Retrospective #187: Chronic Systemic Inflammation

This is a primer for the layman (by a layman) on “Chronic Systemic Inflammation.” Chronic means “persistent, long-standing, long term.”  It is in contrast to “acute” which means “with a rapid onset and/or a short course.” Systemic means “throughout the body,” as when you have a fever. Inflammation is the body’s response to an “injury.” I put injury in quotes because, while we understand the outward manifestation of the body’s “acute” inflammatory response to stubbing a toe (pain, swelling, etc.), we are often unaware of the presence and dire consequences of “chronic, systemic inflammation.” It is a continuing “injury” that is often undetected, and can be very serious.

To be clear, our body’s response to an acute injury (i.e., pain and swelling), is actually a good thing. It means our immune system has swung into high gear to defend itself against the “injury.” The biological process is technical, so suffice it to say they involve a temporary mobilization of “hormone-like” proteins, e.g., cytokines and macrophages. But enough of that; my eyes glaze over when I write about those little buggers. The point is: when the body has completed a repair to the injury, the inflammation goes away and everything returns to normal.

Chronic systemic inflammation is a whole other thing and is mostly unrecognized. So, why should we care? Dr. Art Ayers, a PhD biomedical researcher with a special interest in inflammation and disease, puts it this way: “Inflammation is the foundation for cancer and degenerative/autoimmune diseases. Small changes in diet and exercise, e.g. omega-3 oils, vitamin D, low starch, and maintaining muscle mass, can dramatically alter predisposition to disease and aging, and minimize the negative impact of genetic risks.”

One of the most common markers of chronic systemic inflammation is a blood test: the high-sensitivity C-reactive protein (hsCRP). Results in the range of 3.1 to 10mg/L are considered “Higher Relative Cardiovascular Risk;” 1.0 to 3.0 “Average Relative Cardiovascular Risk;” and <1.0 “Lower Relative Cardiovascular Risk.” When I started eating Very Low Carb in September 2002, my hsCRP had never been tested. Here are my scores for the last 16 years:

3/03	10/03	12/06	4/09	7/10	4/11	11/12	4/13	4/14	8/15	8/17	8/19
6.4	5.8	2.5	1.8	0.7	1.5	0.1	1.3	0.4	0.6	0.8	1.7

Note that my doctor, an internist/cardiologist, shortly after starting me on Very Low Carb in September 2002, tested my CRP twice in the first year. Both times the result put me at a “Higher Risk” (6.4 & 5.8mg/L). He didn’t test me again for 3 years, and by this time my CRP-based risk had dropped to “Average” (2.5mg/L). The next test, 3 years later, my hsCRP had dropped further to 1.8mg/L. The next 5 years he tested my hsCRP just once a year, three of them <1.0 (0.7, <0.1 and 0.4), a “lower” CVD risk. I think my doctor had noticed the big difference that Dr. Ayers mentions in “Cooling Inflammation,” his blog. I think he was particularly interested in the effect the Very Low Carb diet (and my 170-pound weight loss) had on Chronic Systemic Inflammation. Now he tests only every other year.

How did I lose 170 pounds and lower my hsCRP? Well, you can start by reading my two previous blog posts, #185, “Your Diet is Very Restrictive” and #186, “Your Diet is Very Restrictive Part 2.” And there’s more to come.

Note 1: The Google heading “Inflammation” includes the following: “Chronic inflammation is widely observed in obesity. The obese commonly have many elevated markers of inflammation, including: CRP (C-Reactive Protein).” “Waist circumference correlates significantly with systemic inflammatory response,” and “C-reactive protein (CRP) is generated at a higher level in obese people.” VISCERAL FAT (abdominal fat around the internal organs) IS VERY INFLAMMATORY. “Mild elevation in CRP increases risk of heart attacks, strokes…and high blood pressure.”

Note 2: A common cause of Chronic Systemic Inflammation is periodontitis, an inflammatory disease affecting the tissues that surround and support the teeth. “Periodontitis is caused by microorganisms on the tooth's surfaces, along with an overly aggressive immune response by pro-inflammatory cytokines, lymphocytes & macrophages against these microorganisms.”