Inflammation and CRP
Inflammation is a normal bodily process that occurs in response to injury and infection. It is a part of the normal healing process and includes the migration of white blood cells to the site of injury and the secretion of a variety of chemicals by the immune system. Inflammation becomes a problem when it becomes chronic, however. Inflammation is thought to play a role in many chronic diseases including anything that ends in “itis” (such as arthritis, colitis, bursitis, and tendinitis) as well as other diseases such as heart disease, asthma, diabetes, and possibly some cancers. Typical symptoms of inflammation include redness, swelling, and pain, although some of these are less common in chronic inflammation.
There are a variety of ways to determine if inflammation is occurring in the body. The two most commonly used tests are sedimentation rate (or ESR) and C-reactive protein (CRP). Sedimentation rate is most commonly used to diagnose and monitor auto-immune diseases such as rheumatoid arthritis and lupus that typically cause severe inflammation. CRP, on the other hand, is a very useful test for the lower levels of chronic inflammation that can promote heart disease and diabetes.
In particular, the relationship between elevated CRP and heart disease (including heart attack) has been strongly established. While elevated cholesterol is more widely known as a risk factor for heart attack and stroke, only about half the people who experience heart attacks have high cholesterol. Elevated CRP may account for some of those with heart attacks who have normal cholesterol. In fact, in a large 10-year study of cardiac death, those with the highest levels of CRP (4.2 mg/dL) had 6 times the risk of cardiac death compared to those with the lowest CRP (1.2 mg/dL). An optimal level of CRP is anything less than 1.0 mg/dL, while 1.0-3.0 is considered borderline high and greater than 3.0 is considered high. CRP is also independent of cholesterol levels, so those with normal cholesterol can have high CRP and vice versa.
The primary causes of chronic inflammation (and hence elevated CRP) include eating too much sugar and white flour, inadequate intake of omega 3 oils, food allergy, overweight/obesity, physical inactivity, smoking, and excessive alcohol intake.
Sugar and white flour – High glycemic foods such as sugar and flour are one of the most common causes of inflammation and elevated CRP. They can also increase blood pressure, cholesterol, and weight and promote fatigue and depression. Those who have high blood sugar, high triglycerides, low HDL (good) cholesterol, or are overweight may have metabolic syndrome and are especially likely to benefit from avoiding high glycemic foods. Added sugars such as dessert, soda, and maple syrup should be eliminated, and all grains should be whole grains and limited to once daily.
Omega 3 oils – found primarily in fish, omega 3 oils such as EPA and DHA are precursors to anti-inflammatory chemicals called prostaglandins that are produced by the body. In addition to reducing inflammation, they lower the risk of heart attack and stroke by about one third.
Food allergies – Food allergies are also a very common cause of chronic inflammation. Blood allergy testing, which is available through most naturopathic physicians, is an easy way to determine if you are allergic.
Physical activity – In addition to causing inflammation, physical inactivity tends to cause weight gain, high blood pressure, high cholesterol, and high blood sugar – all of which are risk factors for heart attack and a host of other chronic diseases. The minimum guideline for physical activity is 30 minutes daily of moderate intensity exercise. Optimal is 45-60 minutes per day.
Alcohol – While alcohol in moderation may lower the risk of heart attack and stroke, alcohol in excess can cause inflammation and raise blood pressure. In general, men should limit alcohol to 2 drinks per day or less and women to 1 per day or less. Those with inflammation may benefit from further reductions.
Smoking – In addition to causing inflammation, tobacco raises the risk of heart attack and stroke in other ways, such as by increasing the risk of forming blood clots and by raising blood pressure. For help with tobacco cessation, call the Quitline at 1-877-YES-QUIT.
Overweight – Body fat, particularly abdominal fat, is an inflammatory tissue. Physical activity, avoiding sugar and flour, and eating lots of fruits and vegetables are great ways to promote weight loss.
Fruits and vegetables – Fruits and vegetables contain a variety of compounds that can reduce inflammation including flavonoids and anti-oxidants. They also promote detoxification, which may play a role in inflammation in some people. Countless studies have found that those with the highest intake of fruits and vegetables are at the lowest risk of high blood pressure, heart attack, stroke, diabetes, most cancer, and many other chronic diseases. The minimum intake is 5 servings per day, while optimum intake is 8-10 servings per day.
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