Anti-Inflammatory/Anti-Aging Strategies
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An article in a recent trade publication opened with the following: “Charles couldn’t believe the intensity of the pain – and he had been shot during a tour in Iraq with the Marines. “I was lying in my sleeper and my big toe just went on fire. It was like nothing I had ever experienced. I thought I was going to pass out from the pain,” Charles explained. “My big toe was red, swollen and when I touched it, even a little, it hurt like hell”. Charles’ problem is that he suffers from gout.

 Gout is a type of arthritis that seems to run in families and results from the presence of crystals that form in the body. For example, during digestion and metabolism, the body produces uric acid which is eliminated via urine. Any uric acid that the body cannot excrete accumulates in the blood. For reasons not understood, about 30% of people with high levels of uric acid in their blood form needle-like, sharp urate crystals that end up in their joints and/or other parts of the body.

 Herbert Baraf, MD, Chevy Chase, MD, has a great analogy: “Imagine pouring packets of sugar into a glass of tea; can only hold so much in solution. And sooner or later, the sugar is going to start accumulating on the bottom of the glass.

 People with gout may go weeks or months without an attack, but when it flares up it can be excruciating and last for days. Over time, repeated attacks can eat into bone and cartilage, causing permanent damage to affected joints.

Inflammation

The presence of crystals triggers an intense inflammatory response and painful swelling the result of the body’s attempt to break down the crystals. Typically the crystals end up in joint cartilage, and for unknown reasons, especially the big toe.

gouty toe

In others, crystals settle in kidneys or the urinary tract, impairing their function or forming stones. White blood cells migrate into the joint spaces and fluids and the lubricating membranes that line the joints, the synovial membranes trying to eliminate the crystals. The immune cells attracted to the area release biological factors, cytokines and chemokines, into the surrounding area. This attracts more inflammatory cells with a result of redness, swelling and debilitating pain.

Certain immune factors are typically only in small amount in normal uninflamed joint fluids, but in individuals undergoing a gout attack (flare) the levels of the factors are significantly increased.

 Since inflammation is associated with many diseases, such as cancer, diabetes, obesity and cardiovascular health, it is not surprising to find that patients with gout are at higher risk of these diseases when compared to the general population.

 Summary:

Gout is caused by an overactive immune system using inflammation unsuccessfully to get rid of the crystals that are causing the discomfort.

Returning the immune system to balance, immune homeostasis, can result in a higher level of quality of life (QOL) for people with gout.

For years I have helped people promote  joint, digestive, energy and overall health.   Feel free to contact me DrHellen@DrHellenGreenblatt.info, use the form, or give me a call at 302.265.3870 (ET) and let us talk. Let me help you help yourself, it is  time!

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Middle East Respiratory Syndrome (MERS) is a viral disease of the lungs that was first reported in Saudi Arabia in 2012 and has now spread to several other countries, including South Korea and the United States. Genetic material isolated from an individual that died of MERS was identical to genetic material found in one of his own camels. The infected camel possibly infected the owner and is responsible for the death of the man.

 People infected with the virus initially report mild symptoms of a cold, chills, body aches, sore throat, fever, difficulty in breathing, and a cough.  Some individuals report gastrointestinal issues such as diarrhea, nausea, and vomiting.  When symptoms become severe, death may follow failure of the lungs and kidneys.

Most of individuals that have succumbed to infection with MERS suffered with other medical conditions, such as diabetes, cancer, chronic lung conditions, heart, or kidney disease.

MERS and SARS

There is limited scientific information on MERS.  However, the MERS virus is in the same family of viruses as SARS, the virus that causes severe acute respiratory syndrome. Infection with this virus results in severe breathing difficulties which too frequently results in death. (Both the traveling businessman and his World Health Organization physician, Dr. Carlo Urbani who identified the infection as a new disease in the business person, died of the virus.)

 Although there are similarities in symptoms, two major differences between MERS and SARS are: a) MERS progresses to lung failure more rapidly than SARS and b) MERS affects older individuals more than it does younger people. [The high numbers of fatalities from MERS may be related to the older age of infected persons and the fact that individuals with other conditions are more susceptible to respiratory failure].

 Since so little is understood about the disease, people with diabetes, lung, kidney, and immune disorders should take precautions if they are exposed to infected individuals.

The Immune System and Infections

The only part of the body that protects us from infection is our immune system. The role of the immune system is to recognize threats from pathogens, stop, and then up regulate inflammatory responses to destroy the pathogens before they can multiply.

 When the immune system is recognizes invasion by pathogens, immune cells are triggered to produce antibodies and other immune factors, such as cytokines. Cytokines are proteins that help recruit immune cells into an area to help fight the battle, and orchestrate the protective immune responses.In SARS, an over-response of the immune system,  a “cytokine storm” occurs that too often results in the deaths of infected persons.  It is likely that infection with MERS triggers the production of high levels of cytokines, resulting in excessive inflammation and death.

Summary:

People with unbalanced immune systems are at higher risk of having severe symptoms when infected with pathogens.  It is essential that the immune system always be in balance, in homeostasis for optimal protection from disease.

The inflammatory response to infection has to be a controlled, limited response. There must be enough of an immune response to defend the body against disease, but not so great an inflammatory response that the body is harmed.


www.cdc.gov/coronavirus/mers/
www.nejm.org/doi/full/10.1056/NEJMoa1401505
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www.cdc.gov/coronavirus/mers/
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People who are heavy and are not physically active, are at greater risk for conditions such as: increased blood sugar, higher pressures on their artery walls (high blood pressure), increased rate and workload on the heart, stroke, joint problems, sleep disorders, difficulty breathing, and even certain types of  cancer.

There are other posts on this blog relevant to the issue of being overweight or obese, but there is little question that most individuals would feel a lot better if they were only 5 or 10 pounds lighter.

When compared to leaner people, adipose tissue, the fat deposits of obese individuals, have higher numbers of, and larger, fat cells.  These cells produce cytokines, immune factors, that are inflammatory in nature and trigger numerous inflammatory conditions including many mentioned above.

Adipose tissue has “immune-like” properties.  For example, macrophages, white blood cells which alert the body to the presence of invaders, are found in high numbers in fat cell clusters.  Additionally, obese individuals have been shown to have  increased levels of proteins in the blood stream that stimulate inflammation.  Overweight or obese people do not fight infections or heal as well as individuals at more appropriate weights.

 The following hypothesis may have validity.  The immune system may “see” components of adipose tissue as “foreign material” that must be eliminated from the body.  If this scenario is correct, when the body “battles” adipose tissue an autoimmune response is triggered, a response in which the immune system destroys its own tissues, resulting in high levels of inflammation. My hypothesis is supported by the fact that obese individuals produce high levels of autoantibody, antibodies against their own tissues. Rather than resulting from inflammation, these autoantibodies may be the trigger for inflammation.

Muscle cells, like fat cells, secrete cytokines, molecules which help the body regulate inflammatory responses. In response to exercise, many different types of cytokines are produced by muscles and other cells.  Cytokine measurements taken after a marathon demonstrated 100 fold increases of certain cytokines, whereas other cytokines were produced that typically dampen an inflammatory response.

The wide spectrum of immune factors that the body produces in response to physical activity helps the body maintain a steady state of inflammation, an immune balance that helps the body defend itself against infection and helps healing, but not so much that innocent by-stander tissues are damaged.  In fact, studies have shown that individuals that are overweight, nevertheless may be healthy, if they are maintain a level of physical fitness.

The bodies of overweight and obese individuals are consistently exposed to self-generated, inappropriate levels of inflammation.  Helping the body return to a healthy balance of immune responses, a state of homeostasis, will go a long ways towards changing their quality of life.

I would be pleased to hear from you if you are interested in changing your quality of life.  I can be contacted at: drhellen@drhellengreenblatt.info or at:  302.265.3870 USA ET.

 


diabetes.diabetesjournals.org/content/56/6/1517.full

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We humans exist in sea of microorganisms. According to the American Society for Microbiology, there are 10 fold the number of bacteria living in and on our bodies as cells that make up our bodies. Wherever our bodies are exposed to the outside world, for example our digestive tracts, skin, mouth, vagina, etc. we find specific varieties of bacteria and other organisms.

The totality of all the bacteria and other microorganisms that populate our bodies is called the microbiome. The microbiome is highly individualized, with the spectrum of bacteria differing from one person to another; much like an individual’s fingerprints. All people display wide variations in the kinds of bacteria that inhabit them. The types and numbers of bacteria in and on our bodies differ depending on our genetic makeup, our diet, and environmental factors.

Immune cells are found throughout the body where they are always on alert defending the body against infection. Inflammation is the primary way that the immune system controls infections and healing, but overactive immune responses can lead to debilitating inflammatory diseases such as atherosclerosis, diabetes, and bowel disorders.

There is considerable “cross-talk” between the microbiome and the immune cells. Microorganisms influence the responses of the immune system, and the immune system in turn affects the populations of the organisms that inhabit us. For example, evidence suggests that certain bacteria in the gut can decrease inflammation in the gut and decrease chronic disease. [Whether the organisms themselves are producing these molecules, or whether they are triggering immune cells to release anti-inflammatory compounds is not clear.]

Celiac Disease and Diabetes:
Individuals with celiac disease are highly sensitive to foods containing gluten, a protein found in barley, rye, and wheat. People with celiac disease have significant quality of life issues such as bloating, diarrhea, and/or constipation.

When the immune cells of celiacs see gluten, they mount an inflammatory response to try to eliminate the gluten from the intestines. The immune cells produce antibodies that attach to the inner surface of the gut and through inflammatory responses cause direct damage of the gut lining. Inflammatory responses against the body’s own tissues lead to autoimmune (against oneself) disease.

Diabetes is also the result of an autoimmune condition. Inflammatory immune cells destroy specialized cells in the pancreas that produce insulin, a hormone needed to control blood sugar.

Individuals with celiac disease have more than digestive issues, since they have almost 2.5 times a greater chance of developing diabetes than those without intestinal problems. Such conditions are associated with antibodies directed against the insulin-producing cells. When Individuals with celiac disease go on a strict gluten-free diet, they produce fewer anti-insulin-antibodies, suggesting that they are producing less of an inflammatory response.

Gluten intake changes the kinds of bacteria found in the gut. Diabetic-prone mice that eat regular mouse chow containing gluten are more likely to get diabetes than diabetic-prone mice on gluten-free chow. In addition, when the gut bacteria are analyzed, the diabetic-prone mice on gluten have the type of bacteria more often associated with inflammation, than the mice not on gluten. Thus, diet affects the responses of the immune cells and the microbiome.

As followers of this blog are aware, in the face of constantly changing external and internal challenges, the immune system of a healthy person makes adjustments to maintain immune balance, immune homeostasis.

One would expect that if inflammatory and autoimmune responses were better controlled by the body, that individuals with celiac disease and diabetes would experience a far better quality of life.

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Shirley Wang published an article in the WSJ titled “New View of Depression: An Ailment of the Entire Body”. Her lead-in stated: “Scientists are increasingly finding that depression and other psychological disorders can be as much diseases of the body as of the mind. People with long-term psychological stress, depression and post-traumatic stress disorder tend to develop earlier and more serious forms of physical illnesses that usually hit people in older age, such as stroke, dementia, heart disease and diabetes”.

Ms. Wang reported that Dr. Owen Wolkowitz at the University of California, San Francisco thinks of depression as “a systemic illness”, rather than a mental or brain disease. Dr. Wolkowitz found that
“[D]epression is associated with an unusually high rate of aging-related illnesses and early mortality”, or “accelerated aging”. He also points out that individuals who are aging more rapidly and/or are ill, have shorter telomeres than expected.

[Division is essential for most healthy cells. Telomeres are the protective tips of chromosomes that guide the chromosomes during cell division. Every time a cell divides, the telomeres shorten in length. Eventually there is little or no telomere resulting in an inability of the cell to divide efficiently. Eventually the cell dies. Some investigators are of the opinion that the length of telomeres is a predictor of longevity.]

There appears to be a strong association of inflammation with shorter telomeres. Senescent cells, which are unable to divide any longer and have almost non-existent telomeres, produce high concentrations of immune factors, cytokines, that regulate genes that result in inflammation.

Chronic inflammation is found in a myriad of diseases including cardiovascular disease, stroke, diabetes, cancer multiple sclerosis, dementia, as well as depression. Heightened levels of inflammation are found in smokers and the obese. Each pack of cigarettes smoked results in a 18% shortening of telomeres, and the telomeres of obese women are shorter than those of lean women. Using other biomarkers, both smokers and obese individuals have higher levels of inflammation in their bodies than the general population.

Depression results in inflammation and inflammation “feeds” depression. The same cytokines that cause inflammation, pro-inflammatory cytokines, under other circumstances may be anti-inflammatory.
Data from studies demonstrate that depressed individuals have an imbalance of pro- and anti-inflammatory factors.

Some practitioners suggest that depressed patients need to “boost” their immune responses. Instead, “boosting” the immune response, i.e., inflammation, may only exacerbate the disease.

Because of the complexity of immune responses, it is important to let the body find its own “set” point. This is why achieving immune homeostasis, immune balance, is essential for good health.

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When I ask people for their typical dietary intake, many people “shamefully” tell me that they drink coffee.  It  surprises them when I ask “what is wrong with that”?  Coffee is a healthy addition to one’s diet because it can help the body regulate its  immune inflammatory responses.

Studies have shown that coffee consumption reduces the risk of conditions such as diabetes, neurological diseases, cardiovascular disease, certain cancers, depression,and back and neck pain to mention a few.

 Diabetes
Phytonutrients, plant compounds, other than caffeine, found in coffee, are reported to reduce blood sugar levels, and decrease the way the body stores carbohydrates and fats.  Data from over 450,000 people found that every additional cup per day of caffeinated or decaffeinated coffee lowers the risk of diabetes by 5 to 10%.  Heavy consumers of coffee, 12 cups/day, have a 67%  lower risk of getting diabetes.  The effect is not due to the caffeine found in coffee, but to other compounds in coffee.

 Parkinson’s Disease
In Parkinson’s disease, caffeinated coffee may protect nerve cells from destruction, decrease the incidence of Parkinson’s, and the improve mobility of individuals with Parkinson’s disease. In the case of Parkinson’s, the caffeine in coffee is the “magic ingredient”, since decaffeinated coffee does not have the same affect.  Women with Parkinson’s Disease, that were on hormonal replacement therapy, showed less benefit from coffee.  

Alzheimer’s and Dementia
As mentioned above, caffeine may help the body protect nerve cells. Consuming caffeinated coffee over a long period appears to decrease the risk of dementia or Alzheimer’s.

Heart Disease
In other studies, although coffee may raise blood pressure for a brief time, after two months of daily coffee consumption, blood pressure is reduced. It also lowers the risk of heart disease and reduces stroke incidents.

Cancer
Drinking one cup of coffee a day has been associated with a 42% lower risk of liver cancer.  Women that drank two or more cups of coffee per day had a delayed onset of a hard-to-treat cancer.  Individuals drinking three cups of coffee a day had a 40% lower risk of developing pharyngeal, esophageal, and oral cancers. Men who drank over six cups of caffeinated or non-caffeinated coffee a da,y had an 18% lower risk of prostate cancer, and a 40% lower risk of aggressive prostate cancer. Individuals that were heavy coffee drinkers had a 30% lower risk of colorectal cancer.

 Depression
A study of over 50,000 women, found that 4 cups of coffee daily lowered their risk of depression by 20%.

Coffee and Pain Responses
Subjects who consume coffee while working at the computer, report less pain in their back and necks than those that abstain from drinking coffee

Inflammatory Responses  and Coffee:
Regular coffee consumption affects the production of cytokines, such as IL-1 and IL-10 that regulate immune inflammatory responses. The data suggests that the benefits of coffee consumption are due to the phytonutrients, plant nutrients, and caffeine found in coffee. The adage that “coffee is not good for you”, should be re-examined.

 

Reach out to Dr. Hellen Greenblatt for simple steps to help the body balance inflammatory responses. 


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The concept of epigenetics was first introduced in the 1940s, and its implications on how we modulate inflammation through its processes are intriguing and exciting.

For most of my scientific career, we were taught that biological processes of the body were pre-determined by genes. It was said that DNA’s message was set-in-stone, and except through mutations which might result in cancer, or mutations and recombinations of genetic material that were handed down from one generation to another, the message encoded by DNA was unchanging.

Accumulating evidence suggests that altering our diet, life style, and environment, significantly influences gene expression; the way that the body translates the DNA message. We can change the affect our genes have on our physiological and emotional well-being.

It never ceases to amaze me that the medical profession writes off conditions such as arthritis, heart disease, cancer, strokes, Alzheimer’s etc. as being the result of “aging”; basically, saying to their patient, “you have to live with it because you are getting old”.

Instead, health practitioners might better focus on the fact that imbalances of inflammatory and anti-inflammatory responses contribute to health issues. Directing the emphasis on life style changes would enable individuals to take steps towards breaking the inflammation cycle, literally affecting the DNA message, and the resulting quality of their lives.

There are simple approaches that help maintain immune balance, immune homeostasis. Two such changes are: limiting the size of fat cells, and exercise. Fat cells, especially around our abdominal area, produce large amounts of pro-inflammatory cytokines, that trigger inappropriate levels of inflammation.

Exercise is a way to neutralize these molecules since contracting our muscles releases potent anti-inflammatory cytokines.

Additionally, the daily consumption of two or more servings of hyperimmune egg can go a long way toward supporting the body’s natural immune-rebalancing attempts.

In the controversy of genes vs. nurture, we now know that it is a combination of both that makes the difference. We can help regulate what our genes “say” by how we choose to live our lives.

www.sciencemag.org/site/feature/plus/sfg/resources/res_epigenetics.xhtml

www.ncbi.nlm.nih.gov/pubmed/22004920.1

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www.ncbi.nlm.nih.gov/pubmed/20388091

 

(Please see prior posting)

ACHIEVING INFLAMMATORY HOMEOSTASIS, IMMUNE BALANCE, NATURALLY

CONTROL INFLAMMATION

Restoring immune inflammatory balance, homeostasis, may reduce diabetic symptoms, help guard against infections, and contribute to overall health by letting the body heal itself. Lifestyle changes, rather than medication, are the best ways to regain immune balance, inflammatory homeostasis.

BECOME PHYSICALLY ACTIVE.

Muscles release anti-inflammatory molecules every time they contract. To help balance the levels of inflammation in the body, try to be physically active at least 150 minutes a week. Walk to the bus at a brisk pace. Stand, instead of sitting. Work faster when in the garden. Exercise while watching TV. Just get moving!

This week’s pre-publication article from the journal, Diabetes Care, reports that diabetics that participated in aerobic and resistance training twice a week were more fit than controls, even when they personally did not have any weight loss. Moreover, another publication this week in the journal, Endocrine, reports that even without weight reductions, exercise by itself helps control blood sugar levels.

GET TO YOUR IDEAL WEIGHT.

Obese individuals are at greater risk of getting diabetes. Fat cells release pro-inflammatory cytokines, messages that result in inflammation. Many diabetic symptoms are reduced, even with minimal weight loss.

Make smarter beverage and food choices. The most recent discussions about foods is to ignore the amount of fat you take in, and instead, concentrate on decreasing your total carbohydrate intake.

 Limit your intake of:

  • Liquid carbohydrates such as sodas, either regular or “diet”, fruit juices, “energy” drinks, beer.
  • Fried foods.
  • Starches, such as corn, white rice, chips, nachos, French fries.
  • White flour such as found in breads, pasta, cakes, desserts.

 Fill half your plate with vegetables and colorful fruit. The following foods are reportedly helpful to diabetics: Brewer’s yeast, broccoli, buckwheat, liver, okra, peas, and spinach.

VITAMIN D MAY PLAY A ROLE IN BALANCING INFLAMMATORY RESPONSES. Recent studies suggest that vitamin D, actually a hormone-like biochemical, is involved in cell growth and immunity. Studies suggest that vitamin D suppresses proinflammatory cytokines and increases anti-inflammatory cytokines. Organ systems such as liver, skin, thymus, small intestines, and pancreas have cells that bind a form of vitamin D. Certain groups of diabetics have low levels of vitamin D.

The body produces its own vitamin D when sun exposure is appropriate. Moderate sun exposure during the summer months, stimulates the production of its vitamin D. In temperate climes, supplementation may be prudent.

 OMEGA-3 FATTY ACIDS. There are suggestions in the scientific literature that diabetics may benefit from consuming omega-3 fish oils. Consume 2-3 servings of fish/week or take supplements.

MODERATE COFFEE CONSUMPTION. Certain compounds in coffee may help decrease inflammation. Moderate consumption of coffee may be helpful to diabetics.

HYPERIMMUNE EGG. Immunologists have shown that consumption of multiple servings/day of hyperimmune egg is a natural way to help the body regain its immune homeostasis.

IN SUMMARY

Important steps that a diabetic can take are to become physically active, control their diet and weight, and are other steps to reduce inappropriate inflammation.


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The body’s cells, especially brain and red blood cells, obtain their energy needs from the glucose (sugar) that circulates in the bloodstream.  There is an optimum amount of glucose that our body needs.  Too high a level of glucose, is just as bad as too little. The body uses insulin, a hormone, to support healthy levels of blood sugar.  Individuals with diabetes cannot properly control their blood glucose levels, and are therefore at risk of cardiovascular disease, stroke, eye, kidney, skin, and nervous system complications.

 The probability of getting diabetes is especially high in obese individuals.  Fat cells, especially those found around one’s waist, release pro-inflammatory cytokines.  The production of these immune factors result in inflammatory responses that destroy insulin-producing cells, making it difficult for the person to control their blood glucose.

 Dr. Umut Ozcan of Children’s Hospital Boston, has stated that “For 20 years, inflammation has been seen as detrimental, whereas it is actually beneficial.”  Research demonstrates that obese individuals have difficulty in maintaining healthy blood sugar levels due to imbalances of inflammatory molecules. Some proteins triggered by inflammation help the body control glucose levels, whereas other types of inflammatory molecules are detrimental to maintaining healthy glucose levels. 

 Dr. Ozcan continues,  “It may be that inflammatory pathways are not working optimally and there could be a resistance to the cytokines that mediate the inflammation.”.

 Restoring immune homeostasis, balance,  by helping the body control excessive inflammation may reduce the symptoms of diabetes or the risk of getting the condition in the first place.    Lifestyle changes, rather than medication, are the best way to regain immune balance.

 Please look for our next posting that will describe ways that one can help correct imbalances between pro-inflammatory (molecules that lead to inflammatory responses) and anti-inflammatory cytokines (cell messages).

 

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