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It’s the inflammation, stupid

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Fat does not clog arteries, and heart disease — heart attacks, clots, strokes, etc — is a chronic inflammatory disease, mainly treated with exercise, avoiding junk food, and relaxing. See this controversial editorial from the British Journal of Sports Medicine about heart disease:

It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food. There is no business model or market to help spread this simple yet powerful intervention.”

Please also read these strong, credible criticisms of this BJSM editorial that go further than I would have expected. Regarding the author, who apparently has a huge bias I was not aware of:

Malhotra, who maintains a high profile on media sites and television, has long advocated for high-fat diets, and he has blamed the rise of obesity and other health problems solely on sugar and processed foods. He has written scores of editorials and recently produced a documentary on the matter. Last year, Malhotra drew intense backlash from health experts after co-writing a report that encouraged people with type II diabetes and obesity to fight their diseases by eating more fat and ditching efforts to keep track of calories.

Regardless, it’s mostly the claims about saturated fat that are problematic. My focus was on the inflammatory etiology, because it is probably also a factor in chronic pain and vulnerability to overuse injuries like tendinitis or runner’s knee.

Also take note: this is mainstream medicine here, strongly emphasizing the value of diet, exercise, and stress reduction, defying the cynical stereotype.

Read more here on about chronic inflammation and the morbidly fascinating concept of “inflammaging”: Chronic, Subtle, Systemic Inflammation.

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