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Inflammation might be the root of preventable disease

650 points| bookofjoe | 6 years ago |harvardmagazine.com

231 comments

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[+] Someone1234|6 years ago|reply
I found this area interesting:

> “A fat cell is almost like a primitive immune cell,” says Hotamisligil. “It can request the assistance of immune cells when in trouble, but if the stress continues, and the immune cells remain, they start changing their character and behavior from helpful to harmful.”

...

> When overloaded with stored lipid, fat cells begin to lose their functional and structural integrity and may start spilling their toxic cargo. When cells fail like this, the immune system kicks in, initially to assist in clean-up. Macrophages engorge themselves on the leaking fuel, and may die themselves during this process. But in the long run, what is meant to be a mutually beneficial interaction between the metabolic and immune systems turns into a very dangerous and harmful relationship. Obese individuals thus live in a state of chronic stress and inflammation; in fact, many people do, because their energy intake vastly exceeds their needs. Hotamisligil calls this chronic energy overload, and the resulting abnormal immune response, metaflammation: metabolic inflammation.

This article brings together a whole host of different areas of research about human inflammation. I would recommend reading it, but it isn't an article you can skim and there's no big bang conclusions, just more areas of keen research and exploration.

[+] andai|6 years ago|reply
> Critics might suggest that inflammation is just a symptom in these diseases, rather than a cause. But Hotamisligil says, unequivocally, “Chronic inflammation is uniformly damaging and is absolutely causal to the process, because if you interfere with it, you can reverse the pathology.” And this ability to control such diseases simply by reversing inflammation is a biological response, dating far back to the time of a common ancestor, that has been retained across diverse species of animals to the present day, he says, pointing to experimental evidence: “If you can make Drosophila [fruit fly] diabetic, and then block the inflammatory response systems, you can cure diabetes in Drosophila, the same way you can reverse it in the mouse, in primates, and in humans, provided that you do it with the right tools. Of course, the higher the organism, the more complex these pathways are, so it takes more effort to define the precise mechanisms to manipulate.”
[+] nessunodoro|6 years ago|reply
Book recommendation - "Toxic Fat" by Barry Sears (disclosure - the father of a friend of mine). Its thesis is in line with much of the research in this article.
[+] agumonkey|6 years ago|reply
the fat -> immune response is reminiscent of cardiovascular diseases too
[+] rossdavidh|6 years ago|reply
My prediction: 1) reducing chronic inflammation by, for example, exercise or eating better food, is proven to have good health effects 2) pharmaceutical companies try to make that into a pill 3) dang, the benefits of the pill are not nearly as big as if you exercise and eat better food, and not nearly as big as our early trials of the drug indicated they would be 4) we must need a different kind of pill
[+] braink|6 years ago|reply
Bottom line: pharma sells pills to make money; they don't make money off of healthy people who don't take their pills. So long as we link the health industry to making profit, we are prioritizing profits over health.
[+] ixtli|6 years ago|reply
Yup! I would also predict this. You simply can’t engineer your way out of needing better living conditions.
[+] BandOfBots|6 years ago|reply
The most effective natural treatment for inflammation is 20 minutes a day in sauna
[+] jokowueu|6 years ago|reply
The Japanese Ibudilast pill is a super interesting anti inflammatory pill that has very interesting research behind it . I recommend taking a look at it if ur interested is this sort of thing

It's available for sale

[+] manmal|6 years ago|reply
Resveratrol was such a pill/fad, with some companies going belly up eventually.
[+] orangecat|6 years ago|reply
What is your reaction when social conservatives say that there's no need for contraception or STD vaccines, because you can just not have sex unless you're prepared to accept the responsibilities of pregnancy and raising a child?
[+] gnoppa|6 years ago|reply
I'd predict the pharmaceutical pill will be damaging! Our body is very smart and heals most things by itself, given the right nutrition.
[+] alchemism|6 years ago|reply
In this context, I find it interesting that popular ‘folk’ remedy herbs in many regions are ones which reduce inflammation, e.g. chamomile, rosemary, yarrow.

Also many of the ingredients in curry powder, e.g. turmeric, ginger, fenugreek, black pepper have inflammation-fighting properties. Curry powder is traditionally best used within a few weeks of grinding the ingredients together; it may not be the taste which subsides in this time, but the other properties.

[+] arkades|6 years ago|reply
I find these sorts of arguments to be... odd.

“Inflammation” includes so many normal homeostatic processes that it’s essentially a tautology to point to inflammation as being a critical component of disordered homeostasis. The biggest key as to whether a molecule is considered inflammatory is what type of biologist discovered it first.

[+] blotter_paper|6 years ago|reply
>The biggest key as to whether a molecule is considered inflammatory is what type of biologist discovered it first.

I'm super ignorant of this field. Do you have examples of molecules that would be classified differently if found by different researchers?

[+] adamnemecek|6 years ago|reply
If it's that prevalent, maybe it's worthy of being talked about.
[+] Roaexus|6 years ago|reply
Eating a whole foods planet based diet can reverse diabetes and significantly reduce inflammation.

I didn't believe this until I had a dear friend pass away from a heart attack at 33. This forced me into getting my blood work done. I was astonished how bad my numbers looked across the board even though I was skinny.

By eating a planet based diet all my numbers have normalized. I eat and sleep better. My energy has increased. I take 0 drugs. It's been a really eye opening experience. I'm 38.

The standard american diet needs to be fixed. It should look more like this

https://food-guide.canada.ca/en/

https://www.health.harvard.edu/staying-healthy/foods-that-fi...

https://www.health.harvard.edu/blog/eat-more-plants-fewer-an...

Book recommendation - How not to die - Michael Gregor

“Let food be thy medicine and medicine be thy food.” ― Hippocrates

[+] LinuxBender|6 years ago|reply
In my case, inflammation is a side effect of insulin resistance, like my fellow 83 million Americans with metabolic syndrome. If I can reverse the cause long enough, the liver should stop dumping fat into the adipose tissue and triglycerides may drop.
[+] the_economist|6 years ago|reply
I did a 5-day fast last month. Water only, 120 hours.

In the 30 days since I completed the fast, my fasting blood glucose has dropped from ~80-90 down to 65-75.

I'm concerned about the accuracy of my Freestyle Libre, but it was previously consistent with professional labs.

Anyway, a long term fast like the one I did may help improve your insulin resistance; it seems it did for me.

[+] RobertRoberts|6 years ago|reply
How can a symptom be the "cause" of a disease?

Gingivitis is "inflammation of the gums", but it's "caused" by bacteria, plaque, tarter, etc... inflammation is the description of what is happening (ie, symptom) not the "cause".

[+] Someone1234|6 years ago|reply
This article suggests that it might be the symptom of one disease while being the cause of another disease (or range of diseases).

For example the "fat cell leak": The body is correctly responding to a real problem, but the response is so heavy handed it causes other problems.

Which is why suppressing inflammation might be an interesting area of research, but we wouldn't want to completely eliminate it because the body may lose a vital tool needed to fight illnesses and normal maintenance.

[+] tim333|6 years ago|reply
The gum disease thing is actually one of the best bits of evidence for the inflammation does bad stuff hypothesis:

>People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. https://www.health.harvard.edu/heart-health/gum-disease-and-...

The idea is bacteria in the gums cause inflammation (red swollen flesh, more white cells, metabolic changes) causes clogged arteries causes heart attacks.

[+] losteric|6 years ago|reply
If one system's inflammation causes another system to degrade and inflame, and so on, until the body has systemic inflammation without an infection... that over-sensitivity/self-reinforcement mechanism is arguably the problem, but also a moot point without advanced gene editing. The "fix" may be reducing inflammation so those systems can recover homeostasis.
[+] will_brown|6 years ago|reply
Inflammation is tricky because you have accute (a hard work out, an injury, gingivitis) or chronic/dietary inflammation which is more akin to a reversible disease.

It’s like saying type2 diabeties or fatty liver disease are not diseases but symptoms caused by certain dietary habits. Though as I write this...maybe you are correct and we should look at these things like symptoms of poor diet and not diseases.

[+] naasking|6 years ago|reply
> inflammation is the description of what is happening (ie, symptom) not the "cause"

If you chemically turn off inflammation and the negative downstream effects disappear, then inflammation is arguably a cause of those negative effects. Inflammation is supposed to be a healthy response to various conditions, but that isn't always the case, so when it's causing negative effects it becomes a pathology and arguably a cause.

Now if you're trying to argue some sort of infinite regress, then the Big Bang tautologically caused everything and nothing else is a meaningful cause.

[+] refurb|6 years ago|reply
Inflammation is not just a symptom, but also an underlying process.

Lots of things can cause inflammation, but the underlying process can be similar. And it can have good and bad effects.

[+] DoreenMichele|6 years ago|reply
So, what I think is happening is that excess acidity (and other chemical derangement) causes inflammation which promotes infection which causes more inflammation. It's a vicious cycle with a positive feedback loop.
[+] iron0013|6 years ago|reply
Lots of things that have upstream causes also have downstream effects.
[+] openforce|6 years ago|reply
I found the last part about SPMs and anti-inflammatory molecules, very interesting and encouraging. Being a colitis patient, I have found out in my own experiments, that eating a diet rich in well sourced fish and chicken decreases my inflammatory symptoms and is very filling at the same time.
[+] craz8|6 years ago|reply
I found that gluten irritated my Crohns.

I recently started Remicade - it reduces the immune system to try to stop the auto-immune problem that is Crohns. It was eye opening what other little aches and pains went away once the immune system was turned down a bit and the inflammation was lowered

Certainly the extra inflammation was causing other problems where the inflammation is the main cause.

[+] mleonhard|6 years ago|reply
Is this a PR piece paid for by Novartis, the makers of Canakinumab? Wikipedia says the drug costs $8k/week and the initial study showed no survival benefit. Then "further analysis" showed a big benefit. Something seems off.

https://en.wikipedia.org/wiki/Canakinumab

[+] ensiferum|6 years ago|reply
I'm quite sure eventually this will all align with the research into sugar which basically says that sugar is poison. Especially in the quantities that the modern people eat these days.

Dr Lustig has done the sugar research. https://www.youtube.com/watch?v=dBnniua6-oM

[+] tomohawk|6 years ago|reply
> “My papers were rejected,” he recalls; “my grants turned down.”

Why scientific "consensus" is not scientific.

[+] Tharkun|6 years ago|reply
It's curious that the article doesn't mention allergies. AFAIK those have been on the up for decades, with more and more people being allergic to trivially common things (pollen, dust mites,...). Allergic reactions can be a cause of things like asthmatic symtoms. Seems to tie in with the inflammation thing. Maybe it's part of the cause? Or maybe they're themselves another symptom of this proposed chronic inflammation?
[+] rsync|6 years ago|reply
Inflammation ? Fasting. Just try it. It costs nothing.
[+] fnord77|6 years ago|reply
> “To treat excessive inflammation...we don’t want to block the inflammatory response. We want to stimulate the resolution pathways.”
[+] joduplessis|6 years ago|reply
This is interesting! Bit of an anecdotal story, but I struggled with weight issues until about 8 years ago & I've often spoken to friends saying that it really felt like I ALSO suffered from some type of body inflammation. Even on "binge-y" days now, the morning after my sinuses go nuts! Super interesting read.
[+] jimijazz|6 years ago|reply
Can you share what you did do to improve your condition?
[+] tracker1|6 years ago|reply
It's worth noting, that despite being blocked out in the diet list in the research, the state of red meat is still not firm [0]. There seems to be a body of evidence that naturally fed ruminants are very good sources of nutrition for people. It's worth noting said nutrition profile does change DRAMATICALLY when they're fed unnatural sources (grain/feed) over natural sources.

If you don't eat meat because you don't want to for whatever reason, but there is a LOT of bias in food research.

In general, avoid refined sugars, avoid refined seed oils, avoid other refined/processed foods... increase intake of less processed (even if cooked) foods, and try to eat fattier fish 3-4 times a week.

https://chriskresser.com/does-red-meat-cause-inflammation/

[+] katakuchi|6 years ago|reply
I often wonder about the use of herbal medicine instead of our artificial pharmaceutical cousins to combat inflammation. It just seems so arbitrary, counter-productive and ironic to fill your body with more toxins to counter the inflammation achieved by overconsumption of primarily 'bad food' in the first place.
[+] mikedilger|6 years ago|reply
That study they cite: 3 of 4 dose levels didn't meet the statistical significant threshold, and in the one that did there was no difference in all cause mortality.

Look, I wish it was as simple as a single easily treatable vector like inflammation. But it's not. Life is not simple.