Inflammation Evaluation and Dietary Approaches

Inflammation is a major contributor to many chronic diseases and in many cases a driver for autoimmunity, both of which are on the rise in this country.

An important thing to understand about inflammation is that it is not an on/off switch but more like a dimmer switch. Often there are many lifelong contributors that push the dimmer switch towards a full force inflammatory process. But the good news about that is once we understand these inflammatory drivers, we can work on reducing or eliminating them from our lives. At Root we spend time listening to every member’s story and identifying potential contributors to Inflammation throughout a person’s life time.

Testing

When it comes to laboratory evaluation, there are some conventional tests that can be helpful and then also specialized functional medicine testing that can be used to identify inflammation.

Some basic testing, which we like to order for new Root members include:

hsCRP- which stands for high sensitivity C reactive protein. This marker increases in your blood when there’s inflammation in your body. It doesn’t tell us where the inflammation is coming from it just tells us there is general inflammation. This test is more sensitive than a standard C reactive proteins test. It can also be used to assess your risk of coronary artery disease
Ferritin- Traditionally we think of it as a test for low iron stores, but it is also something called an acute phase reactant. When it is elevated, it can be a sign of inflammation
WBC- White blood cell count is also an acute phase reactant. When elevated, it can be a marker of infection, ongoing inflammation or even allergic response.
Omega-3 index- tells us the ratio of anti-inflammatory fat stores which are the omega-3‘s, (found in cold water fish, flax, walnut and chia) to more inflammatory fats, which are the omega 6’s. Omega 6’s (which are found in vegetable oils, red meat, diary and shellfish amongst others) are a precursor to Arachidonic acid, which is a pro inflammatory ecosanoid. Ecosanoids are signaling molecules found in the cell membrane of all mammalian cells. Arachnoid acid in particular is the precursor to prostaglandins and leukotrienes- which are responsible for pain and allergic signals in the body. It’s actually the pathway on which Motrin and anti-allergy pills work. So limiting the amount of Arachidonic acid in the diet can be very helpful to modulate these pathways and shifting the balance away from inflammation. An ideal omega 6/Omega 3 ration is 4:1.
Fasting insulin is another test that is very helpful because insulin resistance is under diagnosed and can be a driver for inflammation. By checking a fasting insulin, we can catch insulin resistance in earlier stages and work on reversing it

We also have several advanced tests called functional tests in our practice that check for inflammation. One of the foundational tests we do is a stool microbiome test. It includes several inflammatory markers:

Fecal calprotectin- Is a marker of neutrophil driven inflammation. It’s produced in sights of inflammation in the colon and this biomarker has been useful in differentiating between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)
Fecal secretory IgA is a marker of gut secretory immunity and barrier function. This is your colon’s first line defense and mucosal lining support.

Dietary Approaches

Once we’ve identified Inflammation, the question is what can we do about it? Diet is a foundational tool by which we can dial back inflammation. But we must not disregard other important lifestyle factors, that are the pillars of good health. These include- sleep, stress reduction, movement and relationships. A good diet is a great starting point however.

Dietary interventions to reduce inflammation include:

Optimize blood sugar balance- by eating lower glycemic foods and balancing with fiber and healthy fat. Eliminate simple sugars and refined carbs. At Root we spend some time with each client talking about protein fat and carbohydrate balance PFC with every meal. We know that diets high in glycemic load are positively associated with inflammation by increasing plasma hsCRP. Hyperglycemia can actually overproduce oxidative stress in the body.
Eat an antioxidant rich diet found in plants- mainly deeply pigmented veggies but also fruit. At Root we have a 30 plant challenge for clients where we try to have people eat 30 different plant based colors throughout the week. Roughly 4-5 servings per day. Plants are rich in something called Phytonutrients, which are the natural components of plants and have powerful antioxidant properties. Each color group has its own health benefit. For example the red colored plants which include tomatoes, raspberries, pomegranate seeds are rich in lycopene which may protect against cancers of the prostate, breast & skin as well as reduce risk of heart attacks.
Increase the amount of omega-3 (EPA/DHA) fats in the diet (found in cold water fish, flax, walnut and chia) which are anti-inflammatory. In the Western diet, often people will need to supplement with fish oil, at least temporarily, to bring these levels up. Our favorite fish oil supplement is our Root Omega 3. EPA also blocks the metabolism of Arachidonic acid. Zinc, magnesium, vitamin C and B vitamins are important coenzymes for metabolism of omega3s so it’s important to get enough of these in diet as well.
Increase the amount of fiber you eat. Aim for 25 to 35 g of dietary fiber per day. All plants have fiber. Eat more nuts, seeds, whole grains, fruits and vegetables to achieve this goal. Fiber increases the energy density of the diet and slows absorption in the gut for a lower glycemic index. The chemical structures of fiber may have inherent anti-inflammatory activities. Fiber promotes the growth of the good bacteria in your microbiome resulting in decreased amount of bad or pathogenic bacteria, positive immune system regulation, and anti-inflammatory bacterial metabolites, such as butyrate. Butyrate is produced when good bacteria breakdown/ferment fiber into Short chain fatty acids that are anti-inflammatory for the colon.
Eliminate hydrogenated oils and trans fats.
Intermittent fasting- can reduce reactive oxygen species (free radicals) in your system and it’s free. Avoid fasting for more than 16 hour stretches as this can slow down your thyroid function and metabolism.

Supplements:

Supplements we use with our members to improve inflammation include Omega 3s, Gut Health Rebalance, and our Root Reset protein powder which includes fiber and anti-oxidants.