When it comes to fighting chronic diseases, researchers are all fired up about inflammation

Inflammation gets a bad rap.

“Possibly because it hangs out with a dangerous crowd,” says Dr. Jean-Francois Legare, a cardiac surgeon with QEII Health Sciences Centre and an associate professor in Dalhousie University’s department of surgery.

From the Latin inflammatio, meaning “set on fire,” inflammation is involved in some way with almost every disease we know—from heart disease, Alzheimer’s disease and cancer to physical disabilities and diabetes. It’s a hard-core group to be sure, yet according to Dr. Legare, we shouldn’t judge inflammation by the company it keeps.

“Inflammation is just the way our body deals with injury,” he explains. “It’s a way of fighting infection, repairing damaged tissue, and warding off bacteria.”

To explain the process, Legare compares inflammation cells to the teammates who rush to the aid of an injured athlete. “They are absolutely critical in the period immediately following an injury,” he says, “but it’s possible to have too many players on the field and for those players to be too enthusiastic. When that happens, it can actually hurt the body and lead to chronic health conditions such as heart disease.”

As an example, Dr. Legare describes the role of inflammation following a heart attack. “The heart is a muscle,” he says, “and part of that muscle dies during a heart attack. Inflammation begins as a healer, but it can hurt the heart if it’s too powerful.”

Treating inflammation

While most researchers are interested in the dysfunctional properties of inflammation and the way it obstructs the healing process, Dr. Legare is taking a different approach as a member of the Restitution Enhancement in Arthritis and Chronic Heart disease (REACH) research program, an international team of surgeons, clinicians and scientists from Canada, Finland and the United States.

“By determining what goes right in the healing process, team members hope to examine ways to better treat inflammation-related heart damage, arthritis, and other inflammatory diseases,” explains Dr. Jean Marshall, a professor in the department of microbiology and immunology at Dalhousie University.

The REACH project received funding for up to five years from the Canadian Institutes of Health Research (CIHR), the Arthritis Society, and Crohn’s and Colitis Canada. Team members researching heart disease will study tissue samples collected from a group of Nova Scotia patients convalescing after a heart attack. By comparing patients whose inflammation responds well to early treatment and those who develop heart failure, the team hopes to discover new ways to diagnose, treat, and manage the chronic diseases in which inflammation is a key factor.

“This study will provide critical knowledge in treating inflammatory conditions and could be used to help develop more powerful treatments and advance the healing abilities of inflammation,” says Dr. Legare. “Also important, it provides an invaluable training ground for highly skilled specialists and stimulates interest in this area.”

So far, the results are encouraging.

“We know that in the early stages of inflammation, immediately after an injury, all the players are on the field,” says Dr. Legare. “The trick is to find ways to regulate those players. In the old days we used anti-inflammatories after a heart attack, but that wasn’t helpful. We are now looking at a wait period before administering specific anti-inflammatory strategies.”

Toll of heart disease

It’s research that is desperately needed. In the past six decades, surgical advances, drug therapies and prevention campaigns have led to a 75 per cent decline in the cardiovascular death rate for Canadians, but heart disease continues to be a major health issue—especially in Atlantic Canada—and accounts for the deaths of more Nova Scotians than any other disease.

The good news is that overall health continues to improve and there are things we can do to help ourselves.

“It’s important to be active,” says Dr. Legare. “In fact, someone who is active and overweight is at less risk for heart disease than someone of a lesser weight who is not active.”

Food triggers

There is no single diet for fighting inflammation, but there are many food categories identified as inflammation triggers. Some of the major culprits include high-fat and high-calorie meals, refined carbohydrates, highly processed foods, red meat, processed meat, fried foods, alcohol, soda and other highly sweetened beverages. Smoking, of course, is a no-no.

On the bright side, there’s a similarly long list of foods that fight inflammation, including fruits and vegetables, fatty fish, nuts and seeds, olive oil, low-sugar cocoa, dark chocolate, and herbs and spices such as ginger, turmeric, pepper and basil.

It’s fortunate that these inflammation-fighting foods are part of a healthy diet, because the jury is still out on how effective diet actually is in reducing inflammation.

Dr. Jean-Francois Legare is optimistic that the REACH team’s findings will lead to a better understanding of inflammation and shed more light on the role of diet and lifestyle. He’s also hopeful of finding new ways to help keep this much-maligned process on the straight and narrow.

“After all,” he says, “inflammation is really one of the good guys—and it’s the new frontier when it comes to attacking many major diseases.”