Whenever mainstream media gets a hold of a scientific term, it becomes a “buzzword.” And, more often than not, it becomes a tragically misunderstood buzzword. Contact one of our chiropractic clinics located in Ellicott City or Clarksville today to learn more.

Inflammation is a fantastic example. Most of us have some sort of idea of what it is, but when asked to define it, we stop and scratch our heads, bewildered by our difficulty in explaining such a seemingly simple concept. Furthermore, our understanding of inflammation’s role in chronic conditions such as low back and neck pain, arthritis, tendinopathy, cardiovascular disease, and diabetes is even more muddled

But it’s something we should try to understand, because it turns out, what you eat every day has a profound impact on inflammation, pain, and chronic disease; in fact, if you experience chronic low back pain that doesn’t wanna die, what you eat may be one of the culprits. Buckle up, because this is going to be a bit of a longer post today, but I’ll do my best to keep it simple. Let’s dive in.

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What Is Inflammation?

First off, let’s set the record straight: inflammation is a good thing. If our bodies didn’t have the mechanisms to create inflammation, we wouldn’t be able to heal. When you get that cut, the body releases cytokines, the alarm bells that signal all the little ambulances to come to the scene to start the repair process. Blood vessels swell to get those little ambulances there faster, which is why you experience redness and heat. Pain receptors in the area become sensitized so that you avoid doing things that could injure the area further. And after those little ambulances clean up the damage, they start the healing process.

Long story short, inflammation is a normal part of the immune system’s response to infection and injury. But inflammation can be detrimental when it is prolonged and out of proportion to mechanical injury–in other words, chronic inflammation.

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What Does Chronic Inflammation Look Like?

It may not be obvious. In fact, many features of chronic inflammation may seem “normal” because chronic inflammation and their consequences have been so ingrained in our diets and our lives. If you experience any of the following, you may be experiencing chronic inflammation:

• Chronic aches and pains and headaches
• Reliance on anti-inflammatory pain medications (NSAIDs) Difficulty maintaining a healthy weight
• Difficulty recovering from exercise or experiencing excessive exercise-induced soreness
• Low energy
• Prone to frequent flu, allergy, or cold symptoms
• Frequent digestive issues
• A diagnosis of a chronic disease such as diabetes, fibromyalgia, arthritis, heart disease, etc.

While chronic disease is multifactorial and complex, it’s worth looking into nutritional factors associated with it.

The mechanisms controlling inflammation are complex. Like, really really complex. So for those of you who don’t have degrees in advanced biochemistry, let’s just focus on two main points: how an excess of refined sugar, flour, and oils can contribute to chronic inflammation and disease, and what this has to do with mechanical pain syndromes such as low back pain.

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Inflammation, arthritis, and the “Four Horsemen” of disease

Medical physician Peter Attia’s popular bestseller Outlive: The Science and Art of Longevity describes the “four horsemen” diseases, or diseases with the highest rate of mortality: cardiovascular/cerebrovascular disease (heart disease, stroke), cancer, neurodegenerative disease (e.g. Alzheimers, Parkinson’s), and diabetes. Diabetes is not one of the top 4 killers, but it does increase your risk of developing the other three. People with type 2 diabetes are also more likely to develop osteoarthritis, lumbar stenosis, and disc herniation in the neck and low back. Why?

The short answer is that diabetes dramatically increases the level of chronic inflammation in the body.

Let’s take arthritis as an example. Arthritis has long been described as a “wear and tear” disease; for example, people develop arthritis in their knees because of impact wearing on the joints over time. But in the 90s researchers began to find clues that this is not the case. Most of these clues come from complex research in molecular biology, but there are some clues that are obvious and easy to understand. For example, contrary to popular belief, recreational runners are less likely to develop knee arthritis than their sedentary counterparts. Another study showed that obese patients had double the risk of developing arthritis in their hands, which can’t be explained by mechanical wear and tear since the joints of the hands are not (typically) weight-bearing.

It turns out that while osteoarthritis has classically been classified separately from the inflammatory arthritides such as rheumatoid and psoriatic arthritis, inflammation plays a bigger role in OA than once thought.

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“Good” fats, “bad” fats

Wehave to be careful when we talk about “good” and “bad” in terms of diet. Firstly, because attaching moral judgment to dietary choices can be psychologically damaging to someone trying to make better choices (you can make changes to your diet without feeling “bad” about them, and in fact, guilt and shame are often obstacles to making any change). But more relevant to this discussion, fats are neither “good” or “bad.” Omega-6 fatty acids, commonly labeled as the “bad” fats, are actually necessary for inflammation to work properly.

But more often than not, the standard American diet is rich in too many of the omega-6 fats and poor in the “good” omega-3 fats, which help decrease chronic inflammation. It’s the balance of the intake of these fats that matters. When the ratio of omega-6 fatty acids in the diet is too high, the balance tips towards inflammatory chemicals that increase chronic pain. Now, instead of inflammation happening when it’s supposed to, like when you step on a nail, it’s happening all the time. This is one reason why many people experience chronic low back pain beyond the level expected for their injury (but not the only possible reason–see other relevant explanations for chronic pain here).

What can we do to prevent this, or intervene once it happens?

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Most people do well with the basics

Fundamentals work wonders. Most people do well at preventing chronic inflammation if they:

• Eat slowly until they are satisfied (not stuffed)
• Prioritize protein from lean sources, such as chicken, beef, eggs, or certain plant sources.
• Include plenty of fruits and vegetables
• Get their carbohydrates and fats mostly from minimally processed sources
• Drink plenty of water

If you follow basic nutrition fundamentals and are still in a chronic inflammatory state, you may need to take it a step further, moderating or eliminating consumption of dairy and grain products, and leaning more toward grass-fed meats. Industrial seed oils such as corn, safflower, sunflower, soybean, peanut, and cottonseed oil (the oils used in most commercially prepared/packaged/processed products) as well as partially hydrogenated oils (the culprit responsible for trans fats) may need to be dramatically reduced.

What still remains:

• fruits and vegetables
• fresh and frozen wild-caught fis
• meat, chicken, and eggs from grass-fed animals
• wild game
• nuts (but not peanuts, as peanuts are not nuts at all, but legumes)
• spices like oregano, turmeric, ginger, garlic, and others
• extra virgin olive oil, coconut oil, and butter from grass-fed cows
• dark chocolate

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It’s what you do most of the time

Occasional indulgences in flour, sugar, and oils aren’t going to immediately doom you to a life of low back pain (as I’m writing this, we are waiting on pizza to arrive for an important meeting we are about to have in the office). While consumption of sugar and refined flour and oil does set off an immediate inflammatory response, long-term inflammatory changes will likely not happen if you are not consuming these foods on the regular. But chronic exposure to an inflammatory dietician have the long term consequences described above. It’s what you do most of the time that counts.