
According to Juan Carlos Nieto González, rheumatologist at the Gregorio Marañón Hospital and co-director of the Center for Immune-Mediated Inflammatory Diseases (CEIMI), such a combination has the capacity to improve the anti-inflammatory profile of some patients with autoimmune diseases, which are characterized by a chronic inflammation, especially in those with lupus.
Fiber is one of the protagonists of the benefits of the Mediterranean diet. In the words of Millán: “Plant fiber, in general, is not digestible except by the bacteria resident in the intestine. This digestion (fermentation) gives rise to short-chain fatty acids that have an attenuating effect on inflammatory signaling by immune system cells, such as macrophages.”
Along with fiber, there are also several lines of research around the possible benefit of certain components. Flavonoids, a group of chemicals widespread in plants, are one of them. These compounds have valuable antioxidant, antimicrobial or anti-inflammatory properties collected in extensive scientific literature and already used in traditional medicine.
“The role of flavonoids as a key component of a healthy diet has gained increasing consideration,” Cabanillas and his colleagues write in an article published in the journal Food Chemistry. The numerous studies with animal models and cell cultures reviewed by the team show a anti-inflammatory action in asthma, cancer or food allergies. Even the data with people is encouraging. For example, one study found a lower risk of cardiovascular disease in people who ate apples with skin, rich in flavonoids, compared to the group that ate them peeled
Vitamin D emerges as another of the leading elements. This plays a regulatory role in the immune system and its participation has been proposed in certain autoimmune diseases such as multiple sclerosis or rheumatoid arthritis. The pathology would be linked mainly to low levels of the vitamin.
A similar situation occurs with omega 3, which can be found naturally mainly in oily fish, vegetable oils and seeds. This type of fatty acids is interesting in that it is a precursor of anti-inflammatory mediators and can control the secretion of inflammatory substances, which is why it could result in anti-inflammatory in some specific contexts. Yes, however, “research is still being done and it is difficult to be categorical about the benefits of omega3 in particular,” in the words of Millán.
The VITAL trial, a follow-up of almost 26,000 people for more than five years, reported in 2019 that neither vitamin D nor omega 3 supplementation reduced the incidence of major cardiovascular events or invasive cancer. Some protection against myocardial infarction was observed, especially in African-American people. In a review published in Nature Reviews Cardiology where the trial is analyzed, the author emphasizes, again, the Mediterranean diet. In fact, he is quite adamant about the title of the manuscript: “Nutrient supplementation is not a substitute for a healthy diet.”
Another effect of the aforementioned Mediterranean style is that it helps prevent obesity. Excess fatty tissue produces the secretion of inflammatory mediators because it produces stress in adipocytes, cells that store fat, and because lipids are precursors of some of the aforementioned inflammatory mediators.
In fact, people with psoriatic arthritis or psoriasis and who are overweight are recommended to lose weight because it has been shown that these patients respond better, says Nieto González.
Along with diet, exercise also serves to control accumulated fat. Practicing sports also allows you to gain another important weapon to fight against excess inflammation: muscle.
“Muscle tissue is an endocrine organ that secretes, for example, anti-inflammatory cytokines called myokines. The muscle also controls fatty tissue through these mediators. But, even if it didn’t, the increase in muscle mass contributes to an increase in basal metabolism and more fat consumption,” says Millán.
Studies with large populations consistently show an association between those who report being physically active and lower concentrations of inflammatory markers. One of them, carried out with more than 3,600 healthy American adults, showed that exercising more than 22 times a month was associated with a 37% reduction in the risk of having a high level of C-reactive protein compared to exercising less. three times a month. This protein is produced by the liver in response to inflammation in the body.
On the side of things to avoid, for Patricia Fanlo Mateo, specialist in Internal Medicine and President of the Spanish Multidisciplinary Society of Systematic Autoimmune Diseases (SEMAIS). Emotional stress tops the list. “We know that it alters the immune system and is one of the most important triggers in autoimmune diseases. Many debut in a situation of family or work stress, a separation…” says the coordinator of the Systemic Autoimmune Diseases Unit of the Navarra Hospital Complex.
In the aforementioned autoimmune diseases, where chronic inflammation comes hand in hand with a response from the immune system to the body’s own tissues, many patients report flare-ups during times of greater stress.
Avoiding toxins is the other great consensus among experts, “especially tobacco, which does a lot of harm,” says Fanlo Mateo in relation to autoimmune diseases. Alcohol is also included in this group.