What social media gets wrong about inflammation

Inflammation is all over our feeds. Influencers claim it’s the reason you're bloated or fatigued, the source of digestive problems and the cause of more serious illnesses like Alzheimer's or cardiovascular disease. But how much of that is scientifically backed, and how viable are the solutions you see on social media? Short Wave talks to immunologist Shruti Naik https://naiklab.com/team/dr-shruti-naik/ to separate the health from the hype. Interested in more wellness science? Email us your question at [email protected] mailto:[email protected]. Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. This show’s perks include sponsor-free listening. Learn more at plus.npr.org http://plus.npr.org. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:22Speaker 01

  If you've been online lately, you probably noticed that health influencers can't stop talking about inflammation. According to the internet, it's the reason you're always sick, tired, or bloated.

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  Ever wondered why your face looks puffy, tired, or bloated, no matter what you do? It's not always fat. It's inflammation.

• 0:38Speaker 03

  You're not ugly. You just have inflammation that's trying to make you ugly because of pathogens and toxins. Inflammation is so common these days, but that doesn't mean it's normal.

• 0:47Speaker 01

  And it's not just online discourse. The Secretary of Health and Human Services, Robert F. Kennedy Jr., weighed in too.

• 0:54Speaker 04

  I'm looking at kids as I walk through the airports today, as I walk down the street, and I see these kids that are just overburdened with mitochondrial challenges, with inflammation.

• 1:06Speaker 01

  And while it might seem like inflammation is getting a bad rap, there is some truth to the hype.

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  Inflammation is at the heart of nearly every disease in the body. And more and more, we're realizing that even diseases like Alzheimer's, Parkinson's, cardiovascular disease, heart disease, of course, cancers, they all have a connection to inflammation.

• 1:29Speaker 01

  That's Trudy Nyack. She's a professor of immunology at the Icahn School of Medicine at Mount Sinai. Trudy says that not all inflammation is harmful. And in fact, it's sometimes necessary. Acute inflammation, or responsive inflammation, is key for your immune system.

• 1:47Speaker 05

  Now, when things will arise, when you have chronic inflammation, so long-lasting inflammation that never stops. Sometimes it's low-grade. Sometimes it's high-grade, and you have an inflammatory disease.

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  Chronic inflammation is this gray zone that sent the internet into a tailspin. And while influencers are quick to promote fat diets and supplements, Trudy believes we're misdiagnosing the problem and overstating the solution.

• 2:14Speaker 05

  Generally, if you have an inflammatory disease, it's not a failure of wellness. There are genetic components. There are environmental components, lifestyle components. So this narrative that everyone needs to wholesale stop inflammation is not good. You need the right response in the right place for the right amount of time. And when that gets out of balance, then you have a disease state. And if you have a disease state, it's not going to be your turmeric milk that's going to fix the issue.

• 2:43Speaker 01

  So today on the show, should you actually worry about your chronic inflammation levels? And can you even do anything about it? I'm Regina Barber, and you're listening to Short Wave, the science podcast from NPR.

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• 4:26Speaker 01

  OK, Trudy, I've been hearing a lot about inflammation. Has it come up in discussions with friends and family for you too? And like, what kind of things are people asking about?

• 4:37Speaker 05

  For sure. I think inflammation is sort of on everyone's mind because there's so much out there in social media about how seed oils and juice cleanses and turmeric, you know, all of these quote-unquote anti-inflammatory.

• 4:52Speaker 01

  Inflammatory diets.

• 4:54Speaker 05

  Exactly. And being an immunologist, my friends and family often come to me and say like, what should I do? Is this something that's going to help me? Is that something that's going to help me? And what I can say is really that a lot of the stuff that's out there are just like blanket claims, right? And what I mean by blanket claims are, they're in the media, and they're very nice little talking points, but none of them have really been tested. So it's sort of like, great, I can make a video and put it on Instagram that says, like, everyone should give up gluten. Gluten's bad. And in some cases, if you have celiac's disease or certain other conditions, it is bad. That is correct. But that doesn't mean that we need to wholesale

• 5:37Speaker 05

  give up pizza and, you know, and like delicious bread. So I think one thing that I tell my friends and family is someone may make a great video, but take a step back and say like, why are they saying that? Where's that coming from? What is the evidence?

• 5:55Speaker 01

  You talked about this chronic, low-level inflammation. Can you tell me what that is? And when does it occur?

• 6:02Speaker 05

  So chronic, low-level inflammation is something that we cannot see. It's low-grade accumulation of inflammatory proteins, inflammatory factors that may not lead to overt disease, but it is something that is actively affecting our health span. So how healthy we are, right? So that manifests in many, many different ways. We know that this is associated with these conditions. What we don't know is, how do we target it? How do we reverse it? And will that sort of make us maybe not live longer, but live healthier longer?

• 6:39Speaker 01

  Yeah, I want to live healthier longer. So how much of a factor is stress and other environmental risks in having chronic, low-level inflammation?

• 6:49Speaker 05

  Yeah, I mean, they're definitely factors. Stress can influence our hormonal system, and we know that hormones influence the immune system. In some cases, cortisol, and in some cases, other hormones. There's neurological factors. We also know now that the nervous system and the immune system actively talk to each other and actively influence each other. So there's evidence that if you're stressed, you're more susceptible to inflammatory diseases, et cetera. That being said, I want to go back and just give a little bit of caution to say like, we need evidence-based interventions.

• 7:25Speaker 01

  Yeah, it sounds like you're saying inflammation isn't necessarily the direct cause or effect. It's more part of this nervous system and immune system loop. Is that what makes it so hard to understand?

• 7:39Speaker 05

  Your immune system is everywhere. So unlike your heart or your liver, which stay in one place, your immune system is in every tissue in the body, every cell in your body. It's everywhere. It's ubiquitous.

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  Ubiquitous.

• 7:52Speaker 05

  That's right. Let's put those SAT words out there for any, you know, any high schoolers listening. And we're starting to realize now that these diseases are all, even though they may appear in different organs, they're all connected through one immune system. And so what we want to start doing as physicians is, instead of having fragmented care, somebody's being treated in neurology, somebody's being treated in rheumatology, somebody's being treated IBD, we want to think about these diseases as one class of disease and start thinking about how we can treat them rationally by targeting the immune system in the same way that folks that treat cancer are using your genetics to treat rationally and precisely.

• 8:36Speaker 01

  Last year, RFK Jr. claimed that he could tell kids were visibly overburdened with inflammation. And I think a lot of us are also like concerned whether our bodies are experiencing too much inflammation. How can we tell if somebody has chronic inflammation? Or is there a test I or anyone can take to measure inflammation and know if it's abnormally high?

• 8:57Speaker 05

  I have not yet come across any such test or measure or visible tell that you have chronic inflammation, and I don't have chronic inflammation. I don't think immunologists have that kind of superpower. What we are thinking about is measuring the immune system through the blood, which is where the immune system uses to travel to different parts of your body. Technologies in the last 10 years have really evolved to the point where we can monitor your immune system in real time.

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  We're in a renaissance, an immune system renaissance or era.

• 9:31Speaker 05

  We are. It's this technology called single-cell sequencing technology, which is profile your immune system at a single-cell level, taking immune cells from the blood, these are your white blood cells, and looking at, what is your immune system today? What is your immune system six months from now? What is it one year from now? And we call that your baseline health. But what we need to do now is collect that information from large groups of people, right? Over time. And then create a measure that folks can use to say, OK, something's off in my body. Like, I'm seeing a deviation from that healthy system in the same way that you take, for instance, a glucose test for diabetes.

• 10:09Speaker 01

  OK, so we know that a lot of the things that social media says helps with inflammation maybe doesn't have a lot of evidence. Like, what can people do in real life? Like, what can they actually do to help reduce chronic inflammation?

• 10:22Speaker 05

  There's no magic bullet. There just isn't. The evidence supports like the least sexy approach, which is exercise, sleep, eat a balanced diet, you know, don't eat like McDonald's fries every day or whatever. Although, who can say no to McDonald's fries? Like, they're delicious.

• 10:41Speaker 01

  Yeah, everything in moderation.

• 10:43Speaker 05

  Everything in moderation. So the evidence is sort of the things we already knew. Like, you need to work out. You need to sleep well. You need to have a balanced diet. High fiber, low sugar, things like that. We sit a lot, and that's not how we evolved as humans. Sedentary lifestyles are a problem. And so even if it is, just take a 10-minute walk after lunch. Movement, exercise, sleeping. The importance of sleep. Cannot be overstated. As somebody who loves sleep, like, this is my favorite recommendation. If you just do the uncool, simple things, that mitigates a lot of these issues of chronic inflammation.

• 11:22Speaker 01

  Well, let's stop there for a second. Like, why do you say sleep is like a really good thing to reduce inflammation?

• 11:28Speaker 05

  Yeah, so there've been some studies in mice, which are now being extended to humans. But there've been studies that show that if you sleep well, some of your low-grade inflammation goes away. There's a lot of research to be done, but that resetting is really important. And sleep, by the way, is not just important for the immune system. It's also important for cognitive function. It's also important for aging. And sleep is one of the things that gets really disturbed when you have inflammatory diseases.

• 11:55Speaker 01

  And when you have stress.

• 11:56Speaker 05

  And when you have stress, exactly. And then diet. I mean, unfortunately, you really are what you eat.

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  Yeah, I mean, when I eat salmon, or I eat ginger, or a handful of blueberries, which I did yesterday at my desk, like, what is that actually doing to my body to help inflammation?

• 12:12Speaker 05

  Yeah, I mean, so omega-3s, fiber, we know that fiber in particular, it helps your microbiota produce certain factors that are directly speaking to the immune system in your gut. It also helps with many things in terms of keeping your intestine healthy. And so these are just normal ways in which you can maintain that healthy immune balance and moving from saturated fats to unsaturated fats, right? So maybe don't eat the T-bone steak every day. Maybe move to salmon.

• 12:46Speaker 01

  I do love the gristle, though. It's so good.

• 12:48Speaker 05

  I know, it's so good.

• 12:50Speaker 01

  OK, I've also heard about, like, maybe GLP-1 drugs helping inflammation too. Can you tell me a little bit more about that?

• 12:58Speaker 05

  Yeah, I mean, GLP-1s are just like a revolution. They were initially put on the market to help with type 2 diabetes and obesity. But we're seeing that GLP-1s seem to have an anti-inflammatory effect. In patients with some inflammatory diseases, we're seeing that their disease flares are going away.

• 13:19Speaker 01

  Oh, wow.

• 13:19Speaker 05

  Yeah, and so now, you know, at Mount Sinai, we have some really exciting clinical trials going on to look at the effects. What we don't understand fully is how much of that effect is directly on the immune system, right? Versus by changing metabolism or by affecting other cells. We still need to gather the evidence. But the early data really suggests that there are some powerful effects on the immune system and on inflammation.

• 13:51Speaker 01

  So who all actually has to worry about chronic inflammation?

• 13:55Speaker 05

  Yeah, I mean, the word chronic inflammation, I think, scares a lot of folks, right? It just sounds sort of horrible. Unless you have an inflammatory disease, if you feel that you're in relatively good health, I don't think that you need to stress out about it. This is not about, like, oh, my god, at some point, chronic inflammation's going to get me. It's just sort of like, how can I live to optimal health? And I think that's a very positive approach because it's basically saying that you can make choices to make your health better and keep it that way for longer. And those choices are exercise, sleep, and diet.

• 14:35Speaker 01

  Yeah, so like, the number of people that are getting like the anti-inflammatory diet Instagram reels and the number of people who really should be going to their doctor and checking it out, not the same number as you're telling me.

• 14:49Speaker 05

  No, not at all. I mean, you know, at least for my friends, like, I see them have anxiety about chronic inflammation. And all I say is, like, you don't have an autoimmune disease. You don't have an inflammatory disease.

• 15:00Speaker 01

  Yeah.

• 15:01Speaker 05

  If you do, then yes, you need to go get treated. But if you're not, then I don't think you need to be crippled by anxiety about chronic inflammation. I think you just think positively about how do you keep your health on track? To me, I always take on approaches to maintain health in a practical manner, right? I'm not going to go to the gym 50 times a week.

• 15:22Speaker 01

  I'm going to try to go twice, you know?

• 15:24Speaker 05

  Yeah, that's great. This is not about sort of like health-maxing or whatever, right? It's being practical, also addressing that you can't just ignore the issue. You have to eat well as best you can. You have to sleep well as best you can and move.

• 15:40Speaker 01

  Yeah. Well, Shuti, thank you so much for talking to me today. I have less anxiety now.

• 15:48Speaker 05

  Mission accomplished. Thank you for having me. It's really been a pleasure.

• 15:56Speaker 01

  This episode was produced by Arundhati Nair and Hannah Chin. It was edited by Rebecca Ramirez and Lauren Gonzalez. Tyler Jones checked the facts. Jimmy Keely was the audio engineer. I'm Regina Barber. Thank you for listening to Shore Wave from NPR.

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