Good Inflammation, Bad Inflammation

This episode with Dr. Pedro Bastos is a broad exploration of the role of inflammation in health and disease.  In popular media, inflammation is regularly referenced only as a process that impairs our health, but as you'll learn today, inflammation also plays an essential and beneficial role in context.  There is good inflammation and bad inflammation, and it is important to understand the difference.

Dr. Bastos is a dietitian and researcher affiliated with the European University of Madrid in Spain, and Lund University in Sweden.  At Lund, he studied and collaborated with Staffan Lindeberg, the principal investigator of the famous Kitava Study.  He lectures extensively on health related topics worldwide and has co-authored influential papers such as "The Western Diet and Lifestyle and Diseases of Civilization, and "Chronic Inflammation in the etiology of disease across the lifespan", which was the most cited recent article in the influential journal, Nature Medicine. He has presented at the Ancestral Health Symposium, most recently in 2022 on a recap of the Kitava study.

In this conversation, Dr. Bastos discusses the definition and function of inflammation, as well as the distinction between acute and chronic inflammation. He explains the various biomarkers used to detect inflammation and highlights their limitations. The conversation also explores the relationship between inflammation and oxidative stress, as well as the evidence supporting a connection between chronic inflammation and a range of diseases, including metabolic syndrome and autoimmune disorders. Inflammation plays a key role in various health conditions, including cardiovascular disease, Type 2 diabetes, and cancer. Chronic inflammation can both cause and be a consequence of immune processes. 

The Kitava study, conducted on a traditional population in Papua New Guinea, revealed that their diet, while high in carbohydrates and saturated fat, is relatively unprocessed and has characteristics that low may contribute to their lower levels of inflammation and better health outcomes. Other lifestyle factors, such as physical activity, sun exposure, sleep patterns, stress and lower exposure to pollutants, may also play a role in reducing inflammation-induced disease.  From this, Dr. Bastos discusses how our diets can be tailored to minimize inflammation, including the roles of specific nutrients.  The conversation touches on some debates around inclusion or exclusion of fiber, whole grains, dairy and alcohol. Overall, the discussion emphasizes the complexity of inflammation and the need for personalized approaches to promote optimal health.

Resources:  

• "Chronic Inflammation in the etiology of disease across the lifespan", Nature Medicine, 24, 1822-1832 (2019) : https://www.nature.com/articles/s41591-019-0675-0

• "The western diet and lifestyle and diseases of civilization", Research Reports in Clinical Cardiology 201, 1:2, 15-35 (2011): https://www.dovepress.com/the-western-diet-and-lifestyle-and-diseases-of-civilization-peer-reviewed-fulltext-article-RRCC-MVP 

• "Revisiting the Kitava study", Ancestral Health Symposium (AH22): 

Here is a guide to topics discussed in this podcast episode:

Time     Topic

00:00      Introduction and background

01:33      Definition and functions of inflammation

04:44      Acute vs. chronic systemic inflammation

09:04      Triggers of acute vs. chronic inflammation

12:25      Inflammation biomarkers - uses and limitations

19:48      Inflammation and oxidative stress

26:45      The role of Inflammation in chronic diseases

27:17       Inflammation in metabolic syndrome, diabetes and cardiovascular disease

29:38       Inflammation in autoimmune disorders

31:56       Inflammation in cancers

34:04       Inflammation and cellular aging

36:58       The Kitava study: Health findings

47:54       The Kitava study: Dietary macronutrients, micronutrients and specific foods

53:07       Inflammation in Kitavans vs. Swedish controls

57:42       The role of lifestyle factors: sleep, physical activity, stress, sun exposure, sleep

1:02:30    Mechanisms of stress-Induced Inflammation

1:05:32    Pedro's dietary and lifestyle recommendations to control chronic Inflammation

1:07:52    The importance of phytochemicals

1:13:11    The question of fiber

1:16:52    Grains, dairy and alcohol

1:25:44    Summary and conclusions