We are all familiar with acute inflammatory reactions that occur in response to an injury or infection, easily recognizable by sensations of heat, pain, redness or swelling (the famous calor, dolor, rubor and tumor already described 2000 years ago by doctors of ancient Rome). This inflammation is a defense reaction orchestrated by our immune system to eliminate pathogens (a bacterium, for example) using highly reactive and irritating molecules. The inflammatory reaction is also used to initiate repair of damaged tissue, due to the numerous growth factors secreted by immune cells that accelerate the arrival of healthy cells and promote the formation of new tissues.
Chronic inflammation can also be much more insidious and develop without visible signs but nevertheless create a climate that disrupts the functioning of the cells present in the inflamed environment. Although less spectacular and without apparent symptoms, this type of inflammation is a major medical problem, as it is now well documented that the development of most chronic diseases that affect our society (cardiovascular disease, type 2 diabetes 2, several cancers) is favored by the presence of these chronic inflammatory conditions.
This is particularly well illustrated in the process of atherosclerosis , the phenomenon responsible for the formation of plaques on the wall of the arteries and which can lead to the appearance of cardiovascular events such as myocardial infarction and stroke. One of the main characteristics of these plaques is to accumulate cholesterol and it is for this reason that the reduction of blood levels of LDL-cholesterol is considered an essential facet of the prevention of cardiovascular diseases .
On the other hand, several clinical studies carried out in recent years ( HOPE-3 , ASCOT , FOURIER) indicate that the decrease, even drastic, of these LDL cholesterol levels using drugs such as statins or PCSK-9 enzyme inhibitors is associated with a fairly modest decrease in the absolute risk of cardiovascular events, around 1-2% in prevention Primary and 4% secondary prevention. These observations suggest that atherosclerosis is not simply caused by passive cholesterol accumulation and that other factors necessarily come into play.
A large number of studies conducted in recent years suggest that chronic inflammation is one of these factors. On the one hand, inflammation that develops on the surface of blood vessels appears to play an important role in the development of cardiovascular disease, as high blood levels of several inflammatory markers have been repeatedly measured in people affected by these diseases. On the other hand, it is proposed that inflammation participate in all stages of the development of atherosclerosis , the appearance of the first lesions ("lipid streaks") caused by the infiltration of certain white blood cells that store cholesterol , Until the formation of clots that block blood circulation and cause infarction and stroke. The clinical importance of this chronic inflammation is well illustrated in patients who have undergone myocardial infarction and who are treated with a statin to lower their LDL cholesterol. Studies show that a high proportion (about 40%) of these people have too high blood levels of inflammatory proteins and this residual inflammatory risk is likely to contribute to the high rate of coronary event recurrence (nearly 30%). Which affects these patients within two to three years of starting treatment, despite a significant reduction in LDL cholesterol. In this sense, It is interesting to note that the preliminary results of the CANTOS study show that the administration of an antibody that neutralizes an inflammatory protein (interleukin-1) is associated with a significant decrease in major cardiovascular events in coronary patients . The reduction of chronic inflammation could therefore be a very promising approach to reduce the risk of cardiovascular disease, both for those who have already suffered a heart attack and who are at very high risk of recurrence and for the general population.
Anti-inflammatory lifestyle
This approach is all the more interesting because it is now known that several lifestyle factors disturb the equilibrium of the organism and at the same time favor the development of chronic inflammatory conditions (see Table).
| Lifestyle factors that promote chronic inflammation |
|---|
| Smoking |
| Excess alcohol |
| Sedentary lifestyle |
| Stress |
| Obesity |
| Insulin resistance (hyperglycaemia) |
| Western food (red meats, cold meats, refined flours, desserts sweetened beverages, fries, ...) |
Exposure to toxic substances such as cigarette smoke or excess alcohol is obviously an important vector of inflammation, but several other lesser known factors also contribute to the creation of an inflammatory climate such as sedentary lifestyle, Excess weight and poor quality food. Modifying these poor lifestyle habits can help reverse chronic inflammation and reduce the risk of cardiovascular disease and chronic diseases in general.
This is especially true with regard to feeding. The studies show that the "Western" diet currently in vogue in our society, that is to say rich in meat, saturated fat and processed foods (meats, refined flours, added sugars) is associated with High blood levels of several inflammatory markers. The pro-inflammatory impact of this mode of feeding can be all the more pronounced as it is often associated with the development of overweight and insulin resistance, two factors recognized for establishing a climate of inflammation Chronic disease in the body .
Conversely, a diet mainly based on plants (fruits, vegetables, Whole grains) is rather associated with a decrease in these inflammatory markers . In other words, simply replacing the consumption of meat and processed industrial products (especially junk food) with a diet rich in plant-based foods can reduce chronic inflammation and,
To curb the development of atherosclerosis and inflammatory processes as a whole. This is supported by the results of studies showing that an increase in the inflammatory index of diet, an index that takes into account the effect of different nutrients on blood levels of inflammatory proteins, is associated with an increase The risk of cardiovascular disease ,
In short, to reduce inflammation, it is simply a matter of adopting lifestyle habits that have been repeatedly associated with an increase in healthy life expectancy - regular physical activity, A normal body weight and a diet mainly based on plants.
A good starting point is to adopt the Mediterranean diet , based on regular consumption of fruits, vegetables, nuts, seeds (linseed, sesame, chia, hemp), fish and olive oil. In addition to allowing a significant intake of bioactive fiber and phytochemicals (polyphenols, for example), this mode of feeding also increases the consumption of omega-3 polyunsaturated fats which possess anti-inflammatory activity
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