All Things Inflammation :
Lisa Costa-Bir interviews Dr Tim Crowe
This is an edited transcript of part of a podcast interview presented by FX Medicine . JATMS gratefully acknowledges the consent of FX Medicine to publish material from their series of broadcast interviews of leading practitioners of natural medicine . Dr . Tim Crowe is a research scientist , a dietician , co-author of Understanding Nutrition , now in its fifth edition , and he also hosts his own podcast , Thinking Nutrition .
KEY POINTS COVERED IN THIS EXTRACT
• Understanding that resolving inflammation , as opposed to reducing it , is important for long term patient care . The analogy given is a raging fire that when contained to a barrel reduces but continues to smoulder . However , pouring water over the fire extinguishes the flames , but putting the fire out resolves the issue .
• Novel metabolic pathways for resolving inflammation include metabolites of omega-3 and omega-6 where the metabolism continues on from EPA / DHA and AA respectively . We ’ re all able to produce these metabolites endogenously while in a healthy state but certain risk factors and conditions detract from our ability to make adequate amounts .
• Pathology tests to help measure and assess inflammation include : - CRP - for measuring severe levels of acute inflammation .
- hsCRP - useful for sub-clinical inflammation , the more sinister type , has a higher sensitivity so can be a useful analyte for patients presenting with signs and symptoms of chronic inflammation or “ sickness behaviours ” and tracking improvements .
• Connections between stress on the HPA axis , the gut-mind connection , and inputs to the vagus nerve cannot be discounted as this contributes to overall inflammation levels . Loneliness and isolation are also shown to increase inflammation .
• Sleep issues are well researched for their role in triggering inflammation . Lack of sleep also increases risk of poor dietary choices leading to metabolic issues and gut dysbiosis which further increases inflammatory processes .
• Physical activity – any physical activity – is better than being sedentary . Tim suggests doing what works , doing what you enjoy , and doing what you can do regularly . It all adds up .
Lisa : Low-grade chronic inflammation is at the heart of most of the conditions that we see in clinic , and it ' s estimated that one in three Australians has a chronic inflammatory disease . So Tim , can you start by telling us a little bit more about inflammation , which is such a complex area , and is inflammation necessarily a bad thing ?
Tim : Yes , inflammation really underpins many of the chronic diseases we are faced with in Western countries like Australia . So , while it ’ s widely thought of as a really bad thing , it ' s actually a good thing as well . We actually need inflammation . It ' s part of our body ' s immune system . If you cut your hand , if you fall over and graze your knee , that redness and pain that you see and feel is acute inflammation . That ' s part of the body ' s way it deals with the acute injury . And then , over time , that inflammation is suppressed and then the body regenerates and heals . So , inflammation ' s critically important . It ' s part of our body ' s natural defence system . It ' s when it ' s chronic that that ' s the problem . If you think about , if it ' s a fire that is not put out , that fire keeps doing a lot of damage . So , inflammation is great short-term because of the changes it causes , but long term it ' s very harmful for our health .
Inflammation you can see and feel is generally going to be acute inflammation , but the bad sort is the chronic inflammation , which you ' re really unlikely to know that you ' ve got . It underpins many of our diseases , and it ' s more systemic . So , it ' s not that inflammation is in itself bad , but too much of it for too long is the big problem .
Lisa : What happens internally when you ' ve got chronic inflammation because , as you said , sometimes we can ' t actually see that in the same way as acute inflammation ? So , say someone has an autoimmune condition , or atherosclerosis , what ' s actually happening internally with chronic inflammation ?
Tim : What ' s happening is there ' s a whole lot of systems involved . One of them is one of the key immune cells , white blood cells , those macrophages . They will go to a site of infection or damage , and initiate cascades with other immune cells to release cytokines , which are signalling molecules that really mediate a lot of the inflammatory process . That can be systemic if there is some form of injury or infection all throughout the body , and you necessarily won ' t know that ' s happening directly . The presence of disease may indicate
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