There's a growing body of evidence suggesting there is a complex interplay between inflammation and metabolic health. These are concerning issues today, as inflammation has been suggested to drive several conditions that collectively represent leading causes of disability worldwide, including poor metabolic health, affecting a third of all adults.
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What is Inflammation?
Inflammation is a natural process in the body that is a response to endogenous or exogenous forms of induced stress. While inflammation aims to protect the body, too much inflammation can impede many of its processes and has been proposed to be an underlying mechanism in the etiology of metabolic health disorders.
How Does Inflammation Affect Metabolic Health?
Inflammation can have a significant impact on metabolic health. Chronic inflammation contributes to the development of several metabolic disorders like obesity, type 2 diabetes (T2D), and cardiovascular disease (CVD). One of the ways in which inflammation affects metabolic health is by disrupting the normal functioning of insulin, an important hormone that regulates blood sugar levels. Chronic inflammation can result in insulin resistance, which impairs the body's ability to utilize insulin effectively, resulting in elevated blood glucose levels.
Inflammation can also impact lipid metabolism, contributing to dyslipidemia, a condition characterized by abnormal lipid levels in the blood. Chronic inflammation can increase levels of triglycerides and low-density lipoprotein (LDL) cholesterol – risk factors for cardiovascular disease – while reducing levels of high-density lipoprotein (HDL) cholesterol, which is protective against CVD.
Moreover, chronic inflammation can contribute to the accumulation of visceral fat, which is fat that's stored deep in the abdomen and is linked to an increased risk of metabolic disorders. Inflammatory molecules released by adipose tissue can also contribute to insulin resistance and dyslipidemia.
Symptoms of Inflammation
While overt symptoms of inflammation include swelling or redness, symptoms of systemic inflammation may include gut microbiome and hormonal imbalances, disrupted gut motility and barrier, compromised digestion, and insulin resistance.
Signs of Metabolic Disorders
Signs of Metabolic Syndrome include elevated triglycerides, hypertension, abnormal fasting plasma glucose, insulin resistance, low high-density cholesterol (HDL), and high low-density cholesterol (LDL).
Possible Causes of Inflammation and Metabolic Disorders
There are several causes of inflammation resulting in metabolic disorders.
Inactivity & Diet
Physical inactivity and diet are key players in the causes of inflammation and metabolic disorders. Exercise is essential for modulating inflammation and improving metabolic health. A diet high in refined carbs, trans fat, sugar, and processed foods can significantly contribute to inflammation and poor metabolic health.
Biochemical Variation
Biochemical variation and genetic variants can also make one more susceptible to metabolic conditions and increased inflammation due to alterations in important metabolic pathways. Variants in the Fat Mass and Obesity Gene (FTO), for instance, have a strong association with the risk of obesity and inflammation.
Poor Gut Health
Gut health issues may be underlying factors involved in inflammation and poor metabolic health. The gut microbiome is involved in the regulation of metabolism and inflammation. Healthy gut flora also helps to promote balanced blood sugar levels. Dysbiosis, an imbalance within the gut microbiome, leads to an impermeable gut lining, allowing food particles and bacteria into the bloodstream. This process leads to inflammation and further contributes to metabolic disturbances.
Chronic Stress
Stress directly affects inflammation through hormonal alterations via the Sympathetic Nervous System (SNS) and HPA axis. Stress can also reshape the composition of gut bacteria, causing metabolites and toxins to be released. This process also results in inflammation which can further compromise metabolic health.
Thyroid Dysfunction
Thyroid hormones are responsible for our metabolism. Low thyroid function is therefore associated with an increased risk of metabolic issues and metabolic syndrome. In addition, an autoimmune form of thyroid dysfunction called Hashimoto's Thyroiditis is associated with increased systemic inflammation.
Poor Sleep
Poor sleep disrupts metabolism and the gut microbiome, leading to systemic inflammation, promoting obesity, diabetes, and insulin resistance. Inadequate sleep can disrupt the circadian rhythm, affecting hormonal balance, including cortisol, leptin, and ghrelin levels that regulate metabolism. Even a couple nights of poor sleep can greatly increase C-reactive protein (CRP) and other inflammation markers.
Functional Medicine Labs to Test for Root Cause of Inflammation and Metabolic Disorders
Several functional labs can provide insight into the underlying causes of inflammation and Metabolic Syndrome. The following may be of particular value to guide an individualized approach to treatment to reduce inflammation and improve metabolic health.
Comprehensive Stool Test
This test gives practitioners insight into the overall health and balance of the digestive tract and microbiome by measuring a variety of microbes and intestinal health markers. This test assesses the makeup of the gut microbiome. This is important because certain bacterial strains are known to be inflammatory while others are anti-inflammatory. This information can help personalize and guide treatment. This test also analyzes inflammatory and digestive markers showing how well a patient can break down and digest fats, proteins, and carbohydrates.
Blood Sugar and Metabolism Markers
The Metabolomic Profile evaluates blood sugar balance and insulin function, among other measures of metabolic health, including indicators of adiposity, like leptin and adiponectin, which can help assess the risk of metabolic syndrome. This test also evaluates levels of C-reactive protein (CRP) in the blood, a protein made by the liver and a marker of systemic inflammation. Elevated levels are strongly associated with metabolic syndrome risk factors, including type 2 diabetes and CVD.
Thyroid Panel
This test evaluates imbalances in thyroid function that could contribute to inflammation and impede metabolic health, as the thyroid is imperative to the metabolism of nearly all of the body's cells.
3 x 4 Genetics
This comprehensive test provides valuable insights into factors contributing to metabolic health and inflammation based on one's unique genetic makeup (such as the FTO gene). Some key highlights are evaluating gene responsiveness to different forms of exercise and nutrition and markers of cardiovascular health.
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Functional Medicine Treatment for Inflammation and Metabolic Disorders
Managing inflammation through lifestyle changes such as adopting a healthy diet, obtaining good quality sleep, engaging in regular physical activity, and stress management can promote optimal metabolic health.
Although each treatment should be individualized for each patient based on intake and lab results, below are some of the most common functional medicine approaches to lowering inflammation and improving metabolic health.
Diet for Inflammation and Metabolic Health
Diet and nutrition play a critical role when it comes to reducing inflammation and improving metabolic health. Adhering to the Mediterranean diet reduces inflammation and supports metabolic health. The Mediterranean diet is a nutrient-dense, whole-food nutrition plan with diverse fruits and vegetables, high-quality anti-inflammatory fats, and proteins, like salmon and olive oil, nuts, beans, and legumes. This way of eating is rich in fiber, phytonutrients, and polyphenols, amongst other vital nutrients, to support metabolic health and blood sugar balance while reducing inflammation.
This diet recommends plenty of omega-3 fatty acids. These have been shown to reduce inflammation throughout the body, improving metabolic health. Omega-3s have also been shown in research to increase healthy thyroid function.
Eating a diet abundant in prebiotics and probiotics is important, as these have been found to be beneficial in supporting inflammation and metabolic health through favorable alterations in gut bacteria. Food sources include yogurt, sauerkraut, artichokes, and asparagus.
It is also crucial to refrain from high glycemic foods such as processed refined carbohydrates, hydrogenated oils, and trans fats, as these can contribute to inflammation and compromise metabolic health.
Supplements and Herbs That Help with Inflammation and Metabolic Health
Several supplements and herbs have been shown to help reduce inflammation and improve metabolic health. Dosages vary depending on individual factors and needs. Some of these include the following:
Alpha-Lipoic Acid
Alpha-lipoic acid (ALA), a natural compound with strong antioxidant properties, has been shown to improve insulin sensitivity and secretion while reducing markers of inflammation. In a meta-analysis study of 18 randomized controlled trials of individuals with metabolic syndrome, reductions in markers of inflammation such as CRP, IL-6, and TNF-α were evidenced after ALA supplementation.
Chromium
In this double-blinded randomized control study, participants who took 1,000 micrograms of chromium picolinate supplementation daily, along with an anti-diabetic medication, were found to improve markers of metabolic health. Specifically, insulin sensitivity and glucose control markers were better than in the group taking the anti-diabetic medication plus a placebo.
Curcumin
Curcumin, a compound abundant in turmeric, has been shown to have anti-inflammatory properties. An analysis of 66 randomized controlled trials demonstrated a significant reduction in inflammation with curcumin supplementation. Supplementation for metabolic syndrome is recommended at 630 mg 3 times daily for 12 weeks.
Vitamin D
Vitamin D has been found to reduce levels of inflammation and has been suggested to improve metabolic health. Supplementation with 2,000 IU per day of Vitamin D for adults engaging in regular endurance exercise is recommended.
Cinnamon
Cinnamon has been shown to improve markers of insulin sensitivity and reduce systemic inflammation, making it beneficial for metabolic health. A randomized, double-blind control trial showed that 3g of cinnamon for 16 weeks can significantly improve metabolic syndrome.
Magnesium
Magnesium is a vital mineral that's involved in many metabolic processes and has been shown to have anti-inflammatory and metabolic health properties. Supplementation with 30 ml daily with Magnesium Chloride solution (equivalent to 382 mg of Elemental Magnesium) for four months may support metabolic syndrome.
Complementary and Integrative Medicine for Metabolic Health
Complementary and integrative medicine can help enhance a healthy diet and supplementation. Below are some of the most beneficial therapies for inflammation and metabolic health:
Exercise
Exercise is essential for metabolic health and also has anti-inflammatory benefits in moderate amounts. Moderate exercise can improve brain-derived neurotrophic factor (BDNF), which can help to modulate inflammation and reduce stress.
Exercise can also help modulate stress and improve gut microbiome balance, affecting metabolic health and inflammation. Strength training, in particular, has been suggested to have favorable effects on metabolic health.
Improve Sleep
Sleep is foundational to health. Among its many integral roles, sleep is essential for regulating gut health, reducing inflammation and stress, and supporting metabolic health. Poor sleep disrupts the gut microbiome, leading to systemic inflammation, promoting poor metabolic health like obesity, diabetes, and insulin resistance. Going to sleep every night at around the same time, ensuring a dark and tranquil bedroom, and using soothing music or aromatherapy are all factors to consider in improving sleep hygiene.
Yoga
The mechanisms yoga exerts on the body in terms of stress can have implications for improving metabolic health and inflammation. Yoga has been suggested to lower blood pressure and blood sugar levels while improving muscle tone.
Yoga has been shown to also increase vagal tone, helping to promote balance and relaxation in the body and reducing inflammation.
Cold Exposure
Acute cold exposure has been suggested to improve metabolism and brown adipose tissue (BAT), a type of body fat that's activated in cold temperatures and helps the body burn calories which is preventive for metabolic health.
Acupuncture
Acupuncture, the insertion of fine needles to elicit physiological responses, has been found to modulate inflammation and reduce stress, indirectly improving metabolic health.
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Summary
Inflammation is an underlying driving factor of poor metabolic health. An integrative and functional medicine approach uses nutrition and lifestyle factors to help modulate and reduce inflammation, helping to support metabolic health.
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