Inflammation often gets a bad reputation, but it’s actually a critical defense mechanism for the body. Inflammation isn’t necessarily a problem. The problems arise when the body doesn’t have time to turn off an inflammatory state.

The amount of information surrounding chronic low-grade inflammation can seem exhausting and confusing, especially about how our decisions about exercise and nutrition influence inflammation. It’s not that nutrition and exercise choices are the universal causes or cures, but approaching food as medicine and exercise as medicine are minimally invasive, highly accessible, and massively influential ways of reducing risk. 

Inflammation Begins with the Immune System

Maintaining metabolic health and muscle health provides your immune system with the most supportive environment possible. Why are we talking about our immune system when we are here to discuss inflammation? Because inflammation is one of the natural health-protective responses our immune system provides our bodies when we are presented with stressors.

Stressors are events, situations and stimuli that signal our brain to communicate to our immune system that circumstances are becoming highly demanding (like exercise, learning a new skill, aging) or even dangerous (like an infection, fever, or injury). A complex interaction of factors  sets up this scenario. Some we have influence on; some we do not. Age (metabolism and physical activity change as we move through different points in our lives), Genetics (family history, body shape) and lifestyle (nutrition practices, exercise practices) are some examples.  

Health-protective exercise and nutrition practices consistently stimulate our immune system so it responds more efficiently, effectively and appropriately to stressors, thus reducing the risk of our immune system underperforming or becoming overwhelmed. 

The Science Behind Inflammation

Chronic inflammation is an immune system response linked to increased risk for multitudes of health conditions including type 2 diabetes, heart disease, kidney disease, stroke, osteoporosis, sarcopenia and many types of cancer  (including colorectal, liver, stomach, pancreatic, lung and esophageal cancer). These health challenges can arise as comorbidities, especially quickly if we already live with the challenge of a primary diagnosis. One common characteristic shared across these disease states is that they result from prolonged disruption/dysfunction in our immune  response. 

Another commonality of increased risk for these health conditions is being overweight or obese. How do overweight and obesity lead to decreased immune system performance? Expanded or stretched adipose tissue cells, the primary locations where our body stores fat as energy, are under stress when they are chronically overloaded with excess energy stored as fat. This constant and excessive tension on the cells is a major stimulus for pro-inflammatory cytokines. Cytokines are small messenger proteins (sort of like ants) that are sent out by immune system cells (macrophages and T-cells)to find and signal where immune system responses like inflammation need to be initiated.  

Why is inflammation a response our immune system uses during stressful circumstances? Inflammation is a protective attempt to isolate and manage harmful stimuli such as pathogens, damaged cells or tissue and toxic compounds. Our immune system uses those cytokines to draw blood, fluids and white blood cells toward the areas of concern for the purpose of eliminating the noxious agent(s).

Inflammation is intended to be a short-term/acute response to a short-term/acute problem. Detrimental inflammatory responses arise when the problem isn’t resolved on time, such as when we live with high levels of excess body weight or untreated illness for long durations. 

Health-protective nutrition and exercise practices can be incredibly potent non-pharmaceutical approaches. How can nutrition (the food and beverages we consume) and exercise (a minimum duration of 10 consecutive minutes when we are experiencing increases in heart rate, breathing rate and body temperature simultaneously) help reduce chronic low-grade inflammation? 

How Nutrition Can Combat Chronic Inflammation

A calorically appropriate nutrition profile (meaning food sources that meet our energy needs but don’t exceed them consistently) based on consumption of Whole Foods will provide the recommended (reference) daily intake (RDI) for most people. Try to choose whole foods (foods that have not been altered from their natural/raw form except for heating and cooking when necessary for safety) as often as possible for yourself.  

The RDI simply reflects the amount needed for most people to avoid deficiencies in these micronutrients. These are not necessarily prescriptive portions to optimize function in every individual, but instead they are the minimum amounts found to prevent deficits.  Our bodies use micronutrients like water-soluble vitamins (B and C, for example), fat-soluble vitamins (A, D, E and K), minerals (magnesium, sodium and potassium among others), and macronutrients (protein, fat and carbohydrates) from foods we consume to support immune function.

Together, these micronutrients and macronutrients protect cells from damage, produce and regulate white blood cells (macrophages) and maintain the protective barriers (like mucous membranes) that block pathogens. 

 Nutrient-rich food sources of some immune system-supporting vitamins include:  

• Vitamin C: Oranges, bell peppers, strawberries and broccoli. 
• Vitamin D: Fatty fish (like salmon), egg yolks and fortified dairy or plant milks. 
• Vitamin A: Sweet potatoes, carrots and spinach. 
• Vitamin E: Sunflower seeds, almonds and avocados. 
• B vitamins: Beef, chicken, chickpeas and leafy greens.

Our body also produces its own internal antioxidant named Glutathione. Glutathione is our body’s own immune system-supporting antioxidant produced in the liver from three amino acids: glutamine, glycine and cysteine. You can boost its production by consuming precursor-rich foods that provide your body with the building blocks it needs to synthesize glutathione. 

Glutathione Precursor-Rich Foods include: 

• Sulfur-Rich Foods (crucial for cysteine production): Cruciferous vegetables (broccoli, kale, Brussels sprouts) and alliums (garlic, onions). 
• Glycine Sources: Bone broth, skin-on chicken and gelatin. 
• Glutamine Sources: Eggs, dairy and lean meats. 
• Selenium: A vital mineral required for glutathione enzymes. You can get this from Brazil nuts, fish and pasture-raised eggs.

The bigger picture for health-protective measures is to consume as many of the above foods in their least processed version as possible. This helps reduce the risk of our body’s reserves of immune system supporting nutrients from becoming severely depleted or overly concentrated. 

How Exercise Can Combat Chronic Inflammation

Anytime we move, there are going to be muscles involved in that movement. Muscles on one side of the joint will contract (shorten) while muscles on the other side of the joint will lengthen. Muscle contraction stimulates some of the proteins (myokines) and immune system cells (T-cells) that function to regulate and resolve inflammation.

Exercise also helps us to move toward a more health-protective body composition. Specifically, exercise can help us reduce the accumulation of fat we have stored as white adipose tissue in our body. It’s a bit of a PUSH/PULL system. We PUSH sources of energy into our body through eating and drinking, then we PULL various amounts of that energy back out of the “system” through maintaining and moving our body.

This is why we hear so much about the health concerns associated with the combination of consuming highly processed, high-calorie foods and a lack of exercise and physical activity encourages high levels of body fat. 

When the cells of our body that store fat become overloaded and remain packed for extended periods of time (such as during overweight and/or obesity), they increase in size (hypertrophy) in an effort to continue holding and accepting more energy stored as fat.

This creates a stress response around these cells that our immune system attempts to resolve with  inflammation. The adipose cells where this happens  first are the subcutaneous adipose tissue (SAT) cells. These are fat cells directly beneath the “pinchable” skin that accumulates around our belly, hips, thighs, and upper arms. As the SAT cells become flooded, our body begins to drive the excess energy into the visceral adipose tissue (VAT) fat cells deeper in our abdomen and around our internal organs. Because the VAT cells are able to grow and shrink more than the SAT cells, the VAT fat cells elicit more of this inflammatory response than other cells in our body. 

This is all in effort to hold more fat as stored energy when the amount of excess energy we are consuming continues to increase beyond what our body requires and expends. Our VAT cells are simply more reactive to changes because they can hypertrophy grow more (and thereby signal for more intense immune system inflammation responses) than our SAT cells. 

The increased amount of stored fat in our bodies interferes with the interaction between organs like our liver and pancreas , which engage in insulin signaling that regulates energy availability in the “system”. High percentages of body fat reduce the efficiency of insulin by acting like a sponge and dampening the signals between these organs.  

Takeaways

The two methods we have the most immediate access to reduce chronic inflammation are choosing whole foods as often as possible and performing a minimum of 150 minutes of moderate to vigorous intensity exercise per week. 

Think in terms of setting these practices as “personal standards” for your lifestyle as opposed to treating them as goals. This does not mean that you transition into accomplishing the entirety of these changes overnight, but that you deliberately make efforts on a daily basis to plan, seek out and actionize opportunities to adhere to these “personal standards”.   

A personal standard is the minimum you will accept from yourself on a daily basis, so set your personal standard(s) for exercise and nutrition at a level you feel confident adhering to on your worst day. 

It’s productive to remind ourselves that “chronic inflammation” does not begin or end with a single decision, and that we almost always have some degree of influence over our own health outcomes through the multitude of decisions we each make across the minutes of our days.