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What it is and why it plays a role in MS

The root of many diseases today, including multiple sclerosis (MS), is inflammation. This typically normal immune response is designed to turn on and off to protect the body from harm. But it goes awry in chronic inflammatory diseases like MS, causing symptoms from pain in the back and/or eyes to fatigue, weakness, and stiff muscles.

What Is Inflammation

Inflammation is an essential protective tool of the immune system to fight off anything that can potentially cause injury to the body, from a virus to bacteria and other harmful pathogens. It’s also set in motion to repair damaged tissue (e.g., a paper cut or a burn). When the immune system responds to a potential problem, immune cells release natural chemicals called cytokines. The release of these cytokines trigger inflammation.

In those with MS, however, instead of attacking harmful pathogens or repairing a wound, the immune system attacks its own healthy nerve cells in the brain, optic nerves, and spinal cord. More specifically, immune cells like T cells target the protective coverings of these nerve cells called the myelin sheath. This causes the myelin sheath itself to become inflamed in patches known as plaques or lesions. (These are identifying characteristics of MS that can be seen on an MRI.)

This neuroinflammation, as it’s called, disrupts signals to the brain, jumbling them, slowing them down, or stopping them completely and is what causes the signs and symptoms of MS. In early stages of MS, some symptoms may flare up during an episode of inflammation and then resolve when the inflammatory episode ends—why making lifestyle changes that can reduce daily inflammation is key.

Acute Inflammation vs. Chronic Inflammation

Inflammation is meant to be short term: it’s designed to turn on to get rid of the invader and turn off once it achieves this goal, with symptoms going away until the next virus or bacteria appears on the scene. In those with MS, however, this inflammation is chronic, meaning it’s not ever fully turning off, though it may come and go. This is why multiple sclerosis is referred to as a chronic inflammatory disease.

Chronic inflammation can cause scarring of the myelin sheath—and eventually, if the chronic inflammation continues unabated and untreated, it can cause permanent nerve damage and disability. Turning off or lowering this inflammation—which can be accomplished with dietary and lifestyle changes (see below), as well as with medication, helps calm the immune system and restores balance to the body.

What triggers inflammation?

No one knows for sure what triggers the inflammation associated with MS, but some things that are proven to cause inflammation in the body include:

An American diet The typical diet is this country is filled with fried foods, sugary sweets, soda, red meat, processed carbs, and unhealthy fats and has been proven to increase inflammation and contribute to many chronic inflammatory diseases. Eating a healthier diet can help lower the risk of disease progression by helping to “turn off” inflammation. (See pp. 12-13 for dietary changes that can reduce inflammation.)

Being overweight Adipose, or fat, is pro-inflammatory. Belly fat in particular is known to cause this immune response. Researchers explain that obesity causes fat cells to issue false distress signals to the immune system as if they’re under attack by pathogens, triggering an immune response and inflammation. Losing weight shuts off this response, calming the immune system and lowering inflammation. What’s more, overeating—even if you’re not overweight—can also trigger an inflammatory response in the body. Eating healthy foods in moderation (until you’re two- thirds full) is best for health.

An unhealthy gut Seventy percent of our immune cells are found in the gut or microbiome, as it’s often called. This is why, when the gut is in balance, our immune system is functioning well and, as research shows, we have little chronic inflammation. Any imbalance (or dysbiosis as it’s often referred to) in the microbiome can cause immune problems and subsequent inflammation.

A healthy diet, including plenty of soluble fiber and fermented foods (pp. 12-13), steering clear of foods and ingredients that don’t agree with you, cutting back on added sugar (which bad bacteria love to feed on, contributing to dysbiosis), drinking plenty of water, and living a healthy lifestyle all work to keep your gut, and everything living in it, in balance. This is one reason why revamping your lifestyle has often been associated with reduced inflammation and why those with multiple sclerosis who incorporate healthy lifestyle habits have fewer and less frequent flare-ups (pp. 18-22).

A sedentary lifestyle The body is meant to move, which is why exercising has been associated with being healthier overall, as well as with reduced inflammation in the body. In fact, just 20 minutes of moderate exercise every day is enough to suppress inflammation in the body, according to one study from the University of California San Diego School of Medicine. When we exercise in moderation, immune cells release substances that help boost immunity and regulate inflammation. Exercising also prevents fat cell build up in the body and reduces stress.

Chronic stress During stressful times, hormones like cortisol are pumped out causing your heart to beat faster, your muscles to tighten, your blood pressure to rise, and your breath to become more shallow. Consistently high levels of stress hormones in the body can trigger inflammation. This is why many people with MS, when stressed, have flare ups. Reducing stress (e.g., doing yoga and meditating) will lower inflammation and help improve quality of life.

myelin sheath illustration