Inflammation and its Relation to Psychoneuroimmunology

An important part of the body’s immune response is inflammation, especially during acute trauma.  The inflammatory response during acute trauma helps to decrease the injury and maintain homeostasis. This might surprise some individuals who believe that inflammation is a bad sign.  For example, when an injury happens, like a twisted ankle, and inflammation occurs, most people will spring into action by applying the RICE rules hoping to reduce or eliminate inflammation.  RICE stands for rest, ice, compress and elevate. According to Patton and Thibodeau (2014), when tissue cells are damaged they release inflammation mediators. Thanks to some of theses inflammation mediators, the redness and warmth felt when inflammation occurs is due to blood vessels widening and blood flow increasing.  This important step allows white blood cells, known as immune system cells to travel quickly to the injured area.  In acute situations, inflammation can be a blessing but when an individual has chronic inflammation it can have detrimental effects on health and wellness.  This brings me to the discussion of the role of Psychoneuroimmunology in health as described in the clinical paper “Stress, Food, and Inflammation:  Psychoneuroimmunology and Nutrition at the Cutting Edge” (Kiecolt-Glaser, 2010).  According to the Dictionary, Psychoneuroimmunology is defined as “the study of the effects of psychological factors on the immune system.”   The clinical paper points out a few serious illnesses that account for 70% of all deaths in America.  They are diabetes, cardiovascular disease, and cancer.  Their common link is inflammation.  Chronic inflammation can also be linked to diet, lifestyle choices, and stress.   Let us take a step back and look at where inflammation might be coming from when not caused by acute trauma and see how it relates to psychoneuroimmunology.

Studies show that diet influences inflammation.  Foods that an individual chooses to eat can cause health or harm, and to make it even more confusing, not all food reacts the same with every person.  This has been described well by a popular phrase thought to be first written by the Roman poet Lucretius, “one man’s meat is another man’s poison.”  However, there are a few food items that are known to promote inflammation no matter who you are.  These inflammatory foods are refined starches, sugars, saturated fats, and trans fat.  Many of these items can be found in the standard American diet (SAD), which includes processed and pre-packaged items.  This SAD diet is also known as the “Westernized” diet.  Some important items this diet is missing are omega-3 fatty acids, antioxidants, fresh fruit which contains fiber, vegetables, and whole grains.  Antioxidants in fruits and vegetables have been linked to lower oxidative stress.  Meals high in antioxidants may have an anti-inflammatory effect even when consuming foods high in saturated fats.

Research shows a connection between inflammation and depression, suggesting that high inflammatory diets could aggravate depressive symptoms which can create more inflammation.  It’s also been suggested that healthy diets like the Mediterranean diet which includes healthy fat like avocado and olive oil, vegetables, fish, and whole grains work to reduce inflammation and can be protective against depression.  So, which came first, the chicken or the egg?  A SAD diet increases inflammation which promotes depression.  Depression may cause individuals to not care about healthy eating and lifestyle factors which in turn leads to the SAD diet promoting inflammation.  This is a perfect example of the role of Psychoneuroimmunology in health. Depression can stem from various social factors like having less money than your neighbor, allowing the bad news on social media or TV to get you down, or dealing with past or present trauma.   These are psychosocial stressors, relating to social factors, thoughts, and feelings.

Once stress kicks in, it can interfere with important health behaviors.  One has already been mentioned, food choices.  Another important health behavior affected by stress is sleep.  Many individuals who have negative emotions and/or emotional stressors end up having disturbed sleep patterns.  These disturbed sleep patterns trigger interleukin 6 (IL-6) which is a pro-inflammatory cytokine.  IL-6 thinks it’s doing its job, helping the body out, but it’s not.  Instead, it’s triggering more inflammation due to the stress that is being put on the body thanks to lack of sleep.  Other lifestyle stressors that contribute to chronic inflammation are caring for a family member with dementia or caring for a chronically ill child.  These lifestyle factors are associated with higher oxidative stress and increased pro-inflammatory cytokine production.   If an individual is in one of the situations above, they can’t just stop caring because they are too stressed.  Luckily there are dietary and lifestyle influences that can help.

A number of studies have shown that increased fish consumption equals lower episodes of clinical depression.  This may be due to increasing omega 3 (n-3) consumption which has been shown to curb depression. N-3 is found in fatty fish like salmon, herring, sardines, and mackerel. N-3 can also be found in supplements, walnuts, chia seeds, and flaxseeds either in oil or ground form.  N-3 is helpful in counteracting the inflammatory response of high fat.  This is helpful because high-fat meals can trigger low-grade endotoxemia, a rise in inflammatory antigens.  A good example regarding n-3 and Psychoneuroimmunology used in the clinical paper, “Stress, Food, and Inflammation” (Kiecolt-Glaser, 2010), was a study focusing on a group of medical students.  One group of students had n-3 serum levels that were low or they had a higher omega 6 (n-6) to n-3 ratio.  The other group of medical students had higher n-3.   The group with higher n-3 produced less pro-inflammatory cytokines during exams compared to the group with lower n-3.  This study suggests that diet (n-3 intake) can influence the level of pro-inflammatory response to stressful situations.  Along with diet, bringing in positive lifestyle factors like mediation, changing your perspective on stress, gentle exercise, journaling, intermittent fasting, and socializing with friends and family can also help ease stress and lessen pro-inflammatory responses.

To conclude, acute inflammation can work to help the body whereas chronic inflammation can harm.  Dietary factors have a great effect on health and the body’s inflammatory response.  Dietary factors can also be influenced by social factors that cause stress and depression.  Unfortunately, there appears to be a vicious circle at play.  When social stressors affect a person and they are feeling depressed, healthy food choices are not on the top of their list which leads to unhealthy food choices, inflammation, and illness. Luckily there are food and lifestyle options to help break this vicious cycle.  It is important when working on a client’s diet to also work on their behavior and visa versa. Diet and behavior go hand in hand.


References
Collins, W. (2012) Collins English Dictionary [Digital Edition] Retrieved from https://www.dictionary.com/browse/psychoneuroimmunology
Goehler, L., Lyte, M. & Gaykema, R. (2007). Infection-induced viscerosensory signals from the gut enhance anxiety: Implications for psychoneuroimmunology. Brain, Behavior, and Immunity. 21(6):721-726. doi: 10.1016/j.bbi.2007.02.005
Kiecolt-Glaser, J. (2010). Stress, food, and inflammation: Psychoneuroimmunology and nutrition at the cutting edge. Psychosomatic Medicine. 72(4):365-369. doi: 10.1097/ PSY.0b013e3181dbf489
Patton, K. & Thibodeau G.(2014). The Human Body In Health & Disease 6th Edition.Maryland Heights, MO: Mosby.

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