Inflammation: Are you playing with fire

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Inflammation Are you playing with fire?
Mark Pettus MD, FACP November 11,
2008 www.savvypatient.com
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The future aint what it used to be. Yogi
Berra
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Learning Objectives

• Connection between inflammation and Immunity
• Review the connection between inflammation and
  age-related decline in health and dis-ease
• Review the common lifestyle, behaviors, stress,
  and toxic contributors to inflammation
• Role of CRP (c-reactive protein)
• Explore every day strategies for reducing the
  burden of inflammation

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Human beings are in perpetual and dynamic
relationship with their environment.

• Environmental Inputs
• Nutrition
• Movement
• Burden of Stress
• Mindfulness
• Sleep
• Environmental toxins
• Trauma
• Social connection

• Imbalance
• Inflammation and Immunity

Genes
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Inflammation

• The Cause of Everything?

Inflammaging
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• The role of inflammation in
• Alzheimers disease
• Depression
• Pain
• PD
• MS
• ADD and ADDHD
• Brain fog
• Anxiety and Panic

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Causes of Inflammation

• Poor dietsugar, trans fats, processed food
• Lack of exercise
• Smoking
• Stress, negative emotional states, and hostility
• Non-restorative sleep
• Hidden allergens such as gluten or dairy
• Hidden infections with viruses, bacteria, yeast,
  or parasites
• Toxins such as mercury, pesticides
• Moldsmycotoxins and dangers of black mold

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Different carbohydrates produce unique genomic
responses!
High Glycemic Carbs Low
Glycemic Carbs 62 genes regulating
Same genes turned off Inflammation,
stress, Genes regulating
insulin Immune responses??
production turned off. Kalle et al. Am J Clin
Nutr20078511417-27
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Glycemic Index-Load

• The extent to which food and beverage raises
  blood sugar e.g., 50 grams of carb in a
  particular food as compared to 50 grams of
  glucose or white bread
• Foods with a high GI have greater effects on
  raising insulin levels
• Glycemic load reflects both the GI of the food
  and the amount of food ingested.
• Excess sugar and insulin damages proteins that
  control bodily function from head to toe
  glycation
• Enhanced by refined carbs e.g. processed carbs,
  pastries, pretzels, chips, bagels, white breads,
  sweetened drinks, HFCS, potatoes, white rice,
  beer, etc.
• Enhances inflammation.

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Ideal BMI lt 25 Body fat lt 25-30
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C-REACTIVE PROTEIN

• Detects hidden inflammation
• Inflammation is connected to every modern
  disease not just obvious ones such as asthma,
  arthritis, or infections
• It is associated with heart disease, cancer,
  dementia, diabetes, obesity, and more.
• There is a range of normal (ideal lt 1)
• CV risk factor stratification

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Do you have the guts for health?

• Large surface area, 1 cell thick
• 70 immune system in the gut just on the other
  side of this cell layer (GALT)
• Leaky gut syndrome
• Dietary impact
• Effects of medications e.g. nsaids, antibiotics,
  prednisone
• Bacterial dysbiosis
• Food allergies, sensitivities
• Stress response-the brain-gut connection

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When the barrier breaks down, disease risk
increases

• Small intestine surface area could cover a
  doubles tennis court
• It is only 1 cell layer thick
• Damage can lead to increased permeability of
  toxins, referred to as leaky gut

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How Do You Treat Inflammation?
Eat food. Not too much. Mostly plants.
Michael Pollan

• Eat whole foodsplant-based diet with a low GL
  (glycemic load) and high PI (phytonutrient index)
• Stop inflammatory foods processed, refined foods
  with sugar, HFCS, and trans fats
• Get an oil changeanti-inflammatory fats such as
  omega-3 fats from small fish like sardines,
  sable, herring, and wild salmon, and
  monounsaturated fats such as avocadoes, almonds,
  and olive oil.

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Cooling Inflammation

• Exercisethe most powerful anti-inflammatory
  medicine
• Activate the parasympathetic nervous systemthe
  stress antidote
• Treat food allergiesgluten, dairy, yeast, eggs,
  soy, and corn
• Omega-3s 2,000 mg per day EPA/DHA
• Vitamin D at least 1,000 units per day (want
  blood levels between 50-80)
• Take probioticscool the gut

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Activity and Movement

• Motion is the lotion
• Aerobic, resistance, dance
• Muscle as a metabolic engine
• ? insulin resistance, ? cortisol, ?endorphins
• Enhanced strength, resilience, balance,
  concentration, mood
• Decreased cardiovascular, diabetes, cancer risk

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The Stress Response

• Fight-flight response
• Increased activity of the HPA axis
• Increased cortisol, adrenalin, inflammatory
  cytokines
• Impairment of immune balance
• Major contributor to age-related diseases and
  diminished quality of life.

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Mindfulness

• Meditation, prayer, relaxation response, guided
  imagery, yoga, biofeedback, gratitude journal
• Decreased cortisol, flight-fight response, BP,
• Increased parasympathetic tone
• Improved mood, concentration, pain tolerance,
  resilience
• Decreased cardiovascular risk

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Supplements-Nutraceuticals

• Omega-3 Fats (2,000 mg EPA/DHA)
• Green tea
• Vitamin D (2000-5000 units/day)
• Probiotics at least 10 billion strains per day
• Botanicals e.g. ginger, curcumin, turmeric,
  evening primrose
• Resveratrol
• MSM-methylsulfonylsulfate
• Zyflamend? (New Chapter)

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Thank you.
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Inflammation

• Connected to most age-related diseases
• Silent but deadly
• CV disease, diabetes, obesity, cancer,
  Alzheimers, neurodegenerative diseases, asthma,
  rheumatoid arthritis, etc
• A systemic imbalance of immune function

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Flow States Exercise Mindfulness Practice
Social Connection Meaning Maker in Love, Work
and Play
Glycemic Load Exercise Weight Loss
Medications Whole Fruits/Veggies

Stress Response
Age-Related Disease
Inflammation
Glycation
Animal Proteins Whole Plant-Based Foods
Omega-3s Healthy Fats
Vitamin D CO Enzyme -Q 10
Alpha Lipoic Acid Resveratrol
Glycemic Load Healthy Fats Mindfulness
Exercise Whole
fruits/veggies Medications Decreased
Animal Proteins
Oxidation Free Radicals
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Lifestyle Syndrome

• 30 American adults have it
• Waist Circumference gt 35 in women and gt 40 in
  men
• BMI gt 30
• Pre-hypertension or High Blood Pressure
• High Blood triglycerides and low HDL (good
  cholesterol)
• Pre-diabetes or insulin resistance
• Increased risk of cardiovascular disease
• Connection between cancer and other inflammatory
  conditions

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Fight-Flight or Sympathetic Tone
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Calm or Parasympathetic Tone
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Integrated Domains of Self-CareBuild your
personal pyramid for living well
Nutrition
Fitness
Social Connection
Mindfulness
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Modern Medicines Approach to Inflammation

• Anti-inflammatory drugs NSAIDs, aspirin,
  steroidsall linked to intestinal bleeding,
  kidney failure, and death
• Why Lipitor works? Inflammation vs. cholesterol
• TNF blockers lead to infection and cancer
• What is the right approach?
• It is not DOWNSTREAM medicine

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Go Upstream!

• What are the real triggers of inflammation?
• Find them and get rid of them!
• Then support your bodys natural immune balance
• The bodys natural intelligence does the rest!