Speaker 1

From cancer to cardiovascular disease, neurodegenerative disorders, musculoskeletal conditions, metabolic disorders, and the list goes on and on.

Speaker 2

And rates of these diseases are only set to increase, which is why this relatively new field of science could hold the key to helping us all live longer and crucially healthier lives.

Speaker 1

So as we get older, many doctors will tell you you should slow down because they're swearing tear. What we want is actually quite the opposite.

Speaker 2

So what do we need to know about the causes of chronic inflammation? And how can we reduce and even reverse its impact? I'm the Guardian Science Editor Ian Sample, and this is Science Weekly.

Speaker 1

So as we get older, many doctors will tell you you should slow down because they're swearing tear. What we want is actually quite the opposite.

Speaker 2

So what do we need to know about the causes of chronic inflammation? And how can we reduce and even reverse its impact? I'm the Guardian Science Editor Ian Sample, and this is Science Weekly.

Speaker 1

Yeah, near to the church and the countryside. It's beautiful, but sometimes...

Speaker 3

It sounds wonderful!

Speaker 2

Dr David Ferman is Director of the 1000 Immunomes Project at Stanford University School of Medicine, and an Associate Professor at the Buck Institute for Research on Aging. But when we spoke, he was in sunny France. Are you working in France at the moment, or are you on holiday?

Speaker 1

I don't really know the distinction between the two. I live in a very pleasant environment in By the Beach in San Francisco. For me, that's a year-round vacation, but I work every day. This is no different from that. We're enjoying the South of France, and I'm working remotely. I have two groups, and I have two startup companies. I'm also a founder of the National Inflammaging Institute. So a lot of things going on. I can't stop working. I can't afford that.

Speaker 2

It's safe to say. He's been pretty busy.

Speaker 1

The inflammatory response is a mechanism for the body to react to foreign entities, and namely infections. It really helps the whole immune system to react to foreign bodies and clear up those infectious agents. And in a normal setting, that should go back to baseline in about, say, three to seven days.

Speaker 2

Okay, so that's acute inflammation. But you're focused on something different. So tell me about that and what it might be doing to us.

Speaker 1

The inflammation that I am mostly focused on is rather the age-associated inflammation, which is sustained over time. It causes collateral damage in tissues and organs, increasing the likelihood of developing the most nasty, very feared diseases of aging. We're talking about cardiovascular disease. So high levels of systemic chronic inflammation increases the risk of heart attack, metabolic disorders that include type two diabetes and metabolic syndrome, musculoskeletal conditions, namely bone joint ailments. We have osteoporosis. It's largely driven by systemic chronic inflammation. Cancer. So cancer cells, they need inflammation to actually replicate and metastasize.

Speaker 2

So clearly the science is suggesting this chronic inflammation is playing a really significant role in our overall health. And we'd expect to see a degree of increased inflammation as we age, wouldn't we? So is inflammation accelerating the aging process in our bodies?

Speaker 1

That's exactly right. It defines rates of aging in different organs. This idea was put forward by Claudia Franceschi in the University of Bologna in early 2000. Before then, we had no clue that inflammation leads the way in defining rates of aging and increasing likelihood of diseases. This is a rather new field.

Speaker 2

So should I think of that chronic inflammation as a sort of low grade but heightened response that's ongoing from the immune system? And if I've got that right, what is the mechanism? What's it actually doing to our organs and tissues?

Speaker 1

The definition is correct. It's typically low grade. This means that it's not like the acute response where the biomarkers increase significantly in the tissue, but rather this is a very mild increase but sustained elevation in some of the biomarkers or the leading proteins that increase in its expression in blood.

Speaker 2

Are there triggers in adulthood, can factors in childhood matter too?

Speaker 1

The bottom line, what we're experiencing here is a distance from our evolutionary experience. We have evolved in a very particular environment. Now any species that you move to a new environment by definition will develop inflammation, and that's exactly the case of humans as well. There are a number of chronic stressors that will ultimately cause systemic chronic inflammation in the body because the mechanisms that we have to cope with inflammation and to bring it back to baseline are not in place because of this sustained chronic social stress.

Speaker 1

So the list is also very long. I can give you a few examples here of social stressors. The fact that we're comparing ourselves with all these influencers and rock stars and people want to be as famous as those individuals, this is a level of chronic stress that you're comparing yourself with someone you'll never be able to be. We're also exposed to a very high load of our work times, right? So now we're going to occupational stress. There are very good papers, examples of experiments where we've seen caregivers of cancer patients, which are a really good example of social stress, because they're taking care of a cancer patient is not an easy task. And we've seen that in cells from these individuals, there's major inflammatory biomarkers very high. When you try to bring that inflammatory response down with, say, classical drugs, you cannot. So this is a classical example where you have a social stressor, you're basically feeling psychologically stressed, and the consequences for the body in terms of systemic chronic inflammation are very clear and very detrimental.

Speaker 2

You tend to see different levels of systemic chronic inflammation across the classic divides we see in sort of inequality. Is there more chronic inflammation among people in poverty, among people with lower socioeconomic status, for example?

Speaker 2

You tend to see different levels of systemic chronic inflammation across the classic divides we see in sort of inequality. Is there more chronic inflammation among people in poverty, among people with lower socioeconomic status, for example?

Speaker 1

Great call. Not just low socioeconomic status, but discrimination, inequality. This is very clear. We've seen a number of reports where, for example, in the U.S., African-American communities have a much higher level of systemic chronic inflammation that co-occasions do, for example, or Latinos. It's very clear how they're in the similar, say, socioeconomic status. Even then, because there is inequality given by ethnicity and other aspects of this, they are more exposed to systemic chronic inflammation. They're chronically stressed, and that increases the likelihood of developing the diseases that we mentioned, and that's how we explain the epidemiologic

Speaker 2

David, I want to get on to sort of what we might be able to do about this, but first of all, are there tests that can detect whether people have systemic chronic inflammation and whether it's at a problematic level? I presume we all have it to some extent.

Speaker 1

In the U.S., across the populations that we've studied, around 80% of people over 40 years old are inflamed. We can measure those responses by taking a blood sample and running that blood sample through a battery of tests that we identified using the Stanford 1000 Immunomes Project. So, can we measure systemic chronic inflammation? Yes, we can measure this and it's a relatively new test that will probably be in the marketplace in six months to a year from now.

Speaker 2

David, a lot of the sort of driving forces for this chronic inflammation that you've talked about really feel like they're products of industrialization, in a sense. And I wondered if, given that we're probably not going to reverse industrialization, urbanization, and what have you, what are the options out there? Are there treatments?

Speaker 1

There are really three major aspects. One is protecting ourselves from the exposure. The second is challenge ourselves. And the third one is repair. So, starting from protection, we have a long list of things I mentioned, maybe cutting on dairy products, on flour and other wheat-derived products, be protected from pesticides, try to eat as much organic food as possible. Fish is, in particular, rich for omega-3 polyunsaturated fatty acids, and these have anti-inflammatory effects.

Speaker 1

Challenge basically refers to a number of interventions that will challenge your body mentally and physically. So, as we get older, many doctors will tell you, you know, you should slow down because there's wear and tear. What we want is actually quite the opposite. You need muscle mass. Muscles are anti-inflammatory organs that produce more than 300 anti-inflammatory peptides. You want to have muscle mass as we grow old, as much as possible. And then also when you compress your bones by having walking every day or even like jogging, you will be creating more bone, and that's what we want as we get older. Intermittent fasting is the best example of challenge. You're challenging your body, triggering an evolutionary conserving response that is largely anti-inflammatory, and we have notable effects, including extension of lifespan and health span in model organisms.

Speaker 2

And the repair side of things, it's not involving things like sleep.

Speaker 1

That's a glad... Yes, I was going to say. So, mastering sleep hygiene, we know very clearly that the effect of electrical light, and in particular, the blue spectrum, will be interpreted by the body as we're starting the day, right?

Speaker 1

That's a glad... Yes, I was going to say. So, mastering sleep hygiene, we know very clearly that the effect of electrical light, and in particular, the blue spectrum, will be interpreted by the body as we're starting the day, right? And starting the day means there's a number of hormonal changes that go with it. Cortisol is the best example of it. So, decreasing electrical light exposure at night, we've seen in a number of papers that meditation lowers systemic chronic inflammation and prepares the body for a good quality sleep. So, maybe half an hour, 20 minutes of meditation prior to sleep, seems to be beneficial.

Speaker 2

David, it seems like there are actually quite a few things people can do, quite a few steps they can take to try and keep this kind of chronic inflammation in check. But it makes me wonder whether doctors and the health systems that they work in really embrace this. Is this sort of knowledge and advice embedded in medicine already? Not yet.

Speaker 1

And this is a really good point. They must catch up, right? There's typically about 15 to 20 years lag from discovery in the academic setting until it reaches the public. The other large effort that we have been now focusing on is the National Inflammaging Institute, which has that mission to disseminate this knowledge

Speaker 2

David, it seems like there are actually quite a few things people can do, quite a few steps they can take to try and keep this kind of chronic inflammation in check. But it makes me wonder whether doctors and the health systems that they work in really embrace this. Is this sort of knowledge and advice embedded in medicine already? Not yet.

Speaker 1

And this is a really good point. They must catch up, right? There's typically about 15 to 20 years lag from discovery in the academic setting until it reaches the public. The other large effort that we have been now focusing on is the National Inflammaging Institute, which has that mission to disseminate this knowledge and make it available to the masses, to the public, including obviously healthcare providers, and be able to lower systemic chronic inflammation in the population around the world, hopefully.

Speaker 2

David, it's great to have you on. Thanks so much.

Speaker 1

Thank you so much, Ian.

Speaker 2

Thank you for having me. Thanks again to Dr. David Furman. Before you go, you need to know about Guardian Jobs, our job platform that connects you with like-minded people to build rewarding careers.