Inflammation is a big problem. New book ‘Inflamed’ explains why we need big solutions

On nutrition

The notion of food as medicine is popular, but while nutritious foods have a positive effect on health, “healthy” eating is not the cure for everything that afflicts us. Many other factors influence health, including genetics (our genes) and epigenetics (how these genes are programmed), as well as social and environmental factors such as stress, racism, climate change and forest fires.

One of the ways these factors affect health is by contributing to chronic inflammation, which in turn contributes to heart disease, diabetes, cancer, and other chronic diseases. Although anti-inflammatory diets are popular – indeed, I wrote about them more than once – when we treat inflammation as an individual problem with an individual solution, are we ignoring its true root causes? In their new book, “Inflamed: Deep Medicine and the Anatomy of Injustice,” Rupa Marya, MD, and Raj Patel, PhD, say that we are doing just that – and that the consequences of this narrow view are serious.

In this gripping and deeply researched book, Marya and Patel explore what inflammation is, how it affects our bodies and health, and what is really fanning its flames. They convincingly argue that while individuals may suffer from chronic inflammation, our individual bodies are part of an inflamed society (due to systemic racism and global capitalism) and a planet on fire (due to climate change) – and which we cannot separate from each other.

“What we are examining in this book is to transform our understanding of what health is and to shift the pursuit of health from the individualistic model to what we call profound medicine, which situates medicine and health as a practice. community engagement and [social and environmental] care and repair, ”said Marya, associate professor of medicine and hospital physician at the University of California, San Francisco. She said if medicine continues to focus on the individual, we will never understand why the rates of diabetes, nonalcoholic fatty liver disease, and inflammatory disease are increasing.

Each chapter explores the effects of inflammation on a bodily system – starting with the immune system and ending with the nervous system – and links them to rooted causes in our social, political and environmental systems. These include trauma, pollution, industrial agriculture, dependence on fossil fuels, debt, income disparities, loss of biodiversity, climate change, gender-based violence, racism, social isolation and stress. And the interface between our body and the world around us? Our intestinal microbiota, whose health and diversity are closely related to the health of our immune system and our levels of inflammation.

“It’s all recorded in our intestines,” Marya said. “Our mental health, our immunity, our ability to stay healthy depend on these ecologies inside of us. And it’s not about taking more pills, it’s about stopping the stress that strips our microbiota.

The book’s approach falls short of those who argue that if you follow the “right” diet and exercise plan, you will enjoy perfect health. Rather, it destroys the myths that good health is equally accessible to everyone and that poor health is a mark of personal failure or weakness. Marya and Patel say the increase in inflammatory disease is the body’s natural response to a pathological world, and the underlying issues cannot be resolved by buying organic food, downloading meditation apps – or uploading to probiotics.

In fact, Patel, a public affairs research professor and professor of nutrition at the University of Texas at Austin, said viewing health as a personal responsibility does blame the victim. “You’re trying to fight the extinction of the world around us by taking a probiotic or two and that’s not how you stop the extinction. There is no pill for that, ”he said. “If we really want to live with rich anti-inflammatory microbiomes, we can’t get out of a social problem. If the problem is systemic, the solution must also be systemic, and that is what deep medicine offers.

Patel said that when someone sees health as an individual pursuit, they separate themselves from the rest of the planet, in a sense. “By taking an individualistic path and trying to escape the type of extinction that we find ourselves in, you are actually delaying the kinds of appropriate solutions,” he said.

To trace the path of our collective inflammation, Marya and Patel go back 600 years to the beginnings of European colonization – including the destruction of indigenous communities – and explore the all-too-real modern manifestations, including civil unrest, the wildfires that ravage the western United States and COVID-19. It is no coincidence that the presence of chronic inflammation is what can turn a mild course of COVID-19 into a fatal one. So, is nutrition important when it comes to calming inflammation and protecting health? Yes, but it’s not that simple.

“As a physician, I always advise my patients as individuals to eat a nutritious diet and try to educate them on the benefits of eating organic and avoiding the food chemicals so ubiquitous in our food system,” but a lot of people can’t afford to do it, ”said Marya. “Part of the joy of deep medicine is starting to develop our connections with communities fighting for the right to be healthy, and a lot of it is fighting for the right to a healthy food system.”

She said we can’t be healthy if others are suffering, and the delta variant of COVID demonstrates that – we can’t vaccinate our way out of the pandemic when the vaccine isn’t available everywhere, because new variations will simply continue to emerge. “We have to stand up and realize that no one is healthy until everyone is healthy,” she said. “It’s really part of what I would call our book’s manifesto – re-conceptualizing health as a species and also as an entity on this planet.”