Healthy Living inflammation

Fat cells as Inflammation Factories

The headline called it “the new” science behind America’s deadliest diseases. WSJ reporter Laura Landro was talking about inflammation and its role in causing human disease.

Now, you all know my reaction when a prestigious newspaper features a founding principle of this blog. Well, let’s just say it felt awfully nice.

A brief Mandrola review of inflammation is in order:

First: Acute Inflammation is normal, and required for life. It’s the name given to a series of complex and protective responses of the body’s tissue when invaded or injured. Think about what happens when your skin is infected: A symphony of cells and chemical messengers rush to the scene to wall off and defeat the invader. You know it’s happening because the area turns red, warm, swollen and painful. If enough inflammation occurs, fibrosis (scar) replaces normal tissue. That’s okay on the skin; but it’s not so good for organs like the heart and brain.

Second: Inflammation becomes problematic when it becomes chronic. Imagine the damage done when the inflammatory system stays turned on for too long. Even at low levels, circulating chemical messengers of inflammation turn the body on itself. In their role of walling off and destroying, inflammatory messengers tell blood vessels to thicken, blood cells to get sticky and scar tissue to infiltrate organs. This chronic process causes heart disease, stroke, Alzheimer’s disease, Cancer and many more.

Ms. Landro is right: Excess inflammation lies at the core of human disease.

But this important mainstream media article does far more than review the damaging role of excess inflammation. Ms. Landro adds two other important facts to the conversation:

Obesity’s Role: The mistake made by many is to consider fat as an inert physical impairment. Meaning, it does its damage by chronically increases the work done by the heart and body. This wear-and-tear thesis greatly underestimates the badness of fat. It turns out that fat cells…

…“act like small factories to churn out molecules known as cytokines, which set inflammation in motion”, says Peter Libby, chief of the division of cardiovascular medicine at Brigham and Women’s Hospital in Boston and a professor at Harvard Medical School.

This is such an important message. Patients and doctors need to emphasize the dangers of fat cells. Fat doesn’t just harm us because of physics; they harm us through biochemistry—through inflammation.

Treating excess inflammation: Here’s where a cyclist and advocate for healthy choices quivers with delight. Thus far, the ‘free lunch’ therapies—taking an anti-inflammation pill—have not been curative. (Though statins help in patients with established artery inflammation.) What works for chronic inflammation? Attention to nutrition. Ms. Landro reviews the growing body of science behind the role of nutrition and inflammation. Can you guess which foods soothe, and which ones inflame? I’ll help. Think real versus man-made.

It turns out that eating whole grains, cold-water fish, vegetables, nuts and fruit are considered by many experts to be “anti-inflammation” diets. While these real foods may help soothe the inflammatory system—perhaps by reducing fat cells—man-made processed food drives fat storage. The white things, like potatoes, donuts and pasta, feed and grow the hotbeds of inflammation—the fat cells.

My only criticism of the nicely done article is the lack of mention of exercise. Oodles of studies show that ‘normal’ levels of exercise—and its chief effect, fitness—lowers markers of inflammation. The way exercise lowers inflammation are obvious: by reducing fat, by lowering blood pressure, by improving sleep, by enhancing sugar metabolism, to name just a few.

Even without the mention of exercise, I loved this piece. In the struggle to help our patients, and our nation, with the epidemic of obesity, new ideas and sticky messages are critical.

The concept that fat cells are factories of inflammation and that good health choices help slow their output is one that I will be using—and liking/tweeting.




14 replies on “Fat cells as Inflammation Factories”

Thanks again for another enlightening article about the mysteries of the inflammatory process and its relationship to health in general,

This begs another question which might help me piece together my comprehension of the bigger picture. How does body uric acid, and the inflammatory process of gout fit into the cardiac picture? I’ve read snippets of information linking uric acid levels to heart disease, but also have read how high uric acid levels are vital for their scavenging properties, and it all gets very confusing. Does lowering uric acid TOO much negatively affect body chemistry? Does “silent” gout (no flares, but tophi accumulation in the joints) over many years increase the risk of cardiac problems? If a person is prone to gouty arthritis, is she also prone to heart or circulatory disease? Does the same theory apply to rheumatoid arthritis or arthritis in general? From your other posts, You mention how bad anti-inflammatory drugs are for the heart. How do people with arthritic conditions cope with balancing medications that make their life bearable with the possible cardiac implications? I know these are questions more for a rheumatologist (and I certainly will ask one at some point), but as you kinda brought up the subject . . . . . .

Good doctor,
Would osteoarthritis in the hip generate cytokines and result in damaging inflammation, i.e., inflammation that can cause heart disease, stroke, Alzheimer’s disease, cancer, etc?

Inflammation in the hip is local. I’m talking about widespread and chronic inflammation. I’ve not read anything that links inflammation in the joint to whole-body inflammation.

You ask: “How do people with arthritic conditions cope with balancing medications that make their life bearable with the possible cardiac implications? “.

Help the body balance its inflammatory responses and you may be able to reduce your medications. Inflammation is essential to help the body heal and protect it from infection, but the body must control the amount of inflammation it produces. Excessive inflammatory responses are the cause of much disease, including RA and gout.

Thanks for this, Dr. John – although that imagery of my little fat cells being busy factories of inflammation seems positively creepy (its intended effect, I’m guessing!)

The list of “soothing” anti-inflammation foods here sounds a lot like what the Mayo Women’s Heart Clinic recommends to heart patients: some variation of the classic Mediterranean Diet (or, as The Journal of Nutrition suggests, more accurately called the ‘Greek diet’ or – even better – “the Greek diet before 1960”).

But why does the noble potato need to be on the same List of Shame alongside donuts? 🙁

“Help the body balance its inflammatory responses”

How? Diet and exercise definitely don’t do it all, judging by the experiences of people I know. I really want to find an answer for someone who has a really rough time with it.

Carolyn, I agree with you regarding potatoes. An unaltered, unadorned with fat and bacon bits potato, is a marvelous thing – especially sweet potatoes (in moderation, of course). Eaten with the skin, it contains a wealth of nutrients.

The so-called Mediterranean diet can be improved upon if you use some of the great new whole wheat with fiber pasta on the market, instead of the old pure starch variety. I definitely will look up the “Greek Diet Before 1960”

Hyperimmune egg, omega-3 fatty acids, vitamin D3 have been shown to help the body attenuate production of the pro-inflammatory cytokines thus balancing inflammatory responses. And of course, colorful fruits and vegetables because of their phytonutrient content (not necessarily their anti-oxidant content).

I was all excited when I saw the headline for this article on WSJ. After reading the article and watching the video clip online, I was very disappointed. There was no discussion at all about treating chronic inflammation in people like me. I have multiple autoimmune diseases, which cause chronic inflammation. I have Rheumatoid Arthritis, Systemic Lupus Erythematosus, Sjogren’s Syndrome, Hashimoto’s Thyroiditis, Fibromyalgia and Autoimmune Narcolepsy. I feel this article wasn’t even a scratch on the surface of ways to treat….or eat your way out of inflammation. I am on a host of medications to try to control and slow my disease processes. Unfortunately, many of these treatments cause weight gain, or in other words, according to Ms. Landro, belly fat inflammation. Prednisone, Lyrica, Cymbalta… just to name a few. Also, with my body, the inflammation of connective tissues, joints and organs really make it difficult to exercise. Most times, the pain levels, inflammation, joint damage, and inability to move, all prevent the ability to exercise.
I wish she had gone much deeper into this and been much more informative about the so-called ravaging of the body from inflammation, but moreso, had gone much deeper into ways to treat and ways to eat that would help people with chronic, progressive, debilitating, inflammatory diseases.

Cheryl: I am sorry you are having such a difficult time. Your immune system needs to learn how to limit its inflammatory responses. I have been working in the area of inflammation for decades, so if contact me, I can share information that might help you return to immune homeostasis, immune balance. Full disclosure: I am an immunologist, but not a health practitioner. Cordially, HCG [email protected].

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