Inflammation is the body’s natural response to injury and infection. However, when inflammation persists, known as chronic inflammation, it can cause damage to healthy cells, impact brain health and healing

In fact, chronic inflammation has been implicated in a whole host of diseases including ischemic heart disease, stroke, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease (NAFLD) and autoimmune and neurodegenerative conditions. Chronic inflammation has also been implicated in stroke recurrence and poorer stroke outcomes.

Fortunately, there are behaviors and lifestyle factors that can decrease chronic inflammation. In this article, you will learn the benefits and harms of inflammation, factors that contribute to chronic inflammation, and strategies to reduce inflammation and improve brain health and healing.

What is acute inflammation?

Acute inflammation is a necessary immune response to fight anything that is harming the body like infections, injuries, or toxins/pollutants.

When a cell in the body is under attack, that cell will release chemicals (called pro-inflammatory cytokines) that will activate the immune system to deploy immune cells.

Immune cells (also known as white blood cells) are released from the blood vessel and attack whatever is causing the problem, clean up any debris, and leave the area. But unfortunately, too much of a good thing is not good.

What is chronic inflammation?

Chronic inflammation occurs when immune cells “outstay their welcome” and continue to attack even after the “threat” has been removed. When this occurs, the tissue will recognize this as “bad” and will release more pro-inflammatory cytokines.  This further activates the immune system to deploy more immune cells and hence we have a downward spiral toward tissue destruction and disease.

How does chronic inflammation impact your health?

If this feedback loop occurs in the blood vessels it can lead to atherosclerosis. Immune cells in the joints lead to cartilage breakdown (aka arthritis). Too much in the stomach results in irritable bowel syndrome. And if immune cells are allowed to linger in the lungs, the result is chronic obstructive pulmonary disease (COPD).

And of course, chronic inflammation can also occur in the brain contributing to diseases such as Alzheimer disease, Parkinson disease, multiple sclerosis, and ALS.

As stated earlier chronic inflammation can also increase the risk of stroke recurrence and lead to poorer stroke outcomes.

However, when it comes to the brain, the mechanisms might be slightly different. To understand this, it is best to first get a better understanding of the brain’s own built-in immune system

The Brain’s Immune System

The central nervous system (brain and spinal cord) has it’s own built-in immune system via cells called microglia. Microglia keep the brain “clean” by removing plaques, damaged nerve cells, and infectious agents. Given that nerve cells have a pretty important job, microglia are extremely sensitive and respond quickly when a “problem” occurs.

In addition to a “specialized” immune system, the brain has added protection from “threat” via the blood-brain barrier (BBB). This is an important structure that if compromised, can make the central nervous system more vulnerable to infection, injury, and/or nerve cell degradation.

How does chronic inflammation impact brain healing after a stroke?

Now that we have a good lay of the land as far as the brain’s built-in immune system and the BBB, let’s talk about how this all impacts the brain following an injury (ie: stroke).

As a review, when an ischemic stroke occurs, blood flow is cut off and the nerve cells are deprived of oxygen. The lack of oxygen activates the microglia to jump into action deploying immune cells to the injured area. The deployment of these immune cells set into motion a variety of events that cause the breakdown of the blood-brain barrier. Unfortunately, degradation of the blood-brain barrier allows immune cells from the body to enter. This sets off another cascade of events which ultimately results in further degradation of healthy tissue. This is one theory behind some post-stroke symptoms including brain fog, fatigue, and cognitive deficits that develop months or even years after injury.

I hope by now, it goes without saying that reducing the risk factors that contribute to chronic inflammation might be a key ingredient to improving recovery following a stroke, brain injury, or concussion.

What are the signs of chronic inflammation?

• Insulin resistance
• Persisting and/or recurring infections
• Chronic pain
• Dyslipidemia meaning too much bad cholesterol and not enough good cholesterol
• High blood pressure
• Visceral fat
• Fatigue
• Recurrent, nonhealing wounds

What causes chronic inflammation?

• Exposure to environmental toxins
• Poor sleep (less than 7 hrs in a 24 hr period)
• Chronic Dehydration
• Ultra-processed foods
• Sedentary lifestyle – sitting more than 6 of the waking hours

How do you minimize or reduce chronic inflammation?

• Get 7-9 hour of sleep per night
• Practice mindfulness
• Decrease exposure to toxins (household cleaners, plug-in air fresheners, cigarette smoke)
• Avoid alcohol
• Drink 4-6 glasses of water per day
• Eat nutrient dense minimally processed foods
• Participate in moderate-intensity exercise 150 min/week

Remember, nothing in life is easy. And that includes changing a behavior that you might have had for your entire life. Slow and steady wins the race and small wins are still wins. Start today. Your future self will be glad you did.

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