Sugar and chronic inflammation

There is a fair chance you have heard about inflammation and anti-inflammatory foods and drugs.

But what exactly is inflammation, and what has it to do with sugar?

Inflammation – friend or foe?

The inflammatory response is a normal activity for our immune system. In fact, we need it!

When injured or infected, the body’s immune system comes to our defense, bringing chemical messengers that act as a repair team, killing off pathogens causing infection, clearing out damaged tissue, and creating an environment that enables healing. This is the inflammatory response.

But on-going dietary and lifestyle factors can cause this defense mechanism to overstay its welcome or become dysfunctional and act inappropriately, leading to damage and disease of the body. This is not ideal, potentially resulting in a myriad of symptoms and disease, including but not limited to:^1-3

• Autoimmune diseases, such as rheumatoid arthritis
• Respiratory diseases, such as asthma
• Cardiovascular diseases
• Functional disorders, such as inflammatory bowel disease
• Mood and mental disorders, such as depression
• Allergic disorder
• Type 2 diabetes
• Cancers

Many factors influence the inflammatory response, including lack of sleep and exercise, poor health of the gut microbiome, excess weight, and persistent stress and exposure to toxins, pollutants and some medications.^1;4 What we eat and drink also plays a significant role, including (surprise!) excess intake of added sugar.

Added sugar and inflammation

Consuming high amounts of added or free sugar persistently and consistently affects the body in several ways that contribute to on-going low-grade inflammation.

These can include and tie into factors mentioned above, such as the impact a high-added sugar diet has on the gut microbiome and contributing to excess weight, as well as other factors, such as the presence of high levels of advanced glycation end-products (AGEs) in the body. 

AGEs can be present in certain foods that are heavily processed and/or cooked at high temperatures. When consumed in excess, these compounds can trigger an inflammatory response.^5-7 They can also be formed in the body, and are more likely to do so and lead to an inflammatory response when blood sugar levels are high, combining with fats or proteins in the blood in a process called glycation.⁸

Then there is the more immediate response following a big hit of free or added sugars. This causes a sudden spike in blood glucose levels, as well as a dramatic drop that follows, activating the systemic stress response.^1;9-10 This triggers a spike in the inflammatory response, which is normal but not great on-going. 

So, there are several ways connecting the excess consumption of the sweet stuff and increased inflammation.

What to do

While added sugars aren’t the sole cause of chronic inflammation in the body, a low sugar diet is an easily modifiable dietary and lifestyle factor to help you lower inflammation. For example, one can of soft drink has been found to increase inflammatory markers in the blood, so the first thing you can do to tackle unnecessary levels of inflammation in the body is kicking that sugary drink!¹¹

On the flip-side, certain whole foods contain compounds considered to be anti-inflammatory.¹² For example, leafy greens provide antioxidants and anti-inflammatory flavonoids, and the intake of high fibre food is correlated with lowered inflammation.

Here are some everyday dietary considerations to discourage chronic inflammation:

Limit

• Added and free sugars
• Sugar-sweetened beverages
• Refined carbohydrate-rich foods
• Heavily processed foods, such as confectionery, refined oils, processed meats and deep-fried stuff

Enjoy 

• Brightly coloured whole veg and fruit
• Omega-3 rich oils from oily fish, walnuts, flaxseed, chia and hemp seed
• Leafy greens, such as spinach, rocket and kale
• Spices and herbs, such as ginger, turmeric and parsley
• High fibre foods, such as whole veg, fruit, legumes and seeds.

Other factors to consider to help manage persistent inflammation include drinking plenty of water, getting regular exercise, and undertaking some de-stressing activities to manage chronic stress.

So, if you needed a little more motivation to kick the sweet stuff, lowering chronic inflammation may be it!

By Angela Johnson (BHSc Nut Med)

References

1. Bosma-den Boer, MM, van Wetten, M, & Pruimboom, L (2012), Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & Metabolism. 9(32). https://doi.org/10.1186/1743-7075-9-32
2. Galli SJ, Tsai M, Piliponsky AM (2008) The development of allergic inflammation. Nature, 454(7203), 445-454. https://doi:10.1038/nature07204
3. Kolb, H. & Mandrup-Poulsen, T. (2010) The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation. Diabetologia, 53(10). https://doi.org/10.1007/s00125-009-1573-7
4. Nat Immunol (2017). A current view on inflammation. Nature Immunology, 18(825). https://doi.org/10.1038/ni.3798 [No authors listed].
5. Aragno, M & Mastrocola, R (2017). Dietary Sugars and Endogenous Formation of Advanced Glycation Endproducts: Emerging Mechanisms of Disease. Nutrients, 9(4). https://doi.org/10.3390/nu9040385
6. Van der Lugt, T (2018). Dietary Advanced Glycation Endproducts Induce an Inflammatory Response in Human Macrophages in Vitro. Nutrients, 10(12). http://doi.org/10.3390/nu10121868
7. Uribarri, J., et al. (2007). Circulating glycotoxins and dietary advanced glycation endproducts: two links to inflammatory response, oxidative stress, and aging. The Journals of Gerontology. Series A, 62(4), 427–433. https://doi.org/10.1093/gerona/62.4.427
8. Barone, J (2017). The ABCs of AGEs (Advanced Glycation End-Products), Berkeley Wellness, viewed 13 November 2019, <https://www.berkeleywellness.com/healthy-eating/food-safety/article/abcs-ages-advanced-glycation-end-products>
9. Dickinson, S. et al. (2008) High–glycemic index carbohydrate increases nuclear factor-κB activation in mononuclear cells of young, lean healthy subjects. The American Journal of Clinical Nutrition, 87(5). https://doi.org/10.1093/ajcn/87.5.1188
10. Jameel, F., et al. (2014). Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation. Lipids in Health and Disease, 13(195). https://doi.org/10.1186/1476-511X-13-195
11. Aeberli. I., et al. (2011). Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. American Journal of Clinical Nutrition, 94(2), 479-85. https://doi.org/ 10.3945/ajcn.111.013540
12. Minihane, A. M., et al. (2015). Low-grade inflammation, diet composition and health: current research evidence and its translation. The British Journal of Nutrition, 114(7), 999–1012. https://doi.org/10.1017/S0007114515002093