In flames
It’s become almost cliché to claim that ‘the world is on fire.’ The statement is an apt analogy to describe any number of crises we face in today’s world, and with the increasing prevalence of devastating wildfires, it often does double-duty as both a metaphor and literal description of our current landscape.
I’ve been thinking a lot about what it means to be inflamed. We can think about this through different lenses: on a global level, a societal level, an interpersonal level, and at the level of our own bodies and minds. It’s interesting to think about how all these levels are related, and maybe in a future post I’ll draw some links to wider issues like political polarization, climate change, inflammatory rhetoric, and ‘stoking the fires’ of division and othering. For the moment, I’ll keep this to the domain of holistic health, and the pervasive problem of chronic inflammation.
Here’s a pretty clear summary statement from a recent overview in Nature Medicine (bold is mine):
One of the most important medical discoveries of the past two decades has been that the immune system and inflammatory processes are involved in not just a few select disorders, but a wide variety of mental and physical health problems that dominate present-day morbidity and mortality worldwide. Indeed, chronic inflammatory diseases have been recognized as the most significant cause of death in the world today, with more than 50% of all deaths being attributable to inflammation-related diseases…
The list of disorders related to chronic inflammation is mind-boggling, and includes cardiovascular disease, stroke, cancer, diabetes, chronic kidney disease, autoimmune conditions, Alzheimer’s, Parkinson’s, non-alcoholic fatty liver disease (NAFLD), arthritis and joint disease, allergies, chronic obstructive pulmonary disease (COPD), many gastrointestinal issues (e.g., IBD, Crohn’s, diarrhea, constipation, bloating), tinnitus, anxiety and depression, not to mention symptoms like body aches, fatigue, dizziness, skin rashes, brain fog, insomnia… You get the gist. The prevalence and negative impact of chronic inflammation simply can’t be overstated.
How is it possible that such a wide variety of problems could have a similar underlying pathology? I’m not suggesting inflammation is the ONLY cause of all of these things, but it plays a major role, and for many things on this list, it’s pretty high up in the causal chain. It’s also important to clarify that the problems come with chronic inflammation, not inflammation in general. The inflammatory response is a critical part out our innate immune response, which is the non-specific arm of the immune system that mounts a generic response to pathogens and tissue damage. (Fever is another aspect of the innate immune response—it’s not specific to a pathogen like antibodies, say, but rather works systemically to make conditions less favorable for invaders.) Without inflammation, we definitely wouldn’t survive long in this world. But the inflammatory response is designed to be quickly mounted, and not last very long, because the cellular processes engaged in fighting the threat can also damage our own tissues. Ideally, inflammation helps get the job done quickly, and once the threat is cleared, inflammation is shut off and other aspects of the immune system come in and clean up the damage.
But these days for many of us, our inflammatory response is being activated a lot of the time, and rarely getting shut off. It may be running at a lower level than during, for example, an acute viral infection, but it can get to a place where it’s kind of like a bed of hot coals that can easily flare up with just a little more fuel. When this happens, the inflammation itself starts to cause damage to our cells and tissues, and the widespread nature of the process means it can affect most any bodily system.
Chronic inflammation can develop due to both external and internal factors. External factors include things that we take into our bodies either by ingestion or through our skin or lungs (e.g., environmental toxins, irritants, and food triggers), and also pathogens in the case of chronic infection. Internal factors include the conditions of our minds and bodies, like high stress, poor sleep, or lack of movement. Even when genetic factors are at play, all of these external and internal conditions combine to make up our overall inflammatory load (similar to the concept of the stress bucket).
This is a bit of a sidebar, but the conventional medical approach to most inflammatory conditions is to suppress the inflammation through pharmaceuticals. You can see the rationale here, of course: if inflammation is the problem, get rid of the inflammation! And in some cases it’s necessary to ‘douse the flames’ through whatever means necessary, but that’s usually where the treatment approach ends. When we consider inflammation as part of the body’s natural intelligence, we see that suppressing inflammation is short-circuiting the body’s response to whatever it’s perceiving as a threat (and also inhibiting our ability to respond to other threats). So is inflammation really the ‘problem,’ or is it the body’s attempt at a solution to a deeper issue? If we think of inflammation as a symptom rather than the problem, the larger question becomes: what is causing the inflammation and how can we reduce it?
I’m starting to understand that finding answers to this question, which will be specific for each individual, is a fundamental aspect of holistic approaches to health in today’s world. And again we come to the reality that there’s never a single cause for anything. These bodies we live in, and this interconnected world we’re a part of, are complex, and there are many causes for any situation we find ourselves in.
But the good news is, because there are so many causes of chronic inflammation, that means there are tons of ways we can work to reduce it! And while the best approaches will vary between people, I’ll touch on three options near the top of my list that are fairly universal. Each of these warrants its own whole post, but this is the TL;DR:
Reduce sugar. It’s a problem for more than just your teeth! Sugar is a major driver of inflammation, especially refined sugar (which also means refined carbohydrates, since our body basically breaks those down into simple sugars, leading to the same effect metabolically). There’s a lot to say here about sugar and cholesterol and cardiovascular disease, and also insulin resistance and metabolic disorders, but for now I think it’s useful to think about the fact that sugars don’t show up in large quantities in the natural environment—what our bodies are designed to take in as food—occurring mostly in fruits. We’re simply not built to handle the amount of sugar we currently consume. Consider that in 1860 in England, which was already a major sugar importing country, the average per capita sugar intake was about 4 lbs/year. These days in the US it’s more like 145 lbs per person per year. (!!) Sugar is in nearly all processed foods—not just candy, sodas, and juices, but crackers, ketchup, yogurt, granola bars, tomato sauce… If you haven’t paid attention to this before and you start reading labels, it’s a real eye-opener. So how much should we be having? Target amounts vary, but the World Health Organization recommends that free sugar be less than 10% of your daily caloric intake (in many cases less than 5%)—or you could use the general benchmark of 20g/day, or less, of ‘added sugar.’ Overall, any efforts to reduce your sugar intake can make a major difference in your inflammation levels (and will probably reduce your cholesterol levels too).
Do the ‘oil change.’ One of my herbal teachers, Paul Bergner, coined this term to refer to removing industrial seed oils from the diet. These include corn, soy, vegetable, and canola oil. The short story here is that these oils require industrial processes (including high heat) to extract the oil from the plant. In the process, the oil molecules become oxidized, producing free radicals, which are highly inflammatory in the body. These oils also skew heavily towards omega-6 fats vs. omega-3, and omega-6 fatty acids are pro-inflammatory. Because of the glut of corn and soy on the market, these oils are produced in high quantities and are very cheap to buy—so it’s no surprise they’re in almost all processed food (and also nearly all restaurant food). Due to the way they’re produced, these oils are basically rancid on the shelf when you buy them. Why don’t they smell rancid? Because it’s an ‘industry standard’ to add deodorizing agents to remove the smell… and because it’s standard practice, the industry doesn’t have to tell you that. Removing these oils from your kitchen (seriously just throw the bottles away right now), and reducing your intake of them as much as possible from processed foods and restaurant foods (especially fried items) can be a massive lever to reduce inflammation. Olive oil, coconut oil, and avocado oil are great alternatives.
Take milk thistle. Here’s perhaps the easiest one! I wanted to add at least one herbal intervention here, although the reality is most plants have some anti-inflammatory capacity. So, eat your vegetables! 🥦 But milk thistle has a unique capacity to support your liver, which carries a large burden when it comes to inflammation, as its main job is to remove toxins (which can be both the cause and byproduct of inflammation). First off, it helps your liver produce glutathione, one of your body’s strongest natural antioxidants. It also supports liver function by promoting regeneration of liver cells and providing liver-specific nourishment. Milk thistle is a supremely gentle yet powerful liver support herb, and it has no known contraindications, so it’s incredibly safe for all ages. It’s also one of the few herbs that’s actually best taken as a capsule since concentrated amounts are preferred, which makes it super easy to incorporate into your daily life. (Make sure you get a product that says 30:1 concentrated; I like the Jarrow brand).
I’m sure I’ll keep circling back to inflammation in future posts, but I hope this is at least a helpful entrée into the topic.1 It’s truly so central to both our mental and emotional health. In the midst of our inflammatory world, here’s hoping you can find many ways to calm the flames.
Peripheral
Herbalists are often very engaged in mutual aid and disaster relief efforts. As the devastation from wildfires in Los Angeles continues, I’ll be joining the effort led by my teacher Kat Maier on Feb 8th to make medicine to send to affected communities (reply to me if you’re local to Cville and want to join!). Kat’s also been involved in the creation of this ever-growing Mutual Aid Directory, initially crafted in response to Hurricane Helene for aid in western NC, and now expanding to the Los Angeles area. It lists free herbal clinics, herbal self-care dispensaries, mutual aid medicine making, and herbal collection points. Feel free to pass along if you know folks in affected areas!
In a very uncharacteristic turn of events, I’ve been diving into a classic (and highly acclaimed) series of fantasy books: The Earthsea Cycle, by Ursula Le Guin. Oh my, what a fantastic read! The writing is beautiful, the lessons are deep and timely, and the plots avoid the all-too-common and simple tropes of good vs. evil, violence as the only solution, a single hero to save everyone… all of which I’ve gotten really sick of seeing repeated endlessly in today’s stories. (We need different narratives.) Highly recommend!
This story about rooftop gardening at a Boston hospital made me happy on so many levels. Improving food quality in hospitals, providing produce for those in need, reducing paved surfaces & increasing green space... what if every hospital partnered with local gardeners and food justice folks to make this widespread? Pure community goodness.
I’m realizing that I really need to get going on my plan to build some lectures or workshoppy-type presentations about all of this stuff, because there’s always more to say than I can fit in a newsletter, and I eventually hope to build some teaching into this work… Stay tuned if you’re interested, as I’ll need some test audiences! 😁