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Over the years several studies have shown a link between an inflammatory marker called C-reactive protein (CRP) and weight gain1. CRP is made by the liver and increases any time your body is trying to fight against something (be it bacteria, virus, autoimmune disease, and even cancer), clinically used now as a general marker for inflammation. The CRP molecule itself really isn’t the issue, but rather the entire inflammatory process that is associated with it, the CRP simply serving as a scientific and clinical marker of inflammation, in general.
Any number of inflammatory processes can cause the liver to produce it but, if the CRP is checked and is high in an otherwise healthy individual who is not carrying any kind of known diagnosis nor having any overt symptoms of inflammation, the underlying issue is probably very subtle but still insidiously dangerous. In such a person a hidden cancer could be to blame, though this is still going to be unlikely. The most likely causes in such an asymptomatic individual will be either actively forming plaque in the walls of arteries that can eventually lead to things like heart disease and stroke (for, the formation of plaque is a highly inflammatory process as the immune system is trying to unsuccessfully clean out the plaque – see my previous blog from June 12th, 2018), or poor dietary and lifestyle choices (including lack of sleep, increased stress) that promote ongoing subtle yet prolonged inflammatory processes in the body. Given our generally horrible American diets (chock-full of processed and fast foods, high in saturated and trans-fats) and high-stress lifestyles, a combination of plaque formation and poor lifestyle choices are going to be the most likely causes of this inflammation/elevated CRP.
The Cleveland Clinic has defined risk groups for heart disease, with respect to CRP level, as follows:
Low risk: less than 1.0 mg/L
Average risk: 1.0 to 3.0 mg/L
High risk: above 3.0mg/L
Given the fact that elevated CRP is associated with these poor lifestyle choices and heart disease, it isn’t surprising that studies have also shown an association between elevated CRP levels and obesity.
It also isn’t surprising that weight loss has been shown to lower the CRP levels2. With weight gain comes more and more inflammation – for, people become more sedentary when obese, begin to develop heart disease and plaque (highly inflammatory processes), begin to develop metabolic syndrome (elevated blood sugar with elevated triglycerides) which can ultimately lead to diabetes, begin to develop sleep apnea, all of this which then promotes more weight gain and more inflammation, and thus the CRP level continues to rise – a vicious cycle.
These factors are all inter-related and all feed off each other. It isn’t that the CRP elevation is the causative agent of all this, rather, the elevation in the CRP is the result of it all and is therefore a very good marker for the ongoing risk of developing end-organ disease (example: heart disease) because of it all. Unfortunately, there isn’t going to be a “medicine” that can get this inflammation down and therefore cause weight loss. Rather, it is the other way around. Weight loss and more healthy lifestyle choices will then reduce the inflammation and drop the CRP, which then begins to reverse this vicious cycle.
There are dietary choices that are less inflammatory (and therefore healthier, inherently promoting weight loss), which include cutting way back on sugar and refined carbohydrates and increasing the intake of fruits, vegetables, lean meats and nuts. A Mediterranean-style diet conforms nicely to these parameters and is promoted by the American Heart Association for that reason3 . Other anti-inflammatory foods include olive oil (the enemy of which is vegetable oil, i.e., avoid vegetable oil), avocados, garlic and onions. Garlic and onions, in particular, have been widely recognized as being very favorable toward heart health (probably by helping to reduce plaque inflammation). Fatty fish (omega-3 fats), berries, red wine and even dark chocolate are also all anti-inflammatory in nature. Diets high in fiber have also been shown to be associated with lower CRP levels, proving the anti-inflammatory effect of fiber4.
Curcumin (an extract of turmeric) has been shown to have potent anti-inflammatory effects, thereby potentially favorably affecting the outcomes of a wide variety of diseases5. Taking this as a supplement is probably a very good idea.
De-stressing and sleeping better have also been shown to link with each other and thereby help reduce the pro-inflammatory effects of cardiovascular disease6.
Vitamin D7, Magnesium8, Vitamin C9and fish oil supplementation10have also been shown to have anti-inflammatory effects. For specifics regarding the best dosing of those for your specific situation is best discussed with your primary care physician. Of course, I would be happy to assume that role for you if you would like (call 972-993-5003 to schedule a meet-greet appointment).
Of course, it should go without saying (though still needs to be said) that exercise certainly promotes the reduction of inflammation while smoking does quite the opposite by promoting plaque formation (and therefore arterial inflammation), COPD lung disease (promoting pulmonary inflammation), disk disease of the spine (promoting arthritic inflammation), etc.
So, if longevity is your goal, making some of these changes for the long haul is highly recommended. There are certainly many specifics here that should be discussed with your personal physician, though asking for a CRP level check if that has not been performed would certainly be a good idea, for it serves as a marker for such inflammation and a strong motivator for lifestyle modification if found to be elevated.
If you do not have a personal physician, feel free to call my office (972-993-5003) and set up a visit to meet me so we can begin discussing all of this and check some basic labwork, which should certainly include a C-reactive protein level. We even have a complimentary dietician in the office (we do not bill for her services) who can provide specific details regarding the anti-inflammatory Mediterranean Diet that anyone with an elevated CRP should initiate.
Author: Christopher Hughes MD
North Texas Preferred Health Partners
3417 Gaston Ave, Suite 700
Dallas, TX 75246