Inflammation is vital for healthy immunity, but steady, low-level inflammation can lead to health problems as we age. Patsy Westcott explores the supplements that can keep it in check.
🕒 5 min read
Inflammation is currently a hot topic due to its links with a host of health problems that can strike us in mid- to later-life. Short-term inflammation is essential for healing, but persistent, low-grade inflammation – systemic chronic inflammation (SCI) – is now thought to be the missing link that unites a swathe of age-related conditions. The good news is that lifestyle changes including diet and supplements may help to reduce inflammation in the body.
What does SCI cause?
Conditions linked to SCI include arthritis, type 2 diabetes, heart disease, inflammatory bowel diseases, autoimmune conditions, obesity, gum disease, sarcopenia (age-linked loss of muscle mass and strength), and more. In fact, half of all deaths are now thought to result from inflammation-related diseases.
How to reduce inflammation in the body
Eat the Mediterranean way
A Mediterranean diet rich in vegetables, fruit, nuts, legumes, olive oil and fish, and low in red meat and saturated fats, is increasingly recognised for its potential to reduce inflammation. A recent review suggests that its secret is a result of its positive influence on the gut microbiota (bacteria and other microorganisms) where inflammation often starts.
A randomised controlled trial of older people from five European countries revealed that sticking closely to a Mediterranean diet for a year had the potential to promote healthier ageing by preserving the diversity of the gut microbiota.
Specifically, those who most closely followed a Mediterranean diet produced fewer inflammatory chemicals, together with a greater abundance of bacterial species linked to a lower risk of frailty and better cognitive function.
Supplements for inflammation
Supplements containing omega-3 fatty acids have been hailed in numerous studies for their anti-inflammatory properties. The long-chain omega-3 polyunsaturated fatty acids EPA and DHA, as found in oily fish such as herring, mackerel, salmon and sardines, are especially potent.
Research suggests that EPA and DHA work in different ways to combat inflammation in the body, with DHA having a wider effect in quelling inflammatory chemicals. Professor Philip Calder, an expert on fatty acids, suggests an intake of at least 2 grams daily to reduce inflammation in the body.
A US study examined the effects of an omega-3 supplement containing EPA and DHA on inflammation markers in 138 healthy but sedentary and overweight middle-aged and older adults. Those who took omega-3 supplements (1.25g or 2.5g a day) experienced a decrease of 10% and 12% respectively in levels of the inflammation marker IL-6.
By contrast, those who took a dummy pill mirroring the typical fat content of the American diet saw a 36% increase in IL-6 levels.
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Omega 3s and arthritis
Omega-3 supplements show promise in reducing symptoms of rheumatoid arthritis (RA). RA is an autoimmune disease in which the immune system turns on itself, causing widespread inflammation and painful swelling in the joints.
In a meta-analysis of ten randomised controlled trials involving 183 RA patients, those who took daily supplements with 2.7g or more omega-3 fatty acids decreased their use of non-steroidal anti-inflammatory drugs (NSAIDs) and reported fewer tender, swollen joints, as well as less morning stiffness.
When it comes to osteoarthritis (OA), the most common type of arthritis as we get older, a meta-analysis of nine RCTs including 2,070 patients with osteoarthritis (OA) found that taking an omega-3 supplement significantly reduced joint pain and improved joint function. The researchers attribute this partly to omega-3 fatty acids' ability to reduce inflammation markers.
The father of medicine, Hippocrates, allegedly said that all disease begins in the gut, and science increasingly supports his conclusion. Indeed, a growing number of studies suggest that probiotics may help to encourage healthy ageing by boosting the production of anti-inflammatory chemicals and dampening down the inflammatory response.
In one such study involving 76 people aged on average 71 years, taking a probiotic supplement and an omega-3 supplement significantly increased levels of an anti-inflammatory marker and a short-chain fatty acid involved in regulating immunity. The researchers conclude that dual supplementation could be the way forward for low-grade inflammation in older people.
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Polyphenols, a massive family of plant chemicals found in grapes, apple, pear, cherries, berries, red wine, tea or coffee, chocolate, cereals, pulses, herbs and spices, are important ingredients in the Mediterranean diet, and are thought to contribute to its power to keep over-zealous inflammation in check.
Curcumin, a potent polyphenol found in turmeric, is currently garnering much attention for its potential role in numerous conditions including arthritis, metabolic syndrome (a forerunner of type 2 diabetes), pain, and degenerative eye conditions. A systematic review and meta-analysis of 29 randomised controlled trials involving 2,396 participants with different types of arthritis, who took supplements containing curcumin or turmeric extract, concluded that the supplements helped to reduce the severity of inflammation and quell pain.
Another meta-analysis comprising 28 out of 32 trials with more than 2,000 participants, meanwhile, showed a reduction in inflammation markers as well as an increase in IL-10, a powerful anti-inflammatory chemical.
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Rose hips contain a wealth of compounds associated with promoting health, including galactolipid (sometimes marketed as GOPO), which is thought to be largely responsible for their anti-inflammatory activity. Rosehips also boast a wealth of anti-inflammatory polyphenols including proanthocyanidins and flavonoids such as quercetin and catechin.
A report in Australian Family Physician concludes that standardised rose hip powder may be an effective first line of treatment as well as offering an alternative to conventional medications for people with OA and, potentially, other inflammatory health problems.
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Resveratrol, an anti-inflammatory polyphenol found in grapes, grape juice and red wine as well as blueberries, bilberries and cranberries, has also attracted attention for its anti-oxidant, anti-inflammatory properties, as shown in studies of inflammatory bowel disease such as Crohn's and ulcerative colitis.
Its ability to block inflammatory chemicals and enhance the composition of gut bacteria is thought to be behind these benefits, as shown in lab and experimental models. Human trials are still sparse, but watch this space.
Find out more about inflammation.