Anti-Inflammatory Strategies–Achieving Homeostasis
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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.

The journal of the American Geriatrics Society, just released a study of older women suggesting  that women, and we assume men as well, add years of healthy living by staying active and increasing their consumption of fruits and vegetables. 

 Women between the ages of 70 to 79 years were followed for a five-year period.  Investigators monitored the amount of physical activity they reported, and their carotenoid blood levels.  [Carotenoids are a class of pigmented, phyto [plant] nutrients found in the yellow, orange, and plants.  Blood levels of carotenoids are associated with the quantity of vegetables and fruits consumed.  The more fruit and veggies consumed, the higher the levels of carotenoids in the bloodstream.]

In the study, women that were most physically active and consumed large amounts of fruits and vegetables, were eight times more likely to be alive after the study’s five years of follow-up, compared to women who were not active, and did not eat many fruits and vegetables.

 Exercise increases survival times

More than half of the 713 participants (53%) did no exercise, 21% were moderately active, and the 26% were very active.  The active women engaged in twice the amount of activity as did women who were not active.  Active woman reported that they walked, or were involved in strength training, bowling, dancing, household, or outdoor chores.  Physical activity resulted in active woman experiencing five-year death rates 71% lower than those of the least active women.

 Fruits and vegetable consumption increases survival times

During the five-year follow-up period, women who consumed the most fruits and vegetables, and had the highest blood levels of carotenoids, were 46 percent less likely to die than woman that ate fewer fruits and vegetables.  Blood carotenoid levels were 12% higher in the women who survived, compared to blood samples taken from women that would die earlier.

 This study supports previous results demonstrating that eating more vegetables and fruits, and consuming moderate amounts of wine products, which also contain phytonutrients,  is linked to people living longer.

 Down-regulation of inflammation:  A probable reason for the reported results.

Most scientists have only vague ideas as to why exercise, and heightened consumption of fruits and vegetables should make a difference in longevity.  However, decades of literature reviews, and successful counseling of individuals in the importance of balancing immune system inflammation, make it evident to me, that exercise and healthy food consumption helps the body limit run-away inflammatory responses, and therefore helps the body balance its natural levels of inflammation.

 Inflammation is the body’s protective response to infection, cancer cell growth, and injury.  However, when inflammatory responses are not controlled, inflammation ends up doing more harm than good, and becomes the origin of most illnesses.

 It has been documented that unhealthy aging is accompanied by excessive inflammation with increases in cytokines that cause inflammation, and inflammatory markers such as C-reactive protein (CRP).

 But the body expends a great deal of energy to naturally control inflammatory responses, and return to immune homeostasis, immune balance.   So for example, moderate exercise lowers inflammation. 

Every time muscle contraction occurs, potent anti-inflammatory cytokines are released.  Therefore, as the women in this study were physically active, their bodies were naturally reducing the amount of inflammation in their bodies.

 As to the contribution of fruits and vegetables in lowering inflammation, hundreds of studies support the fact that carotenoids affect cytokines, the immune system messengers that modulate inflammation. 

 There are many ways to help the body modulate immune system-generated inflammatory responses, but simple lifestyle changes such as regular exercise, and increased consumption of fruits and vegetables, are two simple steps to consider for a healthier, longer, and more active life.

Bernard Lown, MD The Lost Art of Healing Boston New York Houghton Mifflin Company 1996

Medicine in the United States is widely regarded as the best in the world*. Hardly a day passes without a major scientific breakthrough. Many formerly fatal diseases are now curable. People are healthier and live longer than ever. Still, patient dissatisfaction with doctors has rarely been more acute. Although physicians are increasingly able to cure disease and prolong life, the American public is suspicious, distrustful of, even antagonistic to, the profession. Doctors, uneasy, astonished, resentful, and angry, universally acknowledge a crisis in health care. With the focus on colossal medical expenditures, amounting to a trillion dollars annually, most of the numerous solutions involve containing runaway costs….

Medicine’s profound crisis, I believe, is only partially elated to ballooning costs, for the problem is far deeper than economics. In my view, the basic reason is that medicine has lost its way, if not its soul.

* And yet, depending on the Agency that sponsored the study on longevity, America ranks either 27 or 30th , in the world in terms of mortality. Countries like Malta and South Korea have longer life expectancies than individuals in the U.S.

Next week the United Nations will hold a unique Summit, the first one focusing on the worldwide chronic diseases such as diabetes, cancer, heart, and lung disease. These are also the major diseases that challenge Americans.

And it has become increasingly obvious that uncontrolled immune inflammatory responses are major contributors to disease. Inflammation results in illnesses of many types, and vice versa. For example in the case of cancer and inflammation, there is “cross talk” between immune and tumor cells with inflammatory responses playing major roles during different stages of tumor development.

The key to health is immune balance, immune homeostasis. Immune homeostasis is a state where the level of inflammatory cytokines, is inhibited by anti-inflammatory cytokines and other immune factors. The right ratio of these cell messages restores the body’s delicate immune balance, and lessens the likelihood that one will become ill. Controlling inflammation is a primary approach to decreasing chronic disease.