This is Part 1 of a 3-Part series.
Inflammation is no longer seen as just the painful symptom of infection or physical trauma. It is increasingly recognised as a leading cause of a wide range of diseases. In fact, research has revealed a potent inflammation link to heart disease, diabetes, cancer, stroke and Alzheimer's. The entire aging process is marked by increasing levels of inflammation and associated free radical damage. In many cases atherosclerosis, arthritis, neurological degeneration and prostate problems have almost become seen as "acceptable"- as the unavoidable trials of advancing age. In actual fact they represent our failure to "tame the flame" and this failure is often linked to the reigning symptom-treating approach in modern medicine.
30 billion NSAIDs are sold in the US each year (100 each per man, woman and child) and seventy million prescriptions are filled for more powerful anti-inflammatory drugs. 60 million suffer from cardiovascular disease, 44 million from arthritis, 39 million from rhinitis and 17 million from asthma. Many suffer from what author, Jack Challem terms "The Inflammation Syndrome", a constellation of seemingly unrelated diseases united by the same thread – they are all characterised by runaway inflammation.
What Is Inflammation?
Infection or injury triggers a chain of events called the inflammatory cascade, where the immune system initiates repair and recovery. In a delicately balanced exercise, pro-inflammatory hormones called eicosanoids call in the white blood cells to clear out infection and damaged tissue. Anti-inflammatory compounds are then conscripted by another type of eicosanoid to move in and begin the healing process, once the threat has been neutralised. The balance between eicosanoids can determine whether a natural function becomes a liability.
Each of our ten trillion cells can manufacture these eicosanoids, which are molecules that act like localised hormones. Some of the nine types of eicosanoids include prostaglandins, thromboxanes and leukotrienes. Messing with these pervasive molecules can prove counterproductive. Aspirin, for example, shuts down the prostaglandins responsible for both inflammation and healing (so recovery is slowed). Aspirin also shuts down the prostaglandins responsible for triggering the replacement of our gut cells. All of our cells (except our brain cells) are replaced in accord with a pre-programmed timetable. Blood cells are replaced every three months, bone cells every twelve months and our gut cells die and are replaced (a process called apoptosis) within just four days. This short time frame relates to the fact that these cells are bathed in hydrochloric acid in the first stage of the gut and powerful digestive enzymes in the lower digestive tract. A degenerative condition called leaky gut syndrome can be the direct result of tired, old gut cells that were not replaced on schedule.
When the Solution Becomes the Problem
There is an inherent problem in allopathic medicine when treatment involves closing down pathways and shutting down symptoms. A cold, for example, is treated by shutting down mucus with a decongestant, but why did you have mucus in the first place? It is because the body is seeking to cleanse the infected membrane and mucus contains secretory IgA, a potent antibody to kill the virus. Decongestants also constrict blood vessels, which service the paddle-like hairs (cilia), which keep the mucus flowing. If you dam a stream the mosquito larvae grow and many people have experienced serious sinus infections following the use of decongestants. Subsequent problems can be further compounded by immune-compromising antibiotics that are also often prescribed for colds. A similar scenario occurs when we use across the counter drugs to pull our temperatures down at the first sign of a fever. Fever is part of the body’s healing process and it so often prematurely halted (and the healing process compromised) with these “medicines”. These products are cleverly marketed to anxious parents thinking they are doing the right thing by their children when, in fact, riding out the fever would be much more productive.
Understanding the Flame Drivers
The conventional approach to inflammation is to treat the symptom and, of course this strategy will always be more profitable than tracking the root cause of the problem and instigating any necessary changes. The only treatment for the enormously pervasive disease of arthritis, for example, is NSAIDs or perhaps prednisone, if the pain is bad enough. The patient continues with this medication for the rest of their lives and, over time, the side-effects can accumulate to the point that the medicine becomes worse than the malady. In this article we will be considering root causes.
The three key drivers of chronic (long term) inflammation are: insulin, and the foods that boost insulin production, the balance of essential fatty acids (omega-6, omega-3 and arachidonic acid) and food sensitivities.
Insulin – The Destructive Hormone
Excess insulin, and associated insulin resistance, is profoundly linked to the plague of degenerative diseases and the inflammation that is often driving them. Insulin increases the production of arachadonic acid (AA) from EFA’s by activating an enzyme called delta-5-desaturase. AA is the precursor of all pro-inflammatory eicosanoids.
Two recent long-term studies into aging and what it takes to become a centenarian have revealed that the key common denominator, amongst those that made the long haul, is low blood insulin levels. These findings correlate with thousands of animal studies since the 1950’s, which have shown that calorie restriction is something of a magic bullet in relation to longevity. In these studies, the restriction of calories, while maintaining a high level of nutrition, generated lifespan increases ranging from 30% to 200%. These studies involved rats and guinea pigs and there was a valid argument that the findings might not relate to humans. It takes the lifetimes of the researchers to test the applicability of the calorie restriction/longevity link in humans so chimpanzees were chosen as they are the apes most similar to us. In mid 2009, the first primate studies into calorie restriction were completed. The results mirrored the earlier findings involving other animals. There was an average increase in the lifespan of the chimps of almost 150%. If you want to live a healthy, extended life, then restricting your calorie intake to just 2000 calories a day seems to be the key! This will maintain the low blood insulin levels that are the key to a longer life. This insulin link is related to the often-misunderstood roles of this important hormone.
The Principle Purpose of Insulin
Your doctor would suggest that the principle purpose of insulin is to lower blood sugar. However, the evolutionary purpose of insulin is to store excess nutrients. Our feast or famine ancestry required that we store nutrients during the good times. Any elevation in carbohydrates sponsored a rise in insulin to store the surplus. The sugar is stored first as glycogen and then, when the limited glycogen storehouse is full, it is stored as saturated fat (98% of which is palmitic acid). The current food pyramid, emphasising high complex carbohydrates and low saturated fat, is an oxymoron because this high glucose diet actually becomes saturated fat in your body. It turns out that over consumption of carbohydrates may be a bigger contributor to the obesity epidemic than fat.
The Other Roles of Insulin
Insulin is also an anabolic hormone, which builds muscle and stores protein and this is why it is often injected by body builders.
Insulin stimulates the sympathetic nervous system, which can cause arterial spasm and constriction of the arteries. This is one reason why three times more heart attacks occur after a high carbohydrate meal rather than following a high fat meal.
Insulin mediates blood lipids. The small, dense LDL cholesterol is the most easily oxidised and can fit through the small cracks in the endothelium (the lining of the arteries). Unfortunately this is the form of cholesterol sponsored by excess insulin.
Insulin stores magnesium within the cells and as you become more resistant to insulin you can’t store magnesium and you lose it through urine. This is why there is such a strong relationship between low cellular magnesium and Type 2 diabetes.
Insulin also carries the principle cell foods, glucose and fatty acids, into the cell. Hence the “cell starvation” and associated amputations and blindness related to diabetes.
Insulin helps control the sex hormones including estrogen, testosterone and progesterone. Dr Nestler, a researcher from the University of Virginia, has shown conclusively that DHEA levels are directly correlated with insulin levels and associated insulin resistance. If you reduce insulin resistance the DHEA levels rise. Luxury DHEA levels are a good indicator of both health and happiness.
What is Insulin Resistance?
Any time a cell is exposed to insulin it will gradually become more insulin resistant. An increase in insulin resistance is an inevitable feature of aging. It could be argued that aging is insulin resistance. The key is to slow down the rate at which we develop resistance. Our cells should ideally be very sensitive to this keystone hormone and they feature insulin receptors for detection and uptake. The pancreas produces insulin to lower excess blood sugar because sugar is a toxic substance when over-consumed. Like your brain eventually shutting out the noise when you live under a flight path, when we over consume carbohydrates and experience the associated rise in insulin, our cells naturally shut out the excess. Cells essentially become insulin resistant because they are trying to protect themselves from high insulin. They reduce their receptor activity and the number of receptions so they don’t have to listen to the stressful ‘noise’.
Shortening Our Allotted Time
Insulin is what is called a mytogenic hormone - it stimulates cell proliferation and cell division. In 1961, Dr Leonard Hayflick, discovered that human cells are pre-programmed to last for between 40 to 60 divisions. After that number of cell divisions, the cells begin to die and so do we! It is obviously not a good idea to speed up the time it normally takes to achieve these 40 to 60 divisions, or your life will be demonstrably shorter. Excess insulin can speed up that process. It may well be that centenarians are achieving what we all would have achieved had we not shortened our allotted time with excess insulin.
The Mechanics of Resistance
Cells within different parts of the body become resistant at different rates and some do not become resistant at all. The liver cells are the first to become resistant, followed by the muscle cells and then the fat cells. When the liver becomes resistant it suppresses the production of sugar. The sugar in your blood reflects either what you ate or what your liver produced. When the liver has stopped listening to insulin it basically malfunctions and continues to make sugar during the night so you awake with high blood sugar levels.
The next tissue to become resistant is muscle tissue. The key role of insulin in muscle tissue involves the burning of sugar. When muscle cells become insulin resistant the excess that is being produced by the resistant liver can’t be burnt and this raises your blood sugar. Insulin stores fat, so until your fat cells eventually become resistant you get fatter and fatter. You plateau when your fat cells eventually protect themselves and become insulin resistant. As these major tissues become resistant, the pancreas is frantically making more insulin to compensate and you become hyper-insulinemic. The problem is that some of the tissues that don’t become resistant are now flooded with toxic levels of insulin and this can prove disastrous.
Insulin Resistance and Your Heart
The endothelium (the lining of the arteries) doesn't become readily resistant and it suffers when swamped with insulin. In fact, insulin is part of every known cause of heart disease. It encourages the blood to clot too readily and causes the conversion of macrophages into foam cells that accumulate the fatty deposits. Insulin causes plaque build up, it constricts the arteries (via restricted nitric oxide in the endothelium), it stimulates the sympathetic nervous system and it increases platelet adhesiveness and coaguabilty of the blood. The increased cellular proliferation can cause tumors in the endothelium and there are strong links between excess insulin and breast and colon cancer.
Supplementing with calcium to improve bone density can backfire if you are insulin resistant as much of it will be lost in your urine. Anabolic hormones direct calcium into the bone and when these hormones are miscommunicating due to insulin, the calcium can end up elsewhere – often leading to metastatic calcification of the arteries. Diseases are a result of a lack of cellular communication and insulin is like a tornado has struck the telephone system – it is linked to multiple miscommunications.
Sugar Fires the Flames
As mentioned earlier, cells have a limited capacity to divide, so when insulin stimulates cellular proliferation and division, it increases the rate of aging of a cell population. Cellular damage is the other factor involved in the aging process. Sugar is a key determinant of cellular damage during our lifespan. The two main causes of cellular damage are oxidation and glycation. Most of us are aware of the need for anti-oxidants to neutralise the poisonous effects of oxygen. However, we are much less aware of the hazards of sugar in relation to glycation where the sticky glucose molecule combines with everything. Glycated proteins produce very destructive compounds called Advanced Glycation End products with the very appropriate anagram, AGE’s. These compounds are so toxic that there are hundreds of receptors for AGE’s on every macrophage. However, when a macrophage combines with an AGE product it sets up an inflammatory reaction. Glycated proteins can make you very pro-inflammatory and inflammation is linked to everything! When we consider that sugar consumption in most western countries has increased fifteen fold during the last ten decades, it becomes clear that our sweet tooths may well be our most destructive failing.
Restoring Insulin Sensitivity
It is possible to reclaim insulin sensitivity and it is one of the most profound things you can do to improve your health. Dr Ron Rosedale has achieved remarkable results in restoring insulin sensitivity. And his book, The Rosedale Diet, is a must read for anyone interested in developing a deeper understanding of the insulin menace. Here are his seven most successful strategies:
The diet should contain an omega-6 to omega-3 ratio of 2:1 - this will often involve avoiding fast food as this garbage food usually contains omega-6-dominated junk oils that have usually been hydrogenated. You will need to choose different cooking oils as the popular products like canola and sunflower oil all contain excessive levels of omega-6 oils. You should throw out your margarine in favour of butter, which is also a far superior food and it is preferable to eat grass fed beef rather than feedlot beef as the feedlot animals have been reared on cereal grains packed with omega-6 fatty acids. It is also essential to increase your consumption of omega-3 fats. Cod liver oil is a great option, as it also has high levels of vitamin D. The main problem with this option is the repeating after taste which so many experience. The secret here is to mix the cod liver oil with fresh lemon juice as this ensures that it is much more palatable and it will never repeat. Sardines are the ultimate fish dish because they are baby fish that have not yet accumulated heavy metals. They must only be smoked, so the fragile omega-3 component is not damaged by cooking. The organs are very rich in magnesium. The bones are calcium-rich and the eyes contain luxury levels of iodine. Sardines are also the highest food source of CoQ10.
Chromium supplementation is absolutely essential. 500 mcgs per day is appropriate for anyone trying to increase insulin sensitivity but 1000 mcgs is required for diabetics. Chromium is an essential mineral for insulin management but ironically it is depleted through over-consumption of sugar.
Vanadyl Sulfate is an insulin mimic, which can do what insulin does by a different mechanism. When blood sugar is lowered without the need for insulin there is a sparing effect that can improve insulin sensitivity.
Glutamine Powder is a great, multi-purpose tool. Glutamine can act as a brain fuel so it helps eliminate carbohydrate cravings. It is particularly effective at night and this amino acid can also be used to eliminate carbohydrate craving between meals (use 4 grams in a glass of water and sip as required). Glutamine is also the body’s most abundant amino acid and it sponsors the release of Human Growth Hormone (HGH) from the pituitary gland. HGH is a powerful, much-researched anti-aging tool. In one study just two grams of glutamine powder, twice a day, generated a 400% increase in the release of HGH.
The insulin sensitivity diet should ideally comprise 20% of calories from carbs, 30% from protein and 60% from fat. This is a very different scenario to the dominant carbohydrate-dense diet paradigm. It also reflects the importance of healthy fats in our diet.
It has been shown conclusively that resistance training will enhance insulin sensitivity. Interestingly, resistance training has also been shown to be another key strategy in increasing the release of Human Growth Hormone from the pituitary gland. In one study, two hours of resistance training (lifting light weights or doing press ups, etc) resulted in a four-fold increase in Human Growth Hormone.
Calorie restriction is the other strategy to improve insulin sensitivity with 2000 calories per day considered ideal.
It has been suggested that one in three of us may suffer from insulin resistance with the associated issue of inflammation. It is a good idea to monitor your level of inflammation with blood tests.
There are inflammatory markers, which can be monitored with blood tests. These tests are often used to check for post-operative infection or to monitor the effectiveness of a particular treatment. However, it is being increasingly recognised that inflammation is a precursor to a host of degenerative diseases and this test data offers people the opportunity to address the root cause of the problem and pre-empt more serious outcomes. Natural therapists who encourage this type of proactive approach note that many clients are not motivated to act until they start hurting. There is no flame without pain! The four most productive tests include: ESR, C-Reactive Protein (CRP), hs CRP and dry blood testing.
ESR or Erythrocyte Sedimentary Rate is a non-specific test that measures how fast red blood cells (erythrocytes) fall from suspension in a tall, thin tube of blood. The presence of certain proteins (inflammatory markers) causes the red blood cells to drop out more rapidly.
A major problem with many conventional tests is that the results are interpreted in terms of averages. To be above average in a profoundly unwell society is not necessarily ideal. The desired ESR score was more than 4 times lower in 1960 than today’s ideal. i.e. 7 vs. 30. Natural therapists often encounter patients who have fallen through the cracks due to this changing of the goal posts. Cancer, for example, can be missed when levels as high as 28 are now considered to be within the normal range. It would be a good strategy to aim for the old ideals where possible and to recognise that levels over 20 represent a definite issue that should be addressed.
C-reactive protein is a highly specialised molecule called a cytokine, which serves to promote and reflect inflammation. These messenger molecules help activate the white blood cell, clean-up crew. In chronic inflammation these soldiers can mutiny and turn against the body’s tissues. Elevated CPR levels are found in people with heart disease, Alzheimer’s, cancer, arthritis, acute infection, physical trauma and prostrate problems.
A more sensitive test called the highly sensitive or hsCRP test is the preferred tool to determine the level of artery inflammation. Dr Paul Ridker, from the Harvard Medical School, has shown that people with high hsCPR have a 450% higher chance of heart attack. This test is in fact a much better indicator than cholesterol tests. The ideal CRP level is less than 1 mg per litre. Between 1 mg and 2.9 mgs is intermediate risk and high risk is above 3 mg.
The Dried Blood Test is an exceptional tool to monitor inflammation with a view to proactive management. Here you can watch the evidence of your dietary indiscretions appear before you on a screen. If you can locate an experienced practitioner you will be amazed at the diagnostic potential of this test. Often conducted in conjunction with a live blood test, this unique approach offers a host of information for proactive health management including area-specific inflammation information, which is not possible with the more generalised tests. The only downside is that it is not covered by Medicare but your 2-hour consultation with a good practitioner could prove an important investment.
Our misguided obsession with fat has sponsored overconsumption of carbohydrates which, when over consumed, actually produce body fat more effectively than dietary fat. However, this massive increase in carbohydrate consumption is doing more than making us overweight. It is generating production of excess insulin that is shortening our lives (through speeding up cell division) and it is reducing the pleasure potential of those shortened lives, because it is a primary root cause of inflammation. Happiness and an inflamed body do not coexist too well so it can be a remarkably productive strategy to address your insulin issues and make the changes that may increase your chances for a happy, healthy, extended life.
Disclaimer: Any advice provided is for information purposes only. You should seek professional medical advice before supplementing your diet.