Like obesity, inflammation has been identified as a common contributing factor to many chronic diseases. But how are the two interconnected? Adipose tissue, or fat cells, are an active endocrine organ which modulates and synthesizes hormones and various metabolites. These processes are amplified when obesity is present (Lee et al 2013). Some of the metabolites secreted by adipose tissue include cytokines and chemokines, which have been identified as pro-inflammatory and may contribute to chronic conditions such as heart disease and diabetes (Hajer et al 2008). The consistent elevated levels of pro-inflammatory cytokines have been seen in obesity, leading to the chronic condition of low-grade inflammation (Gregor & Hotamisligil 2011). The two disease states have been proposed to play off each other where obesity leads to inflammation and inflammation leads to symptoms that may trigger greater weight gain. Is it a never ending cycle? Or is there something to be done about it?
First, what exactly is inflammation? Inflammation occurs when the immune system responds to an irritant within the body. Inflammation is often associated with redness, heat, swelling, pain, and loss of function and becomes activated as the population of white blood cells and other metabolites increase within the blood to protect the body (Cleveland Clinic). With obesity, low-grade inflammation is sustained at a chronic state. This puts stress on metabolic tissues because the sympathetic nervous system, or fight or flight response, is constantly active. This sympathetic overactivity may also contribute to increased blood pressure, insulin insensitivity, and chronic diseases like heart failure (Smith & Minson 2012). It is known that stress itself is related to obesity and eating behaviors. Associations have been found between stress, BMI, weight, and adiposity, as well as blood sugar, insulin, and insulin response. Individuals with obesity may also be more sensitive to stress potentially leading to greater systemic inflammation (Agustí et al 2018).
Another condition that may be associated with both obesity and inflammation is rheumatoid arthritis or RA. RA is an autoimmune and inflammatory disease where the immune system attacks healthy cells within the joints causing them to become inflamed and leading to tissue damage. Symptoms of RA include pain, aching, tenderness, or stiffness in more than one joint, overall weakness, and fatigue. The exact cause of the disease is unknown, however, obesity is a common risk factor among individuals diagnosed. In fact, those with RA and obesity often have greater difficulty with movement and joint function and experience increased pain sooner than people with RA who have a healthier weight (Baker et al 2018). Yet, it is known that maintaining a healthy weight is an effective management strategy of RA and associated symptoms (CDC).
So what can be done? Obesity, inflammation, and RA are all interconnected, but may potentially be managed the same way. One action is to increase anti-inflammatory foods and nutrients in day to day eating. This may be done by following an anti-inflammatory eating plan including greater intakes of fruits, vegetables, whole grains, nuts and seeds, and legumes within the diet. Some highlights of the foods to add include:
- Berries such as raspberries and blackberries contain polyphenols, which give them their bright colors and modulate inflammatory status within the body (Joseph et al 2014).
- Whole grains including whole-wheat, oats, quinoa, brown rice, and barley may reduce systemic inflammation by reducing inflammatory markers throughout the body (Xu et al 2018).
- Nuts and seeds like walnuts, flax seeds, pumpkin seeds, and peanuts contain omega-3 fatty acids, which have been shown to reduce inflammation by reducing the substances and molecules within the body that spark inflammation (Calder 2010).
Consuming adequate lean protein and healthy fats including omega-3 fatty acids also align with the anti-inflammatory nutrients. Additionally, research shows that increasing your daily protein intake is useful for lowering body weight. The high intake of protein contributes to a sense of fullness after eating, a term deemed satiety (Veldhorst et al 2008). Anti-inflammatory eating has been shown to be beneficial in weight and inflammation reduction although research is promising but limited at this time (Harvard School of Public Health).
HealthWise products can be of great assistance for those struggling with inflammation seen in conditions like RA and its associated signs and symptoms. Not only are the shakes, smoothies, and meal replacements a great source of protein, but fruits and vegetables can be added to these products, which contain antioxidants. An example is adding berries and spinach to HealthWise’s High Protein Wild Berry Splash Shake to assist with inflammation reduction. Similarly, additional protein and fiber can be added to HealthWise soups by including extra vegetables, beans, lentils, or whole grains like quinoa or farro to continue to decrease inflammation throughout the body. The additional protein will also assist with weight loss, which may also potentially lead to a decrease in inflammatory signs and symptoms.
Overall, decreasing inflammation can help minimize the signs and symptoms of rheumatoid arthritis and promote weight loss for those struggling with obesity. Inflammation can be lessened by adding in anti-inflammatory foods and daily movement. HealthWise products are a great way to help increase anti-inflammatory foods eaten and assist in combating the interplay between inflammation, obesity, and other chronic conditions like rheumatoid arthritis.
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Centers for Disease Control and Prevention – Rheumatoid Arthritis – https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html. July 27th, 2020.
Cleveland Clinic – Inflammation – https://my.clevelandclinic.org/health/symptoms/21660-inflammation. July 28th, 2021.
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By Katie Chapmon, MS, RD
About the Author:
Katie Chapmon, MS, RD is a Registered Dietitian Nutritionist specializing in Bariatric Nutrition, GI Issues and Hormonal Health and with 10+ years of hands-on clinical experience for leading medical providers. She is the proud recipient of the 2010 Recognized Young Dietitian of the Year Award and 2018 Excellence in Weight Management Practice Award through the Academy of Nutrition and Dietetics.
She spent the first decade of her career as the lead dietitian for Kaiser Permanente Southern California. For the past several years, she has been working with industry partners and consumers to improve nutrition education within the field and maintains a virtual private practice. In April 2021, she launched Bariatric Nutrition Pro – to provide healthcare practitioners education to start (or continue!) their bariatric career with the confidence and knowledge to succeed.
She is a past Chair of the American Society of Metabolic and Bariatric Surgery Integrated Health Clinical Issues Committee and Chapter author of the 3rd Edition of the Academy of Nutrition and Dietetics Pocket Guide to Bariatric Surgery. She is a national speaker and enjoys time hiking and cooking in the kitchen.