Attack of the Immune System
Credit: Illustration by David Plunkert

Dr. Daniel Egan, a family physician in Alpine, Utah, believed he was living a fairly healthy life. At 46, he wasn't overweight, and he liked to exercise by mountain biking or hiking in the Wasatch Mountains. Still, he knew something was wrong. "I lacked energy and sometimes felt depressed," he recalls. "I just didn't think I was at my best."

So Egan decided to give himself a high-sensitivity test for C-reactive protein, or the hsCRP test, which would measure the level of inflammation in his body. The results confirmed what he suspected: He had chronic inflammation, which occurs when the body's immune system gets fired up and stays fired up over time, attacking healthy tissue alongside unhealthy tissue. Over the years, chronic inflammation has become a hot-button topic, and a growing number of researchers now believe that the condition can cause most serious illness – heart disease, stroke, diabetes, even cancer. Though experts say it usually takes years of chronic cellular inflammation to trigger these types of disease, there are also subtle, short-term consequences, including weight gain, fatigue, aches and pains, indigestion, and the kind of low-grade depression that Egan experienced.

"The test was a real wake-up call," says Egan, who drastically changed his diet and exercise habits afterward. "I tell my patients that you want an immune system that works like a focused laser on viruses, bacteria, and cancer. But when you have chronic inflammation, your immune system works like a shotgun blast. And the damage can be widespread."

In small doses, inflammation is actually good for the body: It helps heal injury and infection. When you get a cold, break a bone, or suffer any other sickness or harm, your immune system recognizes that you're unwell and dispatches an army of inflammatory cells to fight what's wrong. These cells travel to the injured area and release toxic chemicals to attack invading bacteria or injured cells. When these harmful cells are healed or killed, your inflammatory cells retreat, causing your immune system to relax again and your inflammation to subside. But inflammatory cells don't always retreat: Sometimes they keep attacking tissue and your immune system remains in a state of constant stimulation, resulting in chronic low-grade inflammation. The scary part is that there are no telltale symptoms or indicators of chronic inflammation, which is why researchers call it the "hidden disease." One of the best ways to tell if you have the condition is to get an hsCRP test, which, while growing in popularity, is still not commonly administered or even understood by some doctors.

What causes your body's inflammatory cells to stay in attack mode is usually something small that irritates your immune system every day, but not enough to cause an immediate sickness or reaction: eating a food that you're sensitive to, too much stress, too little (or too much) exercise, or a mild infection like a decayed tooth. And while the condition is more likely to befall sedentary people, it can also strike healthy people who eat right and go to the gym.

If you identify what's triggering your immune system to go on the attack, you can treat and even reverse chronic inflammation. For Egan, this meant changing his diet – he stopped eating processed foods, sugar, and most carbohydrates – and adding regular exercise to his occasional forays out into the Wasatch range. "It's been a dramatic improvement," he says. "My mood and energy are better. I've also dropped about 20 pounds."
If you suspect you have chronic inflammation, pay particular attention to the things most commonly responsible for inadvertently sparking the immune system – and fight back with these four steps:

Adopt an anti-inflammatory diet.
What you eat can contribute to chronic inflammation. Anything that's fried, overly processed, or too high in sugar, saturated fat, or trans fat can be a culprit. Not surprisingly, eating too many calories on a daily basis will also stress your immune system and cause chronic inflammation.

There are other, more insidious ways your diet can cause inflammation, though. A biggie is eating too many omega-6 fatty acids, found in cooking oils like safflower, corn, and soybean. It's not that omega-6s are bad for you – they're actually essential to good health in small amounts – but when you eat too many omega-6s and not enough omega-3s, it throws off the critical balance of the two and creates inflammation in the body. To counter the effects, eat food cooked in olive or canola oil instead of soybean or corn oil (common in fast food); eat fewer processed foods, such as margarine and salad dressings (most of which are high in omega-6 oils); and prioritize omega-3-rich foods like wild salmon, grass-fed meat, flax, and beans.

Even if you eat a fairly healthy diet, it could cause chronic inflammation if you have a food sensitivity. Dr. Mark Hyman, author of several books on nutrition, believes more than half of all Americans do have one – and many unknowingly. Unlike food allergies, which cause sudden and severe symptoms that can be life-threatening, food sensitivities have delayed reactions that often lead to vague symptoms like fluid retention, joint pain, fatigue, and headaches.

The best way to determine if you have a food sensitivity is to try an elimination diet, says Hyman. Start by nixing the most common culprits – gluten, yeast, and dairy – from your diet for two weeks. If you notice you have more energy, fewer headaches, or just feel better, you probably have a sensitivity. Reintroduce each one individually into your diet, and note when your symptoms return to determine which food is responsible.

Exercise – but don't overdo it.
All the experts agree: Being sedentary causes inflammation. Multiple studies have shown that consistent, moderate aerobic exercise decreases inflammatory chemicals, but working out for longer or exercising too intensely can actually create inflammation. A recent study found that people who run much more than an hour a day don't live as long as those who jog less, in part because excess exercise is cardiotoxic, stimulating chemicals in the body that are harmful for the heart and that, over time, can create chronic inflammation. A separate study discovered that people who do triathlons show signs of low-grade, full-body inflammation for at least five days after competition. While this eventually dissipates with rest, athletes who don't take enough recovery time can develop chronic inflammation, which will eventually harm their health.

How much exercise is too much? That depends on your current conditioning. If you don't work out often, jumping off the couch and running 10 miles can contribute to inflammation, while it wouldn't adversely affect a guy who runs regularly. "The idea of 'more pain, more gain' is simply not right," says Dr. Christiaan Leeuwenburgh, a professor at the University of Florida's College of Medicine and Institute on Aging. "When untrained people push themselves too hard, they produce massive amounts of oxidative damage and stress."
You can counter some inflammatory effects of a high exercise load by eating more anti-inflammatory foods, like leafy greens and brightly colored berries, and supplementing with certain nutrients, says Dr. David C. Nieman, a professor of health and exercise at Appalachian State University. He suggests taking 1,000 mg of quercetin, 250 mg of green tea extract, and 400 mg of omega-3 fish oils to help reduce exercise-induced inflammation.

Go to the dentist (really).
Perhaps the most established way to court chronic inflammation is to ignore proper oral hygiene. People under 65 years old with periodontal disease like gingivitis, or gum inflammation, have a higher level of inflammation – and a 44 percent greater risk of developing cardiovascular disease, according to a recent Scottish study. While the reason oral problems create inflammation isn't entirely clear, the most common theory is that having a chronic infection in your mouth, even if it's a small one, fires up your immune system and keeps it fired up for as long as you have the infection. What to do? Brush twice a day, floss, and see a dentist every six months.

Get some sleep.
Our modern-day immune systems evolved in ancient environments to anticipate when we might get injured, turning on prophylactically when there was an increase in stress hormones, such as when we had to fight a wild animal or were pursued by a marauding tribe. Yet the likelihood of either of these scenarios happening today is close to nil – and that's a problem. Today, our caveman immune systems can get turned on by the stress of a business presentation or a traffic jam. And when taxing events occur over and over again, every single day, our immune systems get turned on and stay turned on, creating low-grade chronic inflammation.

The solution? Find ways to de-stress. You've heard most of the best tips before: Sign up for a yoga class, spend five minutes every day doing deep-breathing exercises, and unplug from your phone and email at night. But don't think a little deep breathing or downward dog can make up for the lack of one of the best ways to de-stress when it comes to chronic inflammation: getting a good night's sleep. Research shows that people who regularly get fewer than six hours or more than nine hours of sleep per night have less healthy immune systems and higher levels of inflammation. Set a regular sleep schedule, and stick to it, even during the weekends, to help establish a healthy sleep pattern.