Inflammation sounds far from pleasant, but it’s completely normal, and in fact, an essential part of the body’s attempt to heal itself. When you are injured, sick, or develop an infection, for instance, an inflammatory response is triggered and your immune system kicks in to try to repair the affected tissues or protect your body from foreign substances such as bacteria and fungi. Why it’s never too late to start working out, as gym granny shows – just pick the exercise you like and take it from there During this important natural process, you may experience specific symptoms such as pain, warmth, redness, swelling and loss of function (for example, movement, hearing or smell). Without this complex biological response, wounds and damage to the body would not heal. While acute inflammation is short-term, with symptoms subsiding after a few days, the same cannot be said for chronic inflammation. Chronic inflammation occurs when your immune system just can’t seem to “shut off”, putting your body on “high alert” and creating a prolonged inflammatory response. According to Sara Jefferson, a naturopath at Dr Susan Jamieson Integrative Medical Practice in Hong Kong’s Central district, inflammation becomes a problem when there are too many stimuli, such as in some infections where the body is overwhelmed with bacteria. In some cases, such as with autoimmune diseases, the protective immune process goes awry and begins to attack healthy tissue, causing damage, and this can lead to more inflammation. Chronic, systemic inflammation is a worry because it is also thought to contribute to the development or progression of certain long-term conditions, such diabetes and cancer, cardiovascular disease, depression, rheumatoid arthritis and allergies. Indeed, numerous studies over the years support this association. For instance, a study published in 2016 in The Journal of Clinical Psychiatry revealed that people with depression had 46 per cent higher levels of C-reactive protein (CRP), a strong biomarker of inflammation, in their blood samples (note: the study only managed to establish a connection between inflammation and depression but not causation). Another study, published in 2016 in the journal Cell Reports discovered a link between inflammation and an increased risk of prostate cancer. The researchers from the University of California, Los Angeles found a previously unrecognised type of progenitor cell in uncommonly high numbers in inflamed areas of the prostate (the cells are rare in other parts of the prostate). These cells have the ability to develop into aggressive tumours. And earlier this year, another UCLA-led study, published in Cancer Epidemiology, Biomarkers & Prevention found that consuming foods that promoted inflammation increased young women’s risk of developing breast cancer when they were older. What causes an out-of-body experience? Two women from Hong Kong on their life-changing episodes What about inflammation and heart disease? While it is still unclear how inflammation is linked to cardiovascular disease, a 20-year-long study conducted at Brigham and Women’s Hospital in Boston in the US, found that an anti-inflammatory drug reduces the risk of heart attack and stroke. “Almost all diseases have an aspect of inflammation, because where there is disease there is damage, and where there is damage there is inflammation,” says Jefferson. Jefferson points out that genetic testing can tell if a person has a tendency to overreact and produce more inflammation, but certain lifestyle habits can also create increased inflammation responses in the body. “Psychological stress, air pollution, poor hand hygiene, and being in close contact with many people, for example, in public transport or on planes, can all contribute to an increased inflammation response.” Where there is disease there is damage, and where there is damage there is inflammation Sara Jefferson Over the last several years, medical experts have also focused on the link between diet and inflammation. Take coeliac disease and non-coeliac gluten sensitivity (also known as gluten intolerance), for instance. Both are chronic inflammatory conditions that occur in the small intestine. According to Philip Watkins, a naturopath at the Integrated Medicine Institute, a medical clinic in Central, the former is the more extreme version of inflammatory response to gluten, a protein found in wheat, rye and some other grains. If left untreated, he says, the condition can lead to serious symptoms and outcomes, and not just in the small intestine. “Symptoms in response to this type of food sensitivity may also include fatigue, difficulty concentrating, poor immunity, and even neurological symptoms such as pins and needles in the extremities,” he explains. But gluten is not the only food constituent believed to play a role in triggering inflammatory responses in the body. Sugar, saturated and trans fats, refined carbohydrates, monosodium glutamate, and alcohol have also been shown to have a similar effect. “It is often the nutrients within the foods that dictate whether or not they will be inflammatory or anti-inflammatory,” Watkins explains. “Foods that are processed or high in refined sugar are often very low in nutrients such as vitamin A, vitamin C, vitamin E and omega- 3 fats. These nutrients play a large role in helping the body down-regulate the inflammatory process, so if they are not in steady supply, the body may find it difficult to compete the job. On this basis, it is easy to see how foods could play an anti-inflammatory role when they are more nutrient-dense and consumed often.” Is running actually that good for you? Yes, but only if you prepare properly first In 2014, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of a diet. Watkins says that it came as no surprise to learn that the Mediterranean diet – which is high in fibre and nutrients like vitamins A, C and E, and omega-3 fats – came out best in its ability to manage inflammation and its consequences. The so-called “Western” diet, which is high in refined sugar and often processed, was classified as one of the most inflammatory diets, thus validating the importance of foods that are nutrient-dense, such as fruits and vegetables. In his new book, T he TB12 Method: How to Achieve a Lifetime of Sustained Peak Performance , American football quarterback for the New England Patriots Tom Brady offers an insight into his anti-inflammatory diet. It is often the nutrients within the foods that dictate whether or not they will be inflammatory or anti-inflammatory Philip Watkins, naturopath His meals mostly consist of fresh, organic fruit and vegetables, wild-caught fish, free-range, hormone-free meat, whole grains and nuts. The star player limits or avoids inflammatory foods that he believes can affect his physical and mental performance, including dairy, gluten, white sugar, refined flour, and processed foods such as condiments, alcohol, and salt. Adjusting your diet is one of the best and easiest ways to reduce inflammation and minimise your risk of developing serious long-term diseases. Following the Mediterranean diet, it might be a good idea to fill up on foods containing healthy fats, such as avocados, olive oil, fatty fish such as salmon, mackerel and trout, nuts like omega-3 fatty acid-rich walnuts, and seeds. For sustained energy and fibre, be sure to include whole (unrefined) grains such as oats and quinoa, and for protein, fibre and extra nutrients, eat more beans, peas, pulses and lentils. Go big on fruit and vegetables. Jefferson suggests having bright-coloured varieties that are rich in immunity-boosting antioxidants, vitamins and minerals. How Chinese children are at higher risk of obesity from lack of sleep and late bedtimes “In Hong Kong, where our immune systems are often under attack, supplements such as vitamin C and D can be really useful,” Jefferson adds. “For those suffering with chronic inflammation, an IgG [immunoglobulin G] blood test to pinpoint food sensitivities can also be helpful.” Of course, a nutritious diet of fresh whole foods is not the entire answer, because there is still much about inflammation that medical experts have yet to discover and understand. Keeping your immune system healthy is really the key, and that involves reducing stress, maintaining a healthy weight, getting adequate sleep, exercising regularly, managing your mood, and getting plenty of fresh, clean air daily.