DELICIOUS: A diet rich in fresh plant-based produce and marine omega-3s can help reduce inflammation. The results of the international 2017 Cantos study, which looked at the link between inflammation and cardiovascular disease, has had cardiologists around the world talking.

Conducted in over 40 countries, the study tested whether decreasing inflammation would reduce risk of cardiovascular-related death in patients with a heart attack history.

Over 10,000 men and women participated in the study, the mean patient age being 61. Every participant had elevatedCRP, an inflammatory marker determined by a blood test.

The Cantos study found that Canakinumab – an anti-inflammatory medicationcurrently approvedonly for use in the US and Europe for certain rare inflammatorydisorders-was more effective than a placebo for preventing future cardiovascular events, including cardiovascular death from a heart attack or stroke.

“This really proved the inflammation hypothesis,”SydneyCardiologist Associate Professor Edward Barin said.“For the first timeresearchersdid something [to address] inflammationdirectlyand [in turn] reduced heart disease.” The effect was unrelated to changes inserum cholesterol levels.

“Thistreatmentconcept [is currently] just based on one trial, but the datalinking heart disease risk to inflammation has been there forsome time,” he said. Barin referred to a number of statin trialsincluding the Jupiter, Prove-it, and Reversal trials,which linkedreduced risk of cardiovascular eventsto reduced levels of theinflammatory markerCRP.

“We are beginning to think of heart disease as being an inflamed condition.But inflammation is not asnovel anideaas it would seem. Type 2 diabetes for example is a classic inflamed condition. If you measure inflammatory parameters, you pick up a lot of clues that the body is inflamed,” he said. Forty per cent of Cantos study participants had diabetes.

“Inflammatory autoimmune diseases like rheumatoid arthritis and psoriasisalsoincreasetherisk of cardiovascular disease, that’s now well recognised.”

What is inflammation?Inflammation can be the result of unnecessary oxidation in the body, Barin said. “Inflammation damages the endothelium (cells lining the interior surface of blood vessels and lymphatic vessels), which can result in particular damage by cells such as oxidised macrophages,” white blood cells that form part of the immune system. “All this misbehaviourcanbe detected and measured in the blood,” he said.

“The final result of inflammation is that it activates the immune response inappropriately, and the body becomes ill and difficult to repair. So [it might be that] the inflammationcascadethat causes disease is an out-of-control mechanism.”

What can be done to reduce inflammation?“People who have a lot of body fat have been shown to have a lot of raised inflammatory markers, but inflammation is not [only due to] weight,”Barin said.

“Dietis more than justreducing cholesterol and calories. This hasn’t been proven yet, a host of nutritional studiessuggest thatwe need to start thinking about implementing Mediterranean-style anti-inflammatory diets.”

A diet high in meat, alcohol and sugar, and omega-6 rich seed-based diets willpromoteinflammation, whereas a diet rich in freshplant-basedproduce and marine omega-3s can have the opposite effect, Barin said.

“Poor sleep hygiene is linked with increased inflammation markers, so is mental stress,” he said.

“Talk to your doctor about inflammation becauseit can be a strong pointer toheart diseaseand stroke.Treating ithas now been provenbeneficialand we shoulddirect effort to reducing inflammation in a more holistic way.”

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