This blog starts with a grumble, but ends with uplifting, do-able suggestions.
The Times’ lead story yesterday was new research which suggested the possibility of painkillers like aspirin and ibuprofen being effective for treating depression (1). It’s well-established that inflammation can cause depression (2) so it’s reasonable to predict that anti-inflammatory drugs might help. Of course it’s great that these drugs are available, should future research and guidelines find them to be useful.
What I find difficult is that the attention is instantly pointed towards treating any condition with drugs when, for most long-term, chronic ‘lifestyle’ diseases, there is also plenty of evidence that lifestyle approaches can have a huge, positive impact (3). I wish more attention was focused on how small lifestyle changes could have a profound impact on improving health without so much medication. This isn’t a new idea. Professor Dame Sue Bailey, chair of the Royal Academy of Colleges, said in the forward of their report “Exercise – the miracle cure and the role of the doctor in promoting it”(4), “I believe that if physical activity was a drug it would be classed as a wonder drug”.
How do we tackle inflammation without medication?
Preventing and managing inflammation is important because it underlies so many chronic diseases such as cardiovascular disease, obesity, high blood pressure, type 2 diabetes, osteoarthritis and autoimmune conditions as well as depression. There’s even evidence that it can accelerate ageing (5, 6).
By the way, it’s important to recognise that inflammation per se isn’t bad, but it can a double-edged sword. An appropriate inflammatory response can tackle an infection and keep us safe and well. Such an appropriate response has a time-restricted nature with inflammation resolving/receding when the threat has passed. But chronic (long-term) inflammation, even if very low level, that doesn’t resolve is problematic.
Our diet has a huge impact on inflammation (7), being able to both cause it and reduce it. The same goes for stress (8) and obesity (9, 10). So anything we as individuals can do to optimise our diet, reduce our stress levels and minimise overweight will help to keep inflammation at bay.
The good news is that, rather than having to tackle these three aspects individually, tackling one will tend to help the others because they all plait together. For example, a diverse, real food diet with minimal ultra-processed food is anti-inflammatory through optimising nutrition and gut health. A healthy gut can help to keep inflammation at bay and promote mental health. Improving mental health will reduce stress. Tackling stress through meditation or breathing, getting outside for some natural light or improving sleep quality will also promote gut health. Exercise can help with stress and sleep, while better sleep and lower stress levels might make you feel more like getting outside for some exercise. Improving sleep and reducing stress can help reduce weight gain and enhance weight loss.
Start with one change
The evidence for all this is growing, but even without evidence, where is the harm in eating a whole food, minimally-processed diet low in additives? Or getting some exercise, or giving yourself five minutes to breathe to calm down, or go outdoors? It’s all healthy common sense. You don’t have to do everything I’ve just mentioned – perhaps choose one or two things that appeal and see where they take you.
Here’s what a friend said: “I have definitely changed my diet after a recent medical diagnosis involving my gut, which means I try to eat a naturally gluten free diet which happens to be low in sugar. I have noticed a big difference in my energy levels and more recently less joint pains. I am also including mindful nature stomps daily to nurture my mental health. Can honestly say I feel better for it.”
A link between sugar, inflammation and depression
Interestingly, a second new research paper was also published yesterday which reviewed the effects of added sugars on depressive illness (11). Sadly, this one didn’t make the news but combining the two new studies would have presented a really powerful news story. The second makes the link between added sugars and depression via inflammation, oxidative stress (which is what anti-oxidants counteract) and gut flora problems.
Perhaps one day the role of inflammation in modern disease will be understood by everyone, not just researchers. And wouldn’t it be fantastic if everyone knew the steps to take towards better health that don’t rely on drugs as a first port of call? Of course medications are vital and we’re lucky to have them. But in our modern world, wouldn’t it be great if we all have the option to try other safe, cheaper, arguably more effective, fulfilling methods first? Ones that we can easily achieve and that put us in control of our health?
At the start I promised some practical, uplifting suggestions to reduce inflammation and boost health. Here they are. Try one or two for starters and see how it goes.
- Get rid of the sugar in your diet (admittedly not an easy task, I know)
- Aim to cut right down on the unseen sugar and additives by cutting out processed/convenience food. It’s also worth remembering that refined, starchy carbohydrates like bread, pasta, rice and potatoes digest quickly into sugars once inside you
- Eat a diverse real food diet full of as many different types of food as possible, particularly vegetables. Can you manage 30+ different types of plant every week? Nuts, seeds, herbs and spices count. Great for your gut flora and therefore great for supporting your immune system and preventing/reducing inflammation
- Try to do all your eating (including that initial cup of tea/coffee if you have milk or sugar in it) within a 10-12 hour window
- Do whatever you can to reduce stress (yoga/walking/knitting/dancing/meditating/stroking the cat)
- Get outside every day for at least 20 mins to get natural light, in some green nature if possible. Even dull, rainy winter light is better than a brightly-lit building
- Move every day. Getting your heart rate up is a bonus. Walking is great – doesn’t have to be the gym or a marathon!
- Prioritise sleep quality.
- Bai S, Guo W, Feng Y, Deng H, Li G, Nie H, et al. Efficacy and safety of anti-inflammatory agents for the treatment of major depressive disorder: a systematic review and meta-analysis of randomised controlled trials. Journal of Neurology, Neurosurgery & Psychiatry. 2019:jnnp-2019-320912.
- Bullmore E. The Inflamed Mind. London: Short Books; 2019.
- World Health Organisation. Noncommunicable diseases fact sheet 2018 [Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
- Royal Academy of Medical Colleges. Exercise – the miracle cure and the role of the doctor in promoting it. 2015.
- de Magalhães JP, Curado J, Church GM. Meta-analysis of age-related gene expression profiles identifies common signatures of aging. Bioinformatics. 2009;25(7):875-81.
- Zhang J, Rane G, Dai X, Shanmugam MK, Arfuso F, Samy RP, et al. Ageing and the telomere connection: An intimate relationship with inflammation. Ageing Research Reviews. 2016;25:55-69.
- Minihane AM, Vinoy S, Russell WR, Baka A, Roche HM, Tuohy KM, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015;114(7):999-1012.
- Leonidou L, Michalaki M, Leonardou A, Polyzogopoulou E, Psirogiannis A, Kyriazopoulou V, et al. Stress-Induced Hyperglycemia in Patients With Severe Sepsis: A Compromising Factor for Survival. The American Journal of the Medical Sciences. 2008;336(6):467-71.
- Virtue S, Vidal-Puig A. Adipose tissue expandability, lipotoxicity and the Metabolic Syndrome — An allostatic perspective. Biochimica et Biophysica Acta (BBA) – Molecular and Cell Biology of Lipids. 2010;1801(3):338-49.
- Ghanim H, Aljada A, Hofmeyer D, Syed T, Mohanty P, Dandona P. Circulating Mononuclear Cells in the Obese Are in a Proinflammatory State. Circulation. 2004;110(12):1564-71.
- Reis DJ, Ilardi SS, Namekata MS, Wing EK, Fowler CH. The depressogenic potential of added dietary sugars. Medical Hypotheses. 2020;134:109421.