In the first part of our special series on inflammation, NutraIngredients puts the physiological process of inflammation under the microscope, and casts an eye over the nutritional approaches to counter rising inflammation.
‘Inflammation’ is slowly becoming a marketing term. As our series develops we look at what the term means for marketers and consumers. Finished products are already available claiming ‘inflammation balance’ and similar benefits.
But let’s start by going back to the science, and asking ‘what is inflammation?’
Chronic inflammation is brought about by an over-expression or lack of control of the normal protective mechanisms.
In a review in Nutrition, Metabolism & Cardiovascular Diseases (2004, Vol. 14, pp. 228-232), Katherine Esposito and Dario Giugliano from the Department of Geriatrics and Metabolic Diseases at the Second University of Naples in Italy noted that “obesity, insulin resistance, and diabetes are associated with a pro-inflammatory state, which in turn is associated with increased cardiovascular risk”.
Chronic inflammation has also been linked to a range of conditions linked to heart disease, osteoporosis, cognitive decline and Alzheimer's, type-2 diabetes, and arthritis.
A list of established biomarkers for inflammation exists, with commonly touted markers including C-reactive protein (CRP), interleukin-6 (IL-6), IL-10, IL-18, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-alpha (TNF-alpha).
The link between inflammation and chronic disease has been strengthened by identification and acceptance of these biomarkers. Indeed, an article in the New England Journal of Medicine (2004, Vol. 351, pp. 2599-2610) evaluated the role of inflammatory markers heart disease risk in women, and concluded: “Elevated levels of inflammatory markers, particularly C-reactive protein, indicate an increased risk of coronary heart disease”.
Regarding obesity, an interesting study published in Clinical Science (2004, Vol. 107, pp. 365-369) by researchers at the University of Connecticut found that overweight men who embarked on weight loss diets displayed significant reductions in levels of inflammatory biomarkers, IL-6, CRP, and TNF-alpha.
The UConn researchers noted that fat tissue is known to produce TNF-alpha and IL-6, and that “obesity itself promotes and potentiates [artery furring or hardening]”.
Reducing the levels of these biomarkers has been a target for a number of nutrition studies. One of the best studied is the omega-3 fatty acids. A study by Professor Manohar Garg from the University of Newcastle in New South Wales found that increased blood levels of the omega-3s DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) were associated with reduced levels of CRP (European Journal of Clinical Nutrition, 2009, Vol. 63, pp.1154-1156).
The mechanism of omega-3 anti-inflammatory effects is reportedly linked to its ability to inhibit arachidonic acid (AA) metabolism to inflammatory compounds. DHA and EPA are also reported to produce compounds that are less inflammatory than those produced from AA or that are anti-inflammatory.
Other nutrients with potential anti-inflammatory potential include Pycnogenol, an extract from French maritime pine bark. In a 2006 study , German and Slovak scientists reported that a 200 mg dose of the pine bark extract for five days was associated with a 25 percent reduction in matrix metalloproteinase 9 (MMP-9) levels (Journal of Inflammation, 2006, 3:1).
The potential anti-inflammatory power of the so-called super fruits is also being reported in the scientific literature. Both açai (Journal of Agricultural and Food Chemistry, doi: 10.1021/jf8016157) and pomegranate (Journal of Inflammation, 2008, 5:9 & 2009, 6:1) have studies to support their anti-inflammatory effects.
Scientists from TNO Quality of Life in the Netherlands recently formulated a test supplement containing nutrients selected for their anti-inflammatory action to produce metabolic changes in overweight people.
A combination of fish oil, green tea extract, resveratrol, vitamins C and E, and a lycopene-rich tomato extract produced changes to genes associated with inflammation, blood vessel health, and oxidation of fat in the liver, according to findings published in the American Journal of Clinical Nutrition (doi: 10.3945/ajcn.2009.28822).
The researchers noted that the compounds were chosen in order to reproduce real life situations, and that levels were determined by data for their individual anti-inflammatory action. “A more optimal combination may exist,” they noted.
Time for consumers
NutraIngredients’ special on inflammation will continue tomorrow with a look at consumers – do they understand inflammation, and is the market ready for anti-inflammatory products?