Food for Thought

Inflammation and obesity
‘Any changes aimed at reducing weight without changing all aspects of lifestyle are doomed to failure in the long term in today’s inflammatory environment,’ writes Prof. Garry Egger in his newsletter, Professor Trim’s Waistline (23). ‘So, while health “experts” and dinner party guests continue to argue the merits of the Atkins over the Zone diet, or weight lifting over walking, the world moves on, with new findings suggesting the ineffectiveness of single behaviour change programs in the absence of a “lifestyle makeover”.

Leading the charge is research that indicates that body weight or even fat, per se, may not be the issue in disease, and may in fact just be a marker of other problems occurring in the overall lifestyle. Studies on inflammatory processes in the body, normally thought to be associated with infections, have shown that a low grade form of inflammation throughout all cells of the body, seems to result from certain lifestyle behaviours, some of which (but not all) can make us fat at the same time.

Eating too much and not being active enough are the two main lifestyle behaviours that cause obesity. And while obesity has been known for over a decade to be associated with inflammation, certain types of nutrition and inactivity are now known to cause a low grade form of inflammation, with or without the weight gain.

Foods that cause a rise in pro-inflammatory markers (chemical call-out signals to the immune system to fire up its defences) immediately after they have been eaten, have now been identified (e.g. saturated fat, high GI foods, salt, excessive alcohol, starvation) as have foods that have the opposite (anti-inflammatory and hence supposedly good) effect (e.g. fruit and veg, nuts, tea, monounsaturated fats, calorie restriction).

A casual glance at these suggests an immediate hypothesis: pro-inflammatory foods and nutritional behaviours are typically those with which humans have not evolved, and those listed under the anti-inflammatory side are those that humans have consumed for thousands of years – little wonder the body reacts as if it is at war against these foreign invaders. Starvation is the exception, but an inflammatory reaction to this has survival value in increasing insulin resistance and enabling the body to conserve what valuable energy stores (glucose and fat) it may have left. On the positive side, calorie restriction – although obviously not to the point of starvation – can have an anti-inflammatory effect, so bearing in mind the adverse effect of over-eating, it seems like this is a moderation in all things type recommendation

The fact that most of the pro-inflammatory stimulants can also increase body fat may be less relevant than is often thought. And this is reinforced by the fact that other modern behaviours can have a similar effect.

• Inadequate sleep is a common phenomenon in an electric light and entertainment driven environment. Over one-third of individuals in modern industrialised countries are now getting less than 7 hours sleep a night and this has been shown to raise inflammatory markers.
• Depression is also on the rise and is also associated with an inflammatory reaction.
• Finally, smoking, while actually being responsible for keeping weight down, can cause an outpouring of pro-inflammatory markers.

In all of these cases, obesity or weight gain may or may not exist. So by adopting a single behaviour such as a short-term diet or exercise program, could we realistically expect to see a decrease in inflammatory related diseases (such as heart disease and diabetes)?

It seems clear that any changes aimed at reducing weight, without changing all aspects of lifestyle relating to the modern inflammatory environment are doomed to failure in the long term – hence the renowned failure of all forms of dieting, biggest loser programs and TV promoted machines for weight loss. What’s needed for those lucky enough to be “warned” by an expanding waistline, and those who stay lean but should be aware of increasing disease risk factors, is a complete lifestyle “makeover” package. Bits of the package won’t do. It’s the whole kit and kaboodle – good sleep, low stress, non-smoking, good diet and plenty of exercise – that has been promoted since the days of Hippocrates, that must make up the prevention armoury.’

For more information check out Prof Trim’s article in September’s Obesity Reviews.